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HomeMy WebLinkAboutWTLC -2010INSIJP!tN-CE ON FILE A- 2010- 061 -013 WORK MAY PROCEED Urir S NCE EXPIRES UIP OF 0 CIL GATE: AUG 1 8 2014GRE Eno E MENT BETWEEN THE CITY OF SANTA ANA AND WOMEN'S TRANSITIONAL LIVING CENTER, INC. FOR THE USE OF EMERGENCY SHELTER GRANT FUNDS (With Provisions Relating to Compliance with Title X and 24 CFR Part 3-5 Relating to Lead Based Paint) THIS AGREEMENT, is hereby made and entered into this l" day .luly, 2010, by and be- twcen the Co\ ol' Santa Ana. a charter city and municipal corporation of the State of California ( "CITY ") and Women's Transitional Living Center, Inc., a California nonprofit organization ( "SUBRECIPIENT "). WITNESSETH Recitals: I. CITY is the recipient of Emergency Shelter Grant ( "ESG ") funds from the United States Department of I- lousing and Urban Development ( "HUD ") pursuant to tine Stewart B. McKinney Homeless Assistance Act: Emergency Shelter Grants Program 42 USC 11331 et seq. 2. CITY has approved the provision of federal funds tinder the ESG to be used in the op- eration of an emergency shelter program for the homeless of the City of Santa Ana ( "said pro- ,gram ") as further described by a Scope of Work and Schedule of Performance in Exhibit A, at- tached hereto and by this reference incorporated herein. 3. SUBRECIPIENT represents that it has expertise and experience in the provision of e»�er�enc� shelter prop" rams for the homeless and is willing to use said federal funds to operate said program. 4. SUBRECIPIENT agrees to assist homeless individuals and families in obtaining: appropriate supportive services including, but not limited to, temporary and permanent housing, medical health treatment, mental health treatment, counseling supervision and other services es- sential (or achieving independent living. as well as other federal, state, local and private assis- tance available for such individuals. 5. title X of the 1992 Housing and Community Development Act (Title X) established requirements relating to lead based paint ( "LBP ") in housing receiving federal assistance, with particular requirements relating to (i) notification (including pamphlet distribution, disclo- sure to purchasers and lessees. notice of lead hazard presumption or results of evaluation, and/or lead hazard reduction), (ii) lead hazard evaluation (including visual assessment, paint testing, and /or risk assessment), (iii) lead hazard reduction (including paint stabilization, interim con- trols, standard treatments, or abatement depending on the requirements for mousing activity type), (iv) ongoing maintenance, if required, and (v) response to children with environmental interven- tion blood lead levels, as required: and 6. On September 15, 1999 HUD adopted implementing regulations to Title X that became effective September 15, 2000 as set forth in 24 CFR Part 35, et seq. ("LBP Regs. "), which estab- 6/10 lish specific rules regarding notification to owners and occupants about the existence of LBP ha- zards. identification of LBP hazards, and control of LBP hazards; and 7. Residential structures built after January 1, 1978 are exempt from lead -based paint re- quirements as the use of lead -based paint was banned for use in residences after this date by Congress (24 CFR Part 35.1 15). Therefore, the Title X requirements set forth herein shall not be applicable if the structures involved were built after January 1, 1978. 8. Subpart K - Acquisition, Leasing, Support Services, and Operation of the LBP Regs, sets forth specific requirements relating to housing providers, such as SUBRECIPIENT, who admi- nister local programs that provide supportive housing for special needs populations and are funded by HUD Office of Community Planning and Development ( "CPD ") programs, including ESG funds, as provided to SUBRECIPIENT under this Agreement, and 9. In connection with the grant of funds under this Agreement, CITY requires that SUBRECIPIENT comply and shov -v evidence of compliance with all applicable requirements of Title X and the LBP Regs. in particular Subpart K relating to acquisition, leasing, support servic- es, or operations, and Subpart J relating to rehabilitation, as and when applicable; and 10. In connection with the grant of funds under this Agreement, CITY requires that SUBRECIPIENT comply and show evidence of compliance with all applicable requirements of Title X and the LBP Regs.. in particular Subpart M relating to tenant based rental assistance, as and when applicable; and 1 1. Attached and hereby fully incorporated to this Agreement are the following notification attachments: Attachment No. I entitled "Protect Your Family From Lead In Your Home ", EPA7474,-99 -001, Attachment No. 2 entitled "Sample Disclosure Format for Target Housing Sales, Disclosure of Information on Lead -Based Paint and Lead -Based Paint Hazards ", and At- tachment No. 3 entitled "Sample Summary Risk Assessment Notice Format "; provided however, that such attachments are not intended to modify or limit SUBRECIPIENT'S obligation to fully comply with all applicable provisions of Title X and the implementing regulations in the LBP Regs; and 12. By this Agreement SUBRECIPIENT will accept assignment fi-om the CITY of all reapon sibilities set forth in Subpart K ofthe LBP Regs; and 13. SUBRECIPIENT agrees that it will adhere to the performance measurements and out- comes as indicated on Exhibit A -1 (Outcome Tracking). Failure to follow the measurements and meet the stated outcomes may constitute breach of contract that could result in termination of this Agreement or serve as reason for the City to recapture the grant funds awarded to SUBRECIPIENT pursuant to this Agreement. 14. Tlie ClT)' and SUBRECIPIENT have duly executed this Agreement for the expenditure of such funds. and 2 6/10 WHEREFORE, it is agreed by and between the parties, that the foregoing Recitals are a subs- tantive part of this Agreement and the following terms and conditions are approved and together with all exhibits and attachments hereto, shall constitute the entire Agreement between the CITY and SUBRECI1)1FNT: SUBRECIPIENTS'S OBLIGATIONS A. Non -Profit Status - Representations and Warranties ( I ) SUBRECIPIENT acknowledges that its operations and the services it provides to the community are subject to Subpart K, and, in some instance(s) Subpart J and /or Subpart M, of the LBP Regs. (2) SUBRECIPIENT acknowledges that its operations and the services it provides in- clude: (a) acquisition, leasing, or ownership of residential property for the purpose of providing affordable housing for persons with special needs, such as transitional housing, or (b) housing for persons with special needs, such as the disabled, or (c) financial assistance to assist transitional housing participants to move to permanent housing by paying for the first month's rent or securi- ty deposit, or (d) tenant -based rental assistance to program participants who choose their own housiMI units. and by provision of such services such housing is subject to the requirements of the LBP Regs. (3) Representations: (a) Authoritv. SUBRECIPIENT is a duly organized and existing non - profit corporation in good standing and authorized to do business under the laws of the State of California. SUBRECIPIENT has full right, power and lawful authority to accept the funding hereunder and to undertake all obligations as provided herein and the execution, performance and delivery of this Agreement by SUBRECIPIENT has been fully authorized by all requisite actions on the part of SUBRECIPIENT. (b) Experience. SUBRECIPIENT is a qualified provider of the services to be provided hereunder. (c) Familiarity With Services Required. By executing this Agreement, SUBRECIPIENT warrants that (i) it has thoroughly investigated and considered the services to be performed and provided hereunder, (ii) it has carefully considered how the services should be performed, and (iii) it fully understands the facilities, difficulties and restrictions attending per - formance of the services under this Agreement, inclusive of compliance with the LBP REGS. Should SUBRECIPIENT discover any latent or unknown conditions materially differing from those inherent in the work or as represented by CITY, it shall immediately inform CITY of such fact and shall not proceed except at SUBRECIPIENT'S risk until written instructions are re- ceived from CITY'S representative. 6/10 (d) No Conflict. To the best of SUBRECIPIENT'S laiowledge, SUBRECIPIENT'S execution. delivery and performance of its obligations under this Agreement will not constitute a default 01'a breach under any contract, agreement or order to which SUBRECIPIENT is a party or by which it is bound. (e) No Bankruptcy. SUBRECIPIENT is not the subject of any Current or threat- ened bankruptcy proceeding. (t) No Pending Legal Proceedings. SUBRECIPIENT is not the subject of a cur- rent or threatened litigation that would or may materially affect SUBRECIPIENT'S performance under this Agreement. (g) Application Veracity. All provisions of and information provided in SUBRECIPIENT'S application for funding submitted to CITY including any exhibits are true and correct in all material respects. (h) No Pending Investigation. SUBRECIPIENT is not aware that it is the subject of any current or threatened criminal or civil action investigation by any public agency, including, v- vithout limitation a police agency or prosecuting authority, that would relate to affect performance of the Agreement or provision of services hereunder. (4) Compliance with Subpart K of LBP Reas. Subpart K — Acquisition, Leas - ing. Support Services, or Operation (a) SUBRECIPIENT acl.noN, \/ledges and agrees that it shall comply with and im- plement the requirements set forth in Title X and the LBP Regs to eliminate, as far as practicable, LBP hazards in all residential properly that is under its ownership, possession, or control and /or residential property occupied by persons or families that receive financial or other assistance from SUBRECIPIENT. (b) SUBRECIPIENT shall provide a notice to all residents /occupants of residen- tial property that is under its ownership, possession, or control and /or residential property occu- pied by persons or fimilies that receive financial or other assistance from SUBRECIPIENT in accordance with Section 35.1-15 ofthe LBP Regs. (i) SUBRECIPIENT acknowledges that in connection therewith a visual assessment is not considered an evaluation for purposes of the LBP Regs. (c) Notification (24 CFR 3 -5.130). SUBRECIPIENT shall provide the LBP ha- zard information pamphlet in accordance with Section 35.130 of the LBP Regs to all occupants, owners. and purchasers of housing. (1) The pamphlet shall be the EPA /HUD /Consumer Product Safety Commission lead hazard information pamphlet or an EPA - approved equivalent. 4 6/10 The current form and version of the pamphlet is attached as Attachment No. l to this Agreement. (ii) SUBRECIPIENT shall cause to be disclosed to all purchasers and lessees available information and knowledge regarding the presence of LBP and LBP hazards prior to selling or leasing a housing unit in accordance with 24 CFR 35, Subpart A. The current form and version of such notice is attached as Attachment No. 2 to this Agreement. (iii) SUBRECIPIENT shall ensure that all occupants, owners, and purchasers ofhousing be notified in writing of the results of the presumption of LBP and /or LBP hazards, and results of any lead hazard evaluation, and any lead hazard reduction wort: in accordance with 24 CFR 35, Subpart A. The current 161-111 and version ol'such notice is attached as Attachment No. 3 to this Agree- ment. (d) Lead Hazard Evaluation (24 CFR 35.125). SUBRECIPIENT shall conduct all activities described in Section 35.1015 relating to visual assessment, paint stabilization, risk assessment, and maintenance with regard to all residential property that is under its ownership, possession, or control and /or residential property occupied by persons or families that receive financial or other assistance from SUBRECIPIENT, except for the exemptions described below in section 4 (d)(i)(I ). (i) SUBRECIPIENT shall cause a visual assessment to identify de- teriorated paint in all residential property that is under its ownership, possession, or control and /or residential property occupied by persons or families that receive financial or other assis- tance ti'om SUBRECIPIENT. ( I )Section 35.1 15(a) provides exemptions from Subparts B through R of the LBP Regs. including without limitation, (a) short term emergency assistance lasting less than 100 days cumulatively is exempted from compliance with Subpart K as to such short term rental assistance units, and (b) exemption for zero - bedroom units, including SRO units.. Ior which occupancy by a recipient of SUBRECIPIENT'S services is for less than 100 days, and (c) exemption for residential housing units constructed after January 1, 1978. (ii) To the extent that the assistance provided by SUBRECIPIENT to persons or households meets one or more of the exemptions set forth in the LBP Regs, then compliance Nvith the notification, evaluation, reduction, clearance and other requirements of the LBP Regs is not required related to the subject housing unit due to such exemption. (iii) SUBRECIPIENT shall comply with the applicable provisions of both Subpart K and Subpart M (Tenant Based Rental Assistance) of the LBP Regs. as to all tenant -based long term housing assistance, i.e., assistance to persons /households residing in housing units cumulatively for more than 100 days. If SUBRECIPIENT has knowledge that an assisted Ic'unily or household will occupy a dwelling unit for more than 100 days, the LBP Regs require evidence of compliance prior to occupancy. Funding to be provided hereunder is condi- tioned upon evidence of compliance. 5 6/10 (1) Subpart M applies to all dwelling units occupied to be occupied by families or households that have one or more children of less than 6 years of age, as well as the common areas servicing such dwelling units, and exterior painted surfaces associated With such dwelling units or common areas. LBP compliance requirements relating to such dwel- ling units includes, without limitation: notification, evaluation by visual assessment, paint stabi- lization utilizing safe work practices. and clearance. (2) CITY advises SUBRECIPIENT that in the event the services provided hereunder include rental assistance payments, such as first and last month's rent and /or security deposit, and the assisted tenant executes a lease for long term occupancy, in- cludin- occupancy in the same dwelling unit for more than 100 days, then the provisions of Sub- part M (Tenant Based Rental Assistance), will apply (unless otherwise informed and directed by HUD). In this regard, CITY advises SUBRECIPIENTthat Subpart M requires HQS inspection of each dwelling unit prior to occupancy and prior to compliance with applicable notification, evaluation by visual assessment, reduction through paint stabilization utilizing safe work practic- es, and clearance requirements of the LBP BEGS. (e) Lead Hazard Reduction Work. SUBRECIPIENT shall cause LBP hazard reduction. such as paint stabilization, interim controls, standard treatments, or abatement of all residential property that is under its ownership, possession, or control and /or residential property occupied by persons or families that receive financial or other assistance from SUBRECIPIENT, except as exempted as described in subsection 4(d)(i)(1) above. (I) If paint stabilization occurs, SUBRECIPIENT shall cause paint stabi- lization of each deteriorated stn-1 -ace and clearance of residential units pursuant to Section 35.1330(a) and (b) shall occur before occupancy of a vacant dwelling unit, or where a unit is occupied. immediately after receipt of the ESG FUNDS hereunder. (2) Safe Work Practices shall be used in all LBP hazard reduction work. (3) Clearance shall be conducted to confirm that no LBP hazards remain when LBP hazard reduction wort: is complete. Confirmation of clearance by written certification of a qualified inspector is required on an annual basis in connection with submittal of the April 15 quarterly report. (0 Onuoing Maintenance. SUBRECIPIENT shall incorporate ongoing LBP maintenance activities into regular building operations in accordance with Section 35.1355(a) for all residential property that is under its ownership, possession, or control and /or residential prop - ertes occupied by persons or families that receive financial or other assistance from SI1BRLC'1PIEN "I,, except as exempted as described in subsection 4(d)(i)(1) above. (1) Ongoing maintenance includes confirmation ofelearance which shall be conducted to confirm that no LBP hazards remain when LBP hazard reduction work is com- plete. 6 6/10 (2) Ongoing maintenance also includes confirmation of clearance by writ- ten certification ofa qualified inspector on an annual basis in connection with submittal of the April 15 quarterly report. (3) A part of such ongoing maintenance obligation includes notification of the results of clearance confirmation and annual confirmation of clearance. a. SUBRECIPIENT shall cause to be provided a notice to all oc- cupants of all residential property that is under its ownership, possession, or control and /or resi- dential property occupied by persons or families that receive financial or other assistance from SUBRECIPIENT in accordance with Sections 35.125(b)(I) and (e), describing the results of the ClearanCC e\amlllati011 and the I- eSUlts OI al'lnual certification. (g) Units Cleared Prior to Date of Agreement; Confirmation of Clearance. In the event the requirements of the LBP REGS relating to lead hazard evaluation, lead hazard reduction. and lead hazard clearance have been completed on the subject dwelling units prior to the Date of Agreement, then the SUBRECIPIENT shall provide to the CITY with the April 15 quarterly report a certificate from a qualified inspector evidencing a recent inspection and con - Iirmation of clearance of LBP and LBP hazards fi-om the subject dwelling Unit(s). 5. LBP Informational Summary. For purposes of information only and in no respect intended to be a representation or warranty of the provisions of the LBP REGS, the CITY has caused to be prepared an information sumll1ary relating to the LBP REGS and application to dwelling units that may be Occupied by recipients of services and /or finding from SUBRECIPIENT under this Agreement. Attachment No. 4 to this Agreement, attached and he- reby fully incorporated by this reference, is such information summary. CITY staff will coope- rate vvith and make themselves available to SUBRECIPIENT to assist in implementation of compliance with the LBP REGS as to residential dwelling units to be assisted by SUBRECIPIENT. The parties acknowledge and agree the CITY is and shall not be liable or re- sponsible for the accuracy of such summary, and the SUBRECIPENT is directed to the LBP REGS and implementing guidance published and provided by HUD relating to compliance with such LBP REGS B. Amount of Grant: Quarterly Disbursement and Match Funds. The amount granted to SUBRECIPIENT is $39,829 (`ESG FUNDS "), and such funds shall be expended by SUBRECIPIENT on or before June 30, 2011. The ESG FUNDS shall be disbursed by CITY to SUBRECIPIENT on a quarterly basis on or before the 15`x' of each of tile following months(October.. Januar). April and .July), subject to and upon receipt and approval ofa complete quarterly activity report, with the final payment subject to the satisfaction of the condition precedent Of submittal of complete reporting information due on or before July 15 of the applica- ble funding year, as hereinafter more fully set forth. SUBRECIPIENT shall be obligated to per- form such duties as would normally extend beyond the term, including but not limited to obliga- tions with respect to indemnification, audits, reporting, data retention /reporting, and accounting. Failure to provide any of the required documentation and reporting will cause CITY to withhold all or a portion ofa request for reimbursement, or return the entire reimbursement package to 6/10 SUBRECIPIENT.. until such documentation and reporting has been received and approved by In accordance with 42 USC I I375(a), SUBRECIPIENT agrees to match all federal funds provided by CITY to SUBRECIPIENT with an equal amount of funds from sources other than these or other ESG fiends. SUBRECIPIENT cannot use ESG funds from other jurisdictions in order to meet this snatch requirennent. Match documentation showing new, previously unused match dollars. must be provided with each quarterly report. C. Use of Funds. SUBRECIPIENT agrees to use said funds pursuant to this Aoreement to pay for necessary and reasonable costs allowable under the federal law and regula- tions to operate said program only. Said amounts shall include and will be limited to, essential services, homeless prevention, and /or operations costs. Allowable program costs are detailed in the Budget. as set forth in "Exhibit B," attached hereto and by this reference incorporated herein. SUBRECIPIENT'S failure to perform as required may, in addition to other remedies set forth in this Agreement, result in readjustment of the amount of funds CITY is otherwise obligated to pay to SUBRECIPIENT pursuant to the terms hereof. SUBRECIPIENT agrees that the homeless shelter and services under said program shall be made available for the entire period during which said funds are provided. D. Allowable Costs. SUBRECIPIENT agrees to complete said program on or before and to use said funds to pay for necessary and reasonable costs allowable under the federal law and regulations to operate said program. Said amounts shall include essential services, homeless Prevention, and /or operations costs. Other allowable program costs are detailed in the Budget, as set forth in "Exhibit B," attached hereto and by this reference incorporated herein. SUBRECIPIENT shall use all income received fi-om said funds only for the same purposes for which said funds may be expended pursuant to the terms and conditions of this Agreement. E. Licensing. SUBRECIPIENT agrees to obtain and maintain all required licenses, registrations. accreditation and inspections fi-onn all agencies governing its operations. SUBRECIPIENT shall ensure that its staff shall also obtain and maintain all required licenses, registrations, accreditation and inspections from all agencies governing SUBRECIPIENT's operations hereunder. Such licensing requirements include obtaining a City business license, as applicable. F. Zonin <a. SUBRECIPIENT agrees that any facility /property used in furtherance of said program shall be specifically zoned and permitted for such use(s) and activity(ies). Should SUBRECIPIENT fail to have the required land entitlement and /or permits, thus violating any local, state or federal rules and regulations relating thereto. SUBRECIPIENT shall immediately make goocklaith efforts to gain compliance with local, state or federal rules and regulations following written notification of said violation(s) from the CITY or other authorized citing agency. SUBRECIPIEN "h shall notify CITY immediately of any pending violations. Failure to notify CITY of pending violations. or to remedy such known violation(s) shall result in termination of grant fundin", hereunder. SUBRECIPIENT nnust make all corrections required to bring the facility /property into compliance with the law within sixty (60) days of notification of the 8 6/10 violation(s): failure to gain compliance within such time shall result in termination of grant funding hereunder. G. Separation of' Accounts. All funds received by SUBRECIPIENT from CITY Pursuant to this Agreement shall be maintained separate and apart fi-om any other funds of SUBRECIPIENT, or of any principal or member of SUBRECIPIENT, in an account in a federally insured banking or savings and loan institution with record keeping of such accounts maintained pursuant to applicable legal requirements. No monies shall be withdrawn from such account except For expenditures relating to essential services, homeless prevention and /or operations costs, as authorized hereunder. 1 -1. Audit Report Requirements. SUBRECIPIENT agrees that if SUBRECIPIENT receives Five Hundred Thousand Dollars ($500,000.00) or more in federal fiords, SUBRECIPIENT shall have an annual audit conducted by a certified public accountant in accordance with the standards as set forth and published by the United States Office of Management and Budget. SUBRECIPIENT shall provide CITY with a copy of said audit by October I of the year following the program year In which this Agreement is executed. Further, SUBRECIPIENT shall comply and /or cause compliance with audit report(s) required by applicable provisions of Title X and the LBP Regs. 1. Record Keep in <g /Reporting. SUBRECIPIENT shall keep and maintain complete and adequate records and reports to assist CITY in meeting and maintaining its record keeping responsibilities under the ESG REGS, Title X, and the LBP Regs, including the following: ( I ) Records a. Documentation evidencing income level of persons and /or families par - ticipating in or benefiting by the SUBRECIPIENT program. b. Documentation of the number of persons and /or families participating in or benefiting-, by the SUBRECIPIENT program. c. Household information shall include number of persons, identification of'head of household, race /ethnicity, age of children, seniors, income verification. d. Documentation of homelessness pursuant to 42 U.S.C. I I374(a)(4) and 24 CFR 576.21. e. Documentation of all ESG FUNDS received from CITY. f Documentation of expenses as identified in the Budget Proposal, in- cluding evidence of incurring the expense, invoices for goods or services, copies of any and all contracts or documentation pertaining to costs for subcontractors, plus Lill other invoices for which ESG FUNDS were expended, and payment therefor. 9 6/10 g. Any such other related records as CITY shall reasonably require or as required to be maintained pursuant to the ESG REGS. h. DOCUlnentatlon evidencing compliance with all applicable provisions of'Title X and the LBP Revs, in particular Subpart K and, as applicable Subpart J and /or Subpart M. (1) Specific documentation. as required, evidencing com- pliance with all applicable provisions of such LBP Regs in- cluding: (i) notiticatiou, including distribution of the lead ha- zard information pamphlet (Attachment No. 1), disclosure and notices of hazard evaluation and reduction (Attachments No. 2 and 3); (ii) evaluation of lead hazard(s), including paint test- ing and risk assessment; (iii) reduction of lead hazard(s), in- cluding safe work practices and clearance, and confirmation of clearance; and (iv) ongoing maintenance, as and if appli- cable for multifamily properties. (ii) In this regard SUBRECIPIENT shall track information on all persons /households assisted and the housing units assisted with the ESG FUNDS. Attachment No. 5 hereto is a sample form for tracking persons /households and housing units as- sisted with the ESG FUNDS. All categories of information set 1'01111 in such tracking form shall be prepared and submitted to the CITY with the April 15 quarterly report. (iii) In the event that such information and reports are not com- plete and reasonably satisfactory information submitted in order for CITY staff to review and evaluate compliance with applica- ble ESG REGS and LBP Regs, then the final quarterly dis- bursement payment shall be withheld from the SUBRECIPIENT. (iv) Documentation of clearance confirmation as provided herein. (2) Reports (i) Payment Request. Concurrently with the submittal of each quarterly report, on or before the 15th day of October, January, April and July, SUBRECIPIENT shall submit both: an original invoice and true copies of invoices, receipts, agreements or oth- er documentation supporting and evidencing how the ESG FUNDS have been expended during the applicable quarter. 6/10 (ii) Quarterly Activity Report: Including in such reports evidence ofcompliance with all applicable provisions of Title X and the LBP Regs, in particular Subpart K and, as applicable Subpart .1, as further described in subsection (d) hereinafter, and Subpart M, if' SUBRECIPIENT provides long term tenant -based rental assistance. SUBRECIPIENT agrees to provide CITY with Nvritten cumulative (year -to -date) reports of its activities on or before the 15th day of October, January, April and July for the period beginning July 1, and through and including the previous three -month reporting period setting forth the activities, program accomplishments, new program information and year -to -date program statistics on expenditures, caseload and activities. When appropriate, pictures should be included. Failtu-e to provide any of the required documentation and reporting will cause CITY to withhold all or a portion of a request for reimbursement, or return the entire reimbursement package to SUBRECIPIENT, until such documentation and reporting has been received and approved by CITY. (HO Quarterly certification of match, plus documentation of match source. (iv) Any such other reports as CITY (or HUD) shall reasonably require and /or request. including but not limited to the following information: monthly records of all ethnic and racial statistics of persons and families benefited by SUBRECIPIENT in the per- formance of its obligations under this Agreement, including, but not limited to, the activities, program accomplishments, new pro - gram information, match fund certification and current program statistics on expenditures. caseload and activities. When appro- priate, pictures /slides should be included. (3) Recurdkeepin <g, of On guina Maintenance under the LBP Regs. If the services and program activities provided by SUBRECIPIENT hereunder establish an ongoing relationship with a property (such as long term tenant based rental assistance program [Subpart M] or transi- tional or permanent housing operated or administered by the SUBRECIPIENT), then the SUBRECIPIENT shall provide a report to the CITY evidencing that SUBRECIPIENT and /or the property owner(s), as applicable, has performed ongoing maintenance of the subject property. Ongoing maintenance shall include evidence of an annual clearance certification of the subject residential property conducted by a DNS certified technician to ensure that LBP hazard reduction measures arc maintained. All maintenance activities shall be conducted to ensure the threat of LBP hazards is minimized. 6/10 (4) Recordkeeping under the LBP Regs. The SUBRECIPIENT shall keep records of dis- tribution of'notilications, all visual assessment, evaluations, inspections, repairs, and any other lead hazard evaluation, reduction, safe work practices, and clearance activities. (a) The SUBREC'1PIENT shall keep records evidencing distribution of all lead hazard information pamphlet(s). (b) The SUBRECIPIENT shall keep records evidencing each LBP evaluation re- port, LBP hazard reduction documentations, (such as job specifications), and all clearance or ab- atement report(s). (c) The SUBRECIPIENT shall keep ongoing maintenance records and records of relevant bullCIIII( operations for use during reevaluations of subject property for LBP and /or LBP hazards. 1. Such records shall be maintained for not less than longer of (A) 101.11• (4) years after the activities cease or (B) the period re- quired by applicable program regulations. Under the ESG KEGS records shall be retained for not less than five (5) years after the ac- tivities cease. 2. The SUBRECIPIENT shall provide a copy of any of the above records to the CITY or to HUD upon request of either or both. (d) Tracking Report. If the SUBRECIPIENT has provided, or is providing, rental assistance payments directed to a hoUSI'My unit or housing units for more than 100 days, or it is anticipated that during the last quarter of funding that such rental assistance payment will be for more than 100 days, then the April 15 quarterly report shall contain information and evidence of compliance with the requirements herein relating to tracking of housing units, cumulative days of rental assistance. proper notifications to occupants and owners, HQS inspection, visual assess- ment, \vork write -up, stabilization and clearance of LBP and LBP hazards, if any. The proposed F01-111 of such tracking information is attached hereto as Attachment No. 5 and fully incorporated by this reference. In the event such April 15 quarterly report does not fully satisfy the reporting requirements set forth herein and in the LBP Regs, then the final installment payment of the ESG FUNDS shall be withheld from disbursement to SUBRECIPIENT. .1. Access to Records. CITY and the United State Government and /or their representatives shall have access for p1.urposes of monitoring, auditing, and examining SUBRECIPIENT's activities and performance, to books, documents and papers, and the right to examine records of SUBRECIPIENT's subcontractors, bookkeepers and accountants, employees and participants in re�.,ard to said program. CITY and the United States Government and /or their representatives shall also schedule on -site monitoring at their discretion. Monitoring activities may also include, but are not limited to, questioning employees and participants in said program and entering any premises or any site in which any ofthe services or activities funded hereunder are conducted or in which any of 12 6/10 the records oi'SUBRECIPIENT are kept. Nothing herein shall be construed to require access to any privileged or confidential information as set forth in federal or state law. K. Location of Records /Required Length of Record Keeping. All accounting records, reports. and evidence pertaining to all costs, expenses and the ESG FUNDS of SUBRECIPIENT and all documents related to this Agreement shall be maintained and kept available at SUBRECIPIENT'S ol'fice or place of business for the duration of the Agreement and thereafter for five (5) years after completion of an audit in conformity with the ESG REGS, except as hereinafter provided relating to retention of any records or documentation existing, created, or maintained in compliance with Title X or the LBP Regs. Records which relate to (a) complaints, claims. administrative proceedings or litigation arising out of the performance of this Agreement, or (b) costs and expenses of this Agreement to which CITY or any other governmental agency takes exception, shall be retained beyond the five (5) years until complete resolution or disposition of such appeals, litigation claims, or exceptions. All records relating to, or created or maintained in compliance with, Title X and /or the LBP Regs shall be retained and maintained by SUBRECIPIENT indefinitely. including without limitation, all inspection report(s), disclosure statement(s)_ and clearance report(s). In the event SUBRECIPIENT does not make the above - referenced documents available within the city of Santa Ana, California, SUBRECIPIENT agrees to pay all necessary and reasonable expenses incurred by CITY in conducting any audit at the location where said records and books of account are maintained. L. Compliance with Law /Program Income. SUBRECIPIENT acknowledges that the funds being provided by CITY for said program are received by CITY pursuant to applicable ESG I-Iuidelines and that expenditures of these funds shall be in accordance with the ESG guide- lines and all pertinent regulations issued by agencies of the federal government. SUBRECIPIENT agrees to comply fully with all federal, state and local laws and court orders applicable to its operation whether or not referred to in this Agreement, and all Program Re- quirements. Program income received by SUBRECIPIENT shall be returned to CITY unless otherwise provided for in this Agreement. SUBRECIPIENT agrees to comply fully with all fed- eral, state and local laws and court orders applicable to its operation whether or not referred to in this Agreement. M. Standing. SUBRECIPIENT shall be in good standing, without suspension by the California Secretary of State. Franchise Tax Board and Internal Revenue Service. Any change in the corporate status or suspension of SUBRECIPIENT shall be reported immediately to CITY. N. Confidentiality. Without prejudice to any other provisions of this Agreement, SUBRECIPIENT shall, where applicable, maintain the confidential nature of information pro- vided to it concerning participants in accordance with the requirements of federal and state law. SUBRECIPIENT certifies that it will develop and implement procedures to ensure the confiden- tiality of records pertaining to any individual provided family violence prevention or treatment services under any project assisted under the Emergency Shelter Grants Program and that the ad- dress or location of any Iamily violence shelter project assisted under the Emergency Shelter Grants Program will, except with \vritten authorization of the person or persons responsible for the operation of such shelter, not be made public (24 CFR 576.56). However, SUBRECIPIENT 13 6/10 shall submit to CITY and or HUD or its representatives, all records requested, including audit, examinations, monitoring and verifications of reports submitted by SUBRECIPIENT, costs in- curred and services rendered hereunder. O. Independent Contractor. SUBRECIPIENT agrees that the performance of obligations hereunder are rendered in its capacity as an independent contractor and that it is in no vvay an agenC ofCfrT `. P. Violation of 'berms and Conditions. SUBRECIPIENT agrees that if SUBRECIPIENT violates any of the terms and conditions of this Agreement or any prior Agreement whereby ESG funds Nvere received by SUBRECIPIENT, or if SUBRECIPIENT reports inaccurately.. or if on audit there is a disallowance of certain expenditures, SUBRECIPIENT agrees to remedy the acts or omissions causing the disallowance and repay CITY all amounts spent in violation thereof. if SUBRECIPIENT engaged in fi-aldulent activity to obtain and /or justify expenditure of the ESG funds granted hereunder, SUBRECIPIENT shall be required to reimburse the CITY of al I such funds that were obtained /spent under fraudulent circumstances. Q. Equipment. SUBRECIPIENT agrees to maintain a record for each item of non - expendable personal property acquired under the terms of this Agreement in accordance with 24 CFR 85.32. Said record shall be made available to CITY upon request. The term "non- expendable personal properly" shall include leased and purchased equipment. R. Prohibited Use. SUBRECIPIENT hereby certifies and agrees that it will not use funds provided through this Agreement to pay for entertainment, meals or gifts. S. Lobbying. SUBRECIPIENT certifies that it will comply with federal law (31 U.S.C. 132) and re�(Iulations found at 24 CFR Part 87, which provide that no appropriated funds may be expended by the recipient of a federal contract, grant, loan or cooperative agreement to pay any person for influencing or attempting to influence an officer or employee of any agency, Member of Congress, or an officer or employee of a Member of Congress in connection with awarding of any federal contract. the malting of any federal grant or loan, entering into any cooperative agreement and the extension, renewal, amendment or modification of any federal contract, grant, loan or cooperative agreement. SUBRECIPIENT shall sign a certification to that effect in a form as set forth in "Exhibit C," attached hereto and by this reference incorporated herein. SUBRECIPIENT shall submit said signed certification to CITY prior to performing any of its obligations under this Agreement and prior to any obligation arising on the part of CITY to pay any sums to SUBRECIPIENT under the terms and conditions of this Agreement. If any funds other than Federal appropriated funds have been paid or will be paid to WIN, 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 a "Disclosure Form to Report Lobbying," in accordance vwith its instructions (see C-1). 14 6/10 I'. Financial Interest. SUBRECIPIENT agrees that except for the use of ESG funds to pay salaries and other related administrative or personnel costs, no persons who exercise or have exercised any function with respect to ESG activities assisted under the terms of this Agreement, or who are in a position to participate in a decision - making process or gain inside information with regard to such activities. may obtain a financial interest or benefit from a ESG- assisted activity of SUBRECIPIENT.. either for themselves or those with whom they have family or business ties, during( their tenure or for one year thereafter. This prohibition applies to any person who is an employee. agent, consultant, officer, or elected or appointed official ofCITY, or of anv designated public agencies, or the SUBRECIPIENT. U. Davis -Bacon Act. All laborers and mechanics employed by contractors or subcontractors in the performance of construction work, including alterations and repairs, in excess of $2.000.00. financed in whole or in part with federal funds shall be paid wages at rates not less than those prevailing on similar construction in the locality as determined in accordance with the Davis -Bacon Act, as amended.. 40 U.S.C. sections 276a - 276a -5. Any such construction contract shall include and comply with the required contract provisions and rules set forth in 29 C.F.R. §5.5. Further. the payroll reports (along with the "Statement of Compliance ") and basic records are required to be maintained and submitted, or made available, pursuant to 29 C.F.R. §5.5(a)(3). No payment.. advance, grant. loan or guarantee of funds shall be approved by the federal agency unless there is on file with the agency a certification by the contractor that the contractor and its subcontractors have complied with the provisions of 29 C.F.R. §5.5. A breach of the contract clauses in 29 C.F.R. §5.5 play be grounds for termination of the contract, and for debarment as a contractor /subcontractor. as provided in 29 C.F.R. §5.12. Labor standards interviews /investigations shall be made as necessary to assure compliance [29 C.F.R. §5.6(a)(3)]. V. Homeless Involvement. SUBRECIPIENT certifies that it will involve, to the maximum extent practicable, homeless individuals and families in constructing, renovating, maintaining, and operating facilities assisted under the ESG program, and in providing services for occupants of these facilities [24 CFR 576.56(b); 42 USC 11375(d)]. W. Drug, Free Workplace. SUBRECIPIENT certifies that it has established the fol- lowin d111114ree workplace policy: I. '['he LllllabVflll manufacture. distribution, dispensing, possession or use of a con- trolled substance is prohibited in the workplace for any employee involved in a federally funded program. 2. As an employee working in conjunction with a federally fielded program, the em- ployees ol'SUBRECIPIENT will be required to: a) Abide by the terms above in statement 1. b) Notify appropriate ofl- llcials of SUBRECIPIENT and CITY officials of any criminal drug statute conviction for a violation occurring in the workplace not later than five days aftel' SIICII COIIVICtion. 15 6/10 3. The City and the United States Department of Housing and Urban Development will be notified within ten days after receiving notice of any such violation. 4. Within 30 days of receiving such notice, appropriate personnel action will be tak- en against such employee, up to and including termination. 5. Each such employee shall be required to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a federal, state or local health, lavv enforcement, or other appropriate agency. X. Expenditure of Funds: SUBRECIPIENT must spend all of its grant amount within 24 months of the -rant award (24 CFR 576.35). Any funds not obligated within said timefrarne shall be reallocated. Y. Uniform Administrative Requirements for Non - Governmental Subrecipients/Non- Profits The following requirements and standards must be complied with: OMB Circular A -122 "Cost Principles for Non - Profit Organizations" or OMB Circular A -21 "Cost Principles for Educational Institutions". as applicable: 24 CFR Part 84, "Grants and Agreements with Institutions of Higher Education. Hospitals.. and Other Non - Profit Organizations," as modified by 24 CFR 570.502(b); and, OMB Circular A -133, "Audits of States, Local Governments and Non - Profit Organizations ". Z. Subpart K of 24 CFR 570. SUBRECIPIENT will carry out its activities in compliance with the requirements of Subpart K of 24 CFR 570, however SUBRECIPIENT does not assume the CITY's environmental responsibilities or the responsibility for initiating the environmental review process under 24 CFR Part 52. 11. CITY'S OBLIGATIONS A. CITY shall pay to SUBRECIPIENT from funds received under the ESG when, if and to the extent received from HUD, amounts expended by SUBRECIPIENT in carrying out said program pursuant to this Agreement up to a maximum aggregate amount of Thirty-Nine Thousand Eight Hundred Twenty -Nine Dollars ($39,829) in installments determined by CITY. Payments shall be made to SUBRECIPIENT through the submission of quarterly invoices (on or before the 15th day of October, January, April and July) in a form prescribed by CITY, detailing such expenses. CITY shall pay such invoices within thirty (30) days after receipt thereof, pro- vided CITY is satisfied that such expenses have been incurred within the scope of this Agree- ment and that SUBRECIPIENT is in compliance with the terms and conditions of this Agree- ment. Failure to provide any of the required documentation and reporting will cause CITY to withhold all or a portion of a request for reimbursement, or return the entire reimbursement package to SUBRECIPIENT, until such documentation and reporting has been received and ap- proved by CITI'. 16 6/10 Costs incurred prior to the effective date of this Agreement, accrued as of the first day of JLII� I. for purposes identified herein will be allowable for reimbursement upon presentation of evidence of and invoices for such expenditures. B. Audit. CITY shall include an audit of the account maintained by SUBRECIPIENT in CITVs annual audit of all funds pursuant to the Code of Federal Regulations and other applica- ble Federal laws and regulations. C. Common Rule: Pursuant to CFR 85.40(a), the CITY manages the day -to -day operations of each grant and subgrant supported activities. CITY staff has detailed knowledge of the grant program requirements and monitors grant and subgrant supported activities to assure compliance with Federal requirements. Such monitoring covers each program, function and activity and performance goals are reviewed periodically. D. Environmental Review: In accordance with 24 CFR 58, the CITY is responsible for undertaking environmental review and maintaining environmental review records for each appli- cable project. E. Perf- ormance Monitorin : CITY shall monitor the performance of the SUBRECIPIENT against goals and performance standards required herein. Substandard perfor- mance as determined by the CITY will constitute non- compliance with this Agreement. If action to correct such substandard performance is not taken by the SUBRECIPIENT within a reasonable period of time after being notified by the CITY, contract suspension or termination procedures will be initiated. III. NONDISCRIMINATION SUBRECIPIENT agrees that no person on the ground of race, color, national origin, reli- "ion or sex will be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity funded in whole or in part with ESG funds. IV. CONFLICT OF INTEREST Pursuant to the conflict of interest requirements set forth in 24 CFR 576.57 and OMB Circu- lars 1 -102 and A -110. SUBRECIPIENT agrees that no officer, employee, agent or assignee of CITY having direct or indirect control of any ESG monies granted to the CITY, inclusive of the subject ESG FUNDS, shall serve as an officer of SUBRECIPIENT. Further, any conflict or poten- tial conflict of interest of an\ officer of SUBRECIPIENT shall be fully disclosed in writing prior to the execution ofthis Agreement and said writing shall be attached and deemed fully incorporated as a part hereof, Notice shall be sent by SUBRECIPIENT to CITY regarding any changes or mod - if ications to its board of directors and list of officers V. SPECIAL CERTIFICATION FOR RELIGIOUS ENTITIES 17 6/10 In addition to, and not in substitution for, other provisions of this Agreement regarding said program using f- ederal funds, SUBRECIPIENT: A. Represents that it is, or may be deemed to be, a religious or denominational institution or organization or an organization operated for religious purposes that is supervised or controlled by or in connection with a religious or denominational institution or organization; B. A-rees that, in connection v -vith said program: I . It will not discriminate against any employee or applicant for employment on the basis of' religion and will not limit employment or give preference in employment to persons on the basis of religion; 2. It will not discriminate against any person applying for participation in said pro- gram on the basis of relic- ion and will not limit such participation or give preference to persons on the basis of religion; 3. It will provide no religious instruction or counseling, conduct no religious worship or services, engage in no religious proselytizing, and exert no other religious influence in said I)rogram; 4. The funds received under this Agreement shall not be used to construct, rehabili- tate. or restore any facility that is owned by SUBRECIPIENT and in which said program is to be implemented; provided that, minor repairs may be made if such repairs (1) are directly related to said program: (2) are located in a structure used exclusively for non - religious purposes and (3) constitute in dollar terms only a minor portion ofthe federal fund expenditure for said program. VI. CONDITIONS ON PROVISIONS OF DEVELOPMENT AND IMPLEMENTING HOMELESS PREVENTION ACTIVITIES In addition to, and not in substitution for, other provisions of this Agreement regarding said program using 'federal funds, SUBRECIPIENT: A. Represents that it is, or may be deemed to be, a Homeless Prevention Program [24 CFR 576.21(a)(4)) and will implement homeless prevention activities subject to the limitations in 42 USC 1 1374(x)(4); 13. Agrees that, in connection with said program, if ESG funds are to be used to assist families that have received eviction notices or notices of termination of utility services, the fol- lowing conditions will be met: 1. The inability of the family to maize the required payments must be the result of a sudden reduction in income; Is 6/10 2. The assistance must be necessary to avoid eviction of the family or termination of services to the family: 3. "There must be a reasonable prospect that the family will be able to resume pay- ments within a reasonable period of time: and 4. The assistance must not supplant funding for preexisting homeless prevention ac- tivities from any other source. VII. PROHIBITION OF NEPOTISM SUBRECIPIENT agrees not to hire or permit the hiring of any person to fill a position funded through this Agreement il' a member of that person's immediate family is employed in an administrative capacity by SUBRECIPIENT. For the purposes of this section, the term "imme- diate family" means spouse, child, mother, father, brother, sister, brother -in -law, sister -in -law, lather- 111-1mv, mother -in -law, son -in -lave, daughter -in -law, aunt, uncle, niece, nephew, stepparent and stepchild. The term "administrative capacity" means having selection, hiring, supervisor or management responsibilities. VII1. NOTICES Notices to the parties shall. unless otherwise requested in writing, be sent by U.S. Mail, postage prepaid, and addressed as follows: TO CITY: Cite of Santa Ana Community Development Agency (M -25) 20 Civic Center Plaza P.O. Box 1988 Santa Ana CA 92702 -1988 TO SUBRECIPIENT: Kathy Strong Director of Contracts Administration Women's Transitional Living Center, Inc. P.O. Box 6103 Orange, CA 92863 IX. ASSIGNABILITY None ol' the duties ol: or work to be performed by, SUBRECIPIENT under this Agree- ment shall be subcontracted or assigned to any agency, consultant, or person without the prior written consent oT CITY. SUBRECIPIENT must submit all subcontracts and other agreements that relate to this Agreement to CITY. No subcontract or assignment shall terminate or alter the legal obligations of SUBRECIPIENT pursuant to this Agreement. 19 6/10 X. HOLD HARMLESS SUBRECIPIENT shall defend, indemnify and save harmless CITY, its officers, agents, employees, representatives and volunteers 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, employees, rep- resentatives and volunteers from and against any and all claims, demands, suits, actions or pro- ceedings of any land or nature, including, but not by way of limitation, workers compensation claims.. and including attorney fees and reasonable expenses for litigation or settlement, resulting from or arising out of the negligent or wrongful acts, errors or omissions of SUBRECIPIENT, its officers, directors, employees, agents. subcontractors and suppliers arising out of SUBRECI- NENT's performance ofthis Agreement. XI. TERMINATION This Agreement may be terminated in accordance with Federal Register 24 CFR Part 576 as follows: A. This Agreement may be terminated by CITY on thirty (30) days' written notice by ei- ther party. In the event 01' such termination, SUBRECIPIENT shall only be entitled to reirn- bursemelnt for approved expenses incurred to the effective date of termination. B. This Agreement may be suspended or terminated by CITY upon five (5) days' written notice for violation by SUBRECIPIENT of Federal, state and /or local laws governing the use of Emergency Shelter Grant funds. Furthermore, the SUBRECIPIENT shall comply with the Con- ditional Use permit requirements. For failure to comply with the aforementioned terms, suspen- sion or termination shall result. and SUBRECIPIENT shall only be entitled to reimbursement for approved expenses incurred Lip to the effective date of suspension or termination. C. In the event SUBRECIPIENT defaults by failing to fulfill all or any of its obligations hereunder, CITY may declare a default and termination of the Agreement by written notice to SUBRECIPIENT, which default and termination shall be effective on a date stated in the notice which is to be not less than ten (10) days after certified mailing or personal service of such no- tice, unless such default is cured before the effective date of termination stated in such notice. If terminated for cause, CITY shall be relieved of further liability or responsibility under this Agreement. or as a result of the termination thereof, including the payment of money, except for payment for approved expenses incurred for services satisfactorily and timely performed prior to the mailing or service of the notice of termination, and except for reimbursement of (1) any pay- ments made for services not subsequently performed in a timely and satisfactory manner, and (2) costs incurred by CITY in obtaining substitute performance. D. The grant of fllids under this Agreement may be terminated for convenience. 20 6/10 E. The grant of funds under this Agreement may be terminated due to the non- performance of' SUBRECIPIENT and /or failure of SUBRECIPENT to perform the work de- scribed in Exhibits A and B or failure to sleet the performance standards and program goals set Furth therein. F. In the event this Agreement is terminated as set forth in Section X.A through X.E, in- clusive, SUBRECIPIENT agrees to immediately return to CITY, upon CITY's demand and prior to any adjudication of SUBRECIPIENT's rights, any and all funds not used under this Agree- ment. XII. LIMITATION OF FUNDS The United States of America, through HUD, may, in the future, place programmatic or fiscal limitations on the use of ESG funds which limitations are not presently anticipated. Ac- cordingly, CITY reserves the right to revise this Agreement in order to take account of actions affecting HUD program funding. In the event of funding reduction, CITY may, in its sole and absolute discretion, reduce the budget Of this Agreement as a whole or as to costs category, may limit the rate of SUBRECIPIENT's aLlthOrlty to commit and spend funds, or may restrict SUB- RECIPIENT'S use of' both its uncommitted and its unspent funds. Where HUD has directed or requested CITY to implement a reduction in funding, in whole or as to a cost category, with re- spect to funding for this Agreement. CITY's City Manager or delegate is authorized to act for CITY in implementing and effecting such a reduction and in revising, modifying, or amending the Agreement for such purposes. Ifssuch a reduction in fielding occurs, SUBRECIPIENT shall Liu allowed to de -scope accordingly. Where CITY has reasonable grounds to question SUBRE- CIPIENT's fiscal accountability, financial soundness, or compliance with this Agreement, CITY may suspend the operation of this Agreement for up to sixty (60) days upon five (5) days' written notice to SUBRECIPIENT of its intention to so act pending an audit or other resolution of such questions. In no event. however, shall any revisions made by CITY affect expenditures and le- gally binding commitments made by SUBRECIPIENT before it received notice Of such revision, provided that such amounts have been committed in good faith and are otherwise allowable and that such commitments are consistent with HUD cash withdrawal guidelines. X1I1. INSURANCE A. SUBRECIPIENT shall furnish CITY's Clerk Of the Council with an insurance certifi- cate from its workers' compensation insurance carrier certifying that it carries such insurance and that the policy shall not be canceled nor the coverage reduced except upon thirty (30) days prior notice to CITY. B. SUBRECIPIENT shall undertake self-insurance, or shall obtain, at its sole cost, a pol- icy or policies of coninlercial general liability insurance, or equivalent form, with a combined single liniit of not less than $1 Million Dollars per Occurrence. Such insurance shall: (1) name Lhe City of Santa Ana, its officers, agents, employees and volunteers as additional insureds; (2) be primary with respect to insurance or self - insurance pro- 21 6/10 grans maintained by the CITY; (3) contain standard separation of insureds provisions; and (4) give to CITY prompt and timely notice of claim made or suit instituted arising out of SUBRECI- PIENT's operations hereunder. SUBRECIPIENT shall: (1) prior to exercising any right under this Agreement, furnish properly executed certificates of insurance and additional insured endorsement to the CITY which shall clearly evidence all coverages required above; (ii) provide that such insurance shall not be materially changed or terminated except on thirty (30) days prior written notice to the CITY; (iii) maintain such insurance for the period covered by this Agreement; and (d) replace such certificates for policies expiring prior to the expiration of this Agreement. XIV. EXCLUSIVITY AND AMENDMENT TO AGREEMENT This Agreement supersedes any and all other agreements, either oral or in writing, be- tween the parties hereto with respect to the use of CITY's ESG funds by SUBRECIPIENT and contains all the covenants and agreements between the parties with respect to such employment in any manner whatsoever. Each party to this Agreement acknowledges that no representations, inducements, promises or Agreements, orally or otherwise, have been made by any party, or any- one acting on behalf of any party, which are not embodied herein, and that no other agreement or amendment hereto shall be effective unless executed in writing and signed by both CITY and SUBRECIPIENT. XV. LAWS GOVERNING THIS AGREEMENT This Agreement shall be governed by and construed in accordance with the laws of the State of California, and all applicable federal laws and regulations. XVI. VALIDITY The invalidity in whole or in part of any provision of this Agreement shall not void or af- fect the validity of any other provision of this Agreement. XVII. 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 ofthe terms of this Agreement, and shall indemnify CITY {{illy.. including reasonable costs and attorney's fees, for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits and Attachments referenced herein and attached hereto shall be incorporated as if {ally set forth in the body, of this Agreement. 22 6/10 c. No delay or omission by either party hereto to exercise any right or power accruing upon any noncompliance or default by the other part), with respect to an), of the terms of this Agreement shal I impair any such rioht or power or be construed to be a waiver thereof. A waiver by either of the parties hereto of any of the covenants, conditions, or agreements to be performed by the other shall not be construed to be a waiver of any succeeding breach thereof or of any oth- er covenant, condition or agreement herein contained. 23 6/10 IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the date and year first above written. ATTEST: MARIA D. HUIZAR� Clerk of the Council APPROVED AS TO FORM: JOSEPH vX. FL.ETCHER City Attorney — By: LISA E. STORCK Assistant City Attorney DATED: ? - 5� 1ld 24 CITY OF SANTA ANA a municipal corporation Vi �- DAVID N. REAM City Manager SUBRECIPIENT: Name: Kathy Zg Title:Director of Contracts Administration Tax ID: 51-0201813 City of Santa Ana Scope of Work Name of Organization Women's Transitional Living Center, Inc. (WTLC) Name of Funded Program Emergency Shelter Programs Annual Accomplishment Goal I Total number of unduplicated clients (Santa Ana and Non -Santa Ana Residents) anticipated to be served by the funded program, named above, during the 12 -month contract period. 700 Persons II. Number of unduplicated Santa Ana residents expected to be served by the funded program during the 12 -month contract period. Persons Program and Funding Description III. Description of Work - In the space below, describe the program to be funded during the 12 -month contract period. What specific activities will be undertaken during the contract period. Please be concise in your response. Only the viewable space will print. The Emergency Shelters Program includes the 45 -day shelter, 90 -day (substance abuse treatment) shelter, as well as the Step -Two Transitional shelter (up to two year stay) and the Safety Net emergency motel shelter. The primary goals of the program are identification of victims of domestic violence, intervention in both the immediate and intergenerational cycls of violence and other high -risk issues associated with domestic violence (e.g., substance abuse, mental illness, gang involvement, child abuse) and stabilization of those high -risk issues. Self - sufficiency is considered to have occurred when victims find transitional /permenant (preferrably permanent) housing, obtain employment, cease substance abuse, begin the process (if needed) of documentation, live free from abuse, and become emotionally stable. Services will include, but not be limited to: shelter, food, clothing, toys, case management, counseling, 24/7 hotline, translation, transportation, social service /legal /immigration advocacy, on -site medical screening and care, educational /empowerment/process groups, substance abuse treatment, career assistance (counseling, resume preparation, interview techniques, work experience /placement, GED assistance), therapeutic children's programs, housing /financial assistance, safety /independence planning, and household establishment assistance. Schedule of Performance Estimate the number of unduplicated Santa Ana residents to be served by the funded program during the 12 -month contract period per quarter. (Enter number of new Santa Ana clients served each quarter. If they were served in quarter 1 do not count them again in quarter 2) Quarter 1: July 1 - September 30 58 Persons Quarter 2: October 1 December 31 57 Persons Quarter 3: January 1 March 31 58 Persons Quarter 4: April 1 -June 30 58 Persons 231 Total unduplicated Santa Ana Residents to be served. Schedule of Invoicing Estimate the amount of grant funds to be requested during the 12 -month contract period on a quarterly basis. Quarter 1: July 1 - September 30 $ 9,957.25 Quarter 2: October 1 - December 31 $ 9,957.25 Quarter 3: January 1 - March 31 $ 9,957.25 Quarter 4: April 1 -June 30 $ 9,957.25 $ 39,829.00 [Total Grant Exhibit A Page 1 of 1 City of Santa Ana Performance Outcome Tracking Activity/ Program Outcome Tracking Goal HUD Outcome Tracking HUD Goal Emergency Track individuals who 50% of Number of homeless persons given Accessibility for the Shelter received support services that individuals /households that overnight shelter purpose of creating were linked to one or more are provided with AND Suitable Living additional support service emergency shelter will Number of beds created in overnight Environments and /or appropriate housing. transition to interim housing shelter or other emergency housing (i.e., transitional housing). Describe how you will gather the tracking information, noted above, for that activity. WTLC utilizes an intake procedure for all programs. This comprehensive intake details client demographic information such as name, date, residence information, gender, race /ethnicity, age, income level and source, substance abuse /mental health information, children's information, and residences over the past three years (to determine chronic homelessness). WTLC's specialized database ( "Alice ") is used to store all this information, create reports, and is used to enter all services provided for clients. Each client has a client file which is checked against the information in Alice, so provides a system of checks and balances. Exhibit A -1 Page 1 of 1 Final Budget Organization Name Women's Transitional Living Center, Inc. (WTLC) Program Name Emergency Shelter Programs Expenditures Category Expenses Funded by Santa Ana Expenses Funded by Other Sources City General Funds Total Program Budget Total Organizational Budget Administrative Staff Salaries & Benefits $ - $ 49,046 $ 49,046 $ 289,775 Program Staff Salaries & Benefits $ 10,500 $ 752,955 $ 763,455 $ 1,028,475 Contractual /Professional Services $ - $ 61,000 $ 61,000 $ 61,000 Office Supplies $ 2,269 $ 5,731 $ 8,000 $ 15,000 Rent $ - $ 17,700 Communications $ 10,230 $ 20,770 $ 31,000 $ 65,000 Utilities $ 16,830 $ 34,170 $ 51,000 $ 73,000 Insurance $ 8,000 $ 8,000 1 $ 15,000 Other:List below b 1 Maintenance /repairs $ 15,000 $ 15,000 $ 20,000 2 Medical testing supplies $ 1,171 $ 1,171 $ 2,000 3 Postage /printing $ 750 $ 750 $ 5,000 4 Audit /legal $ 12,000 $ 12,000 $ 11,000 5 Transportation costs $ 750 $ 750 $ 3,000 Total $ 39,829 $ 961,343 $ 1,001,172 $ 1,605,950 LIST ALL OTHER PROGRAM FUNDS THAT HAVE BEEN SECURED (Total Funds for Program must equal Total Program Budget above) Source Amount Santa Ana $ 39,829 City General Funds $ 85,568 County $ 109,344 State $ 211,571 Federal $ 21,655 Foundation /private $ 98,400 Program income $ 434,805 Total Funds for the Program $ 1,001,172 Exhibit B Page 1 of 1 Funded Personnel Name ofChganization: Women's Transitional Livinc Center, Inc. (WTLC) Name of Program Fmergency Shelter Programs M:IIINIS FR,�TIN E STAFF Position] ill! (onh list Ilnuled positions) Annual Salary Annual Bcnelits 'total Compensation Funcls Requested for this position Percent of time serving Santa Ana Maximum Amount of eligible Compensation No F'unchm-, Allowed Under FSG $ 31.200 $ 9.672 $ $ 10.500 26% $ "total Amount Rec nested $ Total Amount Re nested $ PROGR.01 S,I:kF1 Position "title (only list funded positions) Annual Salary Annual Benefits Total Compensation Funds Requested for this position Percent of time serving Santa Ana Maximtun Amount of eligible Com ensation Bilineual Client Advocate $ 31.200 $ 9.672 $ 40.872 $ 10.500 26% $ 10.626.72 "total Amount Rec nested $ Total Amount Rec nested $ 10.500 CONTRA( "I'LAL /PROFESSIONAL SERVICES I vpc of Service (onl) list funded services) Annual Conn-act Amount Total Compensation Funds Requested for this position Percent of time serving Santa Ana Maximum Amount of eligible Com ensation "total Amount Rec nested $ Exhibit B -1 Page 1 of" f 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: ( I ) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned. to any person Vol' influencing or attempting to influence an officer or employee ol'any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract. the malting of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contact, grant, loan or cooperative agreement. (2) 1 f 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 a()enc� . 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 subcontract, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for malting or entering into this transaction imposed by Section 1352, Title 31. U. S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Grantee /Contactor Organization Program EXHIBIT C Page 1 of 2 SUBRECIPIENT warrants the Following: 1. SUBRECIPIENT will comply with Public Law 88 -352, Title VI of the Civil Rights Act of' 1964 (42 U. S. C. section 2000 et seq.) and implementing regulation in 24 CFR Part 1. 2. No person in the United States shall on the ground of race, color, religion, national ori,_,in. or sex, be excluded from participation in, or be denied the benefits of, or be subjected to discrimination under any program or activity funded in whole or in part with community development funds made available pursuant to the ACT. 3. All laborers and mechanics, employed by contractors or subcontractors in the peel- ormance of construction wort: financed in whole or in part with community development funds shall be paid wages at rates not less than those prevailing on similar construction in the locality as determined in accordance with the Davis -Bacon Act, as amended, 40 U. S. C. Sections 276 a 1 -5, except for individuals who perform services for \ -vhich they volunteered; do not receive compensation for such services, or are paid expenses, reasonable benefits. or a nominal fee for such services; and are not otherwise employed at any time in construction work. 4. SUBRECIPIENT will comply with all Federal statutes applicable to projects funded With community development funds, except that (a) SUBRECIPIENT does not assume CITY'S environmental responsibilities described at 24 CFR 570.604; and (b) SUBRECIPIENT does not assume CITY'S responsibility for initiating the review process under Executive Order 12372. EXHIBIT C Page 2 of 2 e.« .. e has high _. 1 1ef V Get your young children tested for lead, even if they seem healthy. Wash children's hands, bottles, pacifiers, and toys often. Make sure children eat healthy, low -fat foods. Get your home checked for lead hazards. Regularly clean floors, window sills, and other surfaces. Wipe soil off shoes before entering house. r Talk to your landlord about fixing surfaces with peeling or chipping paint. Take precautions to avoid exposure to lead dust when remodeling or renovating (call 1- 800 -424- LEAD for guidelines). Don't use a belt - sander, propane torch, high temperature heat gun, scraper, or sandpaper on painted surfaces that may contain lead. Y Don't try to remove lead -based paint yourself. Protect Your Family From Lead In Your Home A United States EPA Environmental Protection Agency �GT bFCEY °" • ',, United States Consumer Product Safety Commission PP.MENTpR.y NZ United States zo IIIIIIII �= Department of Housing °9a oQ� and Urban Development A'� DEJ AL e You Manning To Buy, Rent, or Renovate w aP� lore 978? any houses and apartments built before 1978 have paint that contains high levels of lead (called lead- based paint). Lead from paint, chips, and dust can pose serious health hazards if not taken care of properly. �f �S, b 1; IYERS, and RENTERS are © encouraged to check for lead (see page 6) before renting, buying or renovating pre - 1978 housing. ederal law requires that individuals receive certain information before renting, buvin -, or renovating IL pre- 1978 housing: L4,NORDS have to disclose known infor- IL"Yk- mation on lead -based paint and lead -based paint hazards before leases take effect. Leases must include a disclosure about lead -based paint. SEELEkS have to disclose known informa- tion on lead -based paint and lead -based paint hazards before selling a house. Sales contracts must include a disclosure about lead -based paint. Buyers have up to 10 days to check for lead. i f��I 'ORS disturbing more than 2 square feet of painted surfaces have to give you this pamphlet before starting work. E i.�CT: Removing lead-based paint improperly can increase the danger to your family. If you think your home might have lead hazards, read this pamphlet to learn some simple steps to protect your family. Dust, and �:�.L`- i ai�e ous If Not ,�-ed Properly Lead exposure can harm young children and babies even before they are born. L-0- : Even children who seem healthy can have high levels of lead in their bodies. People can get lead in their bodies by breathing or swallowing lead dust, or by eating soil or paint chips containing lead. People have many options for reducing lead hazards. In most cases, lead-based paint that is in good condition is not a hazard. i.�CT: Removing lead-based paint improperly can increase the danger to your family. If you think your home might have lead hazards, read this pamphlet to learn some simple steps to protect your family. s_ e �E.� a� tip .y��rs People can get lead in their body if they: Breathe in lead dust (especially during renovations that disturb painted surfaces). Put their hands or other objects covered with lead dust in their mouths. Eat paint chips or soil that contains lead. Lead is even more dangerous to children under the age of 6: At this age children's brains and nervous systems are more sensitive to the dam- aging effects of lead. Children's growing bodies absorb more lead. Babies and young children often put their hands and other objects in their mouths. These objects can have lead dust on them. Lead is also dangerous to women of childbearing age: Women with a high lead level in their system prior to pregnancy would expose a fetus to lead through the placenta during fetal development. Lead's Effects It is important to know that even exposure to low levels of lead can severely harm children. In children, lead can cause: Nervous system and kidney damage. Learning disabilities, attention deficit disorder, and decreased intelligence. Speech, language, and behavior problems. Poor muscle coordination. Decreased muscle and bone growth. Hearing damage. While low -lead exposure is most common, exposure to high levels of lead can have devastating effects on children, including seizures, uncon- sciousness, and, in some cases, death. Although children are especially susceptible to lead exposure, lead can be dangerous for adults too. In adults, lead can cause: Increased chance of illness during pregnancy. F Harm to a fetus, including brain damage or death. Slowed I Growth Digestive Problems Reproductive Problems (Adults) ., Fertility problems (in men and women). High blood pressure. Digestive problems. Nerve disorders. Memory and concentration problems. Muscle and joint pain. in or Nerve Damage n Lead affects the body in many ways. Hearing Problems 3 Found - -" - - -_ Many homes built before 1978 have lead- _ based paint. The federal government banned lead -based paint from housing in - -y dp=i= 1978. Some states stopped its use even t E i L earlier. Lead can be found: J In homes in the city, country, or suburbs. In apartments, single- family homes, and both private and public housing. Inside and outside of the house. In soil around a home. (Soil can pick up lead from exterior paint or other sources such as past use of leaded gas in cars.) - -- To reduce your child's exposure to lead, get your child checked, have your home _ -- r Ov tested (especially if your home has paint W W _ in poor condition and was built before L 1978), and fix any hazards you may have. Children's blood lead levels tend to increase fy rapidly from 6 to 12 months of age, and Y = -� _nish tend to peak at 18 to 24 months of age. Consult your doctor for advice on testing your children. A simple blood test can detect high levels of lead. Blood tests are usually recommended for: Children at ages 1 and 2. Children or other family members who have been exposed to high levels of lead. Children who should be tested under your state or local health screening plan. Your doctor can explain what the test results mean and if more testing will be needed. Lead -based paint is usually not a hazard if it is in good condition, and it is not on an impact or friction surface, like a window. It is defined by the federal government as paint with lead levels greater than or equal to 1.0 milligram per square centimeter, or more than 0.5% by weight. Deteriorating lead -based paint (peeling, chipping, chalking, cracking or damaged) is a hazard and needs immediate attention. It may also be a hazard when found on sur- faces that children can chew or that get a lot of wear - and -tear, such as: , Windows and window sills. .- Doors and door frames. Stairs, railings, banisters, and porches. Lead from paint chips, which you can see, and lead dust, which you can't always see, can both he serious hazards. Lead dust can form when lead -based paint is scraped, sanded, or heated. Dust also forms when painted surfaces bump or rub togeth- er. Lead chips and dust can get on surfaces and objects that people touch. Settled lead dust can re -enter the air when people vacuum, sweep, or wall< through it. The following two federal standards have been set for lead hazards in dust: 40 micrograms per square foot (pg/ft2) and higher for floors, including carpeted floors. 14 250 pg/ft2 and higher for interior window sills. Lead in soil can be a hazard when children play in bare soil or when people bring soil into the house on their shoes. The following two federal standards have been set for lead hazards in residential soil: 400 parts per million (ppm) and higher in play areas of bare soil. 1,200 ppm (average) and higher in bare soil in the remainder of the yard. The only way to find out if paint, dust and soil lead hazards exist is to test for them. The next page describes the most common meth- ods used. �- IV for Lead A combination risk assessment and inspection tells you if your home has any lead hazards and if your home has any lead -based paint, and where the lead -based paint is located. Hire a trained and certified testing profes- sional who will use a range of reliable ,S methods when testing your home. Visual inspection of paint condition = and location. V. A portable x -ray fluorescence (XRF) : =- machine. Lab tests of paint, dust, and soil samples. There are state and federal programs in place to ensure that testing is done safely, reliably, and effectively. Contact your state or local agency (see bottom of page l 1) for more information, or call 1- 800 - 424 -LEAD (5323) for a list of contacts in your area. Home test kits for lead are available, but may not always be accurate. Consumers should not rely on these kits before doing renovations or to assure safety. U You can get your home tested for lead in several different ways: A paint inspection tells you whether your home has lead -based paint and where it is located. It won't tell you whether or not your home currently has lead hazards. r� A risk assessment tells you if your home - currently has any lead hazards from lead in paint, dust, or soil. It also tells you what actions to tal<e to address any hazards. A combination risk assessment and inspection tells you if your home has any lead hazards and if your home has any lead -based paint, and where the lead -based paint is located. Hire a trained and certified testing profes- sional who will use a range of reliable ,S methods when testing your home. Visual inspection of paint condition = and location. V. A portable x -ray fluorescence (XRF) : =- machine. Lab tests of paint, dust, and soil samples. There are state and federal programs in place to ensure that testing is done safely, reliably, and effectively. Contact your state or local agency (see bottom of page l 1) for more information, or call 1- 800 - 424 -LEAD (5323) for a list of contacts in your area. Home test kits for lead are available, but may not always be accurate. Consumers should not rely on these kits before doing renovations or to assure safety. U -- OLi ai-I o Now To Protect -Lity 1111.e L ran L If you suspect that your house has lead hazards, you can take some immediate steps to reduce your family's risk: If you rent, notify your landlord of peeling or chipping paint. Clean up paint chips immediately. 4 Clean floors, window frames, window sills, and other surfaces weekly. Use a mop or sponge with warm water and a general all- purpose cleaner or a cleaner made specifically for lead. REMEMBER: NEVER MIX AMMONIA AND BLEACH PRODUCTS TOGETHER SINCE THEY CAN FORM A DANGEROUS GAS. Thoroughly rinse sponges and mop heads after cleaning dirty or dusty areas. Wash children's hands often, especial- ly before they eat and before nap time and bed time. Keep play areas clean. Wash bottles, pacifiers, toys, and stuffed animals regularly. IV Keep children from chewing window sills or other painted surfaces. Clean or remove shoes before entering your home to avoid tracking in lead from soil. Make sure children eat nutritious, low -fat meals high in iron and calcium, such as spinach and dairy products. Children with good diets absorb less lead. 7 Lead hazards In The Horne In addition to clay -to -clay cleaning and good nutrition: You can temporarily reduce lead hazards cL 5 by taking actions such as repairing dam- _ aged painted surfaces and planting grass to cover soil with high lead levels. These actions (called "interim controls ") are not permanent solutions and will need ongo- ing attention. 'A UA _ aifCs: To permanently remove lead hazards, you should hire a certified lead "abate- ment" contractor. Abatement (or perma- nent hazard elimination) methods include removing, sealing, or enclosing lead -based paint with special materials. Just painting over the hazard with regular paint is not permanent removal. Always hire a person with special training for correcting lead problems— someone who knows how to do this work safely and has the proper equipment to clean up thoroughly. Certified contractors will employ qualified workers and follow strict safety rules as set by their state or by the federal government. Once the work is completed, dust cleanup activities must be repeated until testing indicates that lead dust levels are below the following: 40 micrograms per square foot (,Ug/ft2) for floors, including carpeted floors; 250 pg/ft2 for interior windows sills; and -4, 400 ,ug/ft2 for window troughs Call your state or local agency (see bottom of page 1 1) for help in locating certified professionals in your area and to see if financial assistance is available. Base , h z avating a Home With C-tf. i, 'A 'C Take precautions before your contractor or you begin remodeling or renovating any- thing that disturbs painted surfaces (such as scraping off paint or tearing out walls): Have the area tested for lead - based paint. Do not use a belt- sander, propane torch, high temperature heat gun, dry scraper, or dry sandpaper to remove lead -based paint. These actions create large amounts of lead dust and fumes. Lead dust can remain in your home long after the work is done. Temporarily move your family (espe- cially children and pregnant women) out of the apartment or house until the work is done and the area is prop- erly cleaned. If you can't move your family, at least completely seal off the work area. Follow other safety measures to reduce lead hazards. You can find out about other safety measures by calling 1- 800 -424 -LEAD. Ask for the brochure "Reducing Lead Hazards When Remodeling Your Home." This brochure explains what to do before, during, and after renovations. If you have already completed renova- tions or remodeling that could have released lead -based paint or dust, get your young children tested and follow the steps outlined on page 7 of this brochure. If not conducted properly, certain types of renova- tions can release lead from paint and dust into the air. k n mot*,, dr, 9 Your yob ,� I ' ",'SO exist. 0 � I Al of Lead Drinking water. Your home might have plumbing with lead or lead solder. Call your local health department or water supplier to find out about testing your water. You cannot see, smell, or taste lead, and boiling your water will not get rid of lead. If you think your plumbing might have lead in it: • Use only cold water for drinking and cooking. • Run water for 15 to 30 seconds before drinking it, especially if you have not used your water for a few hours. The job. If you work with lead, you could bring it home on your hands or clothes. Shower and change clothes before coming home. Launder your work clothes separately from the rest of your family's clothes. Old painted toys and furniture. Food and liquids stored in lead crystal or lead- glazed pottery or porcelain. Lead smelters or other industries that release lead into the air. Hobbies that use lead, such as making pottery or stained glass, or refinishing furniture. Folk remedies that contain lead, such as 11 greta" and "azarcon" used to treat an upset stomach. The National Lead Information Center Call 1- 800 - 424 -LEAD (424 -5323) to learn how to protect children from lead poisoning and for other information on lead hazards. To access lead information via the web, visit www.epa.gov /lead and www.hud.gov /offices /lead /. EPA's Safe Drinking Water Hotline Call 1- 800 - 426 -4791 for information about lead in drinking water. Consumer Product Safety Commission (CPSC) Hotline To request information on lead in consumer products, or to report an unsafe consumer product or a prod- uct- related injury call 1- 800 -638- 2772, or visit CPSC's Web site at: www.cpsc.gov. Health and Environmental Agencies Some cities, states, and tribes have their own rules for lead -based paint activities. Check with your local agency to see which laws apply to you. Most agencies can also provide information on finding a lead abatement firm in your area, and on possible sources of financial aid for reducing lead hazards. Receive up -to -date address and phone information for your local con- tacts on the Internet at www.epa.gov /lead or contact the National Lead Information Center at 1- 800 - 424 -LEAD. For the hearing impaired, call the Federal Information Relay Service at i - K�0 -877 -8339 to access any of the phone numbers in this brochure. Your Regional EPA Office can provide further information regard- ing regulations and lead protection programs. EPA Regional Offices Region 1 (Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island, Vermont) Regional Lead Contact U.S. EPA Region 1 Suite 1 100 (CPT) One Congress Street Boston, MA 021 14 -2023 1 (888) 372 -7341 Region 2 (New Jersey, New York, Puerto Rico, Virgin Islands) Regional Lead Contact U.S. EPA Region 2 2890 Woodbridge Avenue Building 209, Mail Stop 225 Edison, NJ 08837 -3679 (732) 321 -6671 Region 3 (Delaware, Maryland, Pennsylvania, Virginia, Washington DC, West Virginia) Regional Lead Contact U.S. EPA Region 3 (3WC33) 1650 Arch Street Philadelphia, PA 19103 (215) 814 -5000 Region 4 (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee) Regional Lead Contact U.S. EPA Region 4 61 Forsyth Street, SW Atlanta, GA 30303 (404) 562 -8998 Region 5 (Illinois, Indiana, Michigan, Minnesota, Ohio, VVisconsin) Regional Lead Contact U.S. EPA Region 5 (DT -8J) 77 West Jackson Boulevard Chicago, IL 60604 -3666 (312) 886 -6003 Region 6 (Arkansas, Louisiana, New Mexico, Oklahoma, Texas) Regional Lead Contact U.S. EPA Region 6 1445 Ross Avenue, 12th Floor Dallas, TX 75202 -2733 (214) 665 -7577 Region 7 (Iowa, Kansas, Missouri, Nebraska) Regional Lead Contact U.S. EPA Region 7 (ARTD -RALI) 901 N. 5th Street Kansas City, KS 66101 (913) 551 -7020 Region 8 (Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming) Regional Lead Contact U.S. EPA Region 8 999 18th Street, Suite 500 Denver, CO 80202 -2466 (303) 312 -6021 Region 9 (Arizona, California, Hawaii, Nevada) Regional Lead Contact U.S. Region 9 75 Hawthorne Street San Francisco, CA 94105 (415) 947 -4164 Region 10 (Alaska, Idaho, Oregon, Washington) Regional Lead Contact U.S. EPA Region 10 Toxics Section WCM -128 1200 Sixth Avenue Seattle, WA 98101-1128 (206) 553-1985 Regional Offices Your Regional CPSC Office can provide further information regard- ing regulations and consumer product safety. Eastern Regional Center Western Regional Center Consumer Product Safety Commission Consumer Product Safety Commission 201 Varick Street, Room 903 1301 Clay Street, Suite 610 -N New York, NY 10014 Oakland, CA 94612 (212) 620 -4120 (5 10) 637 -4050 Central Regional Center Consumer Product Safety Commission 230 South Dearborn Street, Room 2944 Chicago, IL 60604 (312) 353 -8260 Please contact HUD's Office of Healthy Homes and Lead Hazard Control for information on lead regulations, outreach efforts, and lead hazard control and research grant programs. U.S. Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control 451 Seventh Street, SW, P -3206 Washington, DC 20410 (202) 755-1785 This document is in the public domain. It may be reproduced by an individual or organization without permission. Information provided in this booklet is based upon current scientific and technical understanding of the issues presented and is reflective of the jurisdictional boundaries established by the statutes governing the co- authoring agencies. Following the advice given will not necessarily pro- vide complete protection in all situations or against all health hazards that can be caused by lead exposure. U.S. EPA Washington DC 20460 EPA747 -K -99 -001 U.S. CPSC Washington DC 20207 June 2003 U.S. HUD Washington DC 20410 13 Disclosure of Information on Lead -Based Paint and /or Lead -Based Paint Hazards Lead Warning Statement Housing built before 1978 may contain leod-bosed paint. Lead from paint, paint chips, and dust can pose health hazards if not managed properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre -1978 housing, lessors must disclose the presence of known lead -based paint and /or lead -based paint hazards in the dwelling. Lessees must also receive a federally approved pamphlet on lead poisoning prevention. Lessor's Disclosure (a) Presence of lead -based paint and /or lead -based paint hazards (check (i) or (ii) below): (i) Known lead -based paint and /or lead -based paint hazards are present in the housing (explain). (ii) Lessor has no knowledge of lead -based paint and /or lead -based paint hazards in the housing. (b) Records and reports available to the lessor (check (i) or (ii) below): (i) Lessor has provided the lessee with all available records and reports pertaining to lead -based paint and /or lead -based paint hazards in the housing (list documents below). (ii) Lessor has no reports or records pertaining to lead-based paint and /or lead -based paint hazards in the housing. Lessee's Acknowledgment (initial) (c) Lessee has received copies of all information listed above. (d) Lessee has received the pamphlet Protect Your Family from Lead in Your Home. Agent's Acknowledgment (initial) (e) Agent has informed the lessor of the lessor's obligations under 42 U.S.C. 4852(d) and is aware of his /her responsibility to ensure compliance. Certification of Accuracy The following parties have reviewed the information above and certify, to the best of their knowledge, that the information they have provided is true and accurate. Lessor Date Lessor Date Lessee Date Lessee Date Agent Date Agent Date Disclosure of Information on Lead -Based Paint and /or Lead -Based Paint Hazards Lead Warning Statement Every purchaser of any interest in residential real property on which a residential dwelling was built prior to 1978 is notified that such property may present exposure to lead from lead -based paint that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence quotient behavioral problems, and impaired memory. Lead poisoning also poses a particular risk to pregnant women. The seller of any interest in residential real property is required to provide the buyer with any information on lead -based paint hazards from risk assessments or inspections in the sellers possession and notify the buyer of any known leod-based paint hazards. A risk assessment or inspection for possible lead -based paint hazards is recommended prior to purchase. Seller's Disclosure (a) Presence of lead -based paint and /or lead -based paint hazards (check (i) or (ii) below): (i) Known lead -based paint and /or lead -based paint hazards are present in the housing (explain). (ii) Seller has no knowledge of lead -based paint and /or lead -based paint hazards in the housing. (b) Records and reports available to the seller (check (1) or (ii) below): (i) Seller has provided the purchaser with all available records and reports pertaining to lead - based paint and /or lead -based paint hazards in the housing (list documents below). (ii) Seller has no reports or records pertaining to lead -based paint and /or iead -based paint hazards in the housing. Purchaser's Acknowledgment (initial) (c) Purchaser has received copies of all information listed above. (d) Purchaser has received the parnphlet Protect Your Family from Lead in Your Home. (e) Purchaser has (check (i) or (ii) below): (i) received a 10 -day opportunity (or mutually agreed upon period) to conduct a risk assess- ment or inspection for the presence of lead -based paint and /or lead -based paint hazards; or (ii) waived the opportunity to conduct a risk assessment or inspection for the presence of lead -based paint and /or lead -based paint hazards. Agent's Acknowledgment (initial) (f) Agent has informed the seller of the seller's obligations under 42 U.S.C. 4852(d) and is aware of his /her responsibility to ensure compliance. Certification of Accuracy The following parties have reviewed the information above and certify, to the best of their knowledge, that the information they have provided is true and accurate. Seller Date Seller Date Purchaser Date Purchaser Date Agent Date Agent Date Appendix A-- Sample Summary Inspection Notice Format Note: The following appendix will not appear in the Code of Federal Regulations Summary Notice of Lead -Based Paint Inspection Address /location of property or structure(s) this summary notice applies to: ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- Lead -based paint inspection description: Date(s) of inspection:----------------------------------------------- Summary of inspection results (check all that apply): (a) No lead -based paint was found. (b) Lead -based paint was found. (c) A brief summary of the findings of the inspection is provided below (required if lead -based paint found). Summary of where lead -based paint was found. List at least the housing unit numbers and common areas (for multifamily housing), and building components (including type of room or space, and the material underneath the paint): ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- Contact person for more information about the inspection: Printed name:-------------------------------------------------------- Organization:-------------------------------------------------------- Street and city:----------------------------------------------------- [[Page 50231]] State: ZIP:------------------------------------------------------ Phone number: ( )------------------------------------------------- Person who prepared this summary notice: Printedname:-------------------------------------------------------- Signature:----------------------------------------------------------- Attachment 3 Page 1 of 5 Date:---------------------------------------------------------------- organization:-------------------------------------------------------- Street and city:----------------------------------------------------- State: ZIP: -------------------------------------------------- Phone number: ( )------------------------------------------------- Appendix B-- Sample Summary Risk Assessment Notice Format Note: This following appendix will not appear in the Code of Federal Regulations Summary Notice of Lead -Based Paint Risk Assessment Address /location of property or structure(s) this summary notice applies to: ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- Lead -based paint risk assessment description: Date(s) of risk assessment:------------------------------------------ Summary of risk assessment results (check all that apply): (a) No lead -based paint hazards were found. (b) Lead -based paint hazards were found. (c) A brief summary of the findings of the risk assessment is provided below (required if any lead -based paint hazards were found) . Summary of types and locations of lead -based paint hazards. List at least the housing unit numbers and common areas (for multifamily housing), bare soil locations, dust -lead locations, and /or building components (including type of room or space, and the material underneath the paint), and types of lead -based paint hazards found: ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- Contact person for more information about the risk assessment: Printed name:-------------------------------------------------- - - - - -- ---------------------------------------------------------------------- Organization:-------------------------------------------------------- ---------------------------------------------------------------------- Street and city:----------------------------------------------------- ---------------------------------------------------------------------- State: ZIP: Phone number: ( )--------------------------- Attachment 3 Page 2 of 5 ---------------------------------------------------------------------- Person who prepared this summary notice: Printed name:-------------------------------------------------------- ---------------------------------------------------------------------- Signature:----------------------------------------------------------- Date:---------------------------------------------------------------- ---------------------------------------------------------------------- Organization:-------------------------------------------------------- ---------------------------------------------------------------------- Street and city:----------------------------------------------------- ---------------------------------------------------------------------- State: ZIP: Phone number: ( )--------------------------- ---------------------------------------------------------------------- Appendix C-- Sample Summary Presumption Notice Format Note: The following appendix will not appear in the Code of Federal Regulations Notice That Lead -Based Paint or Lead -Based Paint Hazards Are Presumed to be Present Address /location of property or structure(s) this notice of presumption applies to: ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- Type of presumption (check all that apply): (a) Lead -based paint is presumed to be present. (b) Lead -based paint hazard(s) is(are) presumed to be present. Summary of presumption. List at least the housing unit numbers and common areas (for multifamily housing), bare soil locations, dust - lead locations, and /or building components (including type of room or space, and the material underneath the paint), and types of lead - based paint hazards presumed to be present: ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- Contact person for more information about the presumption: Attachment 3 Page 3 of 5 Printed name:-------------------------------------------------------- Organization:-------------------------------------------------------- Streetand city:----------------------------------------------------- State: ZIP: Phone number: ( )--------------------------- Person who prepared this notice of presumption: Printed name:-------------------------------------------------------- Signature:----------------------------------------------------------- Date:---------------------------------------------------------------- ---------------------------------------------------------------------- organization:-------------------------------------------------------- ---------------------------------------------------------------------- Street and city:----------------------------------------------------- ---------------------------------------------------------------------- State: ZIP: Phone number: ( )--------------------- - - - - -- Appendix D-- Sample Hazard Reduction Completion Notice Format Note: The following appendix will not appear in the Code of Federal Regulations. Summary Notice of Completion of Lead -Based Paint Hazard Reduction Activity Address /location of property or structure(s) this summary notice applies to: ---------------------------------------------------------------- - - - - -- Summary of the hazard reduction activity: Start and completion date(s):-------------------------------------- Activity locations and types. List at least the housing unit numbers and common areas (for multifamily housing) , bare soil locations, dust -lead locations, and /or building components (including type of room or space, and the material underneath the paint), and types of hazard reduction activities performed at the locations listed: ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- ---------------------------------------------------------------------- Date(s) of clearance testing and /or soil analyses: Locations of building components with lead -based paint remaining in the rooms, spaces or areas where activities were conducted: ---------------------------------------------------------------------- AttachmeI1t 3 Page 4 of 5 Summary of results of clearance testing and soil analyses: (a) No clearance testing was performed. (b) Clearance testing showed clearance was achieved. (c) Clearance testing showed clearance was not achieved. Contact person for more information about the hazard reduction: Printed name:-------------------------------------------------------- Organization:-------------------------------------------------------- Street and city: -- --- ---- -- --- State: ZIP:----------------------------------------------------- Phone number: ( )------------------------------------------------- Person who prepared this summary notice: Printed name: ---------------------------- ---------------------------- Signature:----------------------------------------------------------- Date:---------------------------------------------------------------- Organization:------------------- ------------------------------------- Street and city: --------- --- --- State: ZIP:----------------------------------------------------- Phone number: ( ) ------------------------------------------- - - - - -- [FR Doc. 99 -23016 Filed 9- 14 -99; 8:45 am] BILLING CODE 4210 -32 -P Attachment 3 Page 5 of ATTACHMENT NO. 4 LBP INFORMATION SUMMARY 1. ZERO /0 BEDROOM < (LESS THAN) 100 DAYS IN UNIT; ASSISTANCE IN HOMELESS SHELTER • STATUS: EXEMPT TITLE X 2. ZERO /0 BEDROOM > (MORE THAN) 100 DAYS IN UNIT • STATUS: OPEN ISSUE UNDER LBP REGS ZERO /0 BEDROOM > (MORE THAN) 100 DAYS ASSISTANCE IN HOMELESS SHELTER • STATUS: OPEN ISSUE UNDER LBP REGS • SEE SUBPART K • CLEARANCE OF UNITS) WILL BE REQUIRED BY CITY FOR ALL HOUSING UNITS (EVEN ZERO BEDROOM). FOR WHICH OCCUPANCY OCCURS BY ASSISTED HOUSEHOLD FOR MORE THAN 100 DAYS, PENDING FURTHER INTERPRETATION /GUIDANCE FROM HUD 3. ONE OR MORE (1 +) BEDROOMS OCCUPANCY < 100 DAYS IN RESIDENTIAL UNIT AND /OR OCCUPANCY IN HOMELESS SHELTER • EXEMPT TITLE X 4. 1+ BEDROOMS > 100 DAYS IN RESIDENTIAL UNIT • STATUS: SAME AS #2 ABOVE; CLEARANCE REQUIRED • SEE SUBPART K 5. EMERGENCY RENTAL ASSISTANCE < 100 DAYS • EXEMPT TITLE X 6. EMERGENCY RENTAL ASSISTANCE > TO HOUSEHOLD TO BE OCCUPANCY IN RESIDENTIAL UNIT FOR MORE THAN 100 DAYS (SUCH AS LONG TERM LEASE SIGNED AT TIME OF EMERGENCY ASSISTANCE) Attachment 4 Page I of 2 • CLEARANCE BEFORE ANY MONEY DISBURSED; LBP COMPLIANCE: NOTIFICATION, EVALUATION, REDUCTION THROUGH CLEARANCE REQUIRED BEFORE OCCUPANCY OF UNIT • MAY BE CONSIDERED TENANT BASED RENTAL ASSISTANCE (TBRA); THUS HQS INSPECTION AND SUBPART M MAY APPLY • SEE SUBPARTS K AND M • PENDING HUD GUIDANCE 7. TB RA < 100 DAYS • EXEMPT TITLE X 8. TBRA > 100 DAYS OF HOME ASSISTANCE (SUCH AS WHEN TENANT ENTERS INTO LONG TERM LEASE • SEE SUBPART M • CLEARANCE BEFORE ANY MONEY DISBURSED; LBP COMPLIANCE: NOTIFICATION, EVALUATION, REDUCTION THROUGH CLEARANCE REQUIRED BEFORE OCCUPANCY OF UNIT • HQS INSPECTION REQUIRED BEFORE OCCUPANCY • CLEARANCE BEFORE ANY MONEY DISBURSED 9. TBRA < 100 DAYS - TENANT ENTERS INTO LONG TERM LEASE, CITY GIVES LESS THAN 100 DAYS OF ASSISTANCE. EXEMPT TITLE X Attachment 4 Page 2 of 2 Attachment 5 Page 1 of 1 PTI O O y n D ffQ d .r ara 0 0 C c� O Cr Y � �. C. un a. 0 0 I o U, c N fD O C. ^� o o c n z„ o � i a. pox d� � o 0 i �. rA CL cr A.' o � o n< a Attachment 5 Page 1 of 1 PTI O O y n D ffQ d .r ara 0 0 C c� O Cr ACORQ4 CERTIFICATE OF LIABILITY INSURANCE 1 0DATE (MWDONYYY) 4/19/2010 PRODUCER 310.393.9477 FAX 310.393.7186 White Sutton & Company Insurance Services P 0 Box 70 Santa Monica, CA 90406 -0070 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 NAIC # INSURED Women's Transitional Living Center PO Box 6103 Orange, CA 92863 INSURERA: Philadelphia Ins Co POLI Y EFFECTIVE INSURER B: LIMITS INSURER C: PJSURER D: PHPK547344 INSURER E: 04/04/2011 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN$R JJJL D' TYPE OF INSURANCE POLICY NUMBER POLI Y EFFECTIVE P r ATI LIMITS GENERALUABILrrY PHPK547344 04/04/2010 04/04/2011 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 CLAIMS MADE I OCCUR MED EXP (Any one person) $ 15,000 A PERSONAL d ADV INJURY $ 1.0001000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIAR APPLIES PER: PRODUCTS • COMNOP AGG $ 11000,000 POLK:Y jE a LOG AUTOMOBILE LIABILITY ANYAUTO PHPK547344 04/04/2010 04/04/2011 COMBINED SINGLE LIMIT (Eaauldenl) $ 1,000,000 BODILY INJURY (Per person) $ A ALL OWNED AUTOS X SCHEDULED AUTOS X HIREDAUTOS X NON -OWNED AUTOS App VED AS LISA �+ Si Cilty poll% -- ' CK v �C../ 0rile7 BODILY INJURY (Peraccldont) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY } 1( AUTO ONLY • EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGO $ ANY AUTO 7 $ EXCESSfUMBRELLA LIABILITY PHUB302335 04/04/2010 04/04/2011 EACH OCCURRENCE $ 5,000,000 X OCCUR FI CLAIIAS MADE AGGREGATE $ 5,000,000 $ A $ DEDUCTIBLE X RETENTION $ 10,00 $ WORKERS COMPENSATION AND VC STATU I1, O R DRY Tj EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEWEXECUTIVE OFFICEWMEMBER EXCLUDED? E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ Y Yes, describe under SPECIAL PROVISIONS below E.L. DISEASE •POLICY LIMIT $ OTHER itylof SantaAAnagILitsDO $Mcers,Eagents, employees, and$voAlunteers$are additional insureds as per form G 20 26 07 04 and Primary Insurance as per form CG00 01 1207, both attached to the general liability policy and accompanying this certificate. *Except for 10 days written notice of cancellation for non - payment of premium. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Santa Ana - CDBG M -25 EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL ESG 30" DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn : Frank Hernandez BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY P.O. Box 1988 M -25 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE Ellie Liu CISR ELI ACORD 25 (2001!08) FAX: 714.647.6549 OACORD CORPORATION 1988 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. AGUHU 25 (2007!05) (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written no- tice of the claim or "suit" as soon as practica- ble. c. You and any other Involved insured must: (1) Immediately send us copies of any de- mands, notices, summonses or legal pa- pers received in connection with the claim or "suit' (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, in the en- forcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or Incur any expense, other than for first aid, without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an Insured; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are In excess of the ap- plicable limit of Insurance. An agreed settlement means a settlement and release of liability signed by us, the Insured and the claimant or the claim- ant's legal representative. CG 00 0112 07 4. Other Insurance if other valid and collectible insurance is available to the insured for a loss we cover under Cover- ages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when Para- graph b. below applies. if this insurance Is pri- mary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insur- ance by the method described in Paragraph c. below. b. Excess Insurance (1) This Insurance is excess over: (a) Any of the other Insurance, whether primary, excess, contingent or on any other basis: (1) That Is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work'; (11) That is Fire insurance for premises rented to you or temporarily occu- pied by you with permission of the owner; (ill) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occu- pied by you with permission of the owner; or (iv) if the loss arises out of the mainte- nance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section i -- Coverage A -- Bodily Injury And Properly Dam- age Liability. AS To vovo (2) R�pgOV D �•. ---'' r �5�a a � �►tY �'�tur (b) Any other primary insurance available to you covering liability for damages aris- ing out of the premises or operations, or the products and completed operations, for which you have been added as an additional insured by attachment of an endorsement. When this insurance Is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit ". If no other insurer de- fends, we will undertake to do so, but we will be entitled to the Insured's rights against all those other insurers. © ISO Properties, Inc., 2006 Untitled (2).max Page 11 of 16 ❑ (3) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other Insurance would pay for the loss In the absence of this Insurance; and (b) The total of all deductible and self - insured amounts under all that other In- surance. (4) We will share the remaining loss, if any, with any other insurance that is not de- scribed in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer con- tributes equal amounts until it has paid its ap- plicable limit of Insurance or none of the loss remains, whichever comes first. If any of the other Insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of Insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Cover- age Part In accordance with our rules and rates. b. Premium shown in this Coverage Part as ad- vance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computa- tion, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accu- rate and complete; c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned In this Coverage Part to the first Named Insured, this in- surance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The in- sured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expi- ration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS "Advertisement" means a notice that is broadcast or published to the general public or specific mar- ket segments about your goods, products or ser- vices for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding web - sites, only that part of a web - site that is about your goods, products or ser- vices for the purposes of attracting customers or supporters Is considered an advertisement. 2. "Auto" means: a. A land motor vehicle, trailer or semitrailer de- signed for travel on public roads, including any attached machinery or equipment; or b. Any other land vehicle that is subject to a com- pulsory or financial responsibility law or other motor vehicle insurance law In the state where It is licensed or principally garaged. However, "auto" does not include "mobile equip- ment". b. Those statements are based upon representa- S Tt-) FORM tions you made to us; and L Attorney .star't pity Page 12 of 16 ©ISO Propert les, ItTr; , 2006 Untitled (2).max CG 00 01 12 07 ❑