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HomeMy WebLinkAboutCHILDREN'S BUREAU 1On the Job Training Pre Award Survey,,-,,,,,,_.,, BUSINESS NAME: Children's Bureau STATE TAX I.D. # 26110753 ADDRESS: INSURANCE ON FILL to 4"dOR?C N1AY PROCEED 1901 W 4 St., Suite 310 FEDERAL TAX I.D. # 951690975 UNTIL. INSUP,NCE EXPIRE`s // _ ,2z_/p Santa Ana, CA 92705 DATE: L ` he business does provide worker's compensation coverage. v; C%),A Policy Number: RI00010666 Koh ^a 2. The business does provide General Liability Insurance in the amount of PhGm One Million Dollars ($1,000,000). Policy must identify the City of Santa Ana as the certificate holder. 3. The system used for business accounting does document cash received, state and federal tax withholdings, FICA deductions. 4. The business has not been cited for any health, safety, wage and hour, or child labor violations during the past 12 months. 5. The business maintains a grievance and/or complaint handling procedures for employees. 6. The prospective OJT client is not a former employee of the business. 7. Wages for the planned OJT position are wages comparable to similar positions. 8. A written job description for this position is on file. 9. Union concurrence has been obtained. 10. Business license is current. l 11. The business has not had any employees laid off in the past 6 months. 12. The business is financially stable and has the means to train and pay for the prospective OJT employee. X ? X ? X X X ? X ? X ? X ? N/A ? X ? X X The employer stipulates and agrees by signing below that the establishment in which on-the-job training will be given: (1) Has not been moved from any previous location less than 120 days prior to the effective date of the OJT contract. (2) Is not a branch, affiliate or subsidiary of a business entity in another location which has, at any time subsequent to the date of the OJT contract, relocated or expanded so as to cause an increase in unemployment or the closing down of operations in which the entity conducts business operations. TOTAL WORKFORCE # 346 Employer TitlV ' Date Z-t0 CONTRACT AWARDED YES X NO ? /%U N-2010-090 12/09 Agreement No. ON-THE-JOB TRAINING AGREEMENT UNDER THE WORKFORCE INVESTMENT ACT THIS AGREEMENT is made and entered into this 16 day of August , 2010 between the City of Santa Ana, a charter city and municipal corporation duly organized and existing under the Constitution and laws of the State of California (hereinafter "CITY") and Children's Bureau (hereinafter "EMPLOYER"). WITNESSETH Recitals: A. CITY has been designated a Local Workforce Investment Area ("LWIA") pursuant to Section 116 of the Workforce Investment Act ("WIA" ), P.L. 105-220, 29 USC Section 2801, to receive federal funds to promote effective delivery of job training services to local area residents. B. The State of California has created the California Workforce Investment Board pursuant to Section 111 of the Workforce Investment Act, P.L. 105-220, 29 USC 2821 to administer the WIA programs operated by the State of California. C. As a LWIA, CITY is entitled to receive federal funds to establish programs to prepare eligible unskilled youth, adults and dislocated workers for entry into the labor market, and to provide job training to those individuals who face serious barriers in obtaining productive employment ("said Program"). D. EMPLOYER is able and willing to train eligible unskilled applicants for entry into the labor market and is willing to operate said program pursuant to the WIA and applicable federal, state and local laws. WHEREFORE, for and in consideration of the respective and mutual covenants and promises hereinafter contained and made, and subject to all the terms and conditions hereof, the parties hereto do hereby agree as follows: 1. Term. The effective term of this Agreement is for the period beginning August 16, 2010, and ending February 16, 2011 . The term of this Agreement may be extended upon agreement of all parties and execution of an amendment of the term. 2. Scope of Work. The EMPLOYER shall employ and train one employee (hereinafter "Trainee") in the occupation and in accordance with the OJT Training Outline set forth in Exhibit A, attached hereto and incorporated herein by this reference. Said Trainee shall be referred by the City of Santa Ana W/O/R/K Center. Training must significantly raise the Trainee from his/her prior position in both level of skill and salary by the end of the training period. 3. Funding. CITY shall reimburse the EMPLOYER an amount not to exceed $ 8,502.00 in accordance with the Cost Computation included in Exhibit 12/09 A. EMPLOYER shall bill the CITY monthly on an invoice provided by CITY for actual and reasonable cost for providing the services described in this Agreement. Reimbursement of EMPLOYER under this Agreement shall be limited to the costs incurred during the basic work week, excluding overtime and any paid holidays or sick leave. 4. Subcontracting Prohibited. The EMPLOYER shall not subcontract or assign the OJT Training. Any attempt by the EMPLOYER to delegate or assign OJT training duties under this Agreement shall void, and permit CITY to immediately terminate, this Agreement. 5. Employer Obligations. During the training, the EMPLOYER shall ensure that the Trainee: a. is on the EMPLOYER's payroll, not paid as a contracted employee/independent contractor; and, b. receives the same benefits as EMPLOYER's other employees performing similar work; and, c. is paid the salary as indicated in Exhibit A with appropriate payroll taxes withheld and reported; and, d. is provided Worker's Compensation Insurance coverage, pursuant to state law; and, e. is provided by EMPLOYER with safety instructions and equipment necessary for reasonable protection against injury and damage. CONTRACTOR shall maintain appropriate standards for health and safety in work and training situations. Where special clothing or equipment is provided to the EMPLOYER's regular employees, EMPLOYER shall provide the same type of clothing or equipment to the Trainee performing similar work. 6. Employment of Trainee. The EMPLOYER shall employ the Trainee as a regular member of EMPLOYER's work force. If EMPLOYER wants to continue to employ the Trainee upon the successful completion of the training period under this Agreement, said employment shall be subject to the same conditions of employment applied to EMPLOYER's other regular employees, including termination for unsatisfactory performance. 7. Patent, Copyrights and Rights in Data. The EMPLOYER will disclose to the CITY any invention, written product, computer program developed or data assembled as a result of performance of work under this Agreement within seventy four (74) days of invention, development or assembly. The CITY, State of California, and U.S. Department of Labor will have the right to patent any invention and copyright any written product or computer program or data generated by EMPLOYER. Upon written request, EMPLOYER will transfer all pertinent information, specifications and right, title and interest to the designated agency. 8. INVENTIONS, PATENTS AND COPYRIGHTS. A. Reporting Procedure. If any project produces patentable items, patent rights, processes, or inventions in the course of work under a U.S. Department of Labor (DOL) grant or agreement, the CONTRACTOR shall report the fact promptly and fully to the CITY. The CITY shall report the fact to the Grant Officer, at the DOL. Unless there is a prior agreement between the CITY and the DOL and its representative on these matters, the DOL shall determine whether to seek protection on the invention or discovery. The DOL and its 2 12/09 representative shall determine how the rights in the invention or discovery, including rights under any patent issued thereon, will be allocated and administered in order to protect the public interest consistent with the "Governmental Patent Policy" (President's Memorandum for Heads of Executive Departments and Agencies, August 23, 1971, and Statement of Government Patent Policy). B. Copyright Policy. 1. Unless otherwise provided in the terms of the grant or agreement, when copyright-able material is developed in the course of or under a DOL Grant or agreement, the author and the CITY which developed the work is free to copyright material or to permit others to do so. The EMPLOYER and the Workforce Investment Board (WIB) shall have a royalty- free, nonexclusive and irrevocable license to reproduce, publish, use and to authorize others to use all copyrighted material. 2. The DOL reserves a royalty-free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use, for Federal Government purposes: (a) The copyright in any work developed under any grant, sub-grant, or contract under a grant or subgrant; (b) Any right of copyright to which a grantee, subgrantee or a EMPLOYER purchases ownership with grant support; and (c) EMPLOYER shall comply with the requirements of 29 CFR Part 97.34. C. Rights to Data. The DOL and the CITY shall have unlimited rights to any data first procured or delivered under this Agreement. 9. Hold Harmless. The EMPLOYER shall indemnify, defend and hold harmless CITY, and its officers, agents and employees, from and against any and all damages to property or injuries to or death of any person or persons, including property and employees or agents of CITY, and shall indemnify, defend and hold harmless CITY, and its officers, agents and employees, from any and all claims, demands, suits, actions or proceedings of any kind or nature, including, but not limited to, workers' compensation claims, resulting from or arising out of the negligent acts, errors or omissions of EMPLOYER, its employees, agents or subcontractors. 10. Insurance. The EMPLOYER shall obtain at its sole cost and file with the City of Santa Ana - Santa Ana W/O/R/K Center, upon execution of this Agreement, and maintain for the period covered by this Agreement, a policy or policies of commercial general liability insurance or a certificate of such insurance, satisfactory to the City Attorney of CITY, naming CITY, and its officers, agents and employees, as insured or additional insured (see attached Additional Insured Endorsement, Exhibit C), which provides coverage not less than that provided in the form of a comprehensive general liability insurance policy against liability for any and all claims and suits for damages or injuries to persons or property resulting from or arising out of operations of EMPLOYER, and its officers, agents, or employees. Said policy or policies of insurance shall provide coverage for both bodily injury and property damage in no less than One Million Dollars ($1,000,000). Said policy or policies shall also contain a provision that no termination, cancellation or change of coverage or of insured or additional insured shall be effective until after thirty (30) days notice thereof has been given in writing to CITY. EMPLOYER shall give to CITY prompt and timely notice of claims made or suit instituted against said policy. EMPLOYER shall procure and maintain at its own costs and expense, any additional kinds and amounts of insurance which, in its own judgment, may be necessary for its proper protection. 11. Record Keeping. CITY, the State of California and the United States government and/or their 3 12/09 representatives shall have access for purposes of monitoring, auditing and examining of EMPLOYER'S activities, performance, books, documents, papers, and records of EMPLOYER'S subcontractors, bookkeepers and accountants, and employees and participants related to this Agreement. Such agencies or representatives shall also schedule on-site monitoring in their discretion. Monitoring activities may also include, but are not limited to, questioning employees and participants and entering any premises or onto any site in which any of the services or activities funded hereunder are conducted or in which any of the records of EMPLOYER are kept. Nothing herein shall be construed to require access to any privileged or confidential information as set forth in federal or state law. In the event EMPLOYER does not make the above-referenced documents available within the City of Santa Ana, California, EMPLOYER agrees to pay all necessary and reasonable expenses incurred by CITY in conducting any audit at the location where said records and books of account are maintained. All accounting records and evidence pertaining to all costs of EMPLOYER and all documents related to this Agreement shall be kept available at the location where EMPLOYER conducted the program, as well as in the County of Orange, for the duration of this Agreement and thereafter for three (3) years after completion of an audit. Records which relate to (a) complaints, claims, administrative proceedings or litigation arising out of the performance of this Agreement, or (b) costs and expenses of this Agreement to which CITY, the State of California or the United States Government take exception, shall be retained beyond the three (3) years until resolution of disposition of such appeals, litigation, claims, or exceptions. 12. Government Funding. This Agreement is valid and enforceable only if sufficient funds are made available to the State by the United States Government for the same Fiscal Year as for this Program. In addition, this Agreement is subject to any additional restrictions, limitations, or conditions enacted by Congress or any statute enacted by Congress which may affect the provision, terms or funding of this Agreement in any manner. 13. Payment Cap. Based on the size of Employer, CITY's OJT payments to EMPLOYER shall not exceed a maximum of fifty percent (50%) of the wages paid by EMPLOYER during the training period specified in Exhibit A. 14. Amendment of Agreement. No alteration or variation of the terms of this Agreement shall be valid and/or binding unless made in writing and signed by both parties. There are no oral understandings or agreements between the parties. 15. Breach/Sanctions. If, through any cause, EMPLOYER violates any of the terms and conditions of this Agreement, or if EMPLOYER reports inaccurately or if any Audit Report makes disallowances, EMPLOYER shall promptly remedy its acts or omissions and/or repay CITY all amounts due CITY as a result of EMPLOYER's violation. For any such failures or violations, CITY shall also have the right at its sole discretion to either: (1) discontinue program support until such time as EMPLOYER fulfills its obligations or remedies all violations of this agreement or prior agreements; and/or (2) collect outstanding amounts as determined by CITY due CITY by offsetting or debiting from current claims or invoices, if after thirty (30) days' written notice EMPLOYER has failed to repay same or a repayment schedule has not been made; and/or (3) terminate this Agreement by giving written notice to EMPLOYER of such termination in accordance the notice provision in Paragraph XVIII herein below. 4 12/09 16. Termination. Either party may terminate this Agreement upon thirty (30) days prior written notice to the other party. However, the CITY may immediately terminate this Agreement at such time as funds are not made available to CITY through the United States Department of Labor or the State of California Employment Development Department for the purpose of carrying out this Agreement. 17. Independent Contractor. The EMPLOYER, and any agents and employees of the EMPLOYER, in the performance of this Agreement, shall act in an independent capacity as independent contractors and not as officers, employees, or agents of the CITY. This Agreement is not intended nor shall it be construed to create an employer-employee relationship between EMPLOYER and CITY, nor a joint venture relationship. The EMPLOYER shall not subcontract in the name of the CITY. 18. Equal Employment Opportunities. The EMPLOYER warrants that it will comply with Title VI of the Civil Rights Act of 1964, and the requirements relating to equal employment opportunities set forth in Executive Order No. 11246, as amended by E.O. 11375 and supplemented by the requirements of 41 CFR Part 60. EMPLOYER will also comply with all applicable federal and state laws and regulations, and particularly those assurances and certifications set forth in Exhibit B attached hereto and by this reference incorporated herein. 19. Prohibitions. The EMPLOYER shall not use any of the training funds provided under this Agreement for political or sectarian activities. 20. Grievance Procedure. The EMPLOYER shall continue to operate, or shall establish and maintain a grievance or complaint handling procedure relevant to the terms and conditions of employment and the EMPLOYER's activities and programs, which shall meet at a minimum the requirements set forth in Section 101(31) of the Act and 663.700-710 and regulations promulgated by the State or Federal Government. Employers that do not have a grievance or complaint handling procedure shall use the procedures prescribed by the CITY. 21. Guidelines. The CITY shall make the WIA applicable federal regulations and policy guidelines available to EMPLOYER at CITY - W/O/R/K Center, 1000 E. Santa Ana Blvd., Suite 200, Santa Ana, California 92701. The CITY shall also inform the EMPLOYER of changes in the WIA regulations or policy guidelines if such changes affect the operation of this Agreement. EMPLOYER shall comply with applicable terms from The American Recovery and Reinvestment Act of 2009 (the "Recovery Act") as set forth in Exhibit F attached hereto and incorporated herein by this reference. 22. Drug Free Workplace. The EMPLOYER agrees to provide a drug-free work place and to execute a certification as set forth in Exhibit D attached hereto and incorporated herein by this reference. 23. Notices. All notices, reports and correspondence between the parties hereto respecting this Agreement shall be in writing and deposited in the United States mail, postage prepaid, addressed as follows: CITY: City of Santa Ana - Santa Ana W/O/R/K Center 1000 E. Santa Ana Blvd., Suite 200 Santa Ana, CA 92701 Attention: WORK Center Director 5 12/09 EMPLOYER: Children's Bureau 1901 W 4t St., Suite 310 Santa Ana. CA 92705 Donna White or Deanna Echevarria 24. Debarment. To protect the public interest and ensure the integrity of Federal programs, CITY may only conduct business with responsible persons and may not make any award or permit any award to any party which is debarred or suspended or is otherwise excluded from or ineligible for participation in Federal assistance programs under Executive Order 12549, "Debarment and Suspension". See also 29 CRF Parts 97.35 and 98.510. EMPLOYER must review and sign Exhibit E "Debarment", which is attached hereto and incorporated herein by this reference. 24. Merger. This Agreement, together with the attachments hereto, expresses the total understanding of the parties. There are no oral understandings of the parties or terms and conditions other than as stated herein. 25. Validity. The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any other provision of this Agreement. 26. Miscellaneous Provisions. a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify CITY fully, including reasonable costs and attorney's fees, for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. 6 12/09 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: Maria D. Huizar Clerk of the Council CITY OF SANTA ANA David N. Ream City Manager APPROVED AS TO FORM: Joseph W. Fletcher City Attorney By: Lisa Storck Assistant City Attorney RECOMMENDED FOR APPROVAL: 6maal Cynthia J. Nels n, Deputy City Manager for Development Services EMPLOYER: aw&. Aza&- Name: Deanna Echevarna Title: Program Supervisor Tax ID#/SS#: 951690975 7 Agreement # Exhibit A TRAINING PLAN 1. GENERAL 1. Name of OJT Employer: Children's Bureau 2. Address of OJT Work-site: 1901 E 4th St. Suite 310 Santa Ana CA 92705 3. Phone Number: (714) 252-3190x202 4. Training Supervisor: Deanna Echevarria 5. Name of OJT Trainee: Alma Sarinana 6. JTA Case Number of Trainee: 1012129 7. Enrollment Component Number of Trainee: 105 (ARRA - Dislocated Worker) 8. Proportion of trainees/employees: (at time Agreement entered into) a. Total number of employer's regular employees 346 b. Number of trainees (this Agreement) 1 C. Cumulative number of trainees currently in OJT 1 II. OCCUPATION AND ON-THE-JOB TRAINING OUTLINE: 1. Vendor #: 2. Occupation/Product or Service: Child, Family, and School Social Workers 3. Length of Time in Business: 12 years 4. ONET Code: 21-1021.00 SVP Level (7.0 < 8.0) 5. Hourly Starting Wage: $16.35 Start Date: 8/16/2010 End Date: 2/16/2011 Hours 1040 or Days or Weeks 6. State and Federal Tax I.D.: State 21610753 Federal 951690975 7. Basic Work Week Hours: 40 Outline of On-the-Job Training Plan and Method of Assessment: ELEMENTS OF TRAINING HOURS OF TRAINING 1. Under supervision - Learn the different programs and community 300 services available to assist families in crisis situations, such as immediate need for shelter and other basic needs. Learn to complete the Keys to Interactive Parenting Scale on-line certification and assess parent-child interaction in 6 families. Measurement Method: Q & A, task observation and inspection. Goal is to achieve rate of proficiency within first Month and a half of training. 2. Under supervision - Learn to complete Target Case Management in a timely fashion. Conduct and document in-home child development and 300 parent-child interaction assessments. Develop a Written Individualized Service Plan. Provide consultation and referral including follow-up within 30 days. Measurement Method: Q & A, task observation and inspection. Goal is to achieve rate of proficiency within subsequent three and a half months. 3. Under supervision - Learn 12 lessons in Partners in Parenting Education curriculum and use at least 6 lessons in home visits with 300 clients or the office. Become proficient using tablets in home visits to electronically enter home visit information. Maintain case files and notes, including activity sheets, statistics, court reports/letters and other required materials in compliance with Children's Bureau guidelines. Measurement Method: Q & A task observation and inspection. Goal is to achieve rate of proficiency within subsequent three and a half months. 4. Under supervision - Learn to identify the signs and symptoms 140 suggesting child abuse or neglect. Learn to advocate for clients on different social service and/or health care systems that clients interact with. Assist Program Supervisor with developing and implementing community outreach programs. Measurement Method: Q & A task observation and inspection. Goal is to achieve rate of proficiency within subsequent three and a half months. RATING LEVELS: Measurement method: how will it be determined if OJT participant acquired the skill? Q&A, observation, product review/inspection, etc. PROFICIENT MODERATE MARGINAL II. COST COMPUTATION Example: Hourly Reimbursement $ 8.18 Hours 1040 cost Per Trainee _ $ 8,502.00 III. Person(s) authorized to sign payment invoices for EMPLOYER: Deanna Echevarria ?WrA 6 0, k L? I,4z Print Name Signature Title Date Print Name Signature Title Date EXHIBIT B ASSURANCES A. The EMPLOYER assures that: 1. It will comply with the requirements of the Workforce Investment Act (WIA), the California Unemployment Insurance Code, as amended, and the regulations and policies promulgated thereunder. 2. No OJT participant displaces a regular employee nor shall an OJT participant fill a position of a person who has been laid off from the same or similar position. 3. No current employees are receiving unemployment insurance benefits as a result of layoffs or work reductions. 4. No person in the United States shall on the grounds of race, color, sex, religion, national origin, age, disability, sexual orientation, or marital status be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the applicant receives federal financial assistance and will immediately take any measure necessary to effectuate this Agreement. 5. It will comply with provisions of the Hatch Act, if applicable, which limits the political activities of employees. 6. Individuals receiving training on the job shall be compensated by the EMPLOYER at such rate, including periodic increases, as may be deemed reasonable under regulations prescribed by the Secretary of Labor, but in no event at a rate less than that specified in Section 6 (a) (1) of the Fair Labor Standards Act of 1938 or, if higher, under the applicable State or local minimum wage law. 7. Services and activities provided under this Agreement will be administered by or under the supervision of the EMPLOYER. 8. No relative by blood, adoption or marriage' of the EMPLOYER may be trained under this Agreement. 9. Appropriate standards for health and safety in work and training situations will be maintained. 10. Conditions of employment or training are appropriate and reasonable with regard to the type of work, the geographical region, and the proficiency of the trainee. 11. Training will not be for any occupation which requires less than six weeks of training according to the Specific Vocational Preparation Table (SVP Code). 12. Training will, to the maximum extent practicable, be consistent with every individual's fullest capabilities and lead to employment possibilities. 13. The program will, to the maximum extent feasible, contribute to the occupational development or upward mobility of individual participants. 14. Training will be in accordance with the training plan, which plan incorporates documentation that must be completed by EMPLOYER before end of contract. 15. EMPLOYER must use the *Dot and **SVP code books to determine length of OJT period. The training time may not be longer than the SVP Code allows; however, contractors are encouraged to negotiate shorter training periods whenever applicable. 16. OJT trainees shall not number more than 40% of the EMPLOYERS work force. 17. All EMPLOYER training payments (reimbursements) must be exclusive of any and all EMPLOYER fringe benefits, paid holidays, paid sick days and overtime compensation. 18. The participating EMPLOYER must keep an accurate and up-to-date time sheet for the OJT trainee. 19. Payroll records, time and attendance records and job duties retained on file by the participating EMPLOYER for each OJT trainee are subject to review. Service Provider Signature 8/12/2010 Date Deanna Print First Name Children's Bureau Organization Name Echevarria Print Last Name 1901 E 4t" St. Suite 310, Santa Ana, CA 92705 Organization Address To whom it may concern, C ?'1+ ELAUis presently conducting a OJT Training Program for the City of Santa Ana and has provided a copy of a current certificate of insurance. I -DMVIa, Okk(. ersonally certify to call & notify the City of Santa Ana regarding any changes or cancellation immediately of policy# ??Gv01 CxOGoCo. If there are any questions please contact my office at Cc4a7" {-O2c? Insurance Agent Name W 10Mn Ha JCE4!0?JRW CERTIFICATE OF LIABILITY INSURANCE OP ID PC DATE(MM/DD/YYYY) F CHILD-1 07/27/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Chapman ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License #0522024 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. 0. Box 5455 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Pasadena CA 91117-0455 Phone: 626-405-8031 Fax : 626-405-0585 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Riverport Insurance Company 36684 Child ' INSURERB: Fidelity 6 Deposit Co Maryland 39306 ren s Bureau of Southern California INSURER C: 1910 Magnolia Avenue INSURER D Los Angeles CA 90007 : INSURER E: (;L)Vr_KAUtb 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MWDDlYYYY DATE MM/DD/YYYY LIMBS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X X COMMERCIAL GENERAL LIABILITY _ RI00010666 11/27/09 11/27/10 PREMISES(Eaoccurence) $ 100000 CLAIMS MADE Fx 1OCCUR MED EXP (Any one person) $ 5000 PERSONAL & ADV INJURY $ 1000000 X Professional GENERAL AGGREGATE $ 3000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 3000000 POLICY PRO- JECT LOC Ben. 1000000. AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 A X ANY AUTO RI00010666 11/27/09 11/27/10 (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS voo NON-OWNED AUTOS ?!. TO (Per accident) $ Y PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY - CjA ?• rney AttO AUTO ONLY - EA ACCIDENT $ ANY AUTO t C n ty EA ACC $ gIsta ?j OTHER THAN f AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 5000000 A X OCCUR 1:1 CLAIMSMADE REL0010667 11/27/09 11/27/10 AGGREGATE $ 5000000 H DEDUCTIBLE $ X RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVEM OFFICERIMEMBER EXCLUDED' E.L. EACH ACCIDENT $ u (Mandatory in NH) describe under es E.L. DISEASE - EA EMPLOYEE $ D EC, SP IAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ OTHER B Crime CCP0062476 08/01/09 08/01/10 Empl Dish 500000 Forgery 500000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Re: Children's Bureau Programs, 1901 E. 4th St., Suite 310, Santa Ana, CA 92705. City of Santa Ana and its officers, agents and employees are named additional insured with respect to the operations of the named insured. Such insurance is primary and non-contributory. 10 days notice of cancellation for non-payment of premium. t;trs 1 IricA I t nuL_utti CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITYSAT DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 ACORD 25 (2009/01) NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO $O SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ©1 PORATION. All riahts The ACORD name and logo are registered marks of ACORD 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 This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 RIVERPORT INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY BROADENING ENDORSEMENT This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Throughout this endorsement, the words "you" and "your" refer to the Named Insured shown in the Declarations. The word "we," "us," and "our' refer to the company providing this insurance. The following is only a summary of the additional coverages provided by this endorsement and is provided only for your reference and convenience. For the Limits of Insurance and the additional coverages provided by this endorsement, read the provisions on the following pages and the Coverage Form, which this endorsement modifies. SUBJECTS OF INSURANCE Broadened Bodily Injury Broadened Personal and Advertising Injury Broadened Property Damage Broadened Fire, Lightning, Explosion, and Sprinkler Leakage - $500,000 Broadened Medical Payments - $10,000 Broadened Supplementary Benefits a. Bail Bonds - $1,000 b. Expenses Incurred to Assist in Defense - $500 per Day Broadened Newly Acquired or Formed Organization Broadened Non-Owned or Chartered Watercraft or Aircraft Broadened Commercial General Liability Conditions a. Duties in the Event of Occurrence, Offense, Claim, or Suit b. Liberalization - Automatic Coverage If We Adopt Broader Coverao 01VN- ' c. Notice to Company 10 T Automatic Coverage for "Special Events" Automatic Additional Insureds a. Athletic Activity Participants 5-?0 R er 6 b. Contractual Obligations ASP E' `ty P? c. Funding Sources -\5tar? C 4- d. Manager or Lessor of Premises Pss e. Owner, Manager, Operator, or Lessor of "Special Event" Premises f. Supervisors or Higher in Rank - Co-Employee Exclusion Removed g. Limitations Blanket Waiver of Subrogation Priority of Application for Multiple Insureds The coverages listed in this endorsement are provided as extensions or additions to your insurance program. RPCG 74 12 08 05 Page 1 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. RIVERPORT INSURANCE COMPANY 1. BROADENED BODILY INJURY SECTION V - DEFINITIONS Item 3. is replaced with: 3. "Bodily injury" means physical injury, sickness, or disease sustained by a person, including death resulting from any of these. "Bodily injury" also means mental injury, mental anguish, humiliation, or shock sustained by a person, if directly resulting from physical injury, sickness, or disease sustained by that person. 2. BROADENED PERSONAL AND ADVERTISING INJURY SECTION V - DEFINITIONS Item 14. is replaced with: 14. "Personal and Advertising Injury" means injury, including consequential "bodily injury" arising out of one or more of the following offenses during the policy period. a. False arrest, detention, or imprisonment; b. Malicious prosecution or abuse of process; C. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling, or premises that a person occupies by or on behalf of its owner, landlord, or lessor; d. Oral, written, televised, videotaped, or electronic publication of material that slanders or libels a person or organization or disparages a person's or organization's goods, products, or services; e. Oral, written, televised, videotaped or electronic publication of material that violates a person's right of privacy; or f. Misappropriation of advertising ideas or style of doing business; or g. Infringement of copyright, title, or slogan. h. Mental injury, mental anguish, humiliation, or shock, if directly resulting from Items 14.a. through 14.g. above. SECTION I - COVERAGES COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 2. Exclusions, Paragraphs b. and c. are replaced with: (b) Material Published with Knowledge of Falsity "Personal and advertising injury" arising out of oral, written, televised, videotaped, or electronic publication of material, if done by or at the direction of the insured with knowledge of its falsity; (c) Material Published Prior to Policy Period "Personal and advertising injury" arising out of oral, written, televised, videotaped, or electronic publication of material whose first publication took place before the beginning of the policy period; 3. BROADENED PROPERTY DAMAGE SECTION I - COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2. Exclusions, Paragraph a. is replaced with: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. 4. BROADENED FIRE, LIGHTING, EXPLOSION AND SPRINKLER LEAKAGE A. SECTION III - LIMITS OF INSURANCE Paragraph 6. is replaced with: 6. Subject to 5. above, the Damage to Premises Rented to You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premises while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner; and b. Personal property of others in your care, custody, or control, while at premises rented to you or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner, arising out of any one fire, lightning, explosion or sprinkler leakage occurrence. The Damage to Premises Rented to You Limit is the greater of: C. $500,000; or d. The amount shown in the Declarations for Damage to Premises Rented to You Limit. B. SECTION I - COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2. Exclusions, Paragraphs c. through n., do not apply to damage by fire, lightning, explosion, or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in LIMITS OF INSURANCE (SECTION III). C. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS 4. Other Insurance, Item b. (1) (b) is replaced with: (b) That is Fire, Lightning, Explosion, or Sprinkler Leakage insurance for premises RPCG 74 12 08 05 Page 2 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. RIVERPORT INSURANCE COMPANY rented to you or temporarily occupied by you with permission of the owner; or D. SECTION V - DEFINITIONS Item 9.a. is replaced with: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; E. This Broadened Coverage is subject to all the terms of SECTION III - LIMITS OF INSURANCE. F. This Broadened Coverage does not apply if Fire Damage Liability of COVERAGE A (SECTION 1) is excluded either by the Declaration to this Coverage Part or by an endorsement to this Coverage Part. 5. BROADENED MEDICAL PAYMENTS A. SECTION III - LIMITS OF INSURANCE The following provision is added to Paragraph 7: The Medical Expense Limit shall be the greater of: a. $10,000; or b. The amount shown in the Declarations for Medical Expense Limit. B. This Medical Expense Limit is subject to all the terms of SECTION III - LIMITS OF INSURANCE. C. This above Medical Expense Limit does not apply if COVERAGE C MEDICAL PAYMENTS is excluded either by the Declaration to this Coverage Part or by an endorsement to this Coverage Part. 6. BROADENED SUPPLEMENTARY PAYMENTS SECTION I - COVERAGES SUPPLEMENTARY PAYMENTS - COVERAGES A AND B Paragraphs 1.b. and 1.d. are replaced with: b. Up to $1,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit," including actual loss of earnings up to $500 a day because of time off from work. 7. BROADENED NEWLY ACQUIRED OR FORMED ORGANIZATION SECTION II - WHO IS AN INSURED Item 3.a is replaced by the following: 3. a. Coverage under this provision is afforded only until the 120th day after you acquire or form the organization or the end of the policy period, whichever is earlier. BROADENED NON-OWNED OR CHARTERED WATERCRAFT OR AIRCRAFT SECTION I - COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY Paragraph 2.g. is replaced by the following: 2. g. "Bodily injury" or "property damage" arising out of the ownership, maintenance, use, or entrustment to others of any aircraft," auto," or watercraft owned by or operated by, or rented or loaned to, any insured. Use includes operation and "loading or unloading," This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons or property for a charge; (3) Parking an "auto" on, or on the ways next to premises you own or rent, provided the "auto" is not owned by or rented, or loaned to you or the insured; (4) Liability assumed under any "insured contract" for the ownership, maintenance, or use of aircraft, watercraft, or "autos"; or (5) "Bodily injury" or "property damage" arising out of the operation of any of the equipment listed in Paragraph f. (2) or f. (3) of SECTION V - DEFINITIONS, Paragraph 12., "Mobile Equipment"; or (6) An aircraft you do not own that is: (a) Hired, chartered, or loaned with a crew; and (b) Not owned in whole or in part by any insured. (7) This insurance does not apply, under Paragraph g.(1) and g.(2) above, if the insured has any other insurance for "bodily injury" or "property damage" which would also apply to loss covered under this provision, whether the other insurance is primary, excess, contingent, or on any other basis. (8) This insurance is excess, under Paragraph g. (6) above, over any other insurance, whether the other insurance is primary, excess, contingent or on any other basis. RPCG 7412 08 05 Page 3 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. RIVERPORT INSURANCE COMPANY 9. BROADENED COMMERCIAL GENERAL d. Which takes place on premises owned by LIABILITY CONDITIONS you, or on premises while rented or A. SECTION IV - COMMERCIAL GENERAL leased to you or to that organization LIABILITY CONDITIONS Paragraph 2. described in Paragraph c. above. Duties in The Event Of Occurrence, 11. SECTION 11- WHO IS AN INSURED Offense, Claims Or Suit is amended to add the The following provisions are added: following provision: S. Automatic Additional Insured(s) e. Your obligation to notify us as soon as " " a. Additional Insureds - Athletic Activity practicable of an occurrence, or offense Participants under Paragraph 2.8. above, or a claim or " " (1) This policy is amended to include as an suit or offense under Paragraphs 2.a., 2.b., insured any person(s) [hereinafter called and 2.c above, is satisfied if you send us Additional Insured(s)] representing you written notice as soon as practicable after any " while participating in amateur athletic of your executive officers," directors, partners, activities that you sponsor. However, insurance managers, or legal representatives becomes aware of, or should have become no such person is an insured for: aware of, such "occurrence," offense, claim or (a) "Medical expenses" under "suit." COVERAGE C. MEDICAL B. SECTION IV - COMMERCIAL GENERAL PAYMENTS. LIABILITY CONDITIONS (b) "Bodily Injury" to: The following provisions are added: (1) A co-participant, your volunteer 10. Liberalization worker or your "employee" while If we adopt any revision that would broaden participating in amateur athletic activities that you sponsor; or the coverage under this coverage part without additional premium within 30 days prior to or (ii) You, or any partner or member, during the policy period, the broadened (if you are a partnership or joint coverage will immediately apply to this venture), or any member (if you coverage part. are a limited liability company); 11. Notice To Company or If you report an "occurrence" or offense to (c) "Property damage" to property owned your Workers' Compensation insurer which , used by, rented of occupied custody in by, the care control off tody or later becomes a claim under this Coverage Part, failure to report such "occurrence" or , , , , , over which physical control is being offense to us at the time of the "occurrence" or exercised for any purpose by: offense will not be considered a violation of (i) A co-participant, your volunteer the Duties In The Event Of Occurrence, worker, or your "employee"; or Offense, Claim Or Suit Condition, if you (ii) You, or any partner or member, notify us as soon as practicable when you (if you are a partnership or joint become aware that the "occurrence" or venture), or any member (if you offense has become a liability claim. are a limited liability company). 10. AUTOMATIC COVERAGE FOR "SPECIAL b. Additional Insured - Contractual EVENTS" Obligations A. You are automatically covered for all "special (1) This policy is amended to include as an events" which you organize, promote, administer, insured any person or organization sponsor, or conduct during the term of this policy. (hereinafter called Additional Insured) that B. SECTION V -DEFINITIONS you are required by a written "insured contract"; This Section is amended to add the following subject to all of the following provisions: 23. "Special Event" means any event: (a) Coverage is limited to liability arising out of: a. The purpose of which is to raise funds for (1) Your ongoing operations you; or performed for such Additional b. To recognize the accomplishments of Insured; or your organization, your "employees," or (ii) Such Additional Insured's your volunteer workers; or financial control of you; or c. Which you, or an individual or (iii) The maintenance, operation or organization with whom you have entered use by you of equipment leased into a contract or agreement, organize, to you by such Additional promote, administer, sponsor, or conduct Insured; or for the purposes described in Paragraphs a. or b. above; and RPCG 74 12 08 05 Page 4 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. RIVERPORT INSURANCE COMPANY (iv) A permit issued to you by a state and exclusions for this policy. The or political subdivision. Limits of Insurance applicable to the (b) Coverage does not apply to any Additional Insured are inclusive of, "occurrence" or offense: and not in addition to, the Limits of Insurance shown in the Declarations. (1) Which took place before the execution of, or subsequent to (b) The coverage provided to the the completion or expiration of Additional Insured is not greater than , the written "insured contract"; or that customarily provided by the policy forms specified in and required (ii) Which takes place after you by the contract. cease to be a tenant in that i (c) In no event shall the coverages or prem ses. (c) With respect to architects, engineers, Limits of Insurance in this Coverage Form be increased by such contract. or surveyors, coverage does not apply to "Bodily Injury," "Property (d) Coverage provided herein shall be Damage," "Personal Injury," or considered excess over any other "Advertising Injury" arising out of the valid and collectible insurance available to the Additional Insured rendering or the failure to render any professional services by or for you whether that other insurance including: primary, excess, contingent, or on (1) the preparing, approving, or any other basis unless a written contractual arrangement specifically failing to approve or prepare requires this insurance to be primary. maps, drawings, opinions, reports, surveys, change orders d. Additional Insured - Manager or , designs or specifications; and Lessor of Premises (ii) supervisory, inspection, or (1) This policy is amended to include as an engineering services. insured any person or organization (d) Coverage provided herein shall be (hereinafter called Additional Insured) from whom you lease or rent your considered excess over any other premises and which requires you to add valid and collectible insurance such person or organization as an available to the Additional Insured Additional Insured in this policy under: whether that other insurance is primary, excess, contingent, or on (a) A written contract; or any other basis unless a written (b) An oral agreement or contract where contractual arrangement specifically a Certificate of Insurance has been requires this insurance to be primary. issued showing that person or (e) In the event that you are engaged in organization as an Additional the manufacture or assembly of any Insured; goods or products for the benefit or but only if the written or oral agreement is at the direction of another parry, an "insured contract," pursuant to a contract or agreement (1) currently in effect or to become with that party, this Paragraph (d). effective during the term of this does not extend coverage to that policy; and party as an Additional Insured. Coverage for such a party will be (ii) executed prior to the "bodily " " " extended only by a specific injury, property damage, "personal injury" or "advertising endorsement issued by us and , injury." such party. c. Additional Insured - Funding Sources (2) With respect the insurance afforded the Additional Insured identified in Paragraph (1) This policy is amended to include as an d. (1) immediately above, the following insured any Funding Source (hereinafter additional provisions apply: called Additional Insured) which requires you in a written contract to name such (a) This insurance applies only to liability Additional Insured but only with respect to arising out of the ownership, liability arising out of your premises or maintenance, or use of that portion of "your work" for such Additional Insured, the premises leased to you; and only to the extent set forth as follows: (b) The Limits of Insurance applicable to (a) The Limits of Insurance applicable to the Additional Insured are the lesser the Additional Insured are the lesser of those specified in the written of those specified in the written contract or agreement or in the contract or agreement or in the Declarations for this policy and Declarations for this policy and subject to all this policy's terms, subject to all the terms, conditions conditions, and exclusions. The Limits of Insurance applicable to the RPCG 74 12 08 OS Page 5 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. RIVERPORT INSURANCE COMPANY Additional Insured are inclusive of, agreement pertaining to the use of not in addition to, the Limits of the premises or in the Declarations Insurance shown in the Declarations. for this policy and subject to all of this (c) In no event shall the coverages or policy's terms, conditions, and Limits of Insurance in this Coverage exclusions. The Limits of Insurance Part be increased by such contract or applicable to the Additional Insured agreement. are inclusive of, not in addition to, the (d) Coverage provided herein shall be Limits of Insurance shown in the Declarations considered excess over any other valid and collectible insurance . (c) In no event shall the coverage or available to the Additional Insured Limits of Insurance in this Coverage whether that other insurance is Form be increased by such contract primary, excess, contingent, or on or agreement. any other basis unless a written (d) Coverage provided herein shall be contractual arrangement specifically considered excess over any other requires this insurance to be primary. valid and collectible insurance (3) This insurance does not apply to: available to the Additional Insured (a) Any "occurrence" or offense which whether that other insurance is primary, excess, contingent on takes place after you cease to be a tenant in the premises covered by , any other basis unless a written this endorsement; or contractual arrangement specifically requires this insurance to be primary. (b) Structural alterations, new (3) This insurance does not apply to: construction, or demolition operations performed by or on behalf of the (a) Any "occurrence" or offense which Additional Insured. takes place after you cease to be a e. Additional Insured - Owner, Manager, tenant, licensee or occupant in the premises covered by this Operator or Lessor of "Special Events" endorsement; or Premises (b) Any acts or "occurrences" caused by (1) This policy is amended to include as an or attributable to the owner, insured any person or organization manager, operator, or lessor of the (hereinafter called Additional Insured) premises upon which the "special from whom you lease, rent or occupy the event" is held. premises upon which a "special event' is held, sponsored or conducted by you or f. Additional Insured - Supervisors or , on your behalf, under: Higher in Rank (a) A written contract; or (1) This policy is amended to include as " " (b) An oral agreement or contract where insured any employees (hereinafter called Additional Insured), designated as a Certificate of Insurance has been supervisor or higher in rank, who are issued showing that person or authorized by you to exercise direct or organization as an Additional indirect supervision and control over Insured; but only if the written or oral " "employees" and the manner in which agreement is an insured contract," work is performed, but only for acts within (i) currently in effect or to become the scope of their employment by you or effective during the term of this while performing duties related to the policy; and conduct of your business. However, none (ii) executed prior to the "bodily of these "employees" designated as injury," "property damage " supervisor or higher in rank, is an insured , "personal injury," or "advertising for: injury." (a) "Bodily injury" or "personal injury": (2) With respect to the insurance afforded the (1) To you, to your partners or Additional Insured identified in Paragraph members (if you are a e. (1) of this endorsement, the following partnership or joint venture), or additional provisions apply: to your members (if you are a (a) This insurance applies only to limited liability company); liability arising out of the use of that (ii) For which there is any obligation portion of the premises while leased to share damages with or repay or rented to you for the specific someone else who must pay "special event'; damages because of the injury (b) The Limits of Insurance applicable to described in paragraph (a)(i) the Additional Insured are the lesser above; or of those specified in the contract or RPCG 74 12 08 05 Page 6 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. RIVERPORT INSURANCE COMPANY (iii) Arising out of his or her providing or failing to provide professional health care services. (b) "Personal Injury": (i) to a co-"employee" while in the course of his or her employment, or (ii) to the spouse, child, parent, brother or sister of that co- "employee" as a consequence of Paragraph (b)(i) above; (iii) for which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph (b) (1) or (b) (ii) above. (c) "Property damage" to property: (1) owned, occupied or used by; or (ii) rented to, in the care, custody, or control of, or over which physical control is being exercised for any purpose by: you, any of your "employees," any partner, or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). g. Additional Insured - LIMITATIONS (1) The persons, entities, or organizations to which coverage is extended under Paragraphs a. (Athletic Activity Participants), b. (Contractual Obligations), C. (Funding Sources), d. (Managers or Lessors of Premises), and e. (Owner, Manager, Operator, or Lessor of "Special Events" Premises) are Additional Insureds, but only: (a) With respect to each Additional Insured's vicarious liability for "actual damages" solely caused by you or by "your work" that is ongoing for such Additional Insured's supervision of "your work"; and (b) If the Additional Insured did not cause or contribute to the "occurrence" or act resulting in liability. (2) If an endorsement is attached to this policy and specifically names a person or organization as an Additional Insured, then the coverage extended under this paragraph 4. AUTOMATIC ADDITIONAL INSURED(S) does not apply to that person, entity, or organization. (3) SECTION V - DEFINITIONS, This section is amended to add the following Item 24: 24. "Actual Damages" is to have its usual and customary legal meaning and excludes without limitation, punitive damages, restitution, penalties, and formula damages added to "actual damages" and any other enhanced damages. (4) All other terms and conditions of this Coverage Part which are not inconsistent with this Paragraph h. apply to coverage extended to the above referenced Additional Insureds REGARDLESS OF WHETHER OR NOT A COPY OF THIS COVERAGE PART AND/OR ITS ENDORSEMENTS ARE DELIVERED TO AN ADDITIONAL INSURED. 12. BLANKET WAIVER OF SUBROGRATION SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS Item 8. is replaced with: 8. Transfer of Rights Of Recovery Against Others To Us And Blanket Waiver Of Subrogation a. If an 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 insured 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. b. If required by written "insured contract," we waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract for that person or organization and included in the "products- completed operations hazard." 13. PRIORITY OF APPLICATION FOR MULTIPLE INSUREDS SECTION III - LIMITS OF INSURANCE This Section is amended to add the following paragraph: 8. In the event a claim or "suit" is brought against more than one insured, due to "bodily injury" or "property damage" from the same 'occurrence," or "personal injury," or "advertising injury," from the same offense, we will apply the Limits of Insurance in the following order: a. You; b. Your "executive officers," directors, "employees," and c. Any other insureds in any order that we choose. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. RPCG 74 12 08 05 Page 7 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Certification Regarding Drug-Free Workplace Requirements The certification set out below is a material representation upon which reliance is placed by the U.S. Department of Housing and Urban Development in awarding the grant. If it is later determined that the contractor knowingly rendered a false certification, or otherwise violates the requirements of the Drug-Free Workplace Act, the U.S. Department of Housing and Urban Development, in addition to any other remedies available to the Federal Government, may take action authorized under the Drug-Free Workplace Act. CERTIFICATION A. The contractor certifies that it will provide a drug-free workplace by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the contractor's workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing a drug-free awareness program to inform employees about - (1) The dangers of drug abuse in the workplace; (2) The contractor's policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance program; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c) Making it a requirement that each employee who will be engaged in the performance of the grant be given a copy of the statement required by paragraph (a); (d) Notifying the employee in the statement required by paragraph -(a) that, as a condition of employment under the contract, the employee will - (1) Abide by the terms of the statement; and (2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction. EXHIBIT D Pg. 2 (e) Notifying the U.S. Department of Housing and Urban Development within ten days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction; (f) Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted - ( 1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; (g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f). B. The contractor shall insert in the space provided on the attached "Place of Performance" form the site(s) for the performance of work to be carried out with the grant funds (including street address, city, county, state, and zip code) .the contractor further certifies that, if it is subsequently determined that additional sites will be used for the performance of work under the contract, it shall notify the U.S. Department of Housing and Urban Development immediately upon the decision to use such additional sites by submitting a revised "Place of Performance" form. Dated: 8/12/2010 Program Operator EXHIBIT D DIVISION OF EMPLOYMENT SERVICES PLACE OF PERFORMANCE FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS Name: Deanna Echevarria Name of Contractor: Children's Bureau Contractor Number: Date: 8/12/2010 The Contractor shall insert in the space provided below the site(s) expected to be used for the performance of work under the contract covered by the certification: Place of Performance (include street address, city, county, state, zip code for each site): 1901 a 4th St., Suite 310 Santa Ana, CA 92705 EXHIBIT D Exhibit E Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, Section 98.510, Participants' responsibilities. The regulations were published as Part VII of the May 26, 1988 Federal Register (pages 19160-19211). (BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS FOR CERTIFICATION - Attached) (1) The prospective recipient of federal assistance funds certifies, by submission of this proposal, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. (2) Where the prospective recipient of federal assistance funds is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Deanna Echevarria - Program Manager Name and Title of Authorized Representative L10 ignature Date INSTRUCTIONS FOR CERTIFICATION By signing and submitting this proposal, the prospective recipient of federal assistance funds is providing the certification as set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective recipient of federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the Department of Labor (DOL) may pursue available remedies, including suspension and/or debarment. 3. The prospective recipient of federal assistance funds shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective recipient of federal assistance funds learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective recipient of federal assistance funds agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the DOL. 6. The prospective recipient of federal assistance funds further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and voluntary exclusion - Lower Tier Covered Transactions," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to check the List of Parties Excluded from Procurement or Non-Procurement Programs. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the DOL may pursue available remedies, including suspension and/or debarment. EXHIBIT F ARRA CONTRACT REQUIREMENTS 1. The American Recovery and Reinvestment Act of 2009 (the "Recovery Act") includes provisions for WIA Adult and Dislocated Worker funds, WIA Youth funds including summer youth employment activities, and Wagner-Peyser Act funds for reemployment services. 2. EMPLOYER has experience in offering education, occupational development, business training, lay-off aversion and employment programs for the labor market participants in the City of Santa Ana ("said program"). EMPLOYER is willing to operate said program pursuant to the Act and California law. 4. EMPLOYER agrees to provide benefits to individuals who participate in the activities and services funded by this Agreement ("participants") in accordance with the standards and requirements set forth in Workforce Investment Act of 1998, Public Law 105-220 and the American Recovery and Reinvestment Act of 2009 ("Recovery Act'). 5. EMPLOYER agrees to include prominent labels and tags in program announcements and literature that clearly distinguish them as "Recovery Act" programs. 6. EMPLOYER shall adhere to the Labor Standards described in the Act including Section 181 of the Act. 7. As a condition of this award of financial assistance under the Act to EMPLOYER from CITY, EMPLOYER assures, with respect to operation of all programs or activities funded with funds provided pursuant to the Act, and all agreements or arrangements to carry out such programs or activities, that it will comply fully with the nondiscrimination and equal opportunity provisions of the Act (Section 188); the Nontraditional Employment for Women Act of 1991; Title VI of the Civil Rights Act of 1964, as amended; section 504 of the Rehabilitation Act of 1973, as amended; the Age Discrimination Act of 1975, as amended; the Americans with Disabilities Act of 1990; and with all applicable requirements imposed by or pursuant to regulations implementing those laws, including, but not limited to, 29 CFR part 37. The United States, the State of California and CITY have the right to seek judicial enforcement of this assurance. 8. EMPLOYER agrees that no participant(s) shall commence training prior to completion of a specialized assessment that demonstrates an ability to benefit from program. 9. EMPLOYER agrees that no participant(s) shall commence training prior to the approval of funding pursuant to Section 123 of the Act. 10. EMPLOYER agrees to provide priority of services for veterans and eligible spouses pursuant to 20 CFR Part 1010 and the regulations implementing priority of service for veterans and eligible spouses in Department of Labor job training programs under the Jobs for Veterans Act published at 73 Fed. Reg. 78132 on December 19, 2008. 11. The parties hereto agree that EMPLOYER shall comply with all applicable federal and state laws and regulations, including, but not limited to the Performance Standards (Exhibit B) and general program requirements described in Sections 106 and 141 of the Act (29 USC Sections 1516 and 1551) and applicable regulations, the Recovery Act and the U.S. Department of Labor guidelines and regulations, including amendments or revisions made during the terms of this Agreement. Said applicable laws are hereby incorporated by reference and made as part of this Agreement as though fully set forth herein. 12. EMPLOYER also assures and certifies that: A. EMPLOYER shall comply with Title VII of the Civil Rights Act of 1964 (P.L. 83-354) and in accordance with Title VII of the Act, no person shall, on the grounds of race, color, religion, sex, age, handicap or national origin be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under this Agreement. B. EMPLOYER shall comply with any and all federal laws limiting the political activity of employees hired under this Agreement. C. EMPLOYER shall comply with the requirements that no program under the Act shall involve political activities. D. RECORD INSPECTION. EMPLOYER shall provide the U.S. Department of Labor and the Controller General, by and through any authorized representative, as well as the WIB Administrative Office, access to and the right to examine all records, books, papers or documents relating to the accounting and use of funds under this Agreement for a three-year period from and after the effective date of this Agreement. E. No person with responsibilities in the operation of any program under the Act shall discriminate with respect to any program participant or any application for participation in such program because of race, creed, color, national origin, sex, political affiliation or beliefs. F. EMPLOYER shall maintain appropriate standards for health and safety in work and training situations. G. EQUAL OPPORTUNITY. Any literature distributed by EMPLOYER for the purpose of apprising businesses, participants, or the general public of its programs under this Agreement shall state that its programs are supported by the City of Santa Ana and the Santa Ana Workforce Investment Board, and shall state that the program is an "equal opportunity employer/program" and that "auxiliary aids and services are available upon request to individuals with disabilities." H. Based on the population eligible to be served, or likely to be directly affected by the WIA program or activity, the services or information may need to be provided in a language other than English in order to allow such population to be effectively informed about or able to participate in the program or activity. Pursuant to 29 CFR 37.35, the EMPLOYER must take reasonable steps to provide services and information in appropriate languages after considering the scope of the program or activity, and the size and concentration of the population that needs services or information in a language other than English. 13. EMPLOYER certifies that all property, finished or unfinished documents, data, studies and reports prepared or purchased under this Agreement, will be disposed of in accordance with the direction of the CITY. In addition, any tools and/or equipment furnished to the EMPLOYER by the CITY and/or purchased by the EMPLOYER with funds pursuant to this Agreement, will be limited to use within the activities outlined in this agreement and will remain the property of the United States Government and/or CITY. Upon termination of this Agreement, EMPLOYER will immediately return such tools and/or equipment to the CITY or dispose of them in accordance with the direction of the CITY. 14. EMPLOYER certifies that this Agreement does not provide for the advancement or aid to any religious sect, church or creed, or sectarian purpose nor does it help to support or sustain any school, college, university, hospital or other institution controlled by any religious creed, church, or sectarian denomination, as specified by Article XVI, Section 5, of the Constitution of the State of California, regarding separation of church and state. 15. PATENT, COPYRIGHTS AND RIGHTS IN DATA. The EMPLOYER will disclose to the CITY any invention, written product, computer program developed or data assembled as a result of performance of work under this Agreement within seventy four (74) days of invention, development or assembly. The CITY, State of California, and U.S. Department of Labor will have the right to patent any invention and copyright any written product or computer program or data generated by EMPLOYER. Upon written request, EMPLOYER will transfer all pertinent information, specifications and right, title and interest to the designated agency. 16. INVENTIONS, PATENTS AND COPYRIGHTS. A. Reporting Procedure. If any project produces patentable items, patent rights, processes, or inventions in the course of work under a U.S. Department of Labor (DOL) grant or agreement, the EMPLOYER shall report the fact promptly and fully to the CITY. The CITY shall report the fact to the Grant Officer, at the DOL. Unless there is a prior agreement between the CITY and the DOL and its representative on these matters, the DOL shall determine whether to seek protection on the invention or discovery. The DOL and its representative shall determine how the rightsin the invention or discovery, including rights under any patent issued thereon, will be allocated and administered in order to protect the public interest consistent with the "Governmental Patent Policy" (President's Memorandum for Heads of Executive Departments and Agencies, August 23, 1971, and Statement of Government Patent Policy as printed in 36 FR 16889). B. Copyright Policy. 1. Unless otherwise provided in the terms of the grant or agreement, when copyright-able material is developed in the course of or under a DOL Grant or agreement, the author and the CITY which developed the work is free to copyright material or to permit others to do so. The EMPLOYER and the Workforce Investment Board (WIB) shall have a royalty- free, nonexclusive and irrevocable license to reproduce, publish, use and to authorize others to use all copyrighted material. 2. The DOL reserves a royalty-free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use, for Federal Government purposes: (a) The copyright in any work developed under any grant, sub-grant, or contract under a grant or subgrant; (b) Any right of copyright to which a grantee, subgrantee or a EMPLOYER purchases ownership with grant support; and (c) EMPLOYER shall comply with the requirements of 29 CFR Part 97.34. C. Rights to Data. The DOL and the CITY shall have unlimited rights to any data first procured or delivered under this Agreement. 17. CLEAN AIR / CLEAN WATER ACT. If the grant hereunder exceeds $100,000, EMPLOYER must comply with Section 306 of the Clean Air Act [(42 USC 1875(h)]; Section 508 of the Clean Water Act (33 USC 1368); Executive Order 11738 and Environmental Protection Agency ("EPA") regulations (40 CFR Part 15) as any may now exist or be hereafter amended. Under these laws and regulations, the EMPLOYER assures that: (a) No facility to be utilized in the performance of the proposed grant has been listed on the EPA List of Violating Facilities; (b) It will notify CITY prior to award of the receipt of any communication from the Director, Office of Federal Activities, U.S. EPA, indicating that a facility to be utilized for the grant is under consideration to be listed on the EPA List of Violating Facilities; (c) It will notify the CITY and the EPA about any known violation of the above laws and regulations. C. EMPLOYER agrees to adhere to the following STANDARDS OF CONDUCT: 1. General Assurance. Every reasonable course of action will be taken by EMPLOYER in order to maintain the integrity of this expenditure of public funds and to avoid favoritism. This Agreement will be administered in an impartial manner, free from errors to gain personal, financial political gain. EMPLOYER, its officers and employees, in administering this Agreement, will avoid situations which give rise to a suggestion that any decision was influenced by prejudice, bias, special interest or desire for personal gain. 2. Employment of Former State or CITY Employees. EMPLOYER will ensure that any of its employees who were formerly employed by the State of California or CITY, in a position that could have enabled such individuals to impact policy regarding or implementation of programs covered by this Agreement, will not be assigned to any part or phase of the activities conducted pursuant to this Agreement for a period of not less than two years following the termination of such employment. 3. Conducting Business Involving Relatives. No relative by blood, adoption or marriage of any executive or employee of EMPLOYER will receive favorable treatment when considered for enrollment in programs provided by, or employment with, EMPLOYER. 4. Conducting Business Involving C_lose personal Friends and Associates. Executives and employees of EMPLOYER will be particularly aware of the varying degrees of influence that can be exerted by personal friends and associates and, in administering this Agreement, will exercise due diligence to avoid situations which give rise to an assertion that favorable treatment is being granted to friends and associates. When it is in the public interest for EMPLOYER to conduct business with a friend or associate of an executive or employee of EMPLOYER, an elected official in the area or a voting or non-voting member of the Workforce Investment Board (WIB), a permanent record of the transaction will be retained. 5. Avoidance of Conflict of Economic Interest. No executive or employee of EMPLOYER, elected official in the area, or voting or non-voting member of a WIB, will solicit or accept money or any other consideration from a third person, for the performance of an act reimbursed in whole or part by EMPLOYER or CITY. Supplies, materials, equipment or services purchased with Agreement funds will be used solely for purposes asserted or allowed under this Agreement. No voting member of the W113 will cast a vote on the provision of services or vote on any matter which would provide direct financial benefit to that member or any business or organization which the member directly represents. 6. Salary and Bonus Limitations. All Subrecipients of WIA program funds are required to comply with federal requirements regarding the limitations on salary and bonus payments in accordance with Public Law 109-149, Section 7013.