HomeMy WebLinkAboutPRICE4COMPUTERS 1 - 2011CD A1,3 4 NV-,, k e--hf. C27) 12/09 011-069
?q , n u V, YXA m
nt 12/
INSURA gFe& FILE No.
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
r7- / - // ON-THE-JOB TRAINING AGREEMENT
CLERK OF COUNC)i 2011 UNDER THE WORKFORCE INVESTMENT ACT
DATE: JUN 'L -
THIS AGREEMENT is made and entered into this 26 day of May, 2011 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 Price4 Computers (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 June 1". 2011,
and ending September 30`h, 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. Fundine. CITY shall reimburse the EMPLOYER an amount not to exceed $6,200.00 in accordance
with the Cost Computation included in Exhibit 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.
1
12/09
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 similaz work; and,
c. is paid the salazy 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 standazds for health
and safety in work and training situations. Where special clothing or equipment is provided to the
EMPLOYER'S regulaz 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. Con +rights 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 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.
2
12/09
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 aroyalty-free, nonexclusive and irrevocable license to
reproduce, publish, use and to authorize others to use all copyrighted material.
2. The DOL reserves aroyalty-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.
1 O. 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
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
3
12/09
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 employer size 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.
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
4
12/09
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 1 O 1(31) of the Act and 663.700-71 O 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.
22. Drug Free Workplace. The EMPLOYER agrees to provide adrug-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
EMPLOYER:
Price4 Computers
2520 N Grand Ave
Santa Ana. CA 92705
(714) 744-5800X202
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.
5
12/09
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
APPROVED AS TO FORM:
Joseph W. Fletcher
City Attorney
By: Lisa Storck
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
"YL ?? u.? `' ??? a?dp
Nancy T. Ed rds
Interim Executive Director
Community Development Agency
CITY OF SANTA ANA
Yau1 M. Walters
Interim City Manager
EMPLOYER:
?? _. ___
Name: Ron Moatamer
Title: CEO
Fed Tax ID# 41-2159927
State Tax ID# 248-87796
7
Agreement # Exhibit A
TRAINING PLAN
I. GENERAL
1. Name of OJT Employer: Price4Comuuters
2. Address of OJT Work-site: 2520 N. Grand Ave., Santa Ana. CA 92705
3. Phone Number: 714-744-5800
4. Training Supervisor: Ron Moatamer
5. Name of OJT Trainee: Kevin Kelly
6. Enrollment Case Number of Trainee: 1012914
7. Proportion of trainees/employees: (at time Agreement entered into)
a. Total number of employer's regulaz employees 8
b. Cumulative number of trainees currently in OJT 1
II. OCCUPATION AND ON-THE-JOB TRAINING OUTLINE:
1. Vendor #:
2. Occupation/Product or Servi
3. Length of Time irr Business:
4. ONET Code: 41-3011.00
5. Hourly Starting Wage:
Start Date: 6/1/11
Hours 620
6. State and Federal Tax I.D.:
7. Basic Work Week Hours:
ce:__ Web Desien/ Sales Marketing Representative
6 years
SVP Level 6.0<7.0
$20/hr
End Date: 9/30/11
or Days or Weeks
State 248-87796
Federal: 41-2159927
40
1
8. Outline of On-the-Job Training Plan and Method of Assessment:
ELEMENTS OF TRAINING HOURS OF TRAINING
1. Learning elements of marketing, including mass a-mail marketing, 220
strategies and interaction with HTML, JAVA and FLASH
Measurement Method: Q 8c A, task observation and inspection. Goal is to achieve rate
of proficiency within first Month and a half of training.
2.. Learning SEO Optimization, Blogging and Social Networking
150
Measurement Method: Q 8c A, task observation and inspection. Goal is to achieve rate
of proficiency within subsequent three and a half months.
3. Marketing on the Web and interaction with classic methods of
marketing and point of sales systems (PDG Soft), in addition to HTML, 150
JAVA and FLASH
Measurement Method: Q 8c A task observation and inspection. Goal is to achieve rate of
proficiency within subsequent three and a half months.
a . Developing a new Web Interactive Marketing page
100
Measurement Method: Q 8c 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? QBcA, observation, product review/inspection,
etc.
PROFICIENT
II.
III.
MODERATE
COST COMPUTATION
Example: Hourly Reimbursement at 50% $ 10.00
_ $6,200.00
MARGINAL
Hours 620 cost Per Trainee
Person(s) authorized to sign payment invoices for EMPLOYER:
Ron Moatamer ??,??- CEO 5/26/1 1
Print Name ? Signature Title Date
2
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.
1 O. 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.
1
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
S?Z L` /
Date
Print First Name Print Last Name
Price4 Computers
Organization Name
Moatamer
2520 N. Grand Ave. Santa Ana. CA 92705
Organization Address
RightFax N1-2 5/18/2011 3:49:47 PM PAGE 2/002 Fax SaFVar `-
40_/20- CERTIFICATE OF LIABILITY INSURANCE 05/i87201??
THIS CERTIFICATE IS ISSUED AS A MATTER OF FNFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER- THIS
?CERTIFlCATE DOES NOT AFFIRMATIVELY OR NEC;IATIVELY AMEND, EXTEND OR ALTER THE COVERAQE AFFORDED HY THE POLIGES BELOW.
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORREiD REPRESENTATVE
OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: H the certMleate hello Is sn ADDITIONAL INSURED, the pollry(les) must be endorsed. M SUBROCiAT10N Is WAIVED, subject to the
terms and eondltloru of the pollry, oerfaM policies may requlle eR endorsement. A slatemerK orf thh oertHleab does not confer rights tar the
eertMleeto holder In IIeM of such eredorsemanVSl_
JVRC ENTERPRISES INC oNE - -
Ne ERI : ase act qua No : sr S3Z
3 f 225 LA BAYA DR #1 OB-A
WESTLAKE VILLAGE
CA 91362 - serviews mvelere.eom '
,
(888) 681-3035 PRODU6R
• 2f S'1 LA1 ae
X2597 $$2 _ INBURER(B)AFTagpWO COVERAGE NAIL e
INBUREO
PRICE4
INC INSURER ATRAVELERS CASUALTY INSURANCE COMPANY OF ANER{CA
,
_
DBA PRICES COMP INSURER B_
-?-
?? ?
?
IJIERS
2520 N
GRAND AVE INSURER C: .
?.i
11 .
? ?
?
.
SANTA ANA
CA 92705 I
INSURER D= ' G I
? -
?
, INSURER E:
INSURER F:
COVERAdES [:FRTIFIr_ATF NI IMRFR- SG4Ft!?,d'Jn7 aaia+La? RFllICIAN NIICw1RPQ-
THIS IS TO CERTB'Y THAT THE POLICIES OF INSURANCE L13TED BELOW HAVE BEEN 133U EO TO THE NSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATE D_ NQTWITHST/WDING ANY REQUIREMENT, TERM OR CONDI"IION OF ANY CONTRACT OR OTFIER DOCUMENT WfTH RESPECT TO MlFIICH TH13
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM 3, EXCLUSIONS
ANO CONDITIONS OF SUCH POLICIES. LIMITS SHOVAV MAY HAVE BEEN RED UCEO BY PAID CLAIMS.
NSR TYPE OFINBURANCE I?R ?? POLICY NUMBER POLICY EFF PODGY EXP UMrr9
A DE NERAL LIABIRY }( BBD-7620R73A-10 07/01/2070 07/01!2071 c 00
COMMERCIAL GENERAL LIABI LrIY 300,000 -
GLAIMS-MADE ? OCCUR
YTIRED
O
xP Il
5 DOO
AIR
X N V IrvJ Uwv 1 000 000
NbN owrveD..Uro 2 000 000
GEN'L AGGwEGI1TF LIM?APPUEB PER-
-
_ P G
2 000 000
PRO
POLICY LOC $
AIITOYOBILE UABILn`/
M
?O? COMBINED SINGLE LIMB _
(E6 aCCltl Bnl) $
ANY AUTO
ALL OWNED ALIT09 ?(C ?®
yi?
i BODILY INJURY (PBr (Jaen) $
9CH FOULED ALfr09 ?p'RpV£ `
4 BODILY INJURY (P>?adtlenQ $
HIRED AUT09
? q pTy
PP?eetitlern AGE
$
NON4 WNED AUT03 E g'?OR $
L? A t Trey $
UMBPElLA LIAB OCCUR
A5515 2
EACH OCCURRENCE -
$
EKCE88 L146 CLAIMS-MADE AOOREGIITE $
DEDUCTIBLE / '
$
REIENTION ?
WORKER3 COMPENSATION
AND EMPLOYCRS LIABILITY YM R/A AT U- O
oFFICREAMI FjNBOEA EAXC?LUOER DT ??IVE a E.L. EACH ACCIDENT $
(MmAebry In NN)
I E.L. DIBEASE - EA EMPLOYEE $
! yyaee, tlexrlha untler
9PECU\L PROV1810NS below
E.L. OISEABE-POLICY LIMIT
$
DE9CRIPTON OF OPERATON9 / LDCATONS/ VEHICLES (ARaah ACORD 701, Atldlllonel Rarva,tc StlladuY, H mer?epes b nqulred)
AS RESPECTS TO GENERAL LIABILITY, CERTIFICATE HOLDER IS ADDITIONAL INSURED -ADDITIONAL
INSURED-FINANCIAL SUPPORT CO T4 B2
CRY OF SANTA ANA
SANTA ANA WORK CENTER
20 CIVIC CENTER PLAZA
PO BOX 7968 SHOULD ANY OF THE ABOVE DESCRIB® POLIGES BE CANCELLED BEFORE THE
E7(PD9ATOM DATE THEREOF, NOr7CE WILL BE DELIVERED IN ACCORDANCE
Mll'1'li TIE POLICY PROVISIONa,
SANTA ANA, CA 92702 Atm(oraz® REPR®EnrrATlvE (__/?/?.??Ayrc-
-T v
O 1988'•2009 ACORD CORPORATION. All rigMa reserved.
ACORD 25 (2009109) The ACORD nano and logo ara registered marks of ACORD
POLICY NUMBER:I-680-1420R73A-ACJ'-10 ISSUE DATE: OS-25-11
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED ENTITY - EARLIER. NOTICE OF
CANCELLATION/NON RENEWAL PROVIDED BY US
This endorsement modifies insurance provided under the following:
ALL COVERAGE PARTS INCLUDED IN THIS POLICY
CANCELLATION
WHEN WE DO NOT RENEW {Nonrenewal):
NAME: CITY OF SANTA ANA
SANTA ANA WORK CENTER
ADDRESS: 20 CIVIC CENTER PLAZA
PO BOX 1988
SANTA ANA , CA 9 2 7 0 2
A.
B.
SCHEDULE
Number of Days Notlce: 3 O
Number of Days Notice:
For any statutorily permitted reason other than
nonpayment of premium, the number of days re-
quired Tor notice of cancellation, as provided in
the CONDITIONS Section of this insurance, or as
amended by any applicable state cancellation
endorsement applicable to this insurance, is in-
creased to the number of days shown in the
SCHEDULE above.
For any statutorily permitted reason other than
nonpayment of premium, the number of days re-
quired for notice of When We Do Not Renew
(Non renewal), as provided in the CONDITIONS
Section of this insurance, or as amended by any
applicable state When We Do Not Renew
(Non renewal) endorsement applicable to this in-
surance, is increased to the number of days
shown in the SCHEDULE above.
C. We will mail notice of cancellation or nonrenewal
or material limitation of those coverage forms to
the person or organization shown in the schedule
above. We will mail the notice at least the Num-
ber of Days indicated above before the effective
date to our action.
£D AS TD F®gLJi
?pg0
7/G g?' ORCK
L\SA E G??y p,?torne`J
Ass?sta?t
`?/?/??
IL T3 54 03 9S Copyright, The Travelers Indemnity Company, '1998 Page 1 of 1
COMMERCIAL GENERAL LIABILITY
POLICY NUMBER: I-680-1420R73A-ACJ-10 ISSUE DATE: 05-18-11
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED-FINANCIAL SUPPORT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
NAME OF PERSON OR ORGANIZATION:
CITY OF SANTA ANA
SANTA ANA WORK CENTER
20 CIVIC C8NT8R PLAZA
PO BOX 1988
SANTA ANA CA 92702
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the
Schedule as an insured but only with respect to Liability arising out of the financial support provided to you.
CG T4 92 11 88 Page 1 of 1
Certification Regarding Drug-Free Workplace Requirements
The certification set out below is a material representation upon which reliance is placed
by the U.S. Department of Housing and Urban Development in awarding the grant. If it
is later determined that the contractor knowingly rendered a false certification, or
otherwise violates the requirements of the Drug-Free Workplace Act, the U.S.
Department of Housing and Urban Development, in addition to any other remedies
available to the Federal Government, may take action authorized under the Drug-Free
Workplace Act.
CERTIFICATION
A. The contractor certifies that it will provide adrug-free workplace by_
(a) Publishing a statement notifying employees that the unlawful manufacture,
distribution, dispensing, possession or use of a controlled substance is
prohibited in the contractor's workplace and specifying the actions that will
be taken against employees for violation of such prohibition;
(b) Establishing adrug-free awareness program to inform employees about -
(1) The dangers of drug abuse in the workplace;
(2) The contractor's policy of maintaining adrug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance program; and
(4) The penalties that may be imposed upon employees for drug abuse
violations occurring in the workplace;
(c) Making it a requirement that each employee who will be engaged in the
performance of the grant be given a copy of the statement required by
paragraph (a);
(d) Notifying the employee in the statement required by paragraph -(a) that,
as a condition of employment under the contract, the employee will -
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a
violation occurring in the workplace no later than five days after
such conviction.
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 adrug-free workplace
through implementation of paragraphs (a), (b), (c), (d), (e) and (f).
B. The contractor shall insert in the space provided on the attached "Place of
Performance" form the site(s) for the performance of work to be carried out with
the grant funds (including street address, city, county, state, and zip code) .the
contractor further certifies that, if it is subsequently determined that additional
sites will be used for the performance of work under the contract, it shall notify
the U.S. Department of Housing and Urban Development immediately upon the
decision to use such additional sites by submitting a revised "Place of
Performance" form.
Dated: 5/26/2011 Price4 Computers
Program Operator
EXHIBIT D
DIVISION OF EMPLOYMENT SERVICES
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
Name: Price4 Cmouters
Name of Contractor: Ron Moatamer
Contractor Number:
Date: 5/26/201 1
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 Pertormance (include street address, city, county, state, zip code for each site):
2520N Grand Ave.. 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.
Signature Date
Ron Moatamer, General Operation Manager
Name and Title of Authorized Representative
05/26/2011
INSTRUCTIONS FOR CERTIFICATION
1. 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 transactionI in addition to other remedies available to the Federal Government, the
DOL may pursue available remedies, including suspension and/or debarment.