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HomeMy WebLinkAboutACCURATE PERFORMANCE MACHING, INC. - 2012INSURANCE ON FILF_ V?OZK PAr:Y PROCEED UNTIL INSURANCE EXPIRES ? _ /s- /3 CLERK OF COUNCIL DATE: I?JN 1 9 p?,greement No. Arace\'? Del odd o ON-THE-JOB TRAINING AGREEMENT UNDER THE WORKFORCE INVESTMENT ACT N-20 ? 2- ? 37 THIS AGREEMENT is made and entered into this 4th day of October, 2012 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 Accurate Performance Machine, Inc. (hereinafter "EMPLOYER"). W I T N E S S E T H 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: Term. The effective term of this Agreement is for the period beginning October 4, 2012, and ending March 04, 2013. 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 $3,'700 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. 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. 2 7. Patent. Couvrights 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. 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. 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. 1 1 . 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 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. 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. 5 1 1375 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 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: Accurate Performance Machining, Inc. 2086 S. Grand Avenue Santa Ana, CA 92705 ATT: Bob Fischer 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. and shall indemnify CITY fully, including reasonable costs and attorney's fees, for any 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, 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. 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 Paul Walters City Manager APPROVED AS TO FORM: Sonia R. Carvalho City Attorney By: Lisa Storck Assistant City Attorney RECOMMENDED FOR APPROVAL: EMPLOYER: Bob Fischer President Tax ID#: 33-0709645 Nancy T. Ed ds Interim Exec ve Director Community Development Agency Agreement # Exhibit A . TRAINING PLAN I. GENERAL 1 . Name of OJT Employer: Accurate Performance Machinine Inc. . 2. Address of OJT Work-site: 2086 S Grand Avenue. Santa Ana. CA92705-5250 3. Phone Number: (714) 434-781 1 4. Training Supervisor: Bob Fischer 5. Name of OJT Trainee: Octaviano T. Loera 6. Application Number of Trainee: 1017835 7. Proportion of trainees/employees: (at time Agreement entered into) a. Total number of employer's regular employees 19 b. Cumulative number of trainees currently in OJT 1 II. OCCUPATION AND ON-THE-JOB TRAINING OUTLINE: 1. Case Number #: 2. Occupation/Product or Service: Machinist/Machine Shoes 3. Length of Time in Business: 15 years 4. ONET Code: 51-4011.00 SVP Level 4.0 to < 6.0 5. Hourly Starting Wage: $ 10.00 per hour Start Date: 10/04/2012 End Date: 03/04/2013 Hours_ 740 or Days or Weeks 6. State and Federal Tax I.D.: State: 33-0709645 Federal: 99-921997 7. Basic Work Week Hours: 40 1 Outline of On-the-Job Training Plan and Method of Assessment: ELEMENTS OF TRAINING HOURS OF TRAINING 1. Will be taught all appropriate safety procedures 40 Measurement Method: Q & A, task observation and inspection. Goal is to achieve rate of proficiency within first Month and a half of training. 2.. Read Blue Prints 50 Will be taught to read, examine blueprints, drawings or samples to determine size, tolerance, type, material, finish plus any special requirements. Measurement Method: Q & A, task observation and inspection. Goal is to achieve rate of proficiency within subsequent three and a half months. 3 . Measurement and Inspection Techniques 50 Will be taught how to inspect any and all blueprint requirement. All inspect tools will be utilized with plenty of hands on time to learn good practice and technique. Included but not limited to will be the inspection of linear dimensions, angles, diameters, depths, finish, thread, run-out, flatness, parallelism and true position.. Measurement Method: Q & A task observation and inspection. Goal is to achieve rate of proficiency within subsequent three and a half months. 4. Secondary Operations 600 Will be trained in numerous techniques involved with deburring a finished part. Minor assembly work shall be included as well. General shop practices plus shipping and receiving shall be included. Measurement Method: Q &C A task observation and inspection. Goal is to achieve rate of proficiency within subsequent three and a half months. ELEMENTS OF TRAINING HOURS OF TRAINING 740 TOTAL RATING LEVELS: Measurement method: how will it be determined if OJT participant acquired the skill? QBcA, observation, product review/inspection, etc. PROFICIENT MODERATE MARGINAL II. COST COMPUTATION Example: Hourly Reimbursement $ 5 Hours 740 cost Per Trainee = $3.700 III. Person(s) authorized to sign payment invoices for EMPLOYER: Bob Fischer ???? i? President 10/04/2012 Print Name Signature Title Date Title Print Name Signature Date 3 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 marriage1 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. 1 1. 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. EXHIBIT B 15. *Dot and **SVP code books will be used 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. `%/%? '?+ S ? 10/04/2012 __ Employer Signature Date EXHIBIT B ?L•, =,? ; -`'Lco?®® CERTIFICATE OF LIABILITY' INSURANCE DATE (MM/DD/YYW) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER RG Business Insurance Agency, Inc. CONTACT NAME: An Affiliate of United Agencies PHONE A/C No - - - - 861 S. Oak Park Rd Covina CA 9'1724 E-MAIL ADDRESS: , INSURERS AFFORDING COVERAGE NAIC # License No.: 0555729 INSURERA: INSURED INSURER B - ' Accurate Performance Machining Inc. 2086 S Grand Avenue INSURERC: . Santa Ana CA 92705 INSURER D: INSURER E' INSURER F COVERAGES CERTIFICATE NUMBER: -I ZSa?F;s? REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANV 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD/1'YYY LIMITS A GENERAL LIABILITY ? M50-C L-00'10"1'19-1 6/15/20'12 6/15/20'13 EACH OCCURRENCE $ '1,000,000 ? COMMERCIAL GENERAL LIABILITY PR EMIS ES OEe occu ante $ 3QQ•000 CLAIMS-MADE ? OCCUR MED EXP (Any one person) $ 5.000 PERSONAL 8 ADV INJURY $ ? •000.000 GENERAL AGGREGATE $ 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ Excluded ? POLICY PRO LOC $ AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT ' Ea accntlent. S ANY AUTO BODILY INJURY (Par person) g ALL OWNED AUTOS SCHEDULED BODILY INJURY (Per accitlent) $ e NON-OWNED P R O P cR T nl AMAGE HIRED AUTOS AUTOS P e a tl $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE ? $ DED RETENTIONS $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY MSOWKOO'10066't 6/15/2072 6/15/20'13 WC STATU- O TORY LIMITS y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE ? N / A E_L. EACH ACCIDENT $ ? OOO QQQ OFFICER/MEMBER EXGLUDED7 (Mentlatory in NH) EL DISEASE - EA EMPLOYEE $ 7 QQQ QQQ If yes, tlescrlbe untler DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 7 ,000,QQQ DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD '101, Atldltlonel Remarks Sehetlule, If more space Is requl reli) The City of Santa Ana, its officers, employees, agents, and volunteers are named as additional insureds in respects to the general liability policy only per the attached form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Santa Ana t ? ®?'lY'?' v `a 2U C C nter Plaza THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE.WITH THE POLICY PROVISIONS. ? . y? ? IVIC e " ?? t. .._- - Santa Ana CA 92702 ?-v _, ??y? ?.r? AUTHORIZED REPRESENTATIVE s-?oRCK ?? /?/t / ` ' i 1sA ?. AttOYney ' - a m lin G Ch v a a f?ssts?u••' ? ©t988-2010 ACORD CORPORATION, All rights reserved- ACORD 25 (20'10/05) The ACORD name nd logo are registered marks of ACORD Exhibit C CERT NO.: 13562652 HaGhezine Hanh ]/5/2012 3:33:20 PM Page 1 0£ 6 M50-CL-001 01 1 9-1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY E?CTRA ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM 1. EXTENDED PROPERTY DAMAGE It is agreed that SECTION 1 - COVERAGE A., paragraph 2. Exclusions a. Expected or Intended is deleted and replaced by the following: a. Extended Property Damage "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. 2. PROPERTY SOLD OR ABANDONED BY YOU It is agreed that SECTION I - COVERAGE A. paragraph 2. Exclusion j.(2) is deleted and replaced by the following: (2) Premises you sell, give away, or abandon, if the 'property damage" arises out of any part of those premises, and occurred from hazards that were known by you or should have reasonably been known by you, at the time the property was transferred or abandoned. 3. NON OWNED WATERCRAFT It is agreed that SECTION 1 - COVERAGE A. paragraph 2. Exclusion g.(2) is deleted and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to cant' persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess, or contingent. 4. DAMAGE TO PREMISES RENTED TO YOU a. It is agreed that SECTION I - COVERAGE A. the last paragraph of 2. Exclusions is deleted and replaced by the following: Exclusions c. through n. does not apply to: (1) damage by fire, lightning, explosion, smoke or leaks from automatic fire protective systems; and (2) damage caused by a resident; to premises while rented to you or temporarily occupied by you with the permission of the owner. b. It is agreed that paragraph 6-of SECTION III - LIMITS OF INSURANCE is deleted and replaced by the following: 6. Subject to S. above, the Damage to Premises Rented To You Limit is the most we will pay under COVERAGE A for damages because of "property damage"; a. resulting from fire, lightning, explosion, smoke or leaks from automatic fire protective systems, or any combination thereof; and b. caused by a resident; to premises, rented to you ortemporarily occupied by you with the permission of the ow?ne ? vaBlvs r%p AGLO1350408 Includes copyright material from Insurance Services Office, Inc. ?- irc e of- SSpi2Cc < CSRT NO.: 13542652 KaChezine Baiffa 9/5/2012 3:33:20 PM Page 2 - 6 osp, f 5. BROAD NAMED INSURED COMMERCIAL GENERAL LIABILITY It is agreed that SECTION II -WHO IS AN INSURED is amended 4o include the following: Any corporation organized under the laws of the United States of America (including any state thereof, its territories or possessions, or Canada (including any province thereof) will qualify as a Named Insured if there is no similar insurance available to that organization, provided that one or more Named Insureds shown in the Declarations has, at the inception of the policy period, an ownership interest in such organization of more than 50%. 6. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT The notification requirements of paragraphs 2.a. and 2. b, of SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS apply only when the "occurrence°, offense, claim, or°suit" is known to: a. You, if you are an individual; b. A partner or member if you are a partnership or Joint venture; c. An officer or director if you are an entity other than a partnership, join4 venture or limited liability company; d. A member or manager if you are a limited liability company; or e. An insurance manager, risk manager or other °employee° you designate prior to loss to give notice to us. Knowledge of an °occurrence,° offense, claim, or °suit° by your agent, servant or °employee° shall not in and of itself constitute knowledge to you unless an individual described in items i. - S. of this provision G. has actual knowledge. 7. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS OR PRIOR OCCURRENCES The following is added to Condition fi_ Representations of SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS: Failure to disclose all hazards or prior °occunrences" or offenses existing as of the inception date of this Coverage Parl shall not prejudice the coverage afforded under this Coverage Part, provided such failure to disclose all hazards or prior "occurrences' or offenses is unintentional. 8. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition 8. Transfer of Rights of Recovery Against Others To Us of SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS is amended by adding the following: We waive any right of recovery we may have against any person or organization when such waiver is required by a written contract 4hat you have agreed to prior to loss. 9. ADDITIONAL INSUREDS a. LESSOR OF LEASED EQUIPMENT i. SECTION 11 -WHO IS AN INSURED is amended to include as an additional insured any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an insured only with respect to their liability for "bodily injury", "property damage° or °personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. ii. With respect to the insurance afforded these additional insureds, this insurance does?gtly to any "occurrence^ which takes place after the equipment lease expires. ?•j?? V F S"f OFZCK AGLOt 350408 Includes copyright material from Insurance Service ffice, I?nss` Sa ? C?'Cy ??a?jer 2e f 6 CERT NO.: 135Q2652 Kath?^rinc Banh x/5/2012 3:33:20 PM Page 3 0£ 6 COMMERCIAL GENERAL LIABILITY b. MANAGERS OR LESSORS OF PREMISES i. SECTION II -WHO IS AN INSURED is amended to include as an additional insured any person or organization from whom you lease premises when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an insured only with respect to liability arising out of your ownership, main4enance or use of that part of the premises leased to you subject Lo the following additional exclusions: ii. With respect to the insurance afforded these additional insureds, the following additional exclusions apply: This insurance doesnot apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises. (2) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. c. VENDORS i. SECTION 11 -WHO IS AN INSURED is amended to include as an additional insured any person or organization (referred to below as vendor) with whom you and such person or organization have agreed in writing in a contract or agreement that such person or organization be addetl as an additional insured on your policy, but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: the vendor's premises in connection with the sale of the product; ii. The insurance afforded the vendor does not apply to: (1) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that. the vendor would have in the absence of the contract or agreement; (2) Any express warranty unauthorized by you; (3) Any physical or chemical change in the product made intentionally by the vendor; (4) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container, (5) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (6) Demonstration, installation; servicing or repair operations, except such operations performed at (7) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or. (8) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for Sts own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (a) The exceptions contained in Sub-paragraphs 4.or 6.; or (b) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. iii. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. AGLO1350408 Includes copyright material from Insurance Services Office, Inc. ; ? a e 3 _-t_ISA E. STO- Key CBRT N- 13542652 -h-- B- 0/5/2012 3:33:20 PM Page 4 0£ 6 /assistant City <`, COMMERCIAL GENERAL LIABILITY d. OWNERS, LESSEES OR CONTRACTORS i. SECTION II -WHO IS AN INSURED is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", °property damage" or °personal and advertising injury" caused, in whole or in part°, by: (i) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf; in the pertormance of your ongoing operations for the additional insured. A person's or organization's status as an insured under this endorsement ands when your operations for that insured are completed_ ii_ With respect to the insurance afforded these additional insureds, the following additional exclusion applies: This insurance does not apply to: (?) "Bodily injury", "property. damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders; change orders or drawings and specifications; and (b) Supervisory, inspection, architectural or engineering adivities_ (2) Bodily injury° or °property damage° occurring after. (a) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insureds) at the location of the covered operations has been completed; or (b) That. portion of "your work° out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. .---.., e. ?. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT SECTION 11 -WHO IS AN INSURED is amended to include as an additional insured: _ (1) Any person or organization is an insured with whom you are required to add as an additional insured to this policy by a written contract, written agreement, or permit that is: ^?? (a) currently in effect or becoming effective during the term of this policy; and ??? (b) executed prior to the "bodily injury°, "property damage°, "personal and advertising injury°. (2) This insurance provided to the additional insured by this endorsement applies as follows: (a) That person or organization is only an additional insured with respect to liability caused by your negligent acts or omissions at or from: (1) Premises you own, rent, lease or occupy, or (2) Your ongoing operations performed for the additional insured at the job indicated by written contract or written agreement. (b) The limits of insurance applicable to the additional insured are those specified in the written contract or written agreement or in the Declarations of this policy whichever is less. These limits of insurance are inclusive of and not in addition to 4he limits of insurance shown in the Declarations. MFR®?T?T? t?.S ?Q :?®F,Ni. AGL09350408 Includes copyright material from Insurance Services Office, In5?I5tant City age a of 5 CERT NO_: 135a2652 Katherine Ha?1 x/5/2013 3:33:20 PM Page 5 of 6 COMMERCIP,L GENERAL LIABILITY (3) ?ih respec4 to the insurance afforded these additional insureds, the following additional exclusions apply: (a) This insurance does not apply to °bodily injury" or "property damage" occurring after. (1) all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insureds) ai the site of the covered operations has been completed; or (2) that portion of °your work° out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations on or ai the same project. (b) This insurance does not apply to °bodily injury°, °property damage°, "personal and advertising injury" caused by the rendering of or failure to render any professional services. (4) Regardless of whether other insurance is available to an additional insured on a primary basis, this insurance will be primary and noncontributory if a written contract between you 'and the additional insured specifically requires that this insurance be primary. 10. EXTENDED DEFINITION OF "BODILY INJURY" The definition of °bodily injury" in SECTION V -DEFINITIONS paragraph 3. is replaced by the following: °Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from any of these ai any time. 11. EXTENDED DEFINITION OF "PERSONAL AND ADVERTISING INJURY" The definition of °personal and advertising injury° in SECTION V -DEFINITIONS paragraph 14. is amended to include the additional offense of abuse of process. ?? ?? ??#?.lvi ??R®?E? L\SA E. SZ ORGK psslstat?t City pttorr?ey AGLO'1350408 Includes copyright material from Insurance Services Office, Inc. Page 5 of 5 CHAT NO.: 13542652 Katherine Hanh ')/5/2012 3:33:20 PM Page 6 0£ 6 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: 1 0/04/201 2 s Employer Signa re EXHIBIT D DIVISION OF EMPLOYMENT SERVICES PLACE OF PERFORMANCE FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS Name: Bob Fischer Name of Contractor: Accurate Performance Machining, Inc. Contractor Number: Date: 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): 2086 S. Grand Avenue Santa Ana, CA 92705 EXHIBIT D 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 Re ig ster (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. Bob Fischer. President Name and Title of Authorized Representative e=: /?? ,? ` - _ 10/04/2012 Signature Date EXHIBIT E 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 in?n?ediate 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 voluntazily 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 Regazding 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 pazagraph 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 E