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HomeMy WebLinkAboutCOAST COMPOSITIES, INC.-2012IN3UItANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES _ ? -3i-/3 L.?ci:?5 C? COUNCIL Dral t` ?? X19 Bement No. Evdy n Len z ON-THE-JOB TRAINING AGREEMENT UNDER THE WORKFORCE INVESTMENT ACT N-2012-135 THIS AGREEMENT is made and entered into this 24`h 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 Coast Composites, Inc. (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 October 26, 2012, and ending April 25, 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. 1 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 $4,511.00 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. 4. Subcontractine 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. Employer Oblieations. 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, 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. Emolovment 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, 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 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 3 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 azising 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 Dollazs ($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 I. 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 aze 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 Fundine. 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 Yeaz 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 aze no oral understandings or agreements between the pazties. 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 aze 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 WORK Center 1000 E. Santa Ana Blvd., Suite 200 Santa Ana, CA 92701 Attention: WORK Center Director EMPLOYER: Coast Composites, Inc. 1395 S. Lyon St. Santa Ana, CA 92705 Mary Magallon 6 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 awazd 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 herein below 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. 7 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 By6/ Lisa Store Assistant City Attorney RECOMMENDED FOR APPROVAL: EMPLOYER: Name: Mary Magallon Title: Human Resources Manager Federal Tax ID#: 71-0950139 State Tax ID#: 229-3890-6 Nancy T. Edw ds Interim Execu b e Director Community Development Agency Agreement # Exhibit A TRAINING PLAN I. GENERAL 1. Name of OJT Employer: Coast Composites Inc 2. Address of OJT Work-site: 1395 S. Lyon St.. Santa Ana CA 92705 3. Phone Number: 949.455.0665 ext. 194 4. Training Supervisor: Mike Arnold 5. Name of OJT Trainee: Aeustin Diaz 6. Application Number of Trainee: 1 O 18774 7. Proportion of trainees/employees: (at time Agreement entered into) a. Total number of employer's regular employees 288 c. Cumulative number of trainees currently in OJT 4 II. OCCUPATION AND ON-THE-JOB TRAINING OUTLINE: 1. Program: WIA -OJT - DW 2. Occupation/Product or Service: Metal Forming Helper 3. Length of Time in Business: 24 years 4. ONET Code: 51-4031.00 SVP Level?4.0 to < 6.01 5. Hourly Starting Wage: $13.00 Start Date: 10/26/2012 End Date: 04/25/2012 Hours 694 or Days or Weeks 6. State and Federal Tax I.D.: State: 229-3890-6 Federal: 71-0950139 7. Basic Work Week Hours: 40 8. Outline of On-the-Job Training Plan and Method of Assessment: 1 ELEMENTS OF TRAINING HOURS OF TRAINING 1. Assists Forming Operator with sets up and operates complex metal forming machinery/press machine in accordance with quality and safety standards: 194 a. Perform grinding, plasma cutting and saw cutting in accordance with quality and safety standards under supervision b. Train how to review shop engineering drawings with Forming Operator C. Based on production specifications and/or instructions, will learn how to assist the Forming Operator with selecting and setting up tools, equipment and machines required for quality production d. Will learn how to review machine tooling requirements and will learn how to plan set-ups Measurement Method: Q.& A, task observation and inspection. Goal is to achieve rate of proficiency within first Month and a half of training. 2. Operates a forklift in accordance with safety standards a. Learn how to use the forklift in the aerospace industry keeping in mind the various sizes and dimensions of the load. b. Learn and follow safe operating procedures associated with driving 100 C. Review, understand Job Hazard Analysis Measurement Method: Q.6k A, task observation and inspection. Goal is to achieve rate of proficiency within subsequent three and a half months. 3. Will learn the operations to understand the flow of work a. Learn to inform the Forming Operator or Supervisor of any operating or material condition that would interfere with quality production b. Learn how to perform routine operator maintenance and operational 200 checks on all tools and equipment utilized to include: tool sharpening, machine oiling, fluid level/air pressure checks, safety switch functioning etc. Measurement Method: Q &c A task observation and inspection. Goal is to achieve rate of roficienc within subsequent three and a half months. 4. Maintain BF work area per standard operating procedures: a. Learn how to maintains work area, tools, and equipment in a neat, clean, and orderly manner 200 b. Trained how to segregate and periodically disposes of scrap material into approved collection containers c. Be trained to assists with the completion of an inspection of equipment prior to use in an effort to ensure safe work practices and reports malfunctions and issues to supervisor 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? QBzA, observation, product review/inspection, etc. PROFICIENT MODERATE MARGINAL II. COST COMPUTATION Example: Hourly Reimbursement at 50% $ 6.50 Hours 694 cost Per Trainee _ $ 4,511.00 III. Person(s) authorized to sign payment invoices for EMPLOYER: ?p?? l?n..rnr??/? .L U ? Print ame Signature Title Date Print Name Signature Title 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 aze 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 mazital 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 mazriage? of the EMPLOYER may be trained under this Agreement. 9. Appropriate standazds for health and safety in work and training situations will be maintained. 1 O. Conditions of employment or training are appropriate and reasonable with regazd 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 upwazd 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. mplo er Signature Date EXHIBIT B rN.,.,ate. ?nza? NA MPPubII DATE (Lt M1VDDfYYYY) ,?IIC®R?+? ??R'T'1F1?/??? ®?' L I.?E311 I'T'Y If??IJRP?RI?? ® e 0 5/3 012 0 1 2 THlS CERTIFICATE IS ISSUED AS A h1ATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLOE R. THIS CERTi FICATE bOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORbED BY THE PO LIGIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSVRER(S), AUTHORIZED REPRESENTATIVE OR PROPVCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if IITa certillcale holder Is an ADDITtO NAL INSURED, the Po11cy(ie s) must bo endorsed. If SUBROGATfON IS WAIVEb, sLlbJecl to lhelerms and con dlNons of the policy, carlahT pollcfes may require an endorsemenf. A slalemenl on Ill is cerliflca[o does no( confor AOh[s to Iho certificate holder In Ilev of such orJdorsomenl(s}. PRODUCER H li€ACT --- Willis of NOYJ' Jersey, Ino. ?) e ----- Ext)`_ _ A/C Ilo 350 Mt. Kemble Avenuo E•h1AIL 00 P.O.BO>: 4969 INSURER 9 AFFORDING COVERAGE NAIC Ji Morristown, NJ 07962 1NSVAER A, Tw11T Clty Flre fns. Co. 29459 wsuRe° IJTSURea BrAmerlcan Zurich Insurance Co. 40442 Coast Composites Inc. INSURER c: Zurich Arnerlcan Ins Co 16535 5/7 Burrougl7 - N+sunER o: Irvine, CA 02018 INSURER E INSURER F : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 8EL04Y HAVE BEEN ISSUED TO THE INSURED NA/.1ED ABOVE FOR THE'POLICY PERI00 INDiCAT ED. NOTWITHSTANOINO ANY REALIREAIE NT, 7ERAL OR CONDITION OP ANY CONTRACTOR OTHER DOCUh1ENT V.'ITH RESPECT TO WHICH THIS CERTIFICATE fh'AV BE ISSVED OR t.SAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERhI S. E %CLUSIONS RND CONDITIONS OF SUCH POLL C1ES. LIMITS SHOWN AlAY HAVE BEEN REDUCED BY PAID CLA1fif S. ?J R LTSJt TYPE OFItfSURAHCE AD ER POLICY NV MBER !A / O iANf00 E P LI/A R3 A GENERAL LIABILITY 13CESOA9021 3/31/2092 03/31/2013 Enc UR RENCE H O C C 51 000 D00 X COt.1\tERC1Al GENERAL LIABILITY ? AG ? r E H ? /1.113E3 EaEO aE,a nce _ 53000D0 CLAN.eS•I.V10E ?X OCCVR l.IEDEXPiAnyoneperson) $iD OOD X BI/PD DVd:5.000 PERSOrIAL8AOVINJURY $1000000 GENERALAGOREOATE 32 000 OOO _ OENT_AG OREGATE lI1.eRAPP LIES PER: PROD VCTS _CO1.1 P/OP AGO $2 DOD 000 POLICY PEC LOC S C AUT OhlORILE LIABIL I7Y BAP5095S620D 3/31/2012 03/31!2013 C LIBINE?SINGLE LlA1R EoaWa nit i 000000 X ANY AUTO BODILY INJURY (POf parson) 5 All OYJNEO AVTOS CI{FOULED ? BOOIW INJURY (POl eCCfdenl) $ X HIRED AVT03 X O 1?01YNED AlJTOS ROPERTY AIfAGE Pare Ida 1 S $ ___ U/.IBRElLA L1A6 OCCUR EACH OCC URRETtCE __ $ _ EXCESS LIAD CLAI AIS?I.rADE ? AGGREGATE $ __ OEO RETEeITION S B \YORKERS COMPENSATION A O ElA P L O E 3'LI BIL N Y W0509588100 3/31/2012 03/31/2013 X WC S7ATV• OTR• ' ITY Y/tJ TTR rr ?? PP gq ?? ?g AI1?? ?LI t1 yy Dj ECVTIVE CE EREX LUD E.L_EACHACCIDENi S4 OOO 000 ? OFFI RR.IEIdB C E (I. tandalory In NH) NrA E.L. DISEASE•EA EI.IPLOVEE $1 000000 } DE3CRIP?NOF OPERATIONS bN.ovr E.L. DISEJISE•POLICYLII.IIT 0 00000 S1 y i F ??? DESCRIPTION OF OPERATIONS/LOCATIONS/VEFI(CLE9(AneehACDRD SDI, AdtllUonal Remarks SChedulq if more apace la repufred) ??, - ' EVIDENCE OF COVERAGE. ????? ,. 4- LISA E-• t{ Attorney J//` ? Assistant G y 7 UCK t IYIIiA 1 t HULUtIi 4'AN CEL LHI IVN Clly of Santa Ana THE V EXPIeRATIONH DATE V THEREOF, E N0701CE1 WIBLL CaE CDELIVEREOOIRN Finance & Mgmt Servloes Agency ACCORDANCE WITH THE POLICY PROVlSfONS. Purchaslnp DWlsfon 20 Glvlc Center Plaza M-10 AVTNORI2ED REPRESe NTATIVE P.O. Box 1988 {' S C 9 ?Jts3.' ? ,.. ?? ??_ •ein ©1986.2010 ACORD CORPORATION. All rlOltls roserved. ACORb 28 2010!06) i of 1 Tho ACORD name and logo aro regisle red marks ai ACORD t/S21 717lM211388 H2B Exhibit C POLICY 1J UR4BER: i.3 CES OA90a1 TS-11S EN[70RSEMENT' Ch1A6VOE5'i'1-IE k?CSI.ICY. P6.GASE REAf? fT' CARt~FULLY. This endorsement modifies Insurance provlded under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anizatton s : Designated Project(s) or Location(s) Of Covered O eratlons The City o£ Santa Ana, its officers, employees, agents and: representative 20 Civio Center Plata Santa Ana, CA 92701 Informallon re utred to com fete this Schedule If riot shown above will be shown In the Declarations. A. Section II -Who Is An Insured Is amended to include as an addillonal Insured the person(s) or organlzatlon(s) slto?vn In the Schedule above wlllt whom you agreed in a written contract or v?riilen agreement to provide insurance such as Is afforded under this policy, but only to the extent that such person or organization 4s liable for "bodliy Injury", "propeny damage" or "personal and advertlslny Injury" caused by your acts or ontlsslons or tits acts or omissions of litose acting on your behalf: 1. !n the performance of your ongoing operations for such addillonal Insured at the proJecl(s} or location(s) desfgnated In fhe Schedule; 2. In connection with your premises owned by or rented to you and shown In the Scitadute; or 3. in conneotton wrth "your work" for tits addillonal Insured at fife project(s) or location(s) designated In the Schedule and Includetl within the "products-completed operations hazard", but only if: a. The written contrac€ or agreement requires you to provide such coverage io such additlonat Insured at the project(s) or location(s) desfgnated in 1ha Schedule; and b. This Coverage Part provides coverage for "bodily Injury" or "property damage" Included within Ilte "products-completed operations hazard". B. The Insurance afforded to these additional insureds applies only If the "bodily injury" or "property damage" occurs, or the "personal and advertising In]ury" offense Is comrnltted: '1. During the policy period; and 2, Subsequent to tits execution of such wrflielt contract or written agreement; and 3. Prior to the expiration of the period of lime that the wrtlten contract or written agreement requires such Insurance be provlded to the addillonal insured. f=orm NS 24 ea 06 08 Page 1 of 3 © 2006, The Hartford (Includes copyrlghletl material of Insurance Services Office, Inc. ?vilh Its perrnlsslon.)? ?? •x® ?®?? 14??R??E ??? ?L1SA ?• SZOA toKrteY Exhibit C Ass}stant Gity I? C. D, Willi respect to the insurance afforded to these additional Insureds under this endorsement, ilia foltowing addlt[onal exclusion applies: This Insurance does not apply to "bodily InJury", "properly damage" or "personal and advertising injury" arising out of the rendering of or Ilse failure to render any professional archifeclural, engineering or surveying services by or Por you, including: ?. The preparing, approving, or fatting to prepare or approve maps, shop drawings, oplnione, reports, surveys, Reid orders, cltanga orders, designs or specificat[ons; and ?.. Supervisory, Inspection, archltecturat or anginaering actlvltles. How Limits Apply To Additional Insureds The most we whl pay on behalf of ilia additional insured shov?n in the Schedule Is the lesser of: •i. The limits of Insurance specified In ilia written contract or written agreemeni; or 2. The Limlls of insurance shown in iho Declarations. Suc1t, amount shall be a part of and not fn addition to Limits of insurance shown In the Declarations ahd tlescrtbed In this Section. buttes Of AUclillonal Insureds in 7ttp want Of Occurrence, Offense, Claim Or Sult The Duties Condtllott In Secflon IV - Condlfions: Is replaced by the foltowing and applies to the additional Insured shown In the Schedule: ?. Notice Of Occurrence Or Offense The addllional insured must see to !t that we are notified as soon as practicable of an "occurrence" or an offense witlctt may result in a clalrn. To i1,e extenf possible, notice should include: a. Ho?v, when and where the "occurrence" or offense took place; b. Tha names and addresses of any InJured parsons and witnesses; and c. TFte nature and tocatfon o! any InJury or damage arising out of the "occurrence" or offense. 2. Notice Of Claim If a claim is made or "suit" is brought against the addltlonal )neared, the additional Insured must: a. Immediately record the spec111cs of the claim or "sail" and the date received; and b. Notify us as soon as practicable. Tha addltlonal Insured must see to [4 that we receive written notice of the claim or "suit" as soon as practicable. Page 2 of 3 Exhibit C 3. Assistance And CooporaElorr pf The Insured Titer adtllttona! insured mtrsl: a. Immediately send us copies of any demands, notices, summonses or legal papers received In connecfion with ilia cfafm or "suit"; b. Authorize us to obtain records and other information; c. Cooperate v?ith us In the Invesltgalion or setttemenl of the claim or defense against ilia "suit"; and d. Asstsl us, upon our request, In the enforcement of any right against any person or organtzatlon v?hlch may be liable io the Insured because of InJury or damage to - which this insurance may also apply. d. Obligations At The Addlflonal Insureds Own Cosf No addllional insured will, except at That irtsurad's o?vn_ cost, voluntarily make a payment, assume any obitgatlon, or incur any expense, other Than for first aid, without our consent. t3. Atldittonal Insureds Other Insurance If wa cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available to ilia addltlonal Insured, such addltlonal insured must submit such claim or "suit" to 11te other Insurer for defense and Indemnity. However, this provision does not apply 4o the extent that you have agreed in a written contract or written agreement that this insurance Is primary and non-contributory w(th the additional insured's own insurance. 8. Knowledge Of An Occurrence, Offense, Claim Or Suit Paragraphs 7. and 2. applies to the addltlonal insured ohly when such "occurrence", offense, claim or "suit" is knov?n to: a. The addltlonal insured that Is an Individual; b. Any partner, if the addllional insured is a partnership; c. Any manager, If the addltlonal fnsuratl Is a limited liability company; d. Any "executive officer" or insurance manager, If ilia atlditlonal insured Is a corporallon; e. Any trustee, (( ilia add111ona1 insured Is a trust; or g? O??L ?,?? a as OB OB ST O RGK t-\SA ?• Attorney Assistant City ?? "{ f. Any elected or appointed olfJclai, if the additlonal Insured is a Itoiltical subdivision or public entity. F. Other htsurance With respect to Insurance provided to the additlonal insured shown In the Schedule, the Other Insurance Condition Sectton IV - Coredlllons Is replaced by lire CollowJng: 4. Prlrnary insurance a. Prllnary Irtsurence When Required By Contract This Insurance is prlmary If you have agreed In a written contract or vrrlllen agreement that this Insurance be primary. if other Insurance is also prlmary, we will share wtlh all that other Insurance by the mothod described in 3. below. b. Pr)rnary And I?fon-Contributory To Other Insurance When Required By Contract lfyou have agreed In a written contract or written agreement that this insurance is primary and non-conlribtrtary with the addlltonal lnsured's own Insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs e. and b. do not apply to other lnsuranca to which the addlltonal insured has boon atlded as an additlonal insured or to of}tar insurance described In paragraph 2. below. a. Excess Insurance Tttls insuranco is excess over any of the other insurance, whether primary, excess, conlingenl or on any other basis: a. Your Work 'that is Plre, Extendod Coverage, Builder's Risk, tnslallatlon Risk or sfmller coverage for "your work"; b. Pratnlses Ranted To You Thal Is fire, lightning . or axp[osfon lnsuranca for premises ranted to you or temporarily occupied by you 4vilh permission of the owner; c. Tenant Liability Tltat is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; d. Aircraft, Auto Or Watercraft if the loss arisea out of the maintenance or use of aircraft, "autos" or vrafercraft to Forrn F1S 24 82 06 08 Exhibit C the extent not subject (o Exclusion g, of Section I -Coverage A - Sodliy Injury Ahd Property Damage Ltabillly; e. property Damage to Borrowed Equipment Or Use Of Elevators if the foss arises out of "properly damages" to borrowed equipment or the use of elevators to the oxtent not subject to Exclusion j. of Sectton 1 - Govaraga A - l3otllly Injury And Property Demage Ltabillly; or f. When You Are Addod As An Additional Insured To Other {nsw•ance That is any other Insurance available to you covering liability for damages arising out of ltte premises or aperatlons, or products and completed operations, for which yarn have been added as an additional Insured by that Insurance. When this Insurance is excess, we wilt have no duly under Coverages A or B to defend the insured against any "suit" If any other tnsurer has a tluly to defend the Ensured against That "suit", 1( no other insurer defends, wa will undertake to do so, but we wilt be entitled to the insured's rights against all those outer insurers. When this Insurance is excess over other insurance, we will pay only our share of the amount of the toss, if any, that exceeds the sum of: a. The total amount that all such ocher insurance would pay for the toss in the absence of this Insurance; and b. The total of all detluctlble and self-Insured amounts under all that other lnsuranca. We will share the remaining loss, if any, with any other insurance that is hot described in this Excess Insurance provision and vas no! bougfrt specifically to apply in excess of the Limits of lnsuranca shown in the Declarations of This Coverage Parf. 3. Method Of Sharing If all of ttta other insurance permits conlributfon by equal shares, we will follow this method also. Under this approach each tnsurer contributes equal arnounts until it has paid Ifs applicable limit of Insurance or none of the toss remains, whichever comes first. If any of the other insurance does not permit conlributfon by equal shares, we w11i contribute by Ilmils. Under this method, each Insurer's share Is based on the ratio of its applicable IImH of Insurance to the total applicable Ilmils of lnsuranca of ail Insurers. ry+ FORM ????? Ee 9?f 3 LISA E.• S?ORCK City Lttorney Assistant ?/ ?` "/ Certification Regarding Drug-Free Workplace Requirements The certification set out below is a material representation upon which reliance is placed by the U.S. Department of Housing and Urban Development in awarding the grant. If it is later determined that the contractor knowingly rendered a false certification, or otherwise violates the requirements of the Drug-Free Workplace Act, the U.S. Department of Housing and Urban Development, in addition to any other remedies available to the Federal Government, may take action authorized under the Drug-Free Workplace Act. CERTIFICATION A. The contractor certifies that it will provide adrug-free workplace by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the contractor's workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing adrug-free awareness program to inform employees about - (1) The dangers of drug abuse in the workplace; (2) The contractor's policy of maintaining adrug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance program; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c) Making it a requirement that each employee who will be engaged in the performance of the grant be given a copy of the statement required by paragraph (a); (d) Notifying the employee in the statement required by paragraph -(a) that, as a condition of employment under the contract, the employee will - (1) Abide by the terms of the statement; and (2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction. Pg. 2 EXHIBIT D (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: ??/? `? ?-? Employer Signature EXHIBIT D DIVISION OF EMPLOYMENT SERVICES PLACE OF PERFORMANCE FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS Name: Coast Composites. Inc. Name of Contractor: Marv Magallon Contractor Number: Date: 10/24/2012 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): Coast Composites. Inc. 1395 South Lvon Street 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 Resister (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 fluids is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. ?f? ??/? /l?he? ?,a?,Q/ly•?t? Name and Tit e of Authorized R presentative ?v?a--??/ a- 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 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 E