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HomeMy WebLinkAboutCOAST COMPOSITES, INC. 3-2012INSURANCE ON FILE VvORK MAY PROCEED UNTIL INSURANCE EXPIRES N-20'12-'143 -?-3/- i3 CLERK OF COUNCIL Agreement No. ??? y n h Z ON-THE-JOB TRAINING AGREEMENT UNDER THE WORKFORCE INVESTMENT ACT THIS AGREEMENT is made and entered into this 7°' day of November, 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 November 12, 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. Fundins. CITY shall reimburse the EMPLOYER an amount not to exceed $3,643.50 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. 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. Emoloyment 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 azising 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 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 1. Record Keeuin?. 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 aze 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 aze 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) yeazs until resolution of disposition of such appeals, litigation, claims, or exceptions. 12. Govermnent Funding. This Agreement is valid and enforceable only if sufficient funds aze 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 Cau. 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 Pazagraph 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 anemployer-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 11375 and supplemented by the requirements of 41 CFR Part 60. EMPLOYER will also comply with all applicable federal and state laws and regulations, and particularly those assurances and certifications set forth in Exhibit B attached hereto and by this reference incorporated herein. 19. Prohibitions. The EMPLOYER shall not use any of the training funds provided under this Agreement for political or sectarian activities. 20. Grievance Procedure. The EMPLOYER shall continue to operate, or shall establish and maintain a grievance or complaint handling procedure relevant to the terms and conditions of employment and the EMPLOYER's activities and programs, which shall meet at a minimum the requirements set forth in Section 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. Drus 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 award to any party which is debarred or suspended or is otherwise excluded from or ineligible for participation in Federal assistance programs under Executive Order 12549, "Debarment and Suspension". See also 29 CRF Parts 97.35 and 98.510. EMPLOYER must review and sign Exhibit E "Debarment", which is attached hereto and incorporated herein by this reference. 24. Merger. This Agreement, together with the attachments hereto, expresses the total understanding of the parties. There are no oral understandings of the parties or terms and conditions other than as stated herein. 25. Validity. The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any other provision of this Agreement. 26. Miscellaneous Provisions. a. Each undersigned represents and warrants that its signature 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 By: Lisa Storck Assistant City Attorney RECOMMENDED FOR APPROVAL: EMPLOYER: Name: Mary aga on Title: Human Resources Manager Federal Tax ID#: 71-0950139 State Tax ID#: 229-3890-6 Nancy T. Elwards Interim Executive 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. Lvon St.. Santa Ana, CA 92705 3. Phone Number: 949.455.0665 ext. 194 4. Training Supervisor: Mazio Tores 5. Name of OJT Trainee: Norman Ramirez 6. Application Number of Trainee: 1 O 18952 7. Proportion of trainees/employees: (at time Agreement entered into) a. Total number of employer's regular employees 285 c. Cumulative number of trainees currently in OJT 5 II. OCCUPATION AND ON-THE-JOB TRAINING OUTLINE: 1. Program: WIA -OJT - DW 2. Occupation/Product or Service: Composite Technician III 3. Length of Time in Business: 24 veazs 4. ONET Code: SVP Level (4.0 to < 6.0) 5. Hourly Starting Wage: $10.00 plus 5% Shift Differential -Will be schedule 2"d shift only Start Date: 11/12/2012 End Date: 04/25/2012 Hours 694 or Days or Weeks 6. State and Federal Tax I.D.: State: 229-3890-6 Federal: 7 1-0950 1 39 7. Basic Work Week Hours: 40 8. Outline of On-the-Job Training Plan and Method of Assessment: ELEMENTS OF TRAINING HOURS OF TRAINING 1. Will learn to fabricate composite molds and parts as per instructions/drawings. Will learn to lay-up dry fabric and prepreg, demold, vacuum bag, wet 194 tie procedures and infuse composite parts as per instructions/drawings. Measurement Method: Q 8c A, task observation and inspection. Goal is to achieve rate of prot£ciency within £rst Month and a half of training. 2. Will learn to polish, deburr, and grind composites parts as per Instructions/drawings. Will learn to drill, ream and countersink. As well as to assemble 100 Parts/components/sub-assemblies. Measurement Method: Q 8c A, task observation and inspection. Goal is to achieve rate of proficiency within subsequent three and a half months. 3. Will provide with instructions and will be trained in written work instructions and will be trained to verify that work or tools meet quality standards as outlined. 200 Will learn to perform general equipment maintenance, including checking all equipment at the start of each shift Will also be required to learn SS Measurement Method: Q 8c A task observation and inspection. Goal is to achieve rate of roficienc within subse uent three and a half months. 4. Will be trained and provided standard operating procedures which are required during all processes. Will learn to drill, ream, and countersink. As well as to assemble 200 parts/components/sub-assemblies. Measurement Method: Q 8c A task observation and inspection. Goal is to achieve rate of roticienc within subse uent 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% $ 5.25 Hours 694 cost Per Trainee _ $ 3.643.50 III. Person(s) aAu/tho,?r/ized to sign payment invoices for EMPLOYER: Print N eSignature Trtle Print Name Signature Title Date Date 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 regulaz employee nor shall an OJT participant fill a position of a person who has been laid off from the same or similaz 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 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 marriages 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 aze 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 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. L Employer Signature ate EXHIBIT B ru?.,[e. ?agno t-r A M O l hill i1 f? qr?1p??•.p?y'`p??v f'Y ks®??,v ???.???????? ®? ??I'W L7 ?6 ??Y ?Itl ?7?fth'i1tl VS? GATE (I.I r.VDOlYYYY) ? 0 5/3 012 0 1 2 THIS GER7IFICATE IS lSSUEb A3 A h1ATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLOE R. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE PO LICIE3 BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRES EN7ATIVE OR PROPVCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if LILa cert(flcale hoiden Is an ADDITIONAL INSURED, the pollcy(le s) nJDSI bo endorsed. If SUBROGATION IS WAIVEb, sLlbJecl to the terms and con dlllons of the policy, certa(n po7lcfes may require an endorsement A sialemenl on Ihls cerllllca[e does no( confor rl0h(s to the certiflce(e holder hl Ileu of such ondorsomanl(s). _ PROOVCER ? NTAGT WIIIIS of Now Jersoy, IItO, I o Yt , ^" c Ito, )'--- 350 Mf. Kemble Avenue E- RI AIL D D -------- P.O,BOX 1969 P19 VRER 9 AFFORDING COVERAGE: NAICU Morristown, NJ OZ9fi2 INS VRER A, TWllt Clty Flre Ins. Co. 2g45s INaDREO NiSVAERB[AiT)BTICan Zurich Msurance Co. 40142 Coast Composites inc. INSURER c: Zurich American Ins Co 16535 617 Burro(Igh INSURER Of Irv III B, CA 92618 INSVRER 8 _ IHSUAER F I (`OVFRGR FR CFRTIF IR ATP NHlARRR. RF VIRIr]N NIIM RER: THIS fS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED eELOSV HAVE BEEN ISSUED TO THE INSURED NA).SED ABOVE FOR THE' POLICY PERIOR INDICATED. NOTWITHSTANOINO ANY RE[tUIREAtE NT. TERhf OR CONDITION OF ANY CONTRAOT OR OTHER DOCUh1ENT VJITH RESPECT TO WHICH THIS CERTIFICATE I,fAY 6E ISSUED OR t.(AV PERTAIN, THE INSURANCE AFFORDED SY 7HE POLICIES DESCRIBED HEREIN IS SVeJECT TO ALL THE TER hI S, E XCLUSIONS AND CONDITIONS OF SUCH POLICIES. LI h11TS SIIOWN 1.(AY HAVE BEEN REDUCED 8Y PAID CLAIh(S. 11 R LT{L TYPROFIH6UrlANCE O e POIICYHVN.pER MM(00 15l.IlOD E P LVARS A GENF.RALLIABILITY 13CESOA9021 3!31/2012 03/31/2013 cc uARENCE En c l lo 51 D00000 X C01.1h1ERCiAL OEIIERAL LIABILITY T ^ At ^ E REf l E9 ?iENTED a o?vr once s300 000 CLAI).1 S•I.V\DE ?X OCCVR 1.1ED EXP(Any mape,son) S1O QOO X BIlPD Doc1:5,000 PERSONAL8ADVINJVRY $i OOO OOO GENERAL AGO REOATE S2 OOO OOO _ GENT AGOAEOATE L11.1RAPPLIES PER: PRODUCTS-COi,1P/OP AGO 52000000 POLICY PEQ LOO $ C AUTOhlOAILa LIABILITY BAP509586200 3!31/2012 03/311201 Eaauia ?91NGLE LIAIlT 1 000000 X ANY AUTO BODILY INJURY (Porperaow) 3 ALLOY/NEO T S CIIEOV LEO T D ? 60DILY INJURY [POI accident) S X H R EO AVT09 X O OWNED V AUT03 PROs E I?YI AIJAGE 5 5 ___ UhIBRElLA LIAB OCCUR EACH OCCUARE NCE S _ EXC ESS LIAD CLAIAIS-I.IADE - _ AGGREGATE $ __ OEO RETETITIO:i S B \YORKERS COMPENSATION • WC5O9588100 3/31/2092 03/31/2013? X LYC STATV- OTK• LIAABIILyITY AA +NyO ERlA?PpLgO?YETERS D7 ECVTfVE YN I C O GL O R E E.L. EACH ACC]DENT Si OOO OOO O FF[ ERR.IE}.I B E % U E (1.landaloryln Nll) 1J)A E.L. DISEASE•FA £/.IPLOYEE $1 OOO OOO Iry os, dasulbo under DESCRIPTION OF OPERATIONS bNoly E.L. DISEASE•POLIGYLII.IIT 51 O9O QO O g? ?N Y??L?L`IJ- .F l`? DESCRIPTION OP OPERATIONS! LOCATION9l VEf11CLE3(AtlachACORD(0/, Adtllllopal Rama[ks 9chedulq if more apace rs requfrad) V? ???? 4- EVIOEP)CE OF COVERAGE. }? - "" g-? ORCK 1,1SA ?• itY gttorneY J r ? Assistant C '7 (:CR I IFIL:A t E HULV t i VANL:CLlP11IVN cllyofsantaAna TIEVEXPIRA710NHDA7EVTHEREOP,EN? ICE! W(LLOBEODELIVEREDORi Finance & Mgmt Services Agency ACCORDAI(CE WITH THE POLICY PROVISIONS. Purchasing DlYtstolt 2O (?.IVtO CStllei PtaZB M-16 AUTHORIZED REPRESENTATIVE P.O. BOX 1988 C 9 702 ?.a(?g,` ? >?° ?_ .e.? CcA 19fl R•2010 AC OR CORPORATION. All rin tits roserved. gCORO 25 (2010(06 1 Of 1 TI1o ACORD name and logo aro registered marks of ACORb NS211717/M?11386 HZB POLICYNURIBER:13 CES OA90a1 THIS l=ND©RSEMENT' CHANOE3 YHE POLICY. PLEASE READ jT' CAi"dEPULL.Y. This endorsement modifies insurance provided under the following: COIv1MERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Addltionai Insured Person(s) Or Or aerizatlon s : Daslgnatad Project(s) or Location(s) Of Covered O eratlons The City of Santa Ana, its oEficars, employees, agents an8 reQresentative 20 Ci_viC Center Plaza Santa Ana, CA 92701 Information re ulred to com fate this Schedule If not shown above will be shown in the Declarallons. A. Section 11 - Wito Is An Insured Is amended to include as an additional Insured the person(s) or organlzallon(s) sitotvn In the Schedule above wlllt whom you agreed in a wrilfen contract or wrlUen agreement to provtda Insurance such as Is afforded under this policy, but only to the extent that such person or organizaflon fs liable for "bodily Injury", "properly damage" or "personal and adve+tislny lnju+y" caused by your acts or ontlsslons or tits acts or omissions of Iftose ac(Ing on your behalf: _ 1. to the performance of your ongoing operations for such addAlonai htsured at the project(s) or Iocallon(s) designated fn the Scltadule; 2. In connection vrlth your premises owned by or ranted to you and shown In the Sctieduie; or 3. In connection with "your work" for the addltlonal insured at Ills project(s) of location(s) dealgnalad in the Schedule and Included within the "products-completed operations hazard", but only if: a. Tha wrillen contract or agreement r®qulres you to provide such coverage to such addltlonal Insured at the project(s) or Iocatfon(s) deslgnaled In 9ita Schedule; and b. This Coverage Part provides coverage for "bodily Injury" or "property damage" Included within the °'products-completed operations hazard". Tha Insurance afforded to these additional Insureds appllas only (f the "bodily Injury" or "property damage" occurs, or the "personal and adverflsing Injury" oNensa Is com+»IF[ed: 1. During the policy period; and 2. Subsequent to the exe culton of such wrillen contract or wrillen agreement; and 3. Prior to the expirallon of iha period of time that the written contract or written agreement requires such Insurance be provtdad to tits addltlonal insured. Form IiS 24 82 08 08 Page 1 of 3 © 2008, The Hartford (Includes copyrigitled rnaterlal of Insurance Services Office, Inc. ?vilh Its permission.) AS .?o ?r®? RCK -??" 1..lSA ?G tYO ttorcteY ?U C. F7. E. With respect to the tnsurance afforded to these addlllonal Insureds under this endorsement, the follotving addlltonal exclusion applies; This Insurance does not apply to "bodify Injury", "property damage" or "personal and advertising injury" arising out of the rendering of or file failure to render any professional archltaclural, engineering or surveying services by or (or you, ]ncluding: 'I, The preparing, approving, or falling to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, cltanga orders, designs or speciflcatlons; and ?.. SUpervlsory, Inspection, archlfecfura[ or anglneerittg activltles. How Llmlts APpty To Addltfonal Insureds TFte most eve will pay on_behalf of Ifte addittortal insured shov?n In the Scftadule is the lesser o(. t. The limits of insurance specified In the written contract or written agreentenl; or 2. The Limits of tnsurance shown in the Declarations. Suctt amount shall ba a paH of and not in addition to Llrnfis of Insurance shown in the Dectarallons and tlescribed In this Sacllon. buttes Of Addltfonal insureds in Tlto want Of Occurrence, Offense, Claim Or Sult The Dulles Condttlott In Sacllon IV - Condltfons Is replaced by the following and applies to the additional insured shown In the schedule; ?. Notice OF Occurrence Or Offense Tate addlltonal insured must see to !t chat we are notified as soon as pracltcable of an "occurrence" or an offense wttfcit may result In a cfattn. To iFte extent possible, nonce should Include: a. Ho?v, wizen and where the "occurrence" or offense took place; b. Tha names and addresses of any Injured parsons and Witnesses; and c. Tfte nature and tocalfon of any SnJury or damage arising out of the "occurrence" or offense. 2. Notice of Calm If a claim is made or "suit" is brought against the addlltonal Insured, the addlltonal Ensured must: a. Immediately record the specifics of lha claim or "cull" and lha date received; and b. Notify us as soon as practicable. The addlllonal Insured roust see to it that we receive written notice of the cfafnt or "suit" as soon as pracllcabfe. Pages 2 of 3 C.. N: 4:a n 3. Asstsfarrce And Cooparaflon Of The Insured Tha additional Insured must: a, Immediately sand us copies of any demands, notices, summonses or legal papers received In connection with the claim or "suit"; b. Authorize us to obtain records and other Information; c. Cooperate vrith us In the Invesligatton or seHlement of lha claim or defense against the "suit"; and d. Asslsl us, upon our reyuesl, in the enforcement of any right against any person or organlzalion vrhich may be liable to the insured because of injury or damage to - which this insurance may also apply. Q. Obflgattorts At The Addltfonal Insureds Own Cost No addlllonal Insured will, except at Ihat insured's otvn_ cost, voluntarily ntaka a payment, assume any obligation, or incur any expense, other than for tlrsl aid, without our consent. 6. Addltfonal Insureds Other insurance If vra cover a claim or "suit" under this Coverage Part that may also ba covered by other Insurance available to ilia addlltonal Insured, such additional insured must submit such claim or "suit" to ilia olttar Insurer for defense and indemnity. However, Ihts provision does not apply to the extent that you have agreed in a written contract or vrrllfen agreement that Ihls tnsurance is primary and non-contributory with the addlltonal fnsured's own insurance. 6. Knowledge Of An Occurrence, Offense, Ctalm OrSuft Paragraphs 1. and 2. apples to the addlllonal insured only when such "occurrence", oKense, claim or "suet" Is k[tov?n to: a. The addlltonal Insured that Is an Individual; b. Any partner, if the addlltonal Insured is a partnership; c. Any manager, If the additional insured Is a limited liability company; d. Any "executive oH(cer" or Insurance manager, if the additional insured Is a corporalton; e. Any truetes, ff the addlltonal insured is a trust; or .nom S ?? ??pTtN? }?.??x slot 2 82 OB OB ST O FtCSC LiSA ?' itY Attorney Assistant C ?? (?/ r. Any elected or appointed olficfal, if the addit[onal insured Is a ltolllical subdivision or pubilo enfit}r. otherlnsuranco With respect to Insurance provided to the additlonal Insured shown In iha Schedule, the Outer insurance Condition Section IV - Condlllons Is replaced by Cite foltowing: 4. prlmary Insurancs a. Prhnary Insurance When f2eyuh•ed By Contract This Insurance is prlmary if you have agreed In a written contract or vrrllten agreement that tills insurance ba prlmary. If outer Insurance Is also primary, we will share with all that other Insurance by the malhod described in 3. below. b. Primary And Non-Confrlbutory To Other Insurance When Required By Contract tf you heve agreed in a written contract or written agreement that this insurance is prlmary and non-contributory with the addltlonal insured's own Insurance, Ih€s insurance is printery and we will not seek contribution from that other insurance. Paragraphs e. and b. do not apply to other Insurance to winch the addltlonal Ensured has bean added as an addiifonal insured or to outer insurance described In paragraph 2. below. a, Excess Insurance TFtis insurance is excess over any of the other Insurance, whether printery, excess, contingent or on any other bests: a. Your Work 'fhal is Flre, Extended Coverage, Bulider's Risk, Irtslallatlon Rlsk or similar coverage for "ycur work"; b, Pretnlses Rented To Vou That is fire, lightning . or expioston Insurance for premises ronled to you or temporarily occupied by you 4vilh permission of the owner; o. Tenant Llabfllfy That Is insurance purchased by you to cover your Ilabllily as a tenant for "property damage" to promises rented to you ar femporarlfy occupied by you with permission of the owner; d. Aircraft, Auto Or Watercraft If fire loss arfses out of the mefnlenance or use of aircraft, "autos" or v?atercraft to Porrn HS 24 82 06 08 Exhibit C the extent not subject to Excluslon g. of Section I -Coverage A - Sodlly Injury Ahd Property Damage Llablllly; e. Property Damage fo Borrowed Equlprttertt Or Use Of Elevators If the foss arfses out of "properly damago" fo borrowed eyulpmenl or the use of olevators to the extent not subject to Excluslon j. of Section 1 - Coverage A - Qodlly Injury And Property Damage L.iabillly; or f. Witen You Are Added As An Additional insured To Othertnsuranee That is any other Insurance available to you covering liability for damages arising out of lfte premises or operations, or products and completed operations, for which yotr have been added as an additlonal Insured by Ihat Insurance. When this insurance is excess, we will have no duly under Coverages A or B to defend the insured against any "suit" If any other Insurer has a duly to defend the Insured against Thal "suit". If no ocher Insurer defends, wa will undertake to do so, but wa w{If ba enlitied to the Insured's rlgitts against all those outer Insurers. When this Insurance is excess over ocher insurance, we will pay only our share of ilia amount of Cite toss, If any, lltat exceeds the sum of: a. The iotaf amount that ail such other insurance would pay for the loss in the absence of This insurance; and b. The tote) of alt deductible and self-insured amounts under all lftat outer insurance. We will share the remaining toss, If any, with any other insurance lltal is not described in this Excess insurance provision and eras no! bought specifically (o apply in excess of the Limits of Insurance shown In the Declarations of Iltls Coverage Part. 3. Method of Sharing If alt of ttte other Insurance permits contribution by equal shares, wa wllf follow lilts method also. Under this approach each Insurer contributes equal arnounls un111 ll has paid Its applicable lintlt of insurance or none of the loss remains, whichever comes first. If any of the olfter Insurance does not permit contribution by equal shares, we wilt contribute by limits. Under this malhod, each insurer's share is based on the ratio of its applicable Ilntit of Insurance to lire total applicable limits of insurance of all Insurers. EORNi R?????]?`,]? e 9 ZSf 3 LISA ECity Attorney 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: l ? ? ??- Employer Signa ure 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: 1 1 /7/2012 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 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," "pazticipant," "person," "primary covered transaction," "principal," "proposal," and "voluntazily 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, declazed 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 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 pazticipant 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 pazticipant may, but is not required to check the List of Parties Excluded from Procurement or Non- Procurement Proerams. 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 pazticipant 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 pazticipant 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 Certification Regazding 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. Name afid Title o?Authorized Representative ? f ? / ?- Si afore Date EXHIBIT E