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PIG'S TAIL USA, LLC 3 - 2013
v,is,UR+IA:NiCE art FELE: u', RW MI'Ar lJIRGUED UNTR WSUfdANCE EXPIRES /g"? CLERROFCOUNCIL MAI 73 I?1t7E;' Agreement No. b',CDA^/Work Cev4e r r?'CGtC??n C}c?(?}fJ?'C? ON-THE-JOB TRAINING AGREEMENT UNDER THE WORKFORCE INVESTMENT ACT N-2013-036 THIS AGREEMENT is made and entered into this 15th day of April, 2013 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 Pig's Tail USA, LLC (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 April 15, 2013, and ending June 28, 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. Funding. CITY shall reimburse the EMPLOYER an amount not to exceed $2,000 in accordance with the Cost Computation included in Exhibit A. EMPLOYER shall bill the CITY monthly on an invoice provided by CITY for actual and reasonable cost for providing the services described in this Agreement. Reimbursement of EMPLOYER under this Agreement shall be limited to the costs incurred during the basic work week, excluding overtime and any paid holidays or sick leave. 4. Subcontracting Prohibited. The EMPLOYER shall not subcontract or assign the OJT Training. Any attempt by the EMPLOYER to delegate or assign OJT training duties under this Agreement shall void, and permit CITY to immediately terminate, this Agreement. 5. Employer Obligations, During the training, the EMPLOYER shall ensure that the Trainee: a. is on the EMPLOYER's payroll, not paid as a contracted employee/independent contractor; and, b. receives the same benefits as EMPLOYER's other employees performing similar work, and, c. is paid the salary as indicated in Exhibit A with appropriate payroll taxes withheld and reported; and, d. is provided Worker's Compensation Insurance coverage, pursuant to state law; and, e. is provided by EMPLOYER with safety instructions and equipment necessary for reasonable protection against injury and damage. CONTRACTOR shall maintain appropriate standards for health and safety in work and training situations. Where special clothing or equipment is provided to the EMPLOYER's regular employees, EMPLOYER shall provide the same type of clothing or equipment to the Trainee performing similar work. 6. Employment of Trainee. The EMPLOYER shall employ the Trainee as a regular member of EMPLOYER's work force. If EMPLOYER wants to continue to employ the Trainee upon the successful completion of the training period under this Agreement, said employment shall be subject to the same conditions of employment applied to EMPLOYER's other regular employees, including termination for unsatisfactory performance. 2 7. Patent, 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. 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 a royalty- free, nonexclusive and irrevocable license to reproduce, publish, use and to authorize others to use all copyrighted material. 2. The DOL reserves a royalty-free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use, for Federal Government purposes: (a) The copyright in any work developed under any grant, sub-grant, or contract under a grant or subgrant; (b) Any right of copyright to which a grantee, subgrantee or a EMPLOYER purchases ownership with grant support; and (c) EMPLOYER shall comply with the requirements of 29 CFR Part 97.34. C. Rights to Data. The DOL and the CITY shall have unlimited rights to any data first procured or delivered under this Agreement. 9. Hold Harmless. The EMPLOYER shall indemnify, defend and hold harmless CITY, and its officers, agents and employees, from and against any and all damages to property or injuries to or death of any person or persons, including property and employees or agents of CITY, and shall indemnify, defend and hold harmless CITY, and its officers, agents and employees, from any and all claims, demands, suits, actions or proceedings of any kind or nature, including, but not limited to, workers' compensation claims, resulting from or arising out of the negligent acts, errors or omissions of EMPLOYER, its employees, agents or subcontractors. 10. Insurance. The EMPLOYER shall obtain at its sole cost and file with the City of Santa Ana - Santa Ana W/O/R/K Center, upon execution of this Agreement, and maintain for the period covered by this Agreement, a policy or policies of commercial general liability insurance or a certificate of such insurance, satisfactory to the City Attorney of CITY, naming CITY, and its officers, agents and employees, as insured or additional insured (see attached Additional Insured Endorsement, Exhibit C), which provides coverage not less than that provided in the form of a comprehensive general liability insurance policy against liability for any and all claims and suits for damages or injuries to persons or property resulting from or arising out of operations of EMPLOYER, and its officers, agents, or employees. Said policy or policies of insurance shall provide coverage for both bodily injury and property damage in no less than One Million Dollars ($1,000,000). Said policy or policies shall also contain a provision that no termination, cancellation or change of coverage or of insured or additional insured shall be effective until after thirty (30) days notice thereof has been given in writing to CITY. EMPLOYER shall give to CITY prompt and timely notice of claims made or suit instituted against said policy. EMPLOYER shall procure and maintain at its own costs and expense, any additional kinds and amounts of insurance which, in its own judgment, may be necessary for its proper protection. 11. Record Keeping. CITY, the State of California and the United States government and/or their representatives shall have access for purposes of monitoring, auditing and examining of EMPLOYER'S activities, performance, books, documents, papers, and records of EMPLOYER'S subcontractors, bookkeepers and accountants, and employees and participants related to this Agreement. Such agencies or representatives shall also schedule on-site monitoring in their discretion. Monitoring activities may also include, but are not limited to, questioning employees and participants and entering any premises or onto any site in which any of the services or activities funded hereunder are conducted or in which any of the records of EMPLOYER are kept. Nothing herein shall be construed to require access to any privileged or confidential information as set forth in federal or state law. In the event EMPLOYER does not make the above-referenced documents available within the City of Santa Ana, California, EMPLOYER agrees to pay all necessary and reasonable expenses incurred by CITY in conducting any audit at the location where said records and books of account are maintained. All accounting records and evidence pertaining to all costs of EMPLOYER and all documents related to this Agreement shall be kept available at the location where EMPLOYER conducted the program, as well as in the County of Orange, for the duration of this Agreement and thereafter for three (3) years after completion of an audit. Records which relate to (a) complaints, claims, administrative proceedings or litigation arising out of the performance of this Agreement, or (b) costs and expenses of this Agreement to which CITY, the State of California or the United States Government take exception, 4 shall be retained beyond the three (3) years until resolution of disposition of such appeals, litigation, claims, or exceptions. 12. Government Funding. This Agreement is valid and enforceable only if sufficient funds are made available to the State by the United States Government for the same Fiscal Year as for this Program. In addition, this Agreement is subject to any additional restrictions, limitations, or conditions enacted by Congress or any statute enacted by Congress which may affect the provision, terms or funding of this Agreement in any manner. 13. Payment Cap. Based on the size of Employer, City's OJT payments to EMPLOYER shall not exceed a maximum of fifty percent (50%) of the wages paid by EMPLOYER during the training period specified in Exhibit A. 14. Amendment of Agreement. No alteration or variation of the terms of this Agreement shall be valid and/or binding unless made in writing and signed by both parties. There are no oral understandings or agreements between the parties. 15. Breach/Sanctions. If, through any cause, EMPLOYER violates any of the terms and conditions of this Agreement, or if EMPLOYER reports inaccurately or if any Audit Report makes disallowances, EMPLOYER shall promptly remedy its acts or omissions and/or repay CITY all amounts due CITY as a result of EMPLOYER's violation. For any such failures or violations, CITY shall also have the right at its sole discretion to either: (1) discontinue program support until such time as EMPLOYER fulfills its obligations or remedies all violations of this agreement or prior agreements; and/or (2) collect outstanding amounts as determined by CITY due CITY by offsetting or debiting from current claims or invoices, if after thirty (30) days' written notice EMPLOYER has failed to repay same or a repayment schedule has not been made; and/or (3) terminate this Agreement by giving written notice to EMPLOYER of such termination in accordance the notice provision in Paragraph XVIII herein below. 16. Termination. Either party may terminate this Agreement upon thirty (30) days prior written notice to the other party. However, the CITY may immediately terminate this Agreement at such time as fiords are not made available to CITY through the United States Department of Labor or the State of California Employment Development Department for the purpose of carrying out this Agreement. 17. Independent Contractor. The EMPLOYER, and any agents and employees of the EMPLOYER, in the performance of this Agreement, shall act in an independent capacity as independent contractors and not as officers, employees, or agents of the CITY. This Agreement is not intended nor shall it be construed to create an employer-employee relationship between EMPLOYER and CITY, nor a joint venture relationship. The EMPLOYER shall not subcontract in the name of the CITY. 18. Equal Employment Opportunities. The EMPLOYER warrants that it will comply with Title VI of the Civil Rights Act of 1964, and the requirements relating to equal employment opportunities set forth in Executive Order No. 11246, as amended by E.O. 5 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 finds provided under this Agreement for political or sectarian activities. 20. Grievance Procedure. The EMPLOYER shall continue to operate, or shall establish and maintain a grievance or complaint handling procedure relevant to the terms and conditions of employment and the EMPLOYER's activities and programs, which shall meet at a minimum the requirements set forth in Section 101(31) of the Act and 663.700- 710 and regulations promulgated by the State or Federal Govermment. 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 a drug-free work place and to execute a certification as set forth in Exhibit D attached hereto and incorporated herein by this reference. 23. Notices. All notices, reports and correspondence between the parties hereto respecting this Agreement shall be in writing and deposited in the United States mail, postage prepaid, addressed as follows: CITY: City of Santa Ana- Santa Ana W/O/R/K Center 1000 E. Santa Ana Blvd., Suite 200 Santa Ana, CA 92701 Attention: WORK Center Director EMPLOYER: Pig's Tail USA, LLC 1601 E. St. Andrews Place, Unit B Santa Ana, CA 92705 ATT: Rob Mitchell 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 hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify CITY filly, 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 filly set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: Maria D. Huizar L. Clerk of the Council CITY /;; ANA Kevin O'Rourke Interim City Manager APPROVED AS TO FORM: Sonia R. Carvalho City Attorney t -4/ By: Lisa Storck Assistant City Attorney RECOMMENDED FOR APPROVAL: EMPLOYER: Rob Mitchell Operations M< Tax ID#: 012- Linda Oberman Economic Development Manager TRAINING PLAN 1. GENERAL Exhibit A I. Name of OJT Employer: Pie'sTail USA, LLC 2. Address of OJT Work-site: 1601 E. St. Andrews Place, Unite B, Santa Ana, CA 92705 3. Phone Number: 714-566-0011 4. Training Supervisor: Rob Mitchell 5. Name of OJT Trainee: Elvia Lopez 6. Application Number of Trainee: 1016940 7. Proportion of trainees/employees: (at time Agreement entered into) a. Total number of employer's regular employees 7 C. Cumulative number of trainees currently in OJT I II. OCCUPATION AND ON-THE-JOB TRAINING OUTLINE: 1. Case Number #: 1013792 2. Occupation/Product or Service: Hydraulic Components 3. Length of Time in Business: 1.5 years 4. ONET Code: Cutter/514031 SVP Level (4.0<6.0) 5. Hourly Starting Wage: $10 Start Date: 04/15/2013 End Date: 06/28/2013 Hours 400 or Days or Weeks 6. State and Federal Tax I.D.: State 012-7760 Federal 90-0774982 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 be trained to support the company by performing duties to 250 include: a. Cut HDPE pipe with a proprietary cutting machine, that measure lengths and cutting radius of the material. b. Package materials according to diameter sizing, length, and color c. Mark identification numbers, trademarks, grades, marketing data, sizes, or model numbers on products. d. Read work orders to determine dimensions, cutting locations and quantities to cut. Measurement Method: Q & A, task observation and inspection. Goal is to achieve rate of proficiency within first Month and a half of training. 2. A. Will be trained to feed various sizes of HDPE pipe through cutting 100 machine. B. Will be trained to measure pipe dimensions as the product is being fed through the cutting machine to ensure product is to specifications. C. Will learn to stack items and load them on racks, conveyors or onto trucks. Measurement Method: Q & A, task observation and inspection. Goal is to achieve rate of proficiency within subsequent three and a half months. 3. Will learn aspect of warehousing operations to include: A. Receiving and counting stock items, packing and unpacking items to be 50 stocked in warehouse. B. Will be trained to store item in orderly and accessible manner in the warehouse. C. Will be trained to mark stock items using identification tags, markings, etc. Will determine proper storage methods, identification and stock location. D. Will learn to maintain records on use and/or damage of stock or stock handling equipment. Will examine and inspect stock for wear or defects, and advise management of any damage. E. Will also perform inventory and shipping and receiving or product. Will also be trained correct operation or forklift and will perform palletizing duties. Measurement Method: Q & A task observation and inspection. Goal is to achieve rate of proficiency within subsequent three and a half months. RATING LEVELS: Measurement method: how will it be determined if OJT participant acquired the skill? Q&A, observation, product review/inspection, etc. PROFICIENT II. COST COMPUTATION Example: Hourly Reimbursement $ 5 MODERATE MARGINAL Hours 400 cost Per Trainee = $ 2,000 III. Person(s) authorized to sign payment invoices for EMPLOYER: Pig'sTail USA, LLC Robert Mitchell F-A C.0.0 04/04/2013 Print Name Signature Title Date Print Name Signature Title Date 3 ASSURANCES A. The EMPLOYER assures that: L It will comply with the requirements of the Workforce Investment Act (WIA), the California Unemployment Insurance Code, as amended, and the regulations and policies promulgated thereunder. 2. No OJT participant displaces a regular employee nor shall an OJT participant fill a position of a person who has been laid off from the same or similar position. 3. No current employees are receiving unemployment insurance benefits as a result of layoffs or work reductions. 4. No person in the United States shall on the grounds of race, color, sex, religion, national origin, age, disability, sexual orientation, or marital status be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the applicant receives federal financial assistance and will immediately take any measure necessary to effectuate this Agreement. 5. It will comply with provisions of the Hatch Act, if applicable, which limits the political activities of employees. 6. Individuals receiving training on the job shall be compensated by the EMPLOYER at such rate, including periodic increases, as may be deemed reasonable under regulations prescribed by the Secretary of Labor, but in no event at a rate less than that specified in Section 6 (a) (1) of the Pair 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 tinder this Agreement. 9. Appropriate standards for health and safety in work and training situations will be maintained. 10. Conditions of employment or training are appropriate and reasonable with regard to the type of work, the geographical region, and the proficiency of the trainee. 11. Training will not be for any occupation which requires less than six weeks of training according to the Specific Vocational Preparation Table (SVP Code). 12. Training will, to the maximum extent practicable, be consistent with every individual's fullest capabilities and lead to employment possibilities. 13. The program will, to the maximum extent feasible, contribute to the occupational development or upward mobility of individual participants. 14. Training will be in accordance with the training plan, which plan incorporates documentation that must be completed by EMPLOYER before end of contract. 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. A kl 04/04/2013 Employer Signatt e Date EXHIBIT B hI'd'Cx?r?r"l o A?t?R1?? CERTIFICATE OF LIABILITY OIVJU RI'11M4E ?---? oATa 1MMInolYYW1 2013 THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: It the certificate holder Is an ADDITIONAL INSURED,. the pailcy(los) must be endorsed. If SUBROGATION 13 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Ilea of Such endorsement(s), PRODUCER 0 ,NAME Comm 1 Nickerson Insurance Services, Inc. ., ?o0°Noexf1, (310)328-5333 ?ra NIlol lz6-5416 - LIC 80991559 EMA? 9QRSE,43:.. 2106 West: Lomita Blvd, INEURERISIAPPORUINOCOVERAga NAICe Lomita _ CA 90717 INSURER A: Sentinel Insurance Compaam LTD INSURED INSURERBEartford Underwriters Ins Co, Pigs Taz1 USA LLC, IDEA: Pro-Con Industries INSURER C: 1601-B East St Andrew Place INSURER 0i INSURER E: ______ Santa Ana CA 92705 _ INSURER F: vvvGRY.VW pgr{1 {Y WHICNUIVIgCtta??ae zve Yz"1G wu REVISION NUMBER; THIS IS I'D CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 8E ISSUED OR MAY PERTAIN, THE INSURANCE AFFOROED BY THE POLICIES DESCRIBCD HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. EGENERALLIAUILITY MERCIALQCNERALLIAEIJTY A CLAIMS MADE [K] OCCUR 13 2,000 1.000 PER: A ANY AUTO AU OSNEU ULE SCT T A UTOS X X NON.OWNE IPI AUTOS AUTOS UMaRELLA LIAR OCCUR EXCESS UAB 11 B'- YIN 0 20DILY INJURY(Pdt prumQ 5 LL2 1/16/2013 1/18/2018 eOgLY INJURY (POraaclGUntl S EA 9,000 OE ORINOf OF OPERATIONS( aA of I ers, agents, s Atl esSeae6ulo, It snecelvequ City of Santa Ana lt its. officers, entts, , and employees are hereby include ded as additional insureds on the liability With respect to claims arising out of L•he operations and uses performed by or on behalf of the namod insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with.any other insurance carried by or for the benofit of the additional insureds 30 days notice of cancellation subject to 10 days notice for non payment of premium, City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 NSnB.R mmmn m SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ISaxah Kelly/M,TP' ©1956•: Thu Arrn PYl name and Inn. eve re.fe}<re.i muree of Exhibit C 11 ?G(,1tklUMAfSu"' ?CJ'gt'kc,l.Et'ved... LISA E. STORCK Assistant City Attorney POLICY NUMBER: 72 SBA AN4172 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ 11" CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) City of Santa Ana its officers, agents, and employees Information required to complete this Schedule, If not shown above, will be shown In the Declarations. Section II - Who Is An Insured Is amended to Include as an additional Insured the person(s) or organization(s) shown In the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or In part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operstlon% or B. In connection with your premises owned by or ranted to you. CG 20 26 07 04 0 ISO Properties, Inc., 2004 S1koV ??G d FORNLPage 1 of 1 TU LI5I E Assistan'r City Fttornev Z/_I Exhibit C Pigs Tail. USA LLC Policy fj72SBAAN4112 Eff: 1/18/2013 - 01/18/2014 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. AMENDMENT OF OTHER INSURANCE CONDITION - PRIMARY OR PRIMARY AND NON-CONTRIBUTORY WHEN REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT This endorsement modifies Insurance provided under the following; UMBRELLA LIABILITY POLICY Paragraph 6.2 of Section III - Who Is An Insured Is replaced by the following: 2. Any person or organization with whom you agreed, because of a written contract, written agreement or because of a permit issued by a state or political subdivision, to provide Insurance such as Is afforded under this policy, but only with respect tc your operations, "your work" or facilities owned or used by you, This provision does not apply: a. Unless the written contract or written agreement has been executed, or the permit has been Issued prior to the "bodily Injury", "property damage", or "personal and advertising injury"; and b. Unless the limits of liability specified In such written contract, written agreement or permit are greater than the limits shown for"underlying Insurance"; or c. Beyond the period of time required by the written contract or written agreement. In no event shall any coverage afforded to any such person or organization apply to any claim or "suit" to which "underlying Insurance" does not apply. Coverage provided by this policy for any such additional Insured will follow the provisions, exclusions and limitations of the "underlying Insurance". It. Solely as respects the Insurance afforded to any person or organization qualifying as an additional insured under Paragraph t. above, the Other Insurance condition In Section VI - Conditions Is replaced by the following: G. Other Insurance This policy shall apply In excess of all "underlying Insurance" whether or not valid and collectible. It shall also apply in excess of other valid and collectible Insurance (except other Insurance purohased specifically to apply in excess of this Insurance) which also applies to any loss for which insurance Is provided by this policy. These excess provisions apply, whether such other insurance Is stated to be; a. Primary; b. Contributing; c. Excess; or d, Contingent, 2. However, the following provisions apply to other Insurance available to any person or organization qualifying as an additional Insured under Paragraph 13Z of Section III - Who Is An Insured, as amended by Item h of this endorsement and who Is also on additional insured under the Commercial General Liability Coverage Part scheduled in the "underlying insurance"; a. Primary Insurance When Required By Contract If you have agreed In a written contract, written agreement or permit to provide primary insurance to the additional Insured, than, after the "underlying insurance" is Form XL 24 37 09 11 © 2011, The Hartford (Includes copyrighted material of Insurance Services Office Exhibit C APT???v,65901 orPf 2'r? FORM, Inc., with Its permission.) ® LISA "c STORGK Assistant City Attorney ) / exhausted, this Insurance will be primary. If other Insurance Is also primary, we will share with all that other Insurance by the method described In Paragraph 3. below, b, Primary And Non-Contrlbutory To Other Insurance When Required By Contract if you have agreed In a written contract, written agreement, or permit to provide Insurance to the additional Insured that Is primary and non-contributory, then, after the "underlying Insurance" is exhausted, this Insurance will be primary and we will not seek contribution from the additional Insured's own Insurance. Paragraphs a. and b. do not apply to other Insurance on which the additional Insured qualifies as an additional Insured pursuant to the terms of that policy or has been added as an additional Insured by endorsement. 3. Method Of Sharing If all of the other Insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until It has paid Its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other Insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each Insurer's share Is based on the ratio of Its applicable limit of insurance to the total applicable limits of Insurance of all Insurers, III. The following is added to Section IV - Limits Of Insurance: H. How Limits Appiy To Additional Insureds If you have agreed in a written contract, written agreement or permit that another person or organization be added as an additional Insured on the Commercial General Liability Coverage Part scheduled In the "underlying Insurance" and such person or organization also qualifies as an additional insured under this policy, the most we will pay on behalf of such Insured Is the lesser of; a, The limits of Insurance specified in the written contract, written agreement at permit, less any amounts payable by any "underlying insurance"; or b. The Limits of Insurance shown In the Umbrella Liability Policy Declarations. Such amount shall be a part of and not in addition to the Limits of Insurance shown In the Umbrella Liability Policy Declarations and described In other provisions of this Section. RPP???EU :?S T? ?o,"Ni LISP, - Assistant CM Attorney Page 2 of 2 Form XL 24 37 09 11 Exhibit C Certification Regarding Druq-Free Workplace Requirements The certification set out below is a material representation upon which reliance is placed by the U.S. Department of Housing and Urban Development in awarding the grant. If it is later determined that the contractor knowingly rendered a false certification, or otherwise violates the requirements of the Drug-Free Workplace Act, the U.S. Department of Housing and Urban Development, in addition to any other remedies available to the Federal Government, may take action authorized under the Drug-Free Workplace Act. CERTIFICATION A. The contractor certifies that it will provide a drug-free workplace by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the contractor's workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing a drug-free awareness program to inform employees about - (1) The dangers of drug abuse in the workplace; (2) The contractor's policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance program; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c) Making it a requirement that each employee who will be engaged in the performance of the grant be given a copy of the statement required by paragraph (a); (d) Notifying the employee in the statement required by paragraph -(a) that, as a condition of employment under the contract, the employee will - (1) Abide by the terms of the statement; and (2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction, EXHIBIT D Pg. 2 (e) Notifying the U.S. Department of Housing and Urban Development within ten days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction; (f) Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted - ( 1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; (g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f). B. The contractor shall insert in the space provided on the attached "Place of Performance" form the site(s) for the performance of work to be carried out with the grant funds (including street address, city, county, state, and zip code) the contractor further certifies that, if it is subsequently determined that additional sites will be used for the performance of work under the contract, it shall notify the U.S. Department of Housing and Urban Development immediately upon the decision to use such additional sites by submitting a revised "Place of Performance" form. Dated: 04/04/2013 Employer S1@nature EXHIBIT D DIVISION OF EMPLOYMENT SERVICES PLACE OF PERFORMANCE FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS Name: Rob Mitchell Name of Contractor: Pig'sTail USA, LLC Contractor Number: Date: 04/04/201 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): 1601 E. St. Andrews Place, Unit B Santa Ana, CA 92705 EXHIBIT D Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, Section 98.510, Participants' responsibilities. The regulations were published as Part VII of the May 26,1988 Federal Re ig ster (pages 19160-19211). (BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS FOR CERTIFICATION - Attached) (1) The prospective recipient of federal assistance fiords 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. Rob Mitchell, Operations Manager Name and Title of Authorized Representative 0Ad Signature Date 04/04/2013 EXHIBIT E INSTRUCTIONS FOR CERTIFICATION 1. By signing and submitting this proposal, the prospective recipient of federal assistance hinds 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 fiords 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 Rinds 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 Govenvnent, the DOL may pursue available remedies, including suspension and/or debamlent. EXHIBIT E MEMORANDUM Kevin O'Rourke To: City Manager Linda Oberman From: Economic Development Manager Date: May 6, 2013 Subject: Workforce Investment Act -On The Job Training Agreements On-the-Job Training (OJT) is a Workforce Investment Act training program in which an OJT contract is designed for a particular individual and employer. An employer which hires a trainee may be reimbursed up to 50 percent of the wages paid for the extraordinary cost of lower productivity in participants, providing the training, and additional supervision. OJT contracts are conducted through noncompetitive negotiations. Per State of California Employment Development Department Directive 12-10, "Customized Training and On-The-Job Training are exempt from Federal and State competitive procurement". Please call me with any questions. Thank you. hina A. Oberman