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HomeMy WebLinkAboutORANGE COUNTY TRANSPORTATION AUTHORITY (OCTA) AND VIETNAMESE COMMUNITY OF ORANGE COUNTY - 2016I NSURANCE ON FILL; ORK MAY PHOOMt7 A-2016-1 UNTIL INSURANCE FXPIRE'S �!- - 20 CLERK OF COUNCIL DATE..: q-6 —/& 1 AMENDMENT NO. 1 TO COOPERATIVE AGREEMENT NO. C-1-2492 2 BETWEEN 3 ORANGE COUNTY TRANSPORTATION AUTHORITY 4 AND 5 11 CITY OF SANTA ANA 6 AND 7 VIETNAMESE COMMUNITY OF ORANGE COUNTY 8 FOR 9 SENIOR MOBILITY PROGRAM 10 THIS AMENDMENT NO. 1 is effective this 2 -- day of e 2016 by and between the 11 Orange County Transportation Authority, a public corporation of the State of California (hereinafter 12 referred to as "AUTHORITY"), the City of Santa Ana (hereinafter referred to as "CITY") and Vietnamese 13 Community of Orange County (hereinafter referred to as "CONTRACTOR"). 14 RECITALS 15 WHEREAS, by Agreement No. C-1-2492 dated June 9, 2011, AUTHORITY, CITY and 16 CONTRACTOR are entered into a contract to provide the Senior Mobility Program (SMP) concerning 17 senior transportation services for seniors receiving services through CONTRACTOR; and 18 WHEREAS, AUTHORITY, CITY and CONTRACTOR agree to comply with the SMP Funding and 19 Policy Guidelines ("Guidelines"); and 20 WHEREAS, AUTHORITY, CITY and CONTRACTOR agree to extend the term of the Agreement 21 through June 30, 2021; 22 NOW, THEREFORE, it is mutually understood and agreed by AUTHORITY, CITY and 23 CONTRACTOR that Amendment No. 1 to Cooperative Agreement No. C-1-2492 is hereby amended in 24 the following particulars only: 25 1. Amend ARTICLES 2 and 3: to delete in their entirety and replace with Attachment 26 11 No. 1 to this Amendment Page 1 of 2 AMENDMENT NO. 1 TO AGREEMENT NO. C-1-2492 2. Amend ARTICLE 5. TERM OF AGREEMENT: Page 4 of 8, line 26, to delete 1 "June 30, 2016" as the expiration date of the Agreement, and in lieu thereof insert "June 30, 2021". 2 3. Amend ARTICLE 8. AUDIT AND INSPECTION OF RECORDS: Page 6 of 8, line 2, to 3 delete "four (4) years" as the period for audit and inspection record, and in lieu thereof insert 4 "five (5) years". 5 The balance of said Agreement remains unchanged. 6 Upon execution by all parties, this Amendment No. 1 to Cooperative Agreement 7 No. C-1-2492 shall be made effective on July 1, 2016. 8 IN WITNESS WHEREOF, the parties hereto have caused this Amendment No. 1 to Cooperative 9 Agreement No. C-1-2492 to be executed on the date first above written. 10 CITY OF SANTA ANA ORANGE CO N Y ANSPORTATION AUTHORITY 11 BY B Y 12 David C vazos Darrell John o 13 City Manager Chief Executive Officer 14 ATTEST: APPROVED T 15 nn By � Iai" 2) By 16 Maria D. Huizar mes M. onict Clerk of the Council General Counsel 17 fiR? 19. 9 ��l _ Q 20 BY ` llz l �/. JoW M. Funk 21 Assistant City Attorney 22 APPROVED: By�� Beth McCormick General Manager, Transit 23 VIETNAMESE ,C/OMMUNITY OF ORANGE COUNTY l24 Byw+� Y 25 Tricia Nguyen Chief Executive Officer 26 RECOMMENDED FOR APPROVAL GERARDO MOUET, Executive Director, PRCSA Page 2 of 2 Attachment 1 to AMENDMENT NO.1 AGREEMENT NO. C-1-2492 1 ARTICLE 2. RESPONSIBILITIES OF AUTHORITY 2 A. AUTHORITY agrees to provide funds in accordance with Article 5 ("Term of 3 Agreement"), for the Senior Mobility Program. Funding levels are determined annually and are 4 calculated using the annual percentage change of AUTHORITY's budget for Transportation 5 Development Act sales tax revenues. 6 B. AUTHORITY will pay to CONTRACTOR the AUTHORITY's annual contribution for the 7 fiscal year by August 3111 of each year. 8 C. AUTHORITY agrees that the CONTRACTOR funding allocation shall be expended 9 within three (3) years of receipt. AUTHORITY may grant an extension to the three-year limit, but 10 extensions shall not be granted beyond a total of five (5) years from the date of the initial funding 11 allocation. 12 D. In the event the time limits for use of SMP funds are not satisfied, then any retained 13 funding that was allocated to the CONTRACTOR and interest earned thereon shall be returned to 14 AUTHORITY. 15 E. AUTHORITY may provide, at AUTHORITY's sole discretion, a refurbished surplus 16 paratransit vehicle, at no cost to CONTRACTOR and no further responsibility to AUTHORITY after 17 vehicle donation. CONTRACTOR may purchase additional vehicle(s) in excess of their vehicle 18 allocation, based on availability, for a cost equivalent to the refurbishment costs incurred by 19 AUTHORITY. 20 ARTICLE 3. RESPONSIBILITIES OF CONTRACTOR 21 A. CONTRACTOR agrees that all funds received from AUTHORITY as specified in 22 Article 2.A. above will be used exclusively for providing accessible senior transportation services as 23 specified in Exhibit A entitled "Senior Mobility Program Service Plan." 24 B. CONTRACTOR will ensure the SMP Service Plan is adopted by their governing board in 25 accordance with Section 7.0 of the SMP Funding and Policy Guidelines. 26 / Page 1 of 3 Attachment 1 to AMENDMENT NO. 1 AGREEMENT NO. C-1-2492 1 C. CONTRACTOR agrees to comply with all provisions of the SMP Guidelines included as 2 Exhibit B. 3 D. CONTRACTOR agrees that the funding allocation shall be expended within three (3) 4 years of receipt. AUTHORITY may grant an extension to the three-year limit, but extensions shall not 5 be granted beyond a total of five (5) years from the date of the initial funding allocation. 6 E. In the event the time limits for use of SMP funds are not satisfied, any retained funding 7 that was allocated to the CONTRACTOR and interest earned thereon shall be returned to B AUTHORITY. 9 F. CONTRACTOR agrees to match a minimum of twenty percent (20%) of the total 10 annual program expenditures. Local match may be made up of cash -subsidies, fare revenues, 11 donations, or in -kind contributions, such as salaries and benefits for the CONTRACTOR employees 12 who perform work on the program. 13 G. CONTRACTOR may contract with a third -party service provider to provide senior 14 transportation services provided that: 15 1. Contractor is selected using a competitive procurement process; and 16 2. Wheelchair accessible vehicles are available and used when requested. 17 H. CONTRACTOR shall procure and maintain insurance coverage during the entire term 18 of this Agreement. Coverage shall be full coverage or subject to self-insurance provisions. 19 CONTRACTOR shall provide the following insurance coverage: 20 1. Commercial General Liability, to include Products/Completed Operations, 21 Independent Contractors', Contractual Liability, and Personal Injury Liability with a minimum limit of 22 $1,000,000.00 per occurrence and $2,000,000.00 general aggregate. 23 2. Automobile Liability Insurance to include owned, hired and non -owned autos with a 24 combined single limit of $1,000,000.00 each accident; 25 3. Workers' Compensation with limits as required by the State of California 26 including a waiver of subrogation in favor of AUTHORITY, its officers, directors, employees or agents; 4. Employers' Liability with minimum limits of $1,000,000.00; and Page 2 of 3 Attachment 1 to AMENDMENT NO. 1 AGREEMENT NO. C-1-2492 1 I. Proof of such coverage, in the form of an insurance company issued policy 2 endorsement and a broker -issued insurance certificate, must be received by AUTHORITY prior to 3 commencement of any work. Proof of insurance coverage must be received by AUTHORITY within ten 4 (10) calendar days from the effective date of this Agreement with AUTHORITY, its officers, directors, 5 employees and agents designated as additional insured on the general and automobile liability. Such 6 insurance shall be primary and non -contributive to any insurance or self-insurance maintained by 7 AUTHORITY. S J. CONTRACTOR shall include on the face of the Certificate of Insurance the Cooperative 9 Agreement Number C-1-2492; and, the Senior Contract Administrator's Name, Sue Ding. 10 K. CONTRACTOR agrees to provide AUTHORITY with monthly summary reports of 11 CONTRACTOR's Senior Mobility Program. CONTRACTOR shall submit monthly summary report 12 by the end of the following month as specified in Exhibit C "Senior Mobility Program Monthly 13 Reporting Form," included in this Agreement, which is incorporated into and made part of this 14 Agreement. 15 L. In the event CONTRACTOR obtains a retired AUTHORITY vehicle for Senior Mobility 16 Program services, CONTRACTOR agrees to transfer vehicle title and registration within fourteen 17 (14) calendar days from taking possession of the vehicle. CONTRACTOR also agrees to provide 18 documentation to AUTHORITY confirming transfer of vehicle title and registration from AUTHORITY 19 to CONTRACTOR within thirty (30) calendar days from taking possession of the vehicle. 20 / 21 / 22 / 23 / 24 / 25 / 26 / Page 3 of 3 EXHIBIT A Senior Mobility Program Agency Service Plan Agency: Vietnamese Community of Orang County i Senior Mobility Program OCTA Agency Service Plan Jurisdictions and agencies participating in the Orange County Transportation Authority (OCTA) Senior Mobility Program (SMP) must complete the following Service Plan in order to receive SMP funding. The Service Plan must be developed in accordance with SMP Guidelines, included as Attachment 1, and submitted to OCTA for review. Upon review from OCTA, the Service Plan must be formally adopted by the agency's council or governing body and. approved by the OCTA Board of Directors. Any modifications to SMP services will require submittal of a new Service Plan. Participant Information: Agency Vietnamese Community of Orange4 Program Contact Trlcia Nguyen Phone Number 714.640.3411 Service Description: 1. Program goals and objectives: Date 04/04/2016 Email ttnguyen@thevncoc..org To provide transportation services to the seniors age 60 years and older. We will provide five categories (senior, nutrition, medical, personal care, and snnlallranrnatinn_I We Asticnated a tntal of d Ann tries annunliy fnr nil fleece a 2. Indicate how SMP service will be operated: (Please check all that apply) ® Directly Operated ❑ Contract Service Provider ® Volunteers Subsidized Taxi Program Other (Please describe) 3. Eligible trips provided under the Senior Mobility Program are limited to the following categories. Please Indicate the categories of service to be provided by your program: (check all that apply) ® Senior Center Nutrition F Medical © Personal Care Shopping ® Social/Recreational (please list locations) Miles Square Park, The Outlets at Orange, Santa Ana Zoo, OC Court House Museum and Liberty Park. 4. SMP Guidelines restricts trips outside of Orange County to medical trips within approximately 10 miles of the Orange County border. Do you intend to provide medical trips outside of Orange County? O yes Q No If yes, please list the trip purpose and destinations: (e.g., medical trips to the VA Hospital In Long Beach) 5. Fare structure: We don't collect any fee for this program. 6. Number of vehicles: 1 7. Projected annual ridership: 20 8. Source(s) of 20 percent match funding: IVNCOC in -kind and One Stop Center who provide senior volunteers: Program Requirements: 1. Jurisdiction/Agency shall follow competitive procurement practices In selection of vendors for all services which lt does notprovide using its own work force. Any Request for Proposals (RFP) ' for services shall specify the use of vehicles meeting Americans with Disabilities Act (ADA) accessibility standards. 2. Jurisdiction/Agency will perform, or ensure that a contracted vendor performs, maintenance of all vehicles used in the Senior Mobility program, including, at a minimum: a) Daily Pre -Trip Inspections that meet or exceed the guidelines provided in the attached Pre -Trip Inspection Checklist (Attachment 2) b) Scheduled preventative maintenance that meets or exceeds the guidelines provided in the attached PM Checklist, Including the maintenance of all accessibility features of the vehicles. c) Maintain maintenance records for each vehicle for five (5) years and, If required, cooperate fully in annual motor coach carrier terminal inspections conducted by the California Highway Patrol. 3. Jurisdiction/Agency will ensure that Its operators, or its contracted vendor's operators, are properly licensed and trained to proficiency to perform duties safely, and In a manner which treats its riders with respect and dignity. Disability awareness and passenger assistance will be included In this training. 4. Jurisdiction/Agency will establish and implement an alcohol and drug program that complies with 41 U.S.C. sections 701707, (the Drug Free Workplace Act of 1988), and will produce any documentation necessary to establish its compliance with sections 701-707. S. Jurisdiction/Agencywlllsubmita monthly report to OCTA's Community Transportation Services Department as illustrated in Attachment3. 6. Jurisdiction/Agency will participate in OCTA marketing and outreach efforts to encourage use of Fixed route transitservice by older adults. 7. Jurisdiction/Agencywilll note OCTA sponsorship in any promotional material for service funded under this agreement and will display an OCTA Senior Mobility Program logo on vehicles used in this program (excluding taxis). 8. Jurisdiction/Agency will ensure that it maintains adequate oversight and control over all aspects of services that are provided by a contracted vendor, IN WITNESS' WHEREOF, has formally adopted the Senior Mobility Program Scope of Work as written above. AGENCY REPRESENTATIVE OCTA REPRESENTATIVE Name: TAMI14 tjrTLri9" l Name: Title: e6 irJCecu Ayr _�2Title: Beth McCormick General Manager, Transit EXHIBIT B Senior Mobility Program Project U Funding and Policy Guidelines March 2016 1.0 Overview The Measure M2 (M2) Project U — Senior Mobility Program (SMP) provides funding to support local, community -based transportation service for seniors. Originally established in 2001 using limited state funding for bus operations, M2 Project U SMP funding was established to continue and expand the existing program. A formula funding allocation was established for all Orange County local jurisdictions based upon their senior population. One percent of M2 net revenue is used to fund the program and local jurisdictions must provide a minimum 20 percent local match of the total annual program expenditures. The Orange County Transportation Authority (OCTA) Board of Directors approved these guidelines on March 28, 2016. The purpose is to provide structure and definitions for all eligible M2 jurisdictions receiving SMP funding. OCTA shall enforce the provisions spelled out in these guidelines. 2.0 Objectives • To provide for local, community -based senior transportation services. ■ To allow local jurisdictions to develop and implement senior transportation services to serve their community. • To provide transit options for seniors which complement rather than duplicate OCTA fixed route and ACCESS paratransit service. 3.0 Eligibility Requirements Participation in the SMP is contingent upon maintaining M2 eligibility. Local jurisdictions must be eligible to receive M2 funding, established on an annual basis as specified in the M2 Ordinance Requirements for Eligible Jurisdictions, to receive the formula allocation for this program.' Adherence to strict funding guidelines is required. Local jurisdictions are required to submit a Service Plan as described in Section 7.0 and must enter into a cooperative funding agreement with OCTA that defines the conditions of use of SMP funds prior to receiving their SMP funding allocation. 1 Orange County Transportation Authority Ordinance No. 3, Attachment B, Section III 11Page S:\TEMP\Sue D\Supplemental\SMP-Attachment B.docx EXHIBIT B 4.0 Funding Allocation Method & Distribution Funding for the program is identified as one percent of M2 net sales tax revenue and will be allocated to eligible local jurisdictions based upon the participating jurisdiction's percentage of the senior population of the county. Senior population is determined by using the most current official decennial Census information provided by the U.S. Census Bureau. Funding allocations are based on actual sales tax receipts. Funding will be distributed on a bi-monthly basis. SMP funds must be expended within three years of receipt. OCTA may grant a two-year extension beyond the three-year expenditure limitation; however, an extension may not exceed five years from the date of the initial funding allocation. Jurisdictions requesting an extension beyond the three-year limitation must submit a justification letter for review and approval by OCTA at least 90 days prior to the end of the third fiscal year. In the event the time limits for use of SMP funds are not satisfied, any retained SMP funds that were allocated to an eligible jurisdiction, including interest, shall be returned to OCTA. 5.0 Match Requirements Participating jurisdictions must provide a minimum 20 percent local match of the total annual program expenditures. Match funding may be made up of cash subsidies, fare revenues, donations, or in -kind contributions such as salaries and benefits for the jurisdiction's employees who perform work on the program. Jurisdictions may also be required to submit supporting documentation to substantiate local match expenditures. Jurisdictions are not required to contribute the minimum match requirement on a monthly basis; however, the minimum 20 percent match requirement must be met by the end of each fiscal year, defined as June 30. Jurisdictions not satisfying the annual 20 percent match shall be subject to withholding of funds from future bi-monthly allocations equal to the difference between the amount of Measure M funds actually spent and the amount of Measure M funds actually matched. 211'age S:\TEMP\Sue D\Supplemental\SMP-Attachment B.docx EXHIBIT B Example: Total Program Expenditures $100,000 Total M2 Funding Allocation $ 80,000 20% Required Match $ 20,000 Actual Reported Match $ 15,000 Withholding Calculation: Total M2 Funds Spent $ 80,000 M2 Funding Eligibility Based on Actual Reported Match - 60,000 Withholding from Future Allocation(s) $ 20,000 6.0 Service Guidelines Services provided under the SMP are available to individuals 60 years of age and older. Jurisdictions have discretion in the types of trips provided within Orange County, such as trips to/from senior centers, medical appointments, shopping, personal care, and social/recreational activities. Jurisdictions should use discretion when providing trips for social/recreational activities when developing their Service Plan to ensure prudent and appropriate use of taxpayer funds. SMP trips outside Orange County are restricted to medical trips only within approximately 10 miles of the Orange County border. Jurisdictions also have discretion in how the service is operated. Senior transportation services may be operated using employees, volunteers, or the jurisdiction may contract with a third -party service contractor. Contractors must be selected using a competitive procurement process and the jurisdiction must ensure the contractor is in compliance with program guidelines and provisions included in the cooperative funding agreement. Jurisdictions whose program offers subsidized taxi service for seniors must ensure trips provided with SMP funding are consistent with the trip types as specified in these guidelines. Wheelchair accessible vehicles must be available for SMP service. Jurisdictions will perform, or ensure that a contractor performs, maintenance of all vehicles used in the Senior Mobility Program. Jurisdictions will ensure that its operators, or its contracted operators, are properly licensed and trained to proficiency to perform duties safely, and in a manner which treats its riders with respect and dignity. Jurisdictions may receive retired OCTA ACCESS paratransit vehicle(s) to support their senior transportation program. Additional retired ACCESS vehicles may be 31Page S:\TEMP\Sue D\Supplemental\SMP-Attachment 8.docx purchased, based on availability, for a cost equivalent to the refurbishment costs incurred by OCTA. 7.0 Service Plan Adoption Participating jurisdictions shall submit to OCTA a SMP Service Plan which defines program services (Exhibit A). The Service Plan must be submitted using a template provided by OCTA and must be adopted by the jurisdiction's governing body and approved by the OCTA Board of Directors. Any deviation from the adopted SMP Service Plan must be submitted to OCTA in advance for review and approval and will require an amendment to the cooperative funding agreement prior to implementing a change in program services. 8.0 Eligible Expenses Participating jurisdictions shall ensure M2 funds are used for eligible direct program -related expenses which may include contract service providers, staff time, vehicle maintenance, fuel, insurance, vehicle acquisition, program supplies and materials, marketing materials, and community outreach. Jurisdictions shall ensure all costs are program -related and are fair and reasonable. Administrative costs up to 10 percent are allowed and considered eligible program expenses. All program expenses are subject to audit. No M2 funding shall be used by a jurisdiction for other than transportation purposes authorized in the M2 Ordinance. 9.0 Program Revenue Participating jurisdictions must maintain adequate controls for collecting and reporting program revenue, including donations, fees, and cash fares. Program revenue must be used to support the transportation service and may be used as part of the jurisdiction's 20 percent local match requirement. 10.0 Reporting Participating jurisdictions are required to submit monthly reports using a reporting template provided by OCTA (Exhibit B). Required monthly reporting data may include, but is not limited to, the following: o Number of Trips by Category o Vehicle Service Hours o Vehicle Service Miles 41Page S:\TEMP\Sue D\Supplemental\SMP-Attachment B.docx EXHIBIT B o Program Cost Detail by Expense Category and % of Total Operating Cost o Fares, Fees and Other Operating Revenue o Jurisdiction Total Contribution & Source o Jurisdiction Share as % of Total Operating Cost o Cumulative Jurisdiction Share to Date o OCTA Contribution o OCTA Contribution as % of Total Operating Cost o Cumulative Contribution Received from OCTA o Total Monthly Program Operating Cost o Cumulative Total Program Operating Cost Jurisdictions shall also be required to maintain supporting documentation to substantiate reporting data. Supporting documentation may include, but is not limited to, actual receipts, contractor invoices, trip sheets, payroll, timesheets, fuel logs, and maintenance records/receipts. Reports are due by the last day of the following month. A preliminary report may be submitted; however, submission of a final report is required within 15 days of the last day of the following month. Failure to meet the established reporting deadline for two months at any time during the fiscal year may result in future withholding of funding and/or other sanctions to be determined. 11.0 Audits & Inspection of Records M2 funding is subject to audit. Jurisdictions shall maintain program documentation and records for a period of no less than five years. Program documents and records, including but not limited to payroll, trip sheets, invoices, vehicle maintenance, fuel, and other program -related expenses, shall be available for review by OCTA SMP administrators, auditors, and authorized agents upon request. Jurisdictions must follow established accounting requirements and applicable laws regarding the use of public funds. Failure to submit to an audit in a timely manner may result in withholding or loss of future funding. Failure to comply with the approved Service Plan will require remediation which may include repayment, reduction in overall allocation, and/or other sanctions to be determined by the OCTA Board of Directors. Audits shall be conducted by the OCTA Internal Audit Department, or other authorized agent, as determined by OCTA. OCTA's failure to insist in any one or more instances of a jurisdiction's performance of the provisions set forth in these guidelines shall not be construed as a waiver or relinquishment of the jurisdiction's obligation to comply with these guidelines. Moreover, only the OCTA Board of Directors shall have the authority to alter and/or waive any requirements/obligations set forth in these guidelines. S1Page 5:\TEMP\Sue D\Supplemental\SMP-Attachment B.docx m Senior Mobility Program ®cTA Monthly Reporting Form Service for the- Monthof: July Program Name: Participating Agency: Agency Contact: Contact Number: Year of: 2016 h, pP Tri{iCat egory P5, '� ,�. ..,' ,'� ,'`'.; .r One WayTnps SennceHours �Servrce,Mles�f `.:1u120W ,,?F1TDN. .'JuY2036 YTD ' nyJu12016 Senior Center - - Medical - - - - Shopping - Personal Care - - - - - - Social / Recreational - - - TIf 1, / u.,, nt �,� hh^_i g# 3n J`Ar 4 }i ]: sE4"' p l`y f _:rt Cosx;[ategory „ v T , Jul C 7 v 5 Yt� •�3 a'YY ^�1 , Cosy , _,_, Asa % Cost , qs a 6y Service Contract $ - 0.0% $ - 0.0% Drivers / Operators [Dispatchers $ - 0.0% $ - 0.0°% Vehicle Maintenance / Fuel / Insurance $ - 0.0% $ - 0.09i Marketing Outreach $ - 0.0% $ - 0.0% Administration $ - 0.0% $ - 0.0% Ttitas. lis . r. , - NUN OCTA Contribution $ - 0.0% $ - 0.0% Agency Contribution $ - 0.0% $ - 0.0% Program Revenue $ - 0.0%j $ - 0.0% Source(s) of Agency Contributions: Agency hereby certifies that this report is a true, complete and correct statement of program revenue, costs and operating data. Please send this report by email to CTSPROGRAMS@OCTA.NET or by fax to 714-560-5927. If there are any questions, please contact JOANNE JACOBSEN by email at JJACOBSEN@OCTA.NET or JP GONZALEZ by email at JGONZALEZI@OCTA.NET. CERTIFICATE OF COVERAGE I 07/05/2016 PRODUCER: I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, Alliant Insurance Services, Inc. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE MEMORANDUM OR POLICY P.O. BOX 6450 BELOW: NEWPORT BEACH, CA 92658-6450 COMPANIES AFFORDING COVERAGE PH (949)756-0271 / FAX (949)756-2713 LICENSE NO, OC36861 COMPANY LETTER (A) BIG INDEPENDENT CITIES EXCESS POOL BIG INDEPENDENT CITIES EXCESS POOL MEMBER: CITY OF SANTA ANA ATTN: ED RAYA RISK MANAGER P.O. BOX 1988 SANTAANA, CA 92702-1988 COMPANY LETTER (B) COMPANY LETTER (C) COMPANY LETTER (D) COMPANY LETTER (E) COMPANY LETTER (F) THIS IS TO CERTIFY THAT THE MEMORANDUM OF COVERAGE OR POLICY(IES) LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY OR MEMORANDUM PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE COVERAGES AFFORDED BY THE MEMORANDUM OR POUCY(IES) DESCRIBED HEREIN ARE SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUM OR POLICY. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO I TYPES LTR OF COVERAGES EXCESS LIABILITY A OCCURRENCE FORM INCLUDING AUTOMOBILE LIABILITY MEMORANDUM MEMORANDUM MEMORANDUM OR OR POLICY OR POLICY POLICY NUMBER EFFECTIVE I EXPIRES BO-05 1 07/01/2016 1 07/01/2017 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/RESTRICTIONS/SPECIAL ITEMS: AS RESPECTS AGREEMENT #C-2-0148 SENIOR MOBILITY PROGRAM. LIMIT DIFFERENCE BETWEEN BI & PD $10,000,000 POOL LIMIT AND COMBINED $1,000,000 SELF -INSURED RETENTION CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED SOLELY WITH RESPECT TO BODILY INJURY AND PRgP�k DAMAGE ARISING OUT OF OPERATIONS AS DESCRIBED BY OR ON BEHALF OF THE NAMED INSURED A ' ) SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS.eJ\Pw` wA \l 2� ll� ORANGE COUNTY TRANSPORTATION AUTHORITY ATTN: REBECCA POTTER, CPM SENIOR PROCUREMENT ADMINISTRATOR 550 S. MAIN STREET ORANGE, CA 92863-1584 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. THIS ENDORSEMENT DOES NOT CHANGE THE MEMORANDUM. PLEASE READ IT CAREFULLY. ADDITIONAL COVERED PARTY - COVERED INDEMNITY CONTRACT This endorsement identifies coverage provided under the following: BICEP MASTER MEMORANDUM OF LIABILITY COVERAGE The following wording can be found in Section II, Definitions: 6. COVERED PARTY -- means: f. Any person or entity holding a certificate of coverage duly issued by BICEP, as limited therein ("ADDITIONAL COVERED PARTY"). An ADDITIONAL COVERED PARTY is not covered for claims arising from the ADDITIONAL COVERED PARTY's sole negligence or for claims by another COVERED PARTY. g. Any person, entity or organization to whom the COVERED PARTY is obligated by virtue of a COVERED PARTY INDEMNITY CONTRACT to provide coverage solely with respect to BODILY INJURY AND PROPERTY DAMAGE arising out of: i. Premises leased, used or occupied by the COVERED PARTY ii. AUTOMOBILES leased or rented by the COVERED PARTY iii. Equipment owned, leased, rented, maintained or used by the COVERED PARTY iv. Mortgagees of the COVERED PARTY; or v. Property owners and property managers of property owned, leased, rented or occupied by the COVERED PARTY, vi. However, these COVERED PARTY INDEMNITY CONTRACT coverages do not apply to: aa. An OCCURRENCE which takes place prior to or after the COVERED PARTY ceases to occupy the premise stated in the COVERED INDEMNITY CONTRACT, bb. Any structural alternation, new construction or demolition operations performed by or on behalf of the COVERED PARTY cc. Any PUBLIC ENTITY ERRORS AND OMISSIONS or EMPLOYMENT PRACTICES. h. The coverage set forth in subsection (g) immediately above will be limited to any limits of coverage within the terms of the COVERED INDEMNITY CONTRACT or the LIMITS OF COVERAGE within this MEMORANDUM, whichever is less, and will apply in excess to any underlying insurance or the COVERED PARTY'S SELF - INSURED RETENTION. BICEP will not be obligated for LIMIT S 712014 Ed BICEP MOC Attachment Page 1 of 1 A-2016-197 INSUAANOP ON NL. WOIx14 MA4 PROCEED UNTIL INSURANCE EXPIRE: r CLERV(QFOUNCIL 1 DATE` AMENDMENT NO. 1 TO COOPERATIVE AGREEMENT NO. C-1-2492 2 BETWEEN 3 ORANGE COUNTY TRANSPORTATION AUTHORITY 4 AND 5 CITY OF SANTA ANA 6 AND 7 VIETNAMESE COMMUNITY OF ORANGE COUNTY 8 FOR 9 SENIOR MOBILITY PROGRAM 10 THIS AMENDMENT NO. 1 is effective this Wday of S41 , 2016 by and between the 11 Orange County Transportation Authority, a public corporation of the State of California (hereinafter 12 referred to as "AUTHORITY"), the City of Santa Ana (hereinafter referred to as "CITY") and Vietnamese 13 Community of Orange County (hereinafter referred to as "CONTRACTOR"), 14 RECITALS 15 WHEREAS, by Agreement No. C-1-2492 dated June 9, 2011, AUTHORITY, CITY and 16 CONTRACTOR are entered into a contract to provide the Senior Mobility Program (SMP) concerning 17 senior transportation services for seniors receiving services through CONTRACTOR; and 18 WHEREAS, AUTHORITY, CITY and CONTRACTOR agree to comply with the SMP Funding and 19 Policy Guidelines ("Guidelines"); and 20 WHEREAS, AUTHORITY, CITY and CONTRACTOR agree to extend the term of the Agreement 21 through June 30, 2021; 22 NOW, THEREFORE, it is mutually understood and agreed by AUTHORITY, CITY and 23 CONTRACTOR that Amendment No. 1 to Cooperative Agreement No. C-1-2492 is hereby amended in 24 the following particulars only: 25 1, Amend ARTICLES 2 and 3: to delete in their entirety and replace with Attachment 26 No. 1 to this Amendment. Page 1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19, 20 21 22 23 24 25 9� AGREEMENT NO. C-1-2492 2. Amend ARTICLE 5. TERM OF AGREEMENT: Page 4 of 8, line 26, to delete "June 30, 2016" as the expiration date of the Agreement, and in lieu thereof insert "June 30, 2021 ". 3. Amend ARTICLE 8. AUDIT AND INSPECTION OF RECORDS: Page 6 of 8, line 2, to delete "four (4) years" as the period for audit and inspection record, and in lieu thereof insert "five (5) years". The balance of said Agreement remains unchanged. Upon execution by all parties, this Amendment No. 1 to Cooperative Agreement No. C-1-2492 shall be made effective on July 1, 2016. IN WITNESS WHEREOF, the parties hereto have caused this Amendment No. 1 to Cooperative Agreement No. C-1-2492 to be executed on the date first above written. CITY OF StANTA ANA ORANGE COUNTY TRANSPORTATION AUTHORITY By ` i — By David C41elizos Darrell Johnson City Manager Chief Executive Officer ATTEST: AF BY �V��` -� �i>�` By Maria D. Huizar Clerk of the Council / ,Ames M. Donich General Counsel By. By Joe M. Funk Beth McCormick Assistant City Attorney General Manager, Transit VIETNAMESE COMMUNITY OF ORANGE COUNTY RECOMMENDED FOR APPROVAL By Tricia Nguyen Chief Executive Officer GERARDO MOUET, Executive Director, PRCSA Page 2 of 2 Attachment 1 to AMENDMENT NO. 1 AGREEMENT NO. C-1.2492 1 ARTICLE 2. RESPONSIBILITIES OF AUTHORITY 2 A. AUTHORITY agrees to provide funds in accordance with Article 5 ("Term of 3 Agreement"), for the Senior Mobility Program. Funding levels are determined annually and are 4 calculated using the annual percentage change of AUTHORITY's budget for Transportation 5 Development Act sales tax revenues. 6 B. AUTHORITY will pay to CONTRACTOR the AUTHORITY's annual contribution for the 7 fiscal year by August 31It of each year. 6 C. AUTHORITY agrees that the CONTRACTOR funding allocation shall be expended 9 within three (3) years of receipt. AUTHORITY may grant an extension to the three-year limit, but 10 extensions shall not be granted beyond a total of five (5) years from the date of the initial funding 11 allocation. 12 D. In the event the time limits for use of SMP funds are not satisfied, then any retained 13 funding that was allocated to the CONTRACTOR and interest earned thereon shall be returned to 14 AUTHORITY. 15 E. AUTHORITY may provide, at AUTHORITY's sole discretion, a refurbished surplus 16 paratransit vehicle, at no cost to CONTRACTOR and no further responsibility to AUTHORITY after 17 vehicle donation. CONTRACTOR may purchase additional vehicle(s) in excess of their vehicle 18 allocation, based on availability, for a cost equivalent to the refurbishment costs incurred by 19 AUTHORITY. 20 ARTICLE 3. RESPONSIBILITIES OF CONTRACTOR 21 A. CONTRACTOR agrees that all funds received from AUTHORITY as specified in 22 Article 2.A. above will be used exclusively for providing accessible senior transportation services as 23 specified in Exhibit A entitled "Senior Mobility Program Service Plan." 24 B. CONTRACTOR will ensure the SMP Service Plan is adopted by their governing board in 25 accordance with Section 7.0 of the SMP Funding and Policy Guidelines. 26 / Page 1 of 3 Attachment 1 to AMENDMENT NO. 1 AGREEMENT NO. C-1-2492 1 C. CONTRACTOR agrees to comply with all provisions of the SMP Guidelines included as 2 Exhibit B. 3 D. CONTRACTOR agrees that the funding allocation shall be expended within three (3) 4 years of receipt. AUTHORITY may grant an extension to the three-year limit, but extensions shall not 5 be granted beyond a total of five (5) years from the date of the initial funding allocation. 6 E. In the event the time limits for use of SMP funds are not satisfied, any retained funding 7 that was allocated to the CONTRACTOR and interest earned thereon shall be returned to 8 AUTHORITY, 9 F. CONTRACTOR agrees to match a minimum of twenty percent (20%) of the total 10 annual program expenditures. Local match may be made up of cash -subsidies, fare revenues, 11 donations, or in -kind contributions, such as salaries and benefits for the CONTRACTOR employees 12 who perform work on the program. 13 G. CONTRACTOR may contract with a third -party service provider to provide senior 14 transportation services provided that: 15 1. Contractor is selected using a competitive procurement process; and 16 2. Wheelchair accessible vehicles are available and used when requested. 17 H. CONTRACTOR shall procure and maintain insurance coverage during the entire term 18 of this Agreement. Coverage shall be full coverage or subject to self-insurance provisions. 19 CONTRACTOR shall provide the following insurance coverage: 20 1. Commercial General Liability, to include Products/Completed Operations, 21 Independent Contractors', Contractual Liability, and Personal Injury Liability with a minimum limit of 22 $1,000,000.00 per occurrence and $2,000,000.00 general aggregate. 23 2. Automobile Liability Insurance to include owned, hired and non -owned autos with a 24 combined single limit of $1,000,000.00 each accident; 25 3. Workers' Compensation with limits as required by the State of California 26 including a waiver of subrogation in favor of AUTHORITY, its officers, directors, employees or agents; 4. Employers' Liability with minimum limits of $1,000,000.00; and Page 2 of 3 Attachment 1 to AMENDMENT NO. 1 AGREEMENT NO. C-1-2492 1 I. Proof of such coverage, in the form of an insurance company issued policy 2 endorsement and a broker -issued insurance certificate, must be received by AUTHORITY prior to 3 commencement of any work. Proof of insurance coverage must be received by AUTHORITY within ten 4 (10) calendar days from the effective date of this Agreement with AUTHORITY, its officers, directors, 5 employees and agents designated as additional insured on the general and automobile liability. Such 6 insurance shall be primary and non -contributive to any insurance or self-insurance maintained by 7 AUTHORITY. 8 J. CONTRACTOR shall include on the face of the Certificate of Insurance the Cooperative 9 Agreement Number C-1-2492; and, the Senior Contract Administrator's Name, Sue Ding. 10 K. CONTRACTOR agrees to provide AUTHORITY with monthly summary reports of 11 CONTRACTOR's Senior Mobility Program. CONTRACTOR shall submit monthly summary report 12 by the end of the following month as specified in Exhibit C "Senior Mobility Program Monthly 13 Reporting Form," included in this Agreement, which is incorporated into and made part of this 14 Agreement. 15 L. In the event CONTRACTOR obtains a retired AUTHORITY vehicle for Senior Mobility 16 Program services, CONTRACTOR agrees to transfer vehicle title and registration within fourteen 17 (14) calendar days from taking possession of the vehicle. CONTRACTOR also agrees to provide 18 documentation to AUTHORITY confirming transfer of vehicle title and registration from AUTHORITY 19 to CONTRACTOR within thirty (30) calendar days from taking possession of the vehicle. 20 / 21 / 22 / 23 ! 24 ! 25 / 26 / Page 3 of 3 EXHIBIT A •TfM*'-,Ti7i7Mg rat I AgencyServicePlan Agency: Vietnamese Community of ge County Senior Mobility Program 00TA Agency Service Plan Jurisdictions and agencies participating in the Orange County Transportation Authority (OCTA) Senior Mobility Program (SMP) must complete the following Service Plan in order to receive SMP funding. The Service Plan must be developed in accordance with SMP Guidelines, included as Attachment 1, and submitted to OCTA for review. Upon review from OCTA, the Service Plan must be formally adopted by the agency's council or governing body and approved by the OCTA Board of Directors. Any modifications to SMP services will require submittal of a new Service Plan. Participant information: Agency Vietnamese Community of Orangg4 Date Program Contact Tricia Nguyen Phone Number 714-640-3411 Service Description: 1. Program goals and objectives; 04/0412016 Email ttnguyen@thevncoc.org To provide transportation services to the seniors age 60 years and older. We will provide five categories (senior, nutrition, medical, personal care, and ienr`ial(ronraational `&a octinnafed a total of d 80n trine gnnnally fnr all fhiQ 2. indicate how SMP service will be operated; (Please check all that apply) ® Directly Operated ® Contract Service Provider ® Volunteers Subsidized Taxi Program ❑ Other (Please describe) 3. Eligible trips provided under the Senior Mobility Program are limited to the following categories. Please Indicate the categories of service to be provided byyour program: (check all that a pply) ® Senior Center ® Nutrition Medical ® Personal Care Shopping ® Social/Recreational (please list locations) Miles Square Park, The Outlets at Orange, Santa Ana Zoo, OC Court House Museum and Liberty Park. I 4. SMP Guidelines restricts trips outside of Orange County to medical trips within approximately 10 miles of the Orange County border. Do you intend to provide medical trips outside of Orange County? a Yes (�) No if yes, please list the trip purpose and destinations: (e.g., medical trips to the VA Hospital in Long Beach) 5. Fare structure: We don't collect any fee for this program. 6. Numberofvebicles; i 7. Projected annual ridership; 200 8. Source(s) of 20 percent match funding: IVNCOC in -kind and One Stop Center who provide senior volunteers: Program Requirements: 1. Jurisdiction/Agency shall follow competitive procurement practices in selection of vendors for all services which It does not provide using its own work force. Any Request for Proposals (RFP) ' for services shall specify the use of vehicles meeting Americans with Disabilities Act (ADA) accessibility standards. 2. Jurisdiction/Agency will perform, or ensure that a contracted vendor performs, maintenance of all vehicles used in the Senior Mobility program, including, at a minimum: a) Daily Pre -Trip Inspections that meet or exceed the guidelines provided in the attached Pre -Trip Inspection Checklist (Attachment 2) b) Scheduled preventative maintenance that meets or exceeds the guidelines provided in the attached PM Checklist, including the maintenance of all accessibility features of the vehicles. c) Maintain maintenance records for each vehicle for five (5) years and, if required, cooperate fully in annual motor coach carrier terminal Inspections conducted by the California Highway Patrol. 1 Jurisdiction/Agency will ensure that its operators, or its contracted vendor's operators, are properly licensed and trained to proficiency to perform duties safely, and in a manner which treats Its riders with respect and dignity. Disability awareness and passenger assistance will be Included in this training. 4. Jurisdiction/Agency will establish and implement an alcohol and drug program that complies with 41 U.S.E. sections 701.707, (the Drug Free Workplace Act of 1988), and will produce any documentation necessary to establish its compliance with sections 701-707, S. Jurisdiction/Agency will submit a monthlyreport to OCTA's Community Transportation Services Department as illustrated in Attachment 3. 6. Jurisdiction/Agency will participate in OCTA marketing and outreach efforts to encourage use of fixed route transitserv%ce by older adults. 7, Jurisdiction/Agencywiill note OCTA sponsorship in any promotional material for service funded underthis agreementand will displayan OCTASenlor Mobility Program logo on vehicles used In this program (excluding taxis). 8. Jurisdiction/Agency will ensure that it maintains adequate oversightand control over all aspects of services that are provided bya contracted vendor. IN WITNESS WHEREOF, has formally adopted the Senior Mobility Program Scope of Work as written above. AGENCY REPRESENTATIVE —1-7��jL OCTA REPRESENTATIVE Name: -Mm(ft (\)a( iEM Name: Title: ekcrl Lr_ rr ' ____7E. �(ttrTitle: Beth McCormick General Manager, Transit Senior Mobility Program Project U Funding and Policy Guidelines March 2016 1.0 Overview The Measure M2 (M2) Project U — Senior Mobility Program (SMP) provides funding to support local, community -based transportation service for seniors. Originally established in 2001 using limited state funding for bus operations, M2 Project U SMP funding was established to continue and expand the existing program. A formula funding allocation was established for all Orange County local jurisdictions based upon their senior population. One percent of M2 net revenue is used to fund the program and local jurisdictions must provide a minimum 20 percent local match of the total annual program expenditures. The Orange County Transportation Authority (OCTA) Board of Directors approved these guidelines on March 28, 2016. The purpose is to provide structure and definitions for all eligible M2 jurisdictions receiving SMP funding. OCTA shall enforce the provisions spelled out in these guidelines. 2.0 Objectives • To provide for local, community -based senior transportation services. • To allow local jurisdictions to develop and implement senior transportation services to serve their community. • To provide transit options for seniors which complement rather than duplicate OCTA fixed route and ACCESS paratransit service. 3.0 Eligibility Requirements Participation in the SMP is contingent upon maintaining M2 eligibility. Local jurisdictions must be eligible to receive M2 funding, established on an annual basis as specified in the M2 Ordinance Requirements for Eligible Jurisdictions, to receive the formula allocation for this program.' Adherence to strict funding guidelines is required. Local jurisdictions are required to submit a Service Plan as described in Section 7.0 and must enter into a cooperative funding agreement with OCTA that defines the conditions of use of SMP funds prior to receiving their SMP funding allocation. ' Orange County Transportation Authority Ordinance No. 3, Attachment 8, Section III 11Pag= S:\TENIP\Sue D\Supplemental\SMP-Attachment 6.docx 4.0 Funding Allocation Method & Distribution Funding for the program is identified as one percent of M2 net sales tax revenue and will be allocated to eligible local jurisdictions based upon the participating jurisdiction's percentage of the senior population of the county. Senior population is determined by using the most current official decennial Census information provided by the U.S. Census Bureau. Funding allocations are based on actual sales tax receipts. Funding will be distributed on a bi-monthly basis. SMP funds must be expended within three years of receipt. OCTA may grant a two-year extension beyond the three-year expenditure limitation; however, an extension may not exceed five years from the date of the initial funding allocation. Jurisdictions requesting an extension beyond the three-year limitation must submit a justification letter for review and approval by OCTA at least 90 days prior to the end of the third fiscal year. In the event the time limits for use of SMP funds are not satisfied, any retained SMP funds that were allocated to an eligible jurisdiction, including interest, shall be returned to OCTA. 5.0 Match Requirements Participating jurisdictions must provide a minimum 20 percent local match of the total annual program expenditures. Match funding may be made up of cash subsidies, fare revenues, donations, or in -kind contributions such as salaries and benefits for the jurisdiction's employees who perform work on the program. Jurisdictions may also be required to submit supporting documentation to substantiate local match expenditures. Jurisdictions are not required to contribute the minimum match requirement on a monthly basis; however, the minimum 20 percent match requirement must be met by the end of each fiscal year, defined as June 30. Jurisdictions not satisfying the annual 20 percent match shall be subject to withholding of funds from future bi-monthly allocations equal to the difference between the amount of Measure M funds actually spent and the amount of Measure M funds actually matched. 2Pa;e S:\TEi%4P\Sue D\Supplemental\SMP-Attachment B,docx Example: Total Program Expenditures $100,000 Total M2 Funding Allocation $ 80,000 20% Required Match $ 20,000 Actual Reported Match $ 15,000 Withholding Calculation: Total M2 Funds Spent $ 80,000 M2 Funding Eligibility Based on Actual Reported Match - 60,000 Withholding from Future Allocation(s) $ 20,000 6.0 Service Guidelines Services provided under the SMP are available to individuals 60 years of age and older. Jurisdictions have discretion in the types of trips provided within Orange County, such as trips to/from senior centers, medical appointments, shopping, personal care, and social/recreational activities. Jurisdictions should use discretion when providing trips for social/recreational activities when developing their Service Plan to ensure prudent and appropriate use of taxpayer funds. SMP trips outside Orange County are restricted to medical trips only within approximately 10 miles of the Orange County border. Jurisdictions also have discretion in how the service is operated. Senior transportation services may be operated using employees, volunteers, or the jurisdiction may contract with a third -party service contractor. Contractors must be selected using a competitive procurement process and the jurisdiction must ensure the contractor is in compliance with program guidelines and provisions included in the cooperative funding agreement. Jurisdictions whose program offers subsidized taxi service for seniors must ensure trips provided with SMP funding are consistent with the trip types as specified in these guidelines. Wheelchair accessible vehicles must be available for SMP service. Jurisdictions will perform, or ensure that a contractor performs, maintenance of all vehicles used in the Senior Mobility Program. Jurisdictions will ensure that its operators, or its contracted operators, are properly licensed and trained to proficiency to perform duties safely, and in a manner which treats its riders with respect and dignity. Jurisdictions may receive retired OCTA ACCESS paratransit vehicle(s) to support their senior transportation program. Additional retired ACCESS vehicles may be 31Page S:\TEMP\Sue D\Supplemental\SMP-Attachment B.docx EXHIBIT B purchased, based on availability, for a cost equivalent to the refurbishment costs incurred by OCTA. 7.0 Service Plan Adoption Participating jurisdictions shall submit to OCTA a SMP Service Plan which defines program services (Exhibit A). The Service Plan must be submitted using a template provided by OCTA and must be adopted by the jurisdiction's governing body and approved by the OCTA Board of Directors. Any deviation from the adopted SMP Service Plan must be submitted to OCTA in advance for review and approval and will require an amendment to the cooperative funding agreement prior to implementing a change in program services. 3.0 Eligible Expenses Participating jurisdictions shall ensure M2 funds are used for eligible direct program -related expenses which may include contract service providers, staff time, vehicle maintenance, fuel, insurance, vehicle acquisition, program supplies and materials, marketing materials, and community outreach. Jurisdictions shall ensure all costs are program -related and are fair and reasonable. Administrative costs up to 10 percent are allowed and considered eligible program expenses. All program expenses are subject to audit. No M2 funding shall be used by a jurisdiction for other than transportation purposes authorized in the M2 Ordinance. 9.0 Program Revenue Participating jurisdictions must maintain adequate controls for collecting and reporting program revenue, including donations, fees, and cash fares. Program revenue must be used to support the transportation service and may be used as part of the jurisdiction's 20 percent local match requirement. 10.0 Reporting Participating jurisdictions are required to submit monthly reports using a reporting template provided by OCTA (Exhibit B). Required monthly reporting data may include, but is not limited to, the following: o Number of Trips by Category o Vehicle Service Hours o Vehicle Service Miles 4Page S!\TEMP\Sue D\Supplemental\SMP-Attachment B.docx o Program Cost Detail by Expense Category and % of Total Operating Cost o Fares, Fees and Other Operating Revenue o Jurisdiction Total Contribution & Source o Jurisdiction Share as % of Total Operating Cost o Cumulative Jurisdiction Share to Date o OCTA Contribution o OCTA Contribution as % of Total Operating Cost o Cumulative Contribution Received from OCTA o Total Monthly Program Operating Cost o Cumulative Total Program Operating Cost Jurisdictions shall also be required to maintain supporting documentation to substantiate reporting data. Supporting documentation may include, but is not limited to, actual receipts, contractor invoices, trip sheets, payroll, timesheets, fuel logs, and maintenance records/receipts. Reports are due by the last day of the following month. A preliminary report may be submitted; however, submission of a final report is required within 15 days of the last day of the following month. Failure to meet the established reporting deadline for two months at any time during the fiscal year may result in future withholding of funding and/or other sanctions to be determined. 11.0 Audits & Inspection of Records M2 funding is subject to audit. Jurisdictions shall maintain program documentation and records for a period of no less than five years. Program documents and records, including but not limited to payroll, trip sheets, invoices, vehicle maintenance, fuel, and other program -related expenses, shall be available for review by OCTA SMP administrators, auditors, and authorized agents upon request. Jurisdictions must follow established accounting requirements and applicable laws regarding the use of public funds. Failure to submit to an audit in a timely manner may result in withholding or loss of future funding. Failure to comply with the approved Service Plan will require remediation which may include repayment, reduction in overall allocation, and/or other sanctions to be determined by the OCTA Board of Directors. Audits shall be conducted by the OCTA Internal Audit Department, or other authorized agent, as determined by OCTA. OCTA's failure to insist in any one or more instances of a jurisdiction's performance of the provisions set forth in these guidelines shall not be construed as a waiver or relinquishment of the jurisdiction's obligation to comply with these guidelines. Moreover, only the OCTA Board of Directors shall have the authority to alter and/or waive any requirements/obligations set forth in these guidelines. slPage S:\TEMP\Sue D\Supplemental\SMP-Attachment e.docx Senior Mobility Program EXHIBiTC oorA Monthly Reporting Form I THIS REPORT IS DUE BY THE LAST DAY OF THE MONTH FOLLOWING THE REPORTING MONTH! Please send this report by email to CTSPROGRAMS@OCTA.NET or by fax to 714-560-5927. If there are any questions, please contact JOANNE JACOBSEN by email at JJACOBSEN@OCTA. NET or JP GONZALEZ by email at JGONZALEZ1@OCTA. NET. CERTIFICATE OF COVERAGE ' 07/05/2016 PRODUCER: ! THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, Alliant Insurance Services, Inc. I EXTEND OR ALTER THE COVERAGE AFFORDED BY THE MEMORANDUM OR POLICY P.O. BOX 6450 I BELOW: NEWPORT BEACH, CA 92658-6450 COMPANIES AFFORDING COVERAGE PH (949) 756-0271 / FAX (949) 756-2713 LICENSE NO. OC36861 �CpMPANY LETTER (A) BIG INDEPENDENT CITIES EXCESS POOL I COMPANY LETTER (B) BIG INDEPENDENT CITIES EXCESS POOL MEMBER: CITY OF SANTA ANA ATTN: ED RAYA COMPANY LETTER (C) RISK MANAGER COMPANY LETTER ( D P.O. BOX 1988 ) SANTA ANA, CA 92702-1988 COMPANY LETTER (E) COMPANY LETTER (F) THIS IS TO CERTIFY THAT THE MEMORANDUM OF COVERAGE OR POLICY(IES) LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY OR MEMORANDUM PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE COVERAGES AFFORDED BY THE MEMORANDUM OR POLICY(IES) DESCRIBED HEREIN ARE SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUM OR POLICY. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPES MEMORANDUM MEMORANDUM MEMORANDUM OF OR OR POLICY OR POLICY I LTR COVERAGES POLICY NUMBER EFFECTIVE I EXPIRES i LIMIT EXCESS LIABILITY i DIFFERENCE BETWEEN II $10,000,000 POOL LIMIT A OCCURRENCE FORM I BI & PD ' 80-05 07/01/2016 07/01/2017 COMBINED AND INCLUDING AUTOMOBILE $1,000,000 LIABILITY I SELF -INSURED RETENTION � I 1 I DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS: AS RESPECTS AGREEMENT #C-2-0148 SENIOR MOBILITY PROGRAM. CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED SOLELY WITH RESPECT TO BODILY INJURY AND PROP���tT`( DAMAGE ARISING OUT OF OPERATIONS AS DESCRIBED BY OR ON BEHALF OF THE NAMED INSURED \A 7 SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS, ol, r P;PTIFIr ATF II nFR ORANGE COUNTY TRANSPORTATION AUTHORITY ATTN: REBECCA POTTER, CPM SENIOR PROCUREMENT ADMINISTRATOR 550 S. MAIN STREET ORANGE, CA 92863-1584 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. I+' THIS ENDORSEMENT DOES NOT CHANGE THE MEMORANDUM. PLEASE READ IT CAREFULLY, ADDITIONAL COVERED PARTY - COVERED INDEMNITY CONTRACT This endorsement identi,Res coverage provided under the following: BICEP MASTER MEMORANDUM OF LIABILITY COVERAGE The following wording can be found in Section II, Definitions: 6. COVERED PARTY -- means: f, Any person or entity holding a certificate of coverage duly issued by BICEP, as limited therein ("ADDITIONAL COVERED PARTY"). An ADDITIONAL COVERED PARTY is not covered for claims arising from the ADDITIONAL COVERED PARTY's sole negligence or for claims by another COVERED PARTY. g. Any person, entity or organization to whom the COVERED PARTY is obligated by virtue of a COVERED PARTY INDEMNITY CONTRACT to provide coverage solely with respect to BODILY INJURY AND PROPERTY DAMAGE arising out of: i. Premises leased, used or occupied by the COVERED PARTY ii. AUTOMOBILES leased or rented by the COVERED PARTY III. Equipment owned, leased, rented, maintained or used by the COVERED PARTY iv. Mortgagees of the COVERED PARTY; or v. Property owners and property managers of property owned, leased, rented or occupied by the COVERED PARTY, vi. However, these COVERED PARTY INDEMNITY CONTRACT coverages do not apply to: aa. An OCCURRENCE which takes place prior to or after the COVERED PARTY ceases to occupy the premise stated in the COVERED INDEMNITY CONTRACT, bb. Any structural alternation, new construction or demolition operations performed by or on behalf of the COVERED PARTY cc. Any PUBLIC ENTITY ERRORS AND OMISSIONS or EMPLOYMENT PRACTICES. h. The coverage set forth in subsection (g) immediately above will be limited to any limits of coverage within the terms of the COVERED INDEMNITY CONTRACT or the LIMITS OF (;OVERAGE within this MEMORANDUM, whichever is lest;, and will apply in excess to any underlying insurance or the COVERED PARTY'S SELF - INSURED RETENTION. BICEP will not be obligated for LIMITS OF LIABILITY greater than that provided by this MEMORANDUM. t1' 1.7 91 712014 Ed BICEP MOC Attachment Page 1 of 1