HomeMy WebLinkAboutNATI'S HOUSE (DBA NEUTRAL GROUND) (6) >. : -0
0
0 . E
a) c
a)
o N
\ 1
0 a
E
-'-
ZI C c I .-__
c cv �
Cr
o Q c a m
_c -
U
2
al. a) CI N a)
_m U
Ill a)
U- c , . is 0 Q
Z r 0 0 E• 0 •0 km E .3
— >� � o c v; p ov 0
13 = Q N .0 a) o O c —� a)C U Z ,, a3 U 0 --r- 0 4
c •- a N N U
a0 c 0 -o Q.
0 ipo) o >. 4. in
C c O is _c a_i O c a)
N c 0 ,� 0in
N } W oN EI •E 5 Cr) (I) 7 N
'.- c U C) vi
_ i _ Q � js E
U U 0 + - E .- C o 3 c c
-, N a m v } o N N m
E m - E � E
o O . a> m -a c5I-
No _0
o N
� � z � � U z 0
INSURANCE ON FILE
WORK MAY PROCEED A-2019-132
UNTILIN URANC EXPIRES
CLERKO COUNCIL
DATE: AUG 2 9 2019 CITY OF SANTA ANA
C� ALv� COMMUNITY BENEFIT AGREEMENT WITH
NATI'S HOUSE (DBA NEUTRAL GROUND)
�aJ�a �\octi
1. PARTIES AND DATE
This Community Benefit Agreement ("Agreement") is entered into on August 20, 2019, by
and between the City of Santa Ana, a charter city and municipal corporation organized and existing
under the Constitution and laws of the State of California ("City") and Nati's House (dba, Neutral
Ground), a California non-profit organization ("Recipient"). City and Recipient are sometimes
individually referred to as "Party" and collectively as "Parties" in this Agreement.
2. RECITALS
2.1 Community Benefit. The City wishes to provide Recipient with funding to assist
Recipient in providing after school programming and mentoring to youth focusing on violence
prevention, gang intervention, restorative practices, mentoring, and drug and alcohol prevention.
Recipient also provides street outreach and programming for parents and community ("Community
Benefit'). The parties wish to enter into this Agreement to establish the terms and conditions under
which the City will provide funding for such program.
2.2 Public Purpose. The City believes there is a public purpose in supporting the
Community Benefit because it will assist City residents with providing a healthy activity and training
in an atmosphere of community participation. The foregoing is a general description of the public
purpose, and is not necessarily the only public purpose to be gained from the Community Benefit.
3. TERMS AND CONDITIONS
3.1 Use of Funds. The City has chosen to provide Recipient with Fifty -Thousand Dollars
($50,000.00), as detailed in Exhibit B ("Program Budget") attached hereto and incorporated herein
by reference, because the City has determined that there is a public purpose to be served in
supporting the Community Benefit. Such funds shall be expended by Recipient on or before June
30, 2020. The funds shall be disbursed by City to Recipient on a quarterly basis subject to and upon
receipt and approval of a complete quarterly activity report from Recipient, with the final payment
subject to the satisfaction of the condition precedent of submittal of complete reporting information
due on or before July 15 of the applicable funding year, as hereinafter more fully set forth. Recipient
shall be obligated to perform such duties as would normally extend beyond the term, including, but
not limited to, obligations with respect to indemnification, audits, reporting, data retention/reporting,
and accounting. Failure to provide any of the required documentation and reporting will cause City
to withhold all or a portion of a request for reimbursement, or return the entire reimbursement
package to Recipient, until such documentation and reporting has been received and approved by
City. In executing this Agreement and receiving the funds, Recipient agrees to use the funds only for
the purpose described and subject to the terms and conditions provided for in this Agreement, and set
forth in greater detail in Exhibit A ("Scope of Services") attached hereto and incorporated herein by
reference. Should Recipient fail to use the funds for such purpose or otherwise comply fully with the
terms of this Agreement, City shall have the right to terminate this Agreement and demand the return
of the funds pursuant to Section 3.2 below.
3.2 Term; Termination of Agreement. This Agreement shall take effect on August 20,
2019 and remain in effect through June 30, 2020. The City has the right to tenninate this Agreement
upon one day's notice, with or without cause. Should the City terminate this Agreement, it shall also
have the right to demand the immediate return of all funds provided to Recipient pursuant to this
Agreement, as well as interest at the rate of ten percent (10%) per armum. Notwithstanding the
foregoing, the indemnification provisions of this Agreement shall survive any expiration or
termination of this Agreement.
3.3 Insurance. Prior to undertaking performance of work under this Agreement,
Recipient shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance
as described below:
a. Commercial General Liability Insurance. Recipient shall maintain commercial
general liability insurance naming the City, its officers, employees, agents, volunteers and
representatives as additional insured(s) and shall include, but not be limited to protection against
claims arising from bodily and personal injury, including death resulting therefrom and damage to
property, resulting from any act or occurrence arising out of Recipient's operations in the
performance of this Agreement, including, without limitation, acts involving vehicles. The amounts
of insurance shall be not less than the following: single limit coverage applying to bodily and
personal injury, including death resulting therefrom, and property damage, in the total amount of
$1,000,000 per occurrence, with $1,000,000 in the aggregate.
b. Business automobile liability insurance, or equivalent form, with a combined single
limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned,
hired and non -owned automobiles,
C. Worker's Compensation Insurance. hi accordance with the provisions of Section
3700 of the Labor Code, Recipient, if Recipient has any employees, is required to be insured against
liability for worker's compensation or to undertake self-insurance. Prior to commencing the
performance of the work under this Agreement, Recipient agrees to obtain and maintain any
employer's liability insurance with limits not less than $1,000,000 per accident.
d. If Recipient is or employs a licensed professional such as an architect or engineer:
Professional liability (errors and omissions) insurance, with a combined single limit of not less than
$1,000,000 per claim with $2,000,000 in the aggregate.
C. The following requirements apply to the insurance to be provided by Recipient
pursuant to this section:
(i) Recipient shall maintain all insurance required above in full force and effect
for the entire period covered by this Agreement.
2
charged to the City for a minimum period of three (3) years, or for any longer period required by
law, from the date of final payment to Recipient under this Agreement. All such records and
invoices shall be clearly identifiable. Recipient shall allow a representative of the City to examine,
audit, and make transcripts or copies of such records and any other documents created pursuant to
this Agreement during regular business hours. Recipient shall allow inspection of all work, data,
documents, proceedings, and activities related to this Agreement for a period of three (3) years from
the date of final payment to Recipient under this Agreement.
3.7 Conflict Of Interest Clause. Recipient covenants that it presently has no interests
and shall not have interests, direct or indirect, which would conflict in any manner with performance
of services specified under this Agreement.
3.8 Independent Contractor. Recipient shall, during the entire term of this
Agreement, be construed to be an independent contractor and not an employee of the City. This
Agreement is not intended nor shall it be construed to create an employer -employee relationship, a
joint venture relationship, or to allow the City to exercise discretion or control over the professional
manner in which Recipient performs the services which are the subject matter of this Agreement;
however, the services to be provided by Recipient shall be provided in a manner consistent with all
applicable standards and regulations governing such services. Recipient shall pay all salaries and
wages, employer's social security taxes, unemployment insurance and similar taxes relating to
employees and shall be responsible for all applicable withholding taxes.
3.9 Assig_rm ent. Inasmuch as this Agreement is intended to secure the specialized
services of Recipient, Recipient may not assign, transfer, delegate, or subcontract any interest herein
without the prior written consent of the City and any such assigmnent, transfer, delegation or
subcontract without the City's prior written consent shall be considered null and void. Nothing in this
Agreement shall be construed to limit the City's ability to have any of the services which are the
subject to this Agreement performed by City personnel or by other Recipients retained by City.
3.10 Exclusivity and Amendment. This Agreement represents the complete and exclusive
statement between the City and Recipient, and supersedes any and all other agreements, oral or
written, between the parties. In the event of a conflict between the terms of this Agreement and any
attachments hereto, the terns of this Agreement shall prevail. This Agreement may not be modified
except by written instrument signed by the City and by an authorized representative of Recipient.
The parties agree that any terms or conditions of any purchase order or other instrument that are
inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate
Recipient or the City. Each party to this Agreement acknowledges that no representations,
inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone
acting on behalf of any party, which are not embodied herein.
3.11 Discrimination. Recipient shall not discriminate because of race, color, creed,
religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined
and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion,
termination or other employment related activities. Recipient affirms that it is an equal opportunity
employer and shall comply with all applicable federal, state and local laws and regulations.
0
(ii) Certificates of insurance shall be furdshed to the City upon execution of this
Agreement and shall be approved by the City.
(iii) Certificates and policies shall state that the policies shall not be canceled or
reduced in coverage or changed in any other material aspect without thirty (30) days prior
written notice to the City.
f. If Recipient fails or refuses to produce or maintain the insurance required by this
section or fails or refuses to furnish the City with required proof that insurance has been procured
and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate
this Agreement. Such termination shall not affect Recipient's right to be paid for its time and
materials expended prior to notification of termination. Recipient waives the right to receive
compensation and agrees to indemnify the City for any work performed prior to approval of
insurance by the City.
3.4 No Oversight by City. Nothing in this Agreement shall be implied or interpreted as
City establishing or providing oversight, control or approval of the Community Benefit or any
activities conducted by the Recipient.
3.5 Indemnification. Recipient understands, acknowledges and agrees that Recipient
shall assume all risks associated with the Community Benefit, including, but not limited to, the
possibility of death or serious trauma or injury. To this end, therefore, Recipient shall defend,
indemnify and hold City and its officials, officers, employees, agents and volunteers free and
harmless from and against any and all claims, demands, causes of action, costs, expenses, liabilities,
losses, damages or injuries, in law or equity, to property or persons, including wrongful death, in any
manner arising out of or incident to any and all acts, omissions, willful misconduct or other activities
of the Recipient or its officials, officers, employees, agents, guests, participants attendees, and
contractors, including the performance of the Community Benefit or this Agreement, including
without limitation the payment of all consequential damages and attorneys fees and other related
costs and expenses. The only exception to the Recipient's obligations hereunder shall be for claims,
demands, causes of action, costs, expenses, liabilities, losses, damages or injuries caused by the sole
negligence, sole willful misconduct or sole active negligence of the City. Recipient shall defend, at
Recipient' own cost, expense and risk, any and all such aforesaid suits, actions or other legal
proceedings of every kind that may be brought or instituted against the City, its officials, officers,
employees, agents, or volunteers. Recipient shall pay and satisfy any judgment, award or decree that
may be rendered against the City or its officials, officers, employees, agents, or volunteers, in any
such suit, action or other legal proceeding. Recipient shall reimburse City and its officials, officers,
employees, agents, and/or volunteers, for any and all legal expenses and costs incurred by each of
them in connection therewith or in enforcing the indemnity herein provided. Recipient' obligation to
indemnify shall not be restricted or limited by insurance proceeds, if any, received by the City, its
officials, officers, employers, agents or volunteers. The indemnification provisions of this
Agreement shall survive any expiration or termination of this Agreement.
3.6 Records. Recipient shall keep records and invoices in connection with the work
to be performed under this Agreement. Recipient shall maintain complete and accurate records with
respect to the costs incurred under this Agreement and any services, expenditures, and disbursements
3
3.12 Jurisdiction — Venue. This Agreement has been executed and delivered in the State
of California and the validity, interpretation, performance, and enforcement of any of the clauses of
this Agreement shall be determined and governed by the laws of the State of California. Both parties
farther agree that Orange County, California, shall be the venue for any action or proceeding that
may be brought or arise out of, in connection with or by reason of this Agreement.
3.13 Professional Licenses. Recipient shall, throughout the term of this Agreement,
maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the
provision of the services hereunder and required by the laws and regulations of the United States, the
State of California, the City of Santa Ana and all other governmental agencies. Recipient shall notify
the City immediately and in writing of its inability to obtain or maintain such permits, licenses,
approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement.
3.14 Entire Contract/Modification. This Agreement contains the entire agreement of the
Parties with respect to the subject matter hereof, and supersedes all prior negotiations,
understandings or agreements. The terns and conditions of this Agreement may be altered, modified
or amended only by written agreement signed by both Parties.
3.15 Authority to Enter Agreement. The person executing below on behalf of Recipient
represents and warrants that the Recipient has all requisite power and authority to conduct its
business and to execute, deliver and perform this Agreement. Each Party warrants that the
individuals who have signed this Agreement have the legal power, right and authority to make this
Agreement bind each respective Party.
(Signatures on following page)
5
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above
written.
ATTEST:
c
• "' • TOFORM:
SONIA R. CARVALHO
Cit}
RECOMMENDED FOR APPROVAL
�L kj�
Steven A. Mendoza
Executive Director
Community Development Agency
CITY OF SANTA ANA
Y15stine Ridge
City Manager
"RECIPIENT"
Nati's House dba Neutral Ground
ame-Narviclad Alvarado
itle: Executive Director
City of Santa Ana CDBG Scope of Work
Program Year 2019-20 (July 1, 2019 - June 30, 2020)
Name of Organization Nati's House (dba Neutral Ground)
Name of Funded Program Neutral Ground
Annual Accomplishment Goal
Unduplicated Participants anticipated to be served during the 12-month contract period.
75 TOTAL 1 75 Santa Ana Participants 100% r 75 Low Income Participants 100%
Schedule of Performance
Unduplicated
(estimated)
Quarter 1: JUL 1 - SEP 30
Quarter 2: OCT 1 - DEC 31
Quarter 3: JAN 1 - MAR 31
Quarter 4: APR 1 - JUN 30
Program and Funding Description
Estimated
Invoicing
$ 12,500.00
$
12,500.00
$
12,500.00
$
12,500.00
$
50,000.00
utral Ground provides gang prevention and intervention, and positive youth
ogramming and mentoring through a multi -prong approach. Through City Funds,
utral Ground will provide a variety of services and programming after -school to
USD students. In addition, Neutral Ground has highly -skilled Community
:ervention Workers that provide street outreach and first responder services to the
.ter -school services are offered 6 days a week After school and intervention services
fered 7 days a week with most students accessing services at least weekly.
-ogramming, services, and interventions are offered in multiple, tiered ways in order
most directly affect the student. Group programming is offered after -school in the
rms of group mentoring, restorative justice circles, community service, and special
•esentations or events. One on one case management, violence intervention, gang
sengagement, and mentoring is consistently offered, and usually accessed at least
weekly. Street outreach and home visits are also conducted as needed. Neutral
round has seen the impact that consistent and quality after -school case management
is in the success of a project. Accordingly, Neutral Ground interventionists are
ained heavily in the case management process because it is important to establish a
lture of accountability and performance. Staff assesses students based on their level
need for intensive after -school case management, and provide case management
rvices as appropriate. Each student served will have their own individual case file
ith relevant information, and every contact with that student will be entered into
se notes on a consistent basis. Staff will work with students after school to identify
itential barriers to their success at school and outside of school. Upon identification
any barriers, services and/or referrals to community partners will be made in order
mitigate the barriers. Neutral Ground staff will offer three different types of
idenred-haled mentnrinu nrartices. This will nrovide different levels of ennaaeenent
EXHIBIT A
. .............» ...b F.........,.,... .. ... V. ... .................k,_t- -----
nd intensity that will accommodate each student's unique emotional and social
eeds. The three -different evidence based mentoring practices are as follows: 1. Staff
,ill offer one-on-one mentoring after school to youth on a daily basis. 2. Group
ientoring opportunities through circles and breakout groups will encourage
tudents' positive behavioral growth through both an adult staff facilitator as well as
trough peer -to -peer interactions. 3. Service -based mentoring will be provided
trough other venues, such as after school community service projects, or post-
acondary education linkages.
idividual case management and mentoring will be student -led with an adult. This will
-eate a dynamic that will encourage students to disclose information and seek out the
eutral Ground staff member with whom they have the most connection. Neutral
round staff will meet after school, at least weekly, to discuss students' progress in
rder to provide support to each other as well as to provide organizational knowledge
could another staff member need to step in, support and help serve the student. All
aff members are trained in restorative practice circles, including Victim -Offender
ediation, the only practice recognized by the Office of Juvenile Justice and
elinquency Prevention as evidenced -based, and a model program. Staff will offer
ter school restorative practice circles to students and parents at least once per week.
EXHIBIT A
FISCAL YEAR 2019-2020
PROGRAM BUDGET
Organization Name Nati's House dba Neutral Ground
Program Name Neutral Ground
EXPENDITURES
Enter budget categories and projected expenditures for the proposed program:
Category
Expenditures
Funded By
Santa Ana
CDBG
Expenditures
Funded By
Other Sources
Program
Budget
Total
Organization
Budget
Administrative Staff Salaries no Benefits
$6,032
$6,032
$ 6,032
Program Staff Salaries & Benefits
$31,500
$31,500
$ 31,500
Direct Program Supplies
$7,4231
$7,423
$ 7,423
Mileage for Home Visits
$500
$500
$ 500
$0
0
$0
$0
0
$0
$0
0
$0
$0
0
$0
$0
0
$0
$0
TOTAL Direct Costs
$45,455
$0
$45,455
$45,455
Indirect Costs 10%
$4,546
$4,546
TOTAL BUDGET
$50,001
$0
$50,001
$45,455
* Indirect cost rate: 10% Non -Federal entity without federaly recognized negotiated indirect
cost rate, will charge a de minimis rate of 10% of modified total direct
costs.
PROGRAM RESOURCES
LISTALL OTHER PROGRAM RESOURCES FOR 2019-2020
Funding Source Total must equal Program Budget Total listed above.
FUNDING SOURCE AMOUNT
Santa Ana CDBG $ 50,000
TOTAL $ 50,000
EXHIBIT B
2019-2020 CDBG BUDGET LINE ITEMS
ADMINISTRATIVE STAFF
Position Title
Annual Salary
& Benefits
CDBG Funds
Requested
Description
President
$ 60,116
$ 6,032
.10%Admin
PROGRAM STAFF
Position Title
Annual Salary
& Benefits
CDBG Funds
Requested
Description
Program Director
$ 60,116
$ 15,000
.23%FTE
CIW
$ 40,000
$ 16,500
.40%FTE
CONTRACTUAL/PROFESSIONAL SERVICES
Type of Service
Contract
Amount
CDBG Funds
Requested
Description
OTHER LINE ITEMS
Line Item
Program
Amount
CDBG Funds
Requested
Description
Direct Program Supplies
$ 12,000
$ 7,423
Supplies tied directly to participant programining
Mileage for Home Visits
$ 500
$ 500
Mileage
I00:llli7:�il
/Js?�Regi- CERTIFICATE OF LIABILITY INSURANCE
- DATE(MMIDDNM)
7110/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsemente).
PRODUCER
LDvitt & Touche -Tempe
NA E Tome SERrldge _
PHONE -- '-- c -
c.µo €xu• 602-956 2250INC N t 602.958-22$8
1050 W Washington Street, Suite 233
gRE33 tseifridges]D lovitt touehe com
Tempe AZ 85281 -
.._INSURERS AFFDRDING COVERAGE
NAIC$_`v
INSURER A. Ll0 d'S Of London
Y_w��
w �+
--
INSURED NATIHOU-Ci
Nati's House
INSURER 9:.
_
_
tquRERc:,
Neutral Ground
InsuRERD:
1733 Valencia St
Santa Ana CA92706
'—"
INSURER E;
------
INSURERF,
9_9A11i191\l�Jl4ltil:fi:N:1.T:1:1:K1r1:S NyTJL4rillnHILT, e
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INeft
LT
•_—.
TYPE OF INSURANCE
ADaL
9IJHi4f-m..._,.�..-.�.—_.rT($�LTC9'E
POWCYNUMDER
F�
R/YYYY
POLICY E%P
lD YYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
1114865
1/29/2019
1/612020
EACH OCCURRENCE
$1,000000
❑ MM_
..-........,�.
�_
CLAIMS -MADE OCCUR
P F,SIEaowrrrencal
$�ID0000 _
MED EXP(Any ono ersenl
$5,000
PERSONAL&AOV INJURY
$1,13OQ000
NI LAGGR2ktAT@O- APPLIES PER:
0
PRODTSCOMP OPAGG
UOG,o
$ nluded
%OE
POLICY Lj�OC
Or] ICH:
$
AUTOMOBILE
LIABILITY
OMaI ❑SNOLe LIM
EMAU11.
$
d
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
/�q(1
BODILY
BODILY INJURY (Per person)
$
BODILY INJURY (Per eccitlenl)
-�
$
-
HIRED -'AUTOS NLY
,.
V'`
RKOPElIYYDAM_dE
AUTOS ONLY ,..; AUTOS ONLY
REVIEWEDD
BY.
(Peer ee5gj?.nff
$
.
$
UMBRELLA LIAB OCCUR
L
! U�
'] yl
EACH OCCURRENCE
EXCESS LIAB CLAIMS -MADE
(I
AGGREGATE
DED RETENTION$
I
$
WORKERS COMPENSATIONS
- PER OTFN'
AND EMPLOYERS' LIABILITY YIN
__-ST.4�UTEj_
OFFIC-ANYPR!MEMB 18PARTUDED?ECUTIVE
OFFICERIMEMBEREXCLUOED9
NIA
E LEACH ACCIDENT
_
it
NH)
DISEA®....,.,EE$
E,L DISEASE -EA EMPLOYEE
$�
rgaRroryln
escribe under
DESCRIPTION OF OPERATIONS below
E. L. DISEASE -POLICY LIMIT
$
A
Professional Llabillty
1114885
1/29/2019
1/6/2020
Each Claim
1,000,ODO
SexuallPhyeical Abuse
Prof Aggregee.
SAMLAggregale
3000,000
1:000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD I ei, ABUitional Remarks Schedulo, may be allachad if mme epeca is required(
Certificate holder Is named Additional Insured to General Liability coverage if required by written contract, subject to all policy terms, conditions, definitions and
exclusions. Primary/Non-Contributory applies.
"City of Santa Ana, officers, agents, employees, and volunteers are named as additionally Insured on this policy pursuant to written contract, agreement, or
memorandum of understanding. Such Insurance as Is afforded by this policy shall be primary, and any Insurance carried by City shall be excess and
noncontributary."
The City of Santa Ana
Risk Management Division
20 Civic Center Plaza
Santa Ana CA 92701
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
All
AUUKU LG IZUIUIU3) I fie ACOKU name and logo are registered marks of ACORD
SOCIAL SERVICES LIABILITY INSURANCE POLICY ENDORSEMENT
I. PROFESSIONAL LIABILITY (CLAIMS MADE AND REPORTED COVERAGE)
II. GENERAL LIABILITY (OCCURRENCE -BASED COVERAGE)
ADDITIONAL INSURED(S) - E18610SB-0616
In consideration of the premium charged and subject to all other terms, conditions, definitions
and exclusions of the Policy, Underwriters agree with the Named Insured that the following
person(s) or organization(s) shall be added to this Policy as Additional Insured(s):
nblg
etroactiv Date Inception Date
Addito al Insured
Qyeraue
Sec o
(applicable to PL (applicable to GL
only) only)
Teio
H Date
Date
1.Charitable Ventures of
Orange County
Project Kinship
rofessional &
General Liability
January 29, 2019 January 29, 2019
N/A
4041 MacArthur Blvd, Set
510
Newport Beach, CA 92660
2.Santa Ana Unified School
District
Its governing board,
officers, agents and
Professional &
January 29, 2019 January 29, 2019
employees
General Liability
WMW
1601 E. Chesnut Ave.
Santa Ana, CA92701
REVIEWEI.
3.The City of Santa Ana
"29,
Managemei
Its officers, employees,
agents and volunteers
Professional &
January 29, 2019N/A
General Liability
20 Civic Center Plaza
Santa Ana, CA 92701
All other terms and conditions. of. the Polley.remain unchanapcl
E18610S8-0616 Page 1 of 2
BY:
Division
The above -designated Additional Insured(s) shall only have coverage for the applicable
coverage section(s) referenced above, and such coverage shall be limited to Claims for:
1. Professional Liability Incidents, if applicable, that occur on or after the retroactive date
specified above, but prior to the termination date specified above, if any;
2. General Liability Incidents, if applicable, that occur on or after the inception date
specified above, but prior to the termination date specified above, if any,
The Additional Insured(s) shall share in the Named Insured's Limits of Liability, as set forth in
Item 4 of the Declarations. Such Additional Insured(s) are not added as Named Insured(s).
This endorsement is to take effect on January 29, 2019.
Policy No.: 1114885
Name: Nati's House dba: Neutral Ground
Policy Effective Date: January 29, 2019 Expiration: January 6, 2020
Endorsement No.
REVIEWED BY:
L-)I�
Rlsk Management blvislon
All nthar terms and rpntlitings�nf_thr, Pollry_remain-unolinnged_
--
E1861056-0616 Page 2 of 2
CERTHOLDER COPY
P.O. BOX 8192, PLEASANTON, CA 94588
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
�JSSUE DATE: 07-11.2019 GROUP:
POLICY NUMBER: 9257170.2019
CERTIFICATE EXPIRES: 07.11.2020
07-11-2019 / 07-11-2020
CITY OF SANTA ANA
RISK MANAGEMENT DIVISION
20 CIVIC CENTER PLAZA
SANTA ANA, CA 92702
This is to certify that we have Issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer.
We will also dive you 30 days advance notice should this policy be cancelled prior to Its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of insurance may be Issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy.
Authorized Representative
President and CEO
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #2065 ENTITLED CERTFICATE HOLDERS' NOTICE EFFECTIVE 07-11-2019 IS ATTACHED TO
AND FORMS A PART OF THIS POLICY.
EMPLOYER
NATI'S HOUSE (A NON PROFIT CORP)
NEUTRAL GROUND FAMILY SERVICES
1733 VALENCIA ST
SANTA ANA, CA 92706
G 11 i ' `"l
REVIEWED BY:
-V 0,ng
Risk Management Division
CSC MCERT PRINTED ON; 07-11-2019
(REV 22017)
POLICYHOLDER COPY
P.O. BOX 8192, PLEASANTON, CA 94588
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 07.11.2019
CITY OF SANTA ANA
RISK MANAGEMENT DIVISION
20 CIVIC CENTER PLAZA
SANTA ANA, CA 92702
GROUP:
POLICY NUMBER: 9257170.2019
CERTIFICATE EXPIRES: 07-11.2020
07-11-2019 / 07-11-2020
This is to certify that we have Issued a valid Workers' Compensation Insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period Indicated.
This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer,
Wewill also give you 30 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of Insurance may be issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy.
Authorized Representative
President and CEO
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #2065 ENTITLED CERTFICATE HOLDERS' NOTICE EFFECTIVE 07-11-2019 IS ATTACHED TO
AND FORMS A PART OF THIS POLICY.
EMPLOYER
NATI'S HOUSE (A NON PROFIT CORP)
NEUTRAL GROUND FAMILY SERVICES
1733 VALENCIA ST
SANTA ANA, CA 92706
(REV. 2.2017)
Awmtm/
REVIEWED BY:
)]
Risk Management Division
CSC MCERT PRINTEO ON: 07-11.2019
ACii CERTIFICATE OF LIABILITY INSURANCE
DATE IMM OO YYn
5/26/2020
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
Lovitt 8 Touchb A Marsh and McLennan Agency. LLC
1050 W Washington Sheet, Suite 233
Tempe AZ 85281
NAM : Tonia Selfridge
PHONE 602-956-2250 m 802-958d258
E MAL
- tselfrid a lovitt-touche.com
INSURE IIAFFORDING COVERAGE
NAICe
INSURER A Underwriters at Uo ds London
INSURED NATIHOU.C1
Nab's House
M�RER a,
Neutral Ground
stsUw1 C'
iii=
1733 Valencia St
MSUREa
Santa Ana CA 92706
MSUREM F:
COVERAGES CERTIFICATE NUMBER: 893284612 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW RAVE 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 BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
mu
LnxPOLICY
TYPE OF INSURANCE
MILER
POLICY EFF
POLICY 6XP
LMrls
A
X COMMERCMLDENEMLUMR.ITY
1114985
1/6/2020
1F1i
IiACHOCCURNENCE
sivallim
CLAMS4 E a OCCUR
PR M S Meo
S50,000
LIED Ei(P (AmI wM peal
$5,000
PERSONA. A AOV INJURY
31.000.000
GEN AOGREGATEUaNTAPPLIESPER:
GENERALAGGREGATE
Ss.00D.000
X POLICY 11 JET F LOC
PRODUCTS-COMP/OPAGO
f1000.DDO
S
On HER:
A
AYTOYpeLE
LUU1Lm'
1114US
//6/2020
106/2021
91NE091N I I
la
s1t00ed3BD;
Auto
BODILY INJURY few persl l
S
X
OWNED Y SCISEwLED
AIJTOS AUTOS
� BODILY INJURY (Per arnderlI)
$
PROPERTY DAMAGE
(Per accident)
S
X
X 110f40MT1ED
AUTO$OILY MUTOS ONLY
S
URBREUAL1Ae
OCCW
EACH OCCURRENCE
$
AGGREGATE
S
Excess LW
CLAN�E
DED RETENT%wS
s
WORRERScOrPEN$ATIDN
AND EWLOYERS LMeILITY YIN
AMVWiOPRETOIUPARTNERIEXECUTNE
PTAT R
E.L. EACH ACCIDENT
S
t FICERMEMBEREXCLWED1 ❑
NIA
E.L DISEASE - EA EMPLOYEE
S
(Ywrdela/Y M aMl
Myn dssvlhe under
DESCRIPTIONOFOPEMTIDNS
ELMSEASE POLICY LIMIT
S
A
rda
Pmx UatxYIY
1114885
1/6/2020
t/BROP
Qam
1,001
seaeVPnyalcal Ux as
la
SSA �gralate
Aggregate
000,000
1 .000.000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AC 101. Additional Romania Schedule, may he attached 11 mom speca Is neulradl
Certificate holder Is named Additional Insured to $JiEneral Liability coverage if required by written contract, subject to all policy terms, conditions, definitions and
exclusions. Pdmary/Non-Contributory applies. -
-City of Santa Ana. officers. agents, employees, and volunteers are named as additionally insured on this poligypursuanl to written contract, agreement. or
memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and
noncontributory' Certificate of Insurance shall provide thirty (30) day prior written notice of cancellaboi
REVIEWED & APPROVED
/ JV ry S{r I 1 /ULU SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
}V7L\Y�I-/} THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
The City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
Risk Management Division ,\N/�IE ACEVEdC
20 Civic Center Plaza y AUTNOI@EDREPRESENTATNE
Santa Ana CA 92701 C� 1
® 1981 ACORD
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE
riahts reserved.
Ei
SOCIAL SERVICES LIABILITY INSURANCE POLICY ENDORSEMENT
I. PROFESSIONAL LIABILITY (CLAIMS MADE AND REPORTED COVERAGE)
II. GENERAL LIABILITY (OCCURRENCE -BASED COVERAGE)
ADDITIONAL INSURED(S) — E18610SB-0616
In consideration of the premium charged and subject to all other terms, conditions, definitions
and exclusions of the Policy, Underwriters agree with the Named Insured that the following
person(s) or organization(s) shall be added to this Policy as Additional Insured(s):
Applicable
Retryactive Date
In=tion Date
Additonal Insured
ov ra a
Section
(applicable to PL
only)
(applicable to GL
only)
Te
te n
Date
Date
LCharitable Ventures of
Orange County
Project Kinship
Professional &
January 29, 2019
January 29, 2019
/A
General Liability
41 MacArthur Blvd, Set
10
Newport Beach, CA 92660
.Santa Ana Unified School
District
its governing board,
&
officers, agents and
General L
General Liability
January 29, 2019
anuary 29, 2019
/A
employees
1601 E. Chesnut Ave.
Santa Ana, CA 92701
3.The City of Santa Ana
its officers, employees,
Professional
gents and volunteers
General Liabil
29, 2019
/A
Risk MANAGEMENT I
(VISION
0 Civic Center Plaza
202
ants Ana, CA 92701
�J'�.
ANCtiE ACEVEdo
All other terms and conditions of the Policy remain unchanged
E18610SB-0616 Page 1 of 2
The above -designated Additional Insured(s) shall only have coverage for the applicable
coverage section(s) referenced above, and such coverage shall be limited to Claims for:
1. Professional Liability Incidents, if applicable, that occur on or after the retroactive date
specified above, but prior to the termination date specified above, if any;
2. General Liability Incidents, if applicable, that occur on or after the inception date
specked above, but prior to the termination date specified above, if any.
The Additional Insured(s) shall share in the Named Insured's Limits of Liability, as set forth in
Item 4 of the Declarations. Such Additional Insured(s) are not added as Named Insured(s).
This endorsement is to take effect on January 29, 2019.
Policy No.: 1114885
Name: Nati's House dba: Neutral Ground
Policy Effective Date: January 29, 2019 Expiration: January 6, 2020
Endorsement No.: 7
REVIEWED & APPROVED
By Risk MANAGEMENT DiviSiON
JUN 2020
ANGiE ACEVEdO
All other terms and conditions of the Policy remain unchanged
E1861OSS-0616 Page 2 of 2