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HomeMy WebLinkAboutKD EDUCATION, LLC dba: HEALTH STAFF TRAINING INSTITUDEON FILE AORK MAY PROCEED A-20 p_ Ohs UNTIL INSURANCE EXPIRES 194-08 0. L7- U • `J, CLERK OF COUNCIL GATE: AGREEMENT FOR WORKFORCE TRAINING 0-. f Pro&nay 150,/1xJ for THIS SUBAWARD AGREEMENT, made and entered into this I" day of March, 2021, by and between the City of Santa Ana, a charter city and municipal corporation duly organized and existing under the Constitution and laws of the State of California ("CITY") and KD Education, LLC dba: HealthStaff Training Institute, a for -profit corporation identified by the assigned Data Universal Numbering System (DUNS) Number 47-1994582("CONTRACTOR"). RECITALS: A. CITY has been designated a Local Workforce Development Area (LWDA) under the Workforce Innovation and Opportunity Act of 2014, Public Law 1-113-128 ("WIOA" or "the Act"), Catalog of Federal Domestic Assistance (CFDA) Number 17.259 and Federal Award Identification Number (FAIN) AA253421455A6. B. The State of California has created the LWDA to administer the Act programs operated by the State of California pursuant to the Act. C. As a LWDA, CITY is entitled to receive federal funds to establish programs to increase the employment, retention and earnings of Participants, and increase occupational skills attainment by Participants, and as a result, improve the quality of the workforce, reduce welfare dependency, and enhance the productivity and competitiveness of the nation. Under WIOA, participants in need of training services may access career training through a list of state -approved schools and their training programs. D. In addition to WIOA, the CITY received funding from the Orange County Social Services Vocational Training grant funded through the California Work Opportunity and Responsibility to Kids Act of 1997, which provides monies for the basic needs of families with children ("CalWORKs" or "SSA"). An important component of CaIWORKs allows for the provision of employment services for parents. Heads of households are provided job training services to help families upgrade job skills with the ultimate goal of self-sufficiency. E. The City intends to utilize the WIOA and SSA Grant Funds to operate a Workforce Training Program in which vocational training courses will be made available to Qualified Participants. Pursuant to the Workforce Training Program, the City desires to contract with public and private organizations, including employers, who are qualified to participate in the City's Workforce Training Program by providing services to Qualified Participants (each, a "Qualified Contractor"). F. CONTRACTOR is a Qualified Contractor that has been selected as one of several vendors that qualified to provide workforce training under the Workforce Training Program. G. CONTRACTOR represents that it is knowledgeable in its field, and is willing to provide workforce training services under the Workforce Training Program pursuant to applicable federal and California laws. Page l of 17 7 H. The CITY and CONTRACTOR (each, a "Party" and jointly, the "Parties") desire to enter into this Agreement so that CONTRACTOR may receive a subgrant of the proceeds of the WIOA and/or SSA Grants (hereinafter defined as the "Subgrant") in consideration for Contractor's participation in the City's WIOA and/or SSA Programs and provision of services to Qualified Participants upon the request of the City. WHEREFORE, for and in consideration of the respective and mutual covenants and promises hereinafter contained and made, and subject to all the terms and conditions hereof, the parties hereto do hereby agree as follows: I. CONTRACTOR'S OBLIGATIONS A. In compliance with all of the terms and conditions of this Agreement, CONTRACTOR shall provide the Contractor's Services, as authorized by the City's Representative. Contractor represents and warrants that Contractor's Services to be provided hereunder shall be performed in a competent, professional and satisfactory manner in accordance with the City's Workforce Training Program. B. CONTRACTOR agrees to provide benefits to individuals who participate in the activities and services funded by this Agreement ("Participants") in accordance with the standards and requirements set forth in this Agreement. C. CONTRACTOR acknowledges and agrees that City shall request that Contractor provide the Contractor's Services on an "as requested" basis and that City does not guaranty a minimum number of Qualified Participants for whom Contractor's Services shall be requested and required under this Agreement. Contractor acknowledges and agrees that Contractor shall not commence to provide Contractor's Services to a particular Qualified Participant hereunder unless and until Contractor receives a Notice to Proceed from the City authorizing the provision of Contractor's Services to that particular Qualified Participant. Contractor further acknowledges and agrees that this Agreement and any request for the provision of services hereunder is nonexclusive and that the City may enter into similar agreements with other entities for the provision of similar services. D. Time is of the essence in the performance of this Agreement. CONTRACTOR shall perform and complete all of CONTRACTOR's Services in a timely and expeditious manner. Contractor shall not be responsible for delays caused by circumstances beyond its reasonable control, provided that CONTRACTOR has delivered to the City written notice of the cause of any such delay within ten (10) days of the occurrence of such cause. E. Scope of Services. On an as -needed basis, and at the sole discretion of CITY, CONTRACTOR shall perform the services that are described in Exhibit A. The Scope of Services shall include the CONTRACTOR's proposal or bid, if any, which shall be incorporated herein by this reference as though fully set forth herein. In the event of any inconsistency between the terms of such proposal and this Agreement, the terms of this Agreement shall govern. When the need for services arise, CITY may initiate services through use of a Letter Agreement for a specific Page 2 of 17 workforce training, including a copy of the course description, executed by the Executive Director of the Community Development Agency and the CONTRACTOR. Work by the CONTRACTOR may not proceed absent this fully executed Agreement and separate Letter Agreements for specific Qualified Participants. F. Compliance with Law. CONTRACTOR's Services shall be provided in accordance with all ordinances, resolutions, statutes, rules, regulations and laws of the City and any Federal, State or local governmental agency of competent jurisdiction. G. CONTRACTOR shall obtain, at Contractor's sole cost and expense, such licenses, permits and approvals as may be required by law for the performance of CONTRACTOR' Services. CONTRACTOR shall have the sole obligation to pay for any fees, assessments and taxes, plus applicable penalties and interest, which may be imposed by law and which arise from or are necessary for the performance of the services required by this Agreement H. CONTRACTOR shall adhere to all applicable Labor Standards. I. If funding is through WIOA, CONTRACTOR agrees to comply with the "Complaint Handling Procedures Under the WIOA", attached hereto as Exhibit H and incorporated herein as though fully set forth in 20 CFR 658.411. CONTRACTOR shall advise Participants of their rights to file complaints under the Act and the procedures for resolution of any complaints. CITY's procedures for handling complaints alleging a violation of the Act, regulations, grants, or other agreements under the Act shall be followed and any decision of CITY, the State or the federal government relating to the complaint shall be binding and followed by CONTRACTOR. CONTRACTORS who are employers shall operate a grievance system that incorporates CITY's procedures for resolution of complaints relating to the terms and conditions of employment; these procedures shall be approved in writing by CITY. J. As a condition of this award of financial assistance under the Act to CONTRACTOR from CITY, CONTRACTOR assures, with respect to operation of all programs or activities funded with funds provided pursuant to the Act, and all agreements or arrangements to carry out such programs or activities, that it will comply fully with the nondiscrimination and equal opportunity provisions of the Act (Section 188) and compliance with Equal Employment Opportunity provisions in Executive Order (E.O.) 11246, as amended by E.O. 11375 and supplemented by the requirements of41 CFR Part 60; the Nontraditional Employment for Women Act of 1991; Title VI of the Civil Rights Act of 1964, as amended; section 504 of the Rehabilitation Act of 1973, as amended; the Age Discrimination Act of 1975, as amended; the Americans with Disabilities Act of 1990; and with all applicable requirements imposed by or pursuant to regulations implementing those laws, including, but not limited to, 29 CFR Parts 33 and 37. The United States, the State of California and CITY have the right to seek judicial enforcement of this assurance. K. CONTRACTOR agrees that no participant(s) shall commence training prior to the approval of funding pursuant to Section 123 of the Act, or the approval of SSA funding, as applicable. Page 3 of 17 L. CONTRACTOR agrees to the following accounting, monitoring, auditing, and review requirements: 1. CONTRACTOR agrees to maintain such records and submit such reports, data and information, on the form and containing such information, at such times as CITY may request or require regarding the performance of CONTRACTOR'S services or activities, costs or other data, including but not limited to Participants' attendance and certifications. 2. CITY, the State of California and the United States government and/or their representatives shall have access for purposes of monitoring, auditing and examining of CONTRACTOR'S activities, performance, and Participants related to this Agreement. Such agencies or representatives shall also schedule on -site monitoring at their discretion. Monitoring activities may also include, but are not limited to, questioning employees and Participants and entering any premises or onto any site in which any of the services or activities funded hereunder are conducted or in which any of the records of CONTRACTOR are kept (2 CFR §200.330). Nothing herein shall be construed to require access to any privileged or confidential information as set forth in federal or state law. 3. In the event CONTRACTOR does not make the above -referenced documents available within the City of Santa Ana, California, CONTRACTOR agrees to pay all necessary and reasonable expenses incurred by CITY in conducting any audit at the location where said records and books of account are maintained. 4. All accounting records and evidence pertaining to all costs of CONTRACTOR and all documents related to this Agreement shall be kept available at the location where CONTRACTOR conducted the program, as well as in the County of Orange, for the duration of this Agreement and thereafter for three (3) years after completion of an audit. Records which relate to (a) complaints, claims, administrative proceedings or litigation arising out of the performance of this Agreement, or (b) costs and expenses of this Agreement to which CITY, the State of California or the United States Government take exception, shall be retained beyond the three (3) years until resolution of disposition of such appeals, litigation, claims, or exceptions. M. Without prejudice to any other section of this Agreement, CONTRACTOR shall, where applicable, maintain the confidential nature of information provided to it concerning Participants in accordance with the requirements of federal and state law. Notwithstanding the foregoing, CONTRACTOR agrees to submit to CITY, the State of California and/or the United States Government or their representatives, all records requested for administrative purposes, including audits, examinations, monitoring and verification of records submitted by CONTRACTOR, costs incurred and services rendered hereunder. N. CONTRACTOR shall not expend funds pursuant to this Agreement to provide services to any participant where costs of training are paid for by any other person or entity. Page 4 of 17 O. If funding is through WIOA, CONTRACTOR shall comply with the provisions of Uniform Guidance 2 CFR Part 200 of the U.S. Office of Management and Budget (OMB) and all other applicable federal statutes and executive orders and their implementing regulations, including regulations at 29 CFR Part 97. P. If funding is through WIOA, CONTRACTOR shall comply with the requirements of federal regulations found at 29 CFR Part 93, which provide that no appropriated funds may be expended by the recipient of a federal contract, grant, loan or cooperative agreement to pay any person for influencing or attempting to influence an officer or employee of any agency, member of Congress or an officer or employee of a member of Congress in connection with awarding of any federal contract, the making of any federal grant or loan, entering into any cooperative agreement and the extension, renewal, amendment or modification of any federal contract, grant, loan or cooperative agreement. CONTRACTOR shall sign a Certification Regarding Lobbying to that effect in a form as set forth in Exhibit D, attached hereto and by this reference incorporated herein. CONTRACTOR shall submit said signed Certification to CITY prior to performing any of its obligations under this Agreement and prior to any obligation arising on the part of CITY to pay any sums to CONTRACTOR under the terms and conditions of this Agreement. Q. CONTRACTOR agrees to provide a drug -free work place and to execute a Drug Free Workplace Certification as set forth in Exhibit E attached hereto and incorporated herein by this reference. R. CONTRACTOR, in accordance with the Child Support Compliance Act, recognizes and acknowledges the importance of child and family support obligations and shall fully comply with all state and federal laws relating to child and family support enforcement, including, but not limited to: disclosure of information and compliance with earnings assignment orders, as provided in Chapter 8 (commencing with Section 5200) of Part 5 of Division 9 of the state Family Code; and, to the best of its knowledge is fully complying with the earnings assignment orders of all employees and is providing the naives of all new employees to the New Employee Registry maintained by the California Employment Development Department (EDD). S. CONTRACTOR agrees to comply with all applicable provisions of the Actor SSA, as applicable, and all applicable federal regulations, including, but not limited to, the Code of Federal Regulations, Subtitle A —Office of Management and Budget Guidance for Grants and Agreements, as well as all applicable state and local regulations. T. If funding is through WIOA, CONTRACTOR agrees to remain in compliance with the Certification Regarding Debarment, attached hereto as Exhibit F and incorporated herein by reference, as required by the regulations implementing Executive Order 12549, Debarment and Suspension, (2 CFR Part 180). U. If funding is through WIOA, CONTRACTOR agrees to provide priority of services for veterans and eligible spouses pursuant to 20 CFR Part 1010, and the regulations implementing priority of service for veterans and eligible spouses in Department of Labor job training programs under the Jobs for Veterans Act published at 73 Fed. Reg. 78132 on December Page 5 of 17 19, 2008. V. CONTRACTOR acknowledges that the official name for the statewide system of providing employment and training through the WIOA partnerships, SSA, and various other local programs is "America's Job Center". To achieve the goals of this Workforce Training Program, it is important that the public has a quick and easy method to identify that the projects or programs they are taking part in are part of the "America's Job Center". CONTRACTOR agrees to place the America's Job Center logo, in accordance with the State of California guidelines for such use, on all public materials, such as statements, press releases, brochures, advertisements, reports and other documents describing projects or programs funded in whole or in part with WIOA or SSA funds. When the America's Job Center logo is used, CONTRACTOR may accompany it with the following statement, "The (Program Name) is a proud partner of the America's Job Center network". CONTRACTOR shall not use the America's Job Center logo in any manner that would imply that the State of California endorses a commercial product, service or activity. II. CITY'S OBLIGATIONS A. On July 1, 2020 the CITY was awarded a Department of Labor Workforce Innovation and Opportunity Act grant of $1,260,082.00 for fiscal year 2020-2021. In addition, on July 1, 2020, the CITY was awarded an Orange County Social Services Vocational Training grant through the California Work Opportunity and Responsibility to Kids Act of 1997 in the total amount of $1,677,928.00 for fiscal year 2020-2022. A portion of both grants in a total amount not to exceed $2,000,000.00 shall be available to all Qualified Contractors to provide workforce training classes for Qualified Participants. B. If a Qualified Participant chooses to enroll in a course offered by CONTRACTOR, CITY agrees to pay to CONTRACTOR when, if and to the extent WIOA or SSA funds are received under the provisions of the applicable grants, in accordance with the Course Costs attached hereto as Exhibit B and incorporated herein by reference, which may be amended during the period of this Agreement. Said sum shall be paid with either WIOA or SSA funds, as determined by the CITY in its sole discretion, after CITY receives invoices submitted by CONTRACTOR as provided herein. C. CONTRACTOR has the ability to adjust line item amounts in the Course Costs with the approval of the Executive Director. D. CITY agrees to provide for on -site monitoring reviews of the Workforce Training Program operation at least annually. In addition, monthly desk -top reviews of pertinent information will be conducted. E. CITY has the right to de -obligate the funds hereunder, and take such funding back from CONTRACTOR, due to any of the following reasons: (a) lack of performance by CONTRACTOR; (b) lack of fiscal accountability of CONTRACTOR; or (c) decrease in available funding. Page 6 of 17 III. COMPENSATION A. CITY neither warrants nor guarantees any minimum or maximum compensation to CONTRACTOR under this Agreement. CONTRACTOR shall be paid only for actual services performed under this Agreement at the rates and charges identified in Exhibit B. Any compensation payable to CONTRACTOR shall be paid from a portion of the above - referenced WIOA and/or SSA grants awarded to the City in a total amount not to exceed $2,000,000.00. B. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. IV. TERM OF AGREEMENT A. This Agreement shall commence on the date stated above and continue through June 30, 2023, with a one-year option to renew executable by the CITY in its sole discretion, unless terminated earlier by either party. The one-year option may be executed, or the Term of this Agreement may be further extended, by a writing executed by the City Manager and the City Attorney. B. Unless the CITY authorizes an extension, CONTRACTOR must liquidate all obligations incurred under the Federal award not later than ninety (90) calendar days after the end date of the period of performance as specified in the terms and conditions of the Federal award, as applicable. IV. INDEPENDENT CONTRACTOR Consultant 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 Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant 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. V. WORKER'S COMPENSATION AND EMPLOYER'S RIGHTS A. CONTRACTOR shall use appropriate funds received from CITY to provide workers' compensation to all those hired by CONTRACTOR under this Agreement. Page 7 of 17 B. CONTRACTOR shall have the right to hire, dismiss, or promote its employees or contract personnel hired under this Agreement so long as its hiring or dismissal policy or standard does not violate Title VII of the Civil Rights Act of 1964, Fair Labor Standards Act of 1938, or any other applicable law, and CONTRACTOR maintains itself as an Equal Opportunity employer. VI. APPLICABLE GUIDELINES A. The parties hereto agree that CONTRACTOR shall comply with all applicable federal and state laws and regulations, including, but not limited to the Performance Indicators attached hereto as Exhibit C and incorporated herein by reference, and general program requirements described in Sections 2 and 116 of the Act, and applicable regulations, and the U.S. Department of Labor guidelines and regulations, including amendments or revisions made during the terms of this Agreement. Said applicable laws are hereby incorporated by reference and made part of this Agreement as though fully set forth herein. B. CONTRACTOR also assures and certifies that: 1. CONTRACTOR shall comply with Title VII of the Civil Rights Act of 1964 (P.L. 83-354) and in accordance with Title VII of the Act, requiring that no person shall, on the grounds of race, color, religion, sex, age, handicap or national origin be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under this Agreement. 2. CONTRACTOR shall comply with any and all federal laws limiting the political activity of employees hired under this Agreement. 3. CONTRACTOR shall comply with the requirements that no program under the Act shall involve political activities. 4. RECORD INSPECTION. CONTRACTOR shall provide the U.S. Department of Labor and the Controller General, by and through any authorized representative, as well as the WDB Administrative Office, access to and the right to examine all records, books, papers or documents relating to the accounting and use of funds under this Agreement for a three- year period from and after the effective date of this Agreement. 5. No person with responsibilities in the operation of any program under the Workforce Training Program shall discriminate with respect to any program participant or any application for participation in such program because of race, creed, color, national origin, sex, political affiliation or beliefs. 6. CONTRACTOR shall maintain appropriate standards for health and safety in work and training situations. Page 8 of 17 7. CONTRACTOR shall comply with general provisions, assurances, and execute the Assurances and Certifications attached hereto as Exhibit G and incorporated herein. 8. EQUAL OPPORTUNITY. Any literature distributed by CONTRACTOR for the purpose of apprising businesses, Participants, or the general public of its programs under this Agreement shall state that its programs are supported by the City of Santa Ana and the Santa Ana Workforce Development Board, and shall state that the program is an "equal opportunity employer/program" and that "auxiliary aids and services are available upon request to individuals with disabilities." 9. Based on the population eligible to be served, or likely to be directly affected by the program or activity, the services or information may need to be provided in a language other than English in order to allow such population to be effectively informed about or able to participate in the program or activity. Pursuant to 29 CFR 37.35, CONTRACTOR must take reasonable steps to provide services and information in appropriate languages after considering the scope of the program or activity, and the size and concentration of the population that needs services or information in a language other than English. 10. CONTRACTOR certifies that all property, finished or unfinished documents, data, studies and reports prepared or purchased under this Agreement, will be disposed of in accordance with the direction of the CITY. In addition, any tools and/or equipment furnished to the CONTRACTOR by the CITY and/or purchased by the CONTRACTOR with funds pursuant to this Agreement, will be limited to use within the activities outlined in this Agreement and will remain the property of the United States Government and/or CITY. Upon termination of this Agreement, CONTRACTOR will immediately return such tools and/or equipment to the CITY or dispose of them in accordance with the direction of the CITY. it. CONTRACTOR certifies that this Agreement does not provide for the advanceruent or aid to any religious sect, church or creed, or sectarian purpose, nor does it help to support or sustain any school, college, university, hospital or other institution controlled by any religious creed, church, or sectarian denomination, as specified by Article XVI, Section 5, of the Constitution of the State of California, regarding separation of church and state. 12. CLEAN AIR / CLEAN WATER ACT. If the grant hereunder exceeds $100,000, CONTRACTOR must comply with Section 306 of the Clean Air Act [(42 USC 1875(h)]; Section 508 of the Clean Water Act (33 USC 1368); Executive Order 11738 and Environmental Protection Agency ("EPA") regulations (40 CFR Part 35) as any may now exist or be hereafter amended. Under these laws and regulations, the CONTRACTOR assures that: (a) No facility to be utilized in the performance of the proposed grant has been listed on the EPA List of Violating Facilities; (b) It will notify CITY prior to award of the receipt of any communication from the Director, Office of Federal Activities, U.S. EPA, indicating that a facility to be utilized for the grant is under consideration to be listed on the EPA List of Violating Facilities; and, Page 9 of 17 (c) It will notify the CITY and the EPA about any known violation of the above laws and regulations. 13. CONTRACTOR agrees to adhere to the following STANDARDS OF CONDUCT: a. General Assurance. Every reasonable course of action will be taken by CONTRACTOR in order to maintain the integrity of this expenditure of public funds and to avoid favoritism. This Agreement will be administered in an impartial manner, free from errors to gain personal, financial, political gain. CONTRACTOR, its officers and employees, in administering this Agreement, will avoid situations which give rise to a suggestion that any decision was influenced by prejudice, bias, special interest or desire for personal gain. b. Employment of Former State or CITY Employees. CONTRACTOR will ensure that any of its employees who were formerly employed by the State of California or CITY, in a position that could have enabled such individuals to impact policy regarding or implementation of programs covered by this Agreement, will not be assigned to any part or phase of the activities conducted pursuant to this Agreement for a period of not less than two (2) years following the termination of such employment. c. Conducting Business Involving Relatives. No relative by blood, adoption or marriage of any executive or employee of CONTRACTOR will receive favorable treatment when considered for enrollment in programs provided by, or employment with, CONTRACTOR. d. Conducting Business Involving Close Personal Friends and Associates. Executives and employees of CONTRACTOR will be particularly aware of the varying degrees of influence that can be exerted by personal friends and associates and, in administering this Agreement, will exercise due diligence to avoid situations which give rise to an assertion that favorable treatment is being granted to friends and associates. When it is in the public interest for CONTRACTOR to conduct business with a friend or associate of an executive or employee of CONTRACTOR, an elected official in the area or a voting or non -voting member of the Workforce Investment Board (WIB), a pennanent record of the transaction will be retained. e. Avoidance of Conflict of Economic Interest. No executive or employee of CONTRACTOR elected official in the area, or voting or non -voting member of a WDB, will solicit or accept money or any other consideration from a third person, for the performance of an act reimbursed in whole or part by CONTRACTOR or CITY. Supplies, materials, equipment or services purchased with Agreement funds will be used solely for purposes asserted or allowed under this Agreement. No voting member of the WDB will cast a vote on the provision of services or vote on any matter which would provide direct financial benefit to that member or any business or organization which the member directly represents. f Salary and Bonus Limitations. If CONTRACTOR receives WIOA funds, CONTRACTOR is required to comply with federal requirements regarding the limitations on salary and bonus payments in accordance with Public Law 109-149, Section 7013. Page 10 of 17 VII. HOLD HARMLESS A. CONTRACTOR shall indemnify and save harmless CITY, its officers, agents and employees, from and against any and all damages to property or injuries to or death of any person or persons, including property and employees or agents of CITY, and shall defend, indemnify and save harmless CITY, its officers, agents and employees, from any and all claims, demands, suits, actions or proceedings of any kind or nature, including, but not by way of limitation, workers' compensation claims, resulting from or arising out of the negligent acts, errors or omission of CONTRACTOR, its employees or subcontractors. B. CONTRACTOR shall indemnify and save harmless CITY, its officers, agents and employees, from and against any and all damages to property or injuries to or death of any person or persons, including property and employees or agents of CITY, and shall defend, indemnify and save hanmless CITY, its officers, agents and employees, from and against any and all claims, demands, suits, actions or proceedings therefore, resulting from or arising out of the intentional or malicious acts of CONTRACTOR, its employees or subcontractors. VIII. INSURANCE 1. Commercial General Liability. CONTRACTOR agrees to obtain and keep in force during the term of this Agreement a policy of comprehensive commercial general liability insurance insuring the State of California, CITY, and CONTRACTOR against any liability for accident, injury or death arising out of or in consequence of this Agreement. Such insurance shall be in an amount not less than One Million Dollars ($1,000,000.00) for any injury to or death of any person or persons in any single accident or occurrence, with $2,000,000 in the aggregate coverage. Said policy of comprehensive general liability insurance shall be endorsed to provide to CITY and to the State of California, Employment Development Department, at least thirty (30) days written notice prior to cancellation; name CITY, its officers, agents, employees, and volunteers, and the State of California, its officers, employees, and volunteers as Additional Insured; and state that such coverage is primary to any other coverage or self-insurance of the State of California and CITY (in substantially the form as Exhibit 1, Additional Insured Endorsement, attached hereto). Governmental entities may substitute a certificate of self-insurance. 2. Workers' Compensation. If CONTRACTOR is an "employer", as set forth in California Labor Code Section 3300 et seq., or utilizes Participants as "employees," as set forth in California Labor Code Section 3350 et seq., CONTRACTOR shall obtain and keep in force during the term of this Agreement full Workers' Compensation insurance coverage for injuries suffered by Participants. Said insurance policy shall guarantee CITY at least thirty (30) days written notice of cancellation or modification. CONTRACTOR shall carry medical and accident insurance for those Participants not qualifying as "employees" for Worker's Compensation Coverage, pursuant to California Labor Code Section 3350, et seq. Page 11 of 17 3. Proof of Insurance. Certificates and endorsements must be submitted and approved by CITY prior to any work under this Agreement. CONTRACTOR understands that CITY will make no payments under this Agreement until the required certificates and endorsements have been approved by CITY. IX. CORPORATESTATUS CONTRACTOR shall be in good standing, without suspension by the California Secretary of State, Franchise Tax Board or Internal Revenue Service. Any change in corporate status or suspension shall be reported immediately to CITY. X. ASSIGNABILITY None of the duties of, or work to be performed by, CONTRACTOR under this Agreement shall be subcontracted or assigned to any agency, consultant, or person without the prior written consent of CITY. CONTRACTOR must submit all subcontracts and other agreements that relate to this Agreement to CITY. If receiving WIOA funds, CONTRACTOR acknowledges and agrees that it must follow procurement regulations for contractors (2 CFR §200.317). No subcontract or assignment shall terminate or alter the legal obligations of CONTRACTOR pursuant to this Agreement. XI. LAWS GOVERNING THIS AGREEMENT In its performance under this Agreement, CONTRACTOR shall fully comply with the requirements of the following, whether or not otherwise referred to in this Agreement: 1. If receiving WIOA funds, the Act and all applicable federal statutes, regulations, policies, procedures and directives, including but not limited to, 2 CFR 200 and 20 CFR. Parts 651 and 654 2. All applicable State statutes, regulations, policies, procedures and directives; 3. All applicable CITY policies, procedures and directives; 4. All applicable local ordinances and requirements, including use permits and licensing; 5. Court orders applicable to its operation; and, 6. The terns and conditions of this Agreement. Page 12 of 17 If any of the foregoing is enacted, amended, or revised, CONTRACTOR will comply with such or will notify CITY after enactment or modification that it cannot so comply. CITY may thereupon terminate this Agreement, if necessary. XII. EXCLUSIVITY AND AMENDMENT OF AGREEMENT This Agreement supersedes any and all other agreements, either oral or in writing, between the parties hereto with respect to the employment of CONTRACTOR by CITY, and contains all the covenants and agreements between the parties with respect to such employment. 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, and that no other agreement or amendment hereto shall be effective unless executed in writing and signed by both CITY and CONTRACTOR. XIII. FRAUD CONTRACTOR shall immediately report to CITY all instances and facts concerning possible fraud, abuse or criminal activity relating to expenditure or receipt of funds under this Agreement. XIV. CONTINGENCY OF FUNDS CONTRACTOR acknowledges that approval of and funding for this Agreement is contingent upon State approval, and WIOA and/or SSA ftmds received or obligated from the State of California to CITY. If such approval of funds is not forthcoming, or is otherwise limited, CITY shall immediately notify CONTRACTOR. Within twenty (20) days of receipt of such notice, CONTRACTOR shall modify or cease operations as directed by CITY and negotiate necessary modification to this Agreement and/or reimbursement of costs incurred hereunder. XV. TERMINATION A. This Agreement may be terminated by either party at its sole discretion, upon thirty (30) days written notice to the other party. Notice shall be deemed served on the date of mailing. However, CONTRACTOR may not terminate this Agreement if undue hardship will result to any participant. Page 13 of 17 B. In the event CONTRACTOR defaults by failing to fulfill all or any of its obligations hereunder, CITY may declare a default and termination of this Agreement by written notice to CONTRACTOR, which default and termination shall be effective on a date stated in the notice which is to be not less than ten (10) days after certified mailing or personal service of such notice, unless such default is cured before the effective date of termination stated in such notice. If terminated for cause, CITY shall be relieved of further liability or responsibility under this Agreement, or as a result of the termination thereof, including the payment of money, except for payment for approved expenses incurred for services satisfactorily and timely performed prior to the mailing or service of the notice of termination, and except for reimbursement of (1) any payments made for services not subsequently performed in a timely and satisfactory manner, and (2) costs incurred by CITY in obtaining substitute performance. XVI. DISPUTES Except as otherwise provided in this Agreement, any dispute concerning any question arising under this Agreement shall be decided by CITY. In such a case CITY shall reduce its decision to writing and mail or otherwise furnish a copy thereof to CONTRACTOR. The decision of the City shall be final and conclusive unless within thirty (30) calendar days from the mailing or delivery of such copy, CITY receives from CONTRACTOR written request to appeal said decision. If receiving WIOA Rinds, procedures governing the appeal shall be prescribed by CITY and/or the State of California in accordance with the Act and all corresponding regulations and OMB circulars. Pending final disposition of the appeal, CONTRACTOR shall act in accordance with CITY's decision unless the dispute involves a change order. XVII. BREACH - SANCTIONS If, through any cause, CONTRACTOR violates any of the terms and conditions of this Agreement, and/or prior agreements whereby grant funds were received by CONTRACTOR pursuant to this Agreement, or if CONTRACTOR reports inaccurately or if any Audit Report makes disallowances, CONTRACTOR shall promptly remedy its acts or omissions and/or repay CITY all amounts due CITY as a result of CONTRACTOR's violation. For any such failures or violations, CITY shall also have the right at its sole discretion to either: (1) discontinue program support until such time as CONTRACTOR fulfills its obligations or remedies all violations of this Agreement or prior agreements; and/or (2) collect outstanding amounts as determined by CITY due CITY by offsetting or debiting from current claims or invoices, if after thirty (30) days' written notice CONTRACTOR has failed to repay same or a repayment schedule has not been made; and/or (3) terminate this Agreement by giving written notice to CONTRACTOR of such termination in accordance the notice provision in Paragraph XVIII herein below. Page 14 of 17 indemnify CITY fully, including reasonable costs and attorney's fees, for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. {Signatures on following page} Page 16 of 17 A-2020-194-08 IN WITNESS WHEREOF, the patties hereto have executed this Agreement the date and year first above -written. ATTEST: aisy Gomez Clerk of the Council APPROVED AS TO FORM: Sonia R. Carvalho City Attorney Un y RECOMMENDED FOR APPROVAL: Steven A. Mendoza Executive Director Community Development Agency "CITY" By: Kri tine Ridge City Manager "CONTRACTOR" By�fZcJ Name:-7_v^fr 6, Pi.j-e/p Title: Tax ID#: s7e71 c? g,PCs-ep, Page 17 of 17 EXHIBIT A & B Scope of Service & Course Cost C a 6: 1 January 1, 2020 to December31, 2020 Classroom, Online, & Hybrid Courses Main Campus Branch Campus Satellite Campus 601 S. Milliken Ave., Suite A 27645 Jefferson Ave., Suite 116 1970 Old Tustin Ave., Suite C Ontario, CA 91761 Temecula, CA 92590 Santa Ana, CA 92705 Phone: (909) 321-5778 Phone: (951) 694-4764 Phone: (714) 543-9828 Fax: (909) 321-5779 Fax: (961)694-4785 Fax: (714) 543-9835 www. healthstatftraini na.00m Campus Business Hours Ontario - Temecula - Santa Ana Campuses 8:30 a.m. - 4:30 p.m. Monday - Thursday By Appointment - Friday Owned by: KD Education, LLC (a California Corporation) 601 S. Milliken Avenue, Suite A Ontario, CA 91761 Revision Date: 101212020 Revised Annually or as Necessary BPPE Approval Number 3006691 HEALTHSTAFF TRAINING INSTITUTE (HSTi) GENERAL CATALOG HealthStaff Training Institute is a private institution with the main campus located at 601 S. Milliken Avenue, Suite A, Ontario, CA 91761, a branch campus at 27645 Jefferson Ave., Suite 116, Temecula, CA 92590, and a satellite campus at 1970 Old Tustin Ave., Suite C, Santa Ana, CA 92705. Class/Lab sessions are held at each of these locations. HealthStaff Training Institute is a non -accredited school but both campuses have been granted institutional "Approval to Operate" by the Bureau for Private Postsecondary Education. The Bureau's granting of Approval to Operate means that this institution and its operations comply with the state standards as set forth in the CEC and 5, CCR, established under the law for occupational instruction by private postsecondary educational institutions. HealthStaff Training Institute programs are not accredited by an accrediting agency recognized by the United States Department of Education. Students are not eligible for federal financial aid programs. HealthStaff Training Institute offers the following programs/courses: Clinical & Administrative Medical Assistant (Front/Back Office), Administrative Medical Assistant (Front Office), Clinical Medical Assistant (Back Office), Computerized Office & Accounting, Drug and Alcohol Counseling, Medical Billing and Coding, Phlebotomy Technician 1, and Pharmacy Technician. Classes are offered either in -class, online, or a combination of both (hybrid). The occupancy level provides a small classroom environment that allows for more one-on-one time between the student and instructor. The time spent between the student and instructor promotes better quality learning. HealthStaff Training Institute's hybrid courses combine traditional, face-to-face classroom/lab instruction with an online learning component. Some are blended but not all. Online chat rooms and threaded discussions provide opportunities for exciting and productive instructor -student interaction, as well as the opportunity to connect with faculty members for help and guidance. The State of California requires that a student who successfully completes a course of study be awarded an appropriate diploma or certificate verifying the fact. A certificate is issued for successful completion of all training programs at HealthStaff Training Institute. Prospective enrollees are encouraged to read the school catalog and visit the physical facilities of the school to discuss personal educational and occupational plans with school personnel prior to enrolling or signing an enrollment agreement. All information in this school catalog is current and correct and is so certified as true by Kim I. Esquerre, R.N., Chief Executive Officer. Our History HealthStaff Training Institute (HSTi) began in September 1986 when the training department of Pharmacy Enterprises, Inc. (PEI), a pharmacy management company formed an education division. When the anticipated expansion of HSTi exceeded the scope of Pharmacy Enterprises, the institute became a privately -owned entity, keeping and carrying on the name of HealthStaff Training Institute. Since 1986, HSTi has grown to offer solid allied healthcare programs and was one of the first vocational schools in Southern California to get approval from the then Bureau of Private Postsecondary Vocational Education (BPPVE), which is now known as Bureau of Private Postsecondary Education (BPPE). HSTi was acquired by KID Education, LLC, in February 2015, whose principals have an extensive successful background in the vocational school industry. Every day the mission is carried forward to train and educate motivated and focused individuals into becoming efficient and capable allied healthcare or business professionals. Blended Learning Classrooms HSTi hybrid courses combine traditional or face-to-face classroom instruction with an online learning environment. Online chat rooms and threaded discussions provide opportunities for exciting and productive class interaction, as well as the opportunity to connect with faculty members for help and guidance. Chat rooms are open for discussion with peers at any time or with instructors during office hours. Each blended course also engages students with interactive learning exercises and animated activities while providing an audio-visual advantage. Effective online learning requires more than simple text on a screen. Students are able to see and hear each lesson from any computer with internet access. For each of our hybrid programs, results of the tests taken are returned to the student on the same day or the following day at the latest. Responses/comments to the lessons or projects submitted are sent back to the students either on the same day or on the next business day at the latest. Equipment HSTi classrooms are supplied with a Laboratory work area and Lecture room equipped with the following at each of their three campuses: • Pharmacy Technician: computers, anatomical charts/models, Laminar -Flow Workbench, mortar and pestle, crash carts, Pharmacological References, Triple beam and electronic balances, scale, ointment slabs, syringes, IV fluids, biohazardous waste containers. • Clinical Medical Assistant/Clinical & Administrative Medical Assistant_ Personal computers, centrifuge, electrocardiograph machine, examination tables, Mayo stands, microscopes, sphygmomanometers, stethoscopes, surgical instruments, training mannequins, autoclave, Audiometer, scales, thermometers, electronic nebulizer, wheelchair, crutches, walker, venipuncture arm, derriere for injections, bio- hazardous waste containers. • Computerized Office & Accounting Personal computers with Windows 10 and MS Office Suite. All required software and operating programs. • Phlebotomy Technician I: Centrifuge, medical laboratory supplies, phlebotomy chair, needles, syringes, butterflies, tourniquets, blood collection tubes, bio-hazardous waste containers, venipuncture arm. • Medical Billing & Coding/Administrative Medical Assistant: Personal computer, Medical Office Software, Coding Books. • Drug & Alcohol Counseling: Personal computer with internet access. Faculty and Staff Kim Esquerre, R.N. - Chief Executive Officer, Director, Ontario Campus kim.e@healthstafftraining.com Kishore Mathrani, MBA, Marketing — Director of Marketing & IT kishore,m@healthstafftraining.com Debbie Lopez - Executive Assistant, Assistant Director Ontario Campus debbie,l@healthstafflraining.com Toni DePiano - Director, Santa Ana Campus toni.d@healthstafftraining.com Mindy Matthews — Director, Temecula Campus mindy,m@healthstafftraining.com Theresa Fernandez - Director of Placement teri.f@healthstaffiraining.com Lucille Trujillo —Assistant Director of Placement lucille.l@healthstafftraining.com Kavita Mathrani, Bachelor's Degree Business Administration — Admissions Coordinator, Ontario Campus kavita,m@healthstaffiraining.com Please refer to our Faculty List Catalog Supplement for Instructor's Names, Qualifications, Certifications, & Campus Locations 4 1964, American Disabilities Act 1990, and Section 504, Rehabilitation Act of 1973, This policy of non- discrimination applies to all students, employees, and applicants for admission and employment and to all participants in institutionally sponsored activities. STUDENT SERVICES Students are encouraged to contact administrative officials and staff for information on local services. Transportation - Bus and Metro line services offering multiple connections are available near most of the HSTi campuses, MTA riders may be eligible for student discounts by providing proof of enrollment. Academic Advising - Instructors and faculty are available to the student Mondays through Thursdays during regular business hours. The student can receive tutoring, guidance, and support throughout their educational path. Housing - HealthStaff Training Institute does not maintain any dormitory facilities and assumes no responsibility to find or assist a student in finding housing. Monthly rental places for 1+ bedrooms within a 5 to 10-mile radius of the Temecula campus average in the low $700's to $1100, the Santa Ana campus' average is in the low $1000's to $1400, and the Ontario campus is in the low $600's to $1200's. LIBRARYILEARNING RESOURCES/REFERENCE MATERIALS HealthStaff maintains a number of reference materials including textbooks, magazines, and other industry - related publications, as well as, a list of websites and information systems. It is available to students either on campus or for home use. Students are encouraged to access the internet for research purposes. Student links are provided by the instructor or in the course syllabus. HealthStaff Training Institute also maintains a computer lab that students may log onto to use the Internet for learning resources as well. The procedure to access these materials is to ask the instructor to email links, "Google" topics of research, or access references provided in online courses or textbooks via the student's own computer or one of the computers in the computer lab. HealthStaff does not have an extensive inhouse library but is able to direct students to local libraries around the surrounding community. Ontario City Library Temecula Public Library Santa Ana Public Library 215 East "C" Street, Ontario 30600 Pauba Rd., Temecula 20 Civic Center Plaza, Santa Ana (909) 395-2004 (951) 693-8900 (714) 647-5250 As a prospective student, you are encouraged to review this catalog prior to signing an enrollment agreement. You are also encouraged to review the School Performance Fact Sheet, which must be provided to you prior to signing an enrollment agreement. Student Rights / Grievance I Complaint Procedures HSTi encourages students who have concerns, complaints, or problems with the school or its employees to bring them to the attention of their instructor or any directors present on campus. An official complaint should be in writing. If the concern or complaint is not resolved within a reasonable time (2-3 days), the concern or complaint will be brought to the attention of the school campus director, Toni DePiano (Santa Ana Campus), Kim Esquerre (Ontario Campus), or Mindy Matthews (Temecula Campus). Please refer to page 4 for their email addresses. A student or any member of the public may also file a complaint about this institution with the Bureau for Private Postsecondary Education by calling (888) 370-7589 Toll -Free or by completing a complaint form, which can be obtained on the Bureau's internet website www.baae.ca.gov. Any questions a student may have regarding this catalog that have not been satisfactorily answered by the institution may be directed to the Bureau for Private Postsecondary Education at 1747 N. Market Street, Suite 225, Sacramento, CA 95834 or P.O. Box 980818, West Sacramento, CA 95798-0818. Telephone #'s (888) 370- 7589 or (916) 574-8900 or by fax (916) 263-1897. Student Conduct Students must adhere to the standards set by HSTi. Professionalism and respect for others are practiced at all times at HSTi. Failure to comply will lead to suspension or to other disciplinary actions (dismissal from the institute). Proper safeguards for the welfare, safety and educational opportunity for all students will be provided. Semester Hour System Unit HealthStaff has adopted the semester credit unit basis of measuring student progress. One reason for adopting this system is that it makes it clearer when calculating a student's Grade Point Average (GPA). A credit unit is based on the following: 1 semester credit unit ... 15 hours of classroom instruction/lecture 1 semester credit unit ... 30 hours of supervised laboratory/practical instruction 1 semester credit unit ... 45 hours of supervised externship at an approved facility A clock hour is defined as a period of 60 minutes with a minimum of fifty minutes of classroom instruction, laboratory, or other academic related work. Grades are based on the result of written tests, laboratory final exams, daily classroom assignments, practical check -off and completion of homework assignments. Final grades are reported at the end of each course and posted to the student's permanent academic record. Attendance Procedure Students are expected to attend all regularly scheduled classes. It is the responsibility of a student to telephone in advance to advise the school when he/she will be absent or late. All students are considered full-time status, which is defined as the enrollment of at least 20 hours per week. • Students may not be absent more than five (5) consecutive days in a module/subject. After five consecutive days of absences, the student will be counseled and/or placed on probation. • A student absent for three (3) consecutive weeks (15 scheduled class days) will be terminated. At midpoint of the program, a student's overall attendance percentage is determined. If the minimum is not achieved the student will be counseled and/or placed on probation. A class may be canceled or rescheduled if there is insufficient enrollment in the first session not to exceed thirty (30) days. if a class reschedule date exceeds thirty (30) days, the students' enrollment will be terminated. Students will be required to complete a new enrollment agreement. Daily Attendance Instructors will take student attendance on a daily basis. Daily attendance records become part of the student's permanent record. The student may make arrangements with the instructor to make up the work and/or time missed during this period. All students (except Phlebotomy Technician 1) must have a minimum of 80% attendance of the total clock hours in order to graduate. Phlebotomy Technician I students are required to have 100% attendance and cannot be late or leave early in order to graduate. If a phlebotomy student misses a class or is one minute or more late to class, or leaves class one minute or more early, the student must make up the same entire day that was missed when the class rotates through it again. There will be no exceptions made as this is mandated by the California Department of Public Health. OnlinefHybrid Students It is a requirement that students must have access to a computer with internet access. Each module is presented with lessons, assignments, handouts, and modulartesting. Instructorwill review educational activity on a weekly basis. This will include message board, live classroom, and chat room forum with instructor and fellow classmates. Instructor is available during regular business hours for telephone communication. Student may Skype in to live classroom at any time. HealthStaff Training Institute students receive full access to course curriculum; however, students are to follow their instructor's lead. Students will be emailed progress reports, Monitoring of Progress Progress reports are reviewed on the 5th of every month by Director, Instructor, and student. During the first increment (25%) of the program, a minimum of 80% of the attempted clock hours and "C" average (70%) are required. If the minimums are not achieved, the student will be placed on academic or attendance probation or both, if applicable. The second increment is reviewed at 50% of the program, which requires a minimum of 80% of the attempted clock hours and "C" average (70%). If the minimums are not achieved, the student will be placed on probation for 30 days. If unsuccessful, the student will be terminated from the program. Academic and Attendance Probation, Warning and Dismissal Students who fail to comply with the standard of attendance or satisfactory academic progress will be placed on probation and given written notification/warning of their probationary standing. One or more of the following may determine unacceptable progress assessment: • Poor attendance (see Daily Attendance) • Below academic standing • Unsatisfactory mastery of pertinent skills Students who are placed on probation will be notified in writing that they are being placed on academic probation, which will begin at the start of the next module. Students on probation will be considered to be making satisfactory academic progress if at the end of the probation period, their cumulative average is 70% or higher. If a student falls below the standards set by the Institute, a consultation between the student and the Instructor(s) and/or the Program Coordinator will be scheduled. At this time arrangements will be made to re-establish satisfactory progress through makeup work and/or tutorial sessions. Within thirty (30) days, all missed course work and/or time is to be made up, to be removed from probation/ warning status. If after the thirty (30) days probation period the student continues to fall below the specified requirements of satisfactory academic progress, the student will then be dismissed from the program. Grading System Any assignment not submitted timely or any test missed will be marked as an, "incomplete." Students are allowed five (5) school days to make up a missed test or an incomplete assignment — it must be turned in to the instructor to be approved. If the student does not submit the assignment or complete a test that the student has missed within five (5) school days, a grade of an "F" will be submitted automatically. The grading system is as follows: Grade GPA Interpretation A (90-100) 4.0 Excellent B (80-89) 3.0 Above Average C (70-79) 2.0 Average F (0-69) 0.0 Fail 1 0.0 Incomplete L Leave of absence T (Transfer Credit) Credit W Withdrawal 10 Graduation Requirements To graduate, students are required to complete a prescribed course of study with a cumulative grade point average (CGPA) of 2.0 (C), have 80% attendance, and if applicable, the required clinical externship hours with satisfactory evaluation or assessment within the maximum time frame and discharge all financial obligations to the school. Students completing these requirements will receive a certificate in their program of study. Students Right to Cancel / Withdrawal and Dismissal A student has the right to cancel his or her enrollment agreement for a program of instruction, without any penalty or obligations, through attendance at the first-class session, or the seventh day after enrollment, whichever is later. After the end of the cancellation period, the student also has the right to stop school at any time and has the right to receive a pro rata refund if the student has completed 60% or less of the program. Cancellation may occur when the student provides a written notice of cancellation to the school, or by the student's conduct, including, but not necessarily limited to, a student's lack of attendance. The written notice of cancellation, if sent by mail, is effective when deposited in the mail properly addressed with proper postage. The written notice of cancellation need not take any particular form and, however expressed, it is effective if it shows that the student no longer wishes to be bound by the Enrollment Agreement. Enrollment time is defined as the time between the actual starting date and the date of the student's last day of physical attendance in school. The student's refund rights are described in the contract. If the school closes before you graduate, you may be entitled to a refund, teach -out, or transfer depending upon the school's closure plan. Determination of Official Withdrawal from School A student's official withdrawal date is determined by the date the student submitted notification to withdraw to a school director, the date the student was expelled or dismissed from school, or the earlier of the scheduled return from leave of absence or the date the student notifies the school that he/she is not returning. Refund Policy HSTi refund policy for the return for unearned institutional charges is as follows: If the student cancels an enrollment agreement or withdraws during a period of attendance the refund policy for students who have completed 60 percent or less of the period of attendance shall be a pro-rata refund. Any money due to the applicant or student shall be refunded within forty-five (45) days of formal cancellation by the student. Students who are terminated by the school shall receive a refund within forty-five (45) days from the student withdrawal date. In the case of a failure to return from a leave of absence, the student shall receive a refund within forty-five (45) days after the expected date of return. Sample Refund Calculator Refunds will be calculated in clock hours using the elapsed time method. The student is entitled to a refund based upon the portion of the program not completed, excluding registration fee. Example: If a student pays $6025.00 for tuition ($5775.00 for tuition fee + 250.00 non-refundable registration fee) in advance for a 720-hour course and withdraws after 200 hours, the tuition refund would be $4170.63. 5201720 x 5775 = 4170.83 Rights & Responsibilities of Loan/Financial Assistance Recipients If the student obtains a loan to pay for an educational program, the student will have the responsibility to repay the full amount of the loan plus interest, less the amount of any refund. If the student receives federal aid funds, the student is entitled to a refund of the money not paid from federal financial aid funds. 12 Methods of Payments HealthStaff participates in the following sponsored programs to assist the student with the financial investment in their education. HSTi does not participate in standard (DOE) federal and state financial aid programs. • Cash, Check, Money orders, Visa, MasterCard, American Express, Discover or Private Payment Arrangements or credit extension • WIOA, Department of Labor, TAA funding • Workers Compensation vouchers, CA Department of Rehabilitation • Veteran's Benefits and MyCAA • Private Banking Lending Agencies Applicants interested in more information regarding financial availability should contact the Director of Admissions. Additional consumer information and forms are available to interested students. The Director of Admissions will assist the applicant in filling out the appropriate forms. Externship (Practical Training) Assignment Externship training is scheduled to begin after the didactic and laboratory portions of the program are successfully completed, and when the student has met the stated requirements below: • All makeup work must be completed prior to placement in an externship facility • Any student removed from an externship site for absenteeism, attitude or unprofessional behavior will forfeit his/her participation in the program • Students may only be reinstated once for the externship rotation portion of the program • The Program Coordinator/Instructor will make the final decision as to the externship placement • The Program Coordinator/Instructor will visit each training site on a regular basis Externship Attendance The externship facility will place the same demands on the student that are placed on their paid employees. HSTi attendance policy applies (see attendance). Students are encouraged to participate in their externship training on a full-time basis (20 - 40 hours per week). Students in the Medical Assistant programs (CAMA, CMA, and AMA) must complete the required number of externship hours (160) at least four (4) months from the date they begin their externship. Pharmacy Technician students must complete their externship requirements (120 hours) at least six (6) months from the date they begin their externship. Drug and Alcohol Counseling students must complete the entire required hours (255) to be recognized by CCAPP, registration or testing must be completed within twelve (12) months of externship. Phlebotomy Technician students must complete 40 hours of externship within six (6) months of training. Students may be required to participate on various days, hours and/or shifts that may or may not rotate at their externship site. This is because some of the tasks might be divided throughout the day; therefore, a student may need to rotate hours or shifts in order to adequately complete their training. Externship hours will be determined between the site and the student. Students are required to adhere to the set schedule of the facility. If the student requests a change of scheduled hours or days, he/she must comply with the procedures set forth by the externship site. It is the student's responsibility to complete the timesheets at the externship facility on a weekly basis and obtain the signature of a staff member of the facility. While at the externship facility, students are required to submit time sheets as defined in the externship policy. Externship Completion All required paperwork must be returned to HealthStaff Training Institute prior to graduation from the program. Completion is determined by the following: ✓ All hours of participation are documented and verified ✓ Externship completion summary form from supervisor of facility ✓ Original documentation 14 CLINICAL & ADMINISTRATIVE MEDICAL ASSISTANT (CAMA) In -class / Hybrid (FRONT AND BACK OFFICE) Course Description 930 Clock Hours / 42.0 Credit Hours This nine hundred -thirty hours (930), 36-week program prepares the student for entry level employment in a clinical/administrative setting of a physician's office or a health care facility. Students receive instruction in medical law and ethics, terminology, anatomy and physiology, human relations, use and care of diagnostic equipment, venipuncture, injections, pharmacology, universal precautions, vital signs, CPR, first aid, hematology, EKG's, stress testing, Holter monitor, urinalysis, and microbiology. Basic computer operations, administration of front office medical procedures, insurance forms, and CPT codes are also included. Students will be required to participate in a 160-hour extern experience after completion of their classroom studies. Upon completion of this program, graduates will receive a certificate of completion, certification in BLS and AED, and will be eligible to test for national certification. COURSE COURSE NAME CLOCK HOURS UNIT LECTURE LAB EXTERN AMA 100 Medical Assisting as a Career, Human Relations, Medical Law & Ethics 50 2.0 50 0 AMA 101 Reception, Office Equip. & Telephone Techniques 50 2.5 25 25 AMA 102 Safety, Patient Education & Scheduling 50 2.5 25 25 AMA 103 Managing Medical Records- Written & Electronic 50 2.5 35 15 AMA 104 Insurance, Billing, & Coding 50 2.5 35 15 AMA 105 Computers & Electronic Health Record 50 2.5 40 10 AMA 106 Patient Billing & Collection l Financial Management 50 2.5 35 15 CMA 100 Exam & Treatment Areas, Anatomy & Physiology 1 50 2.6 25 25 CMA 101 Applied Anatomy & Physiology li 50 2.5 30 20 CMA 102 Applied Anatomy & Physiology 111 50 2.5 30 20 CMA 103 Clinical Practices 1 50 2.5 25 25 CMA 104 Clinical Practices 11 50 2.5 25 25 CMA 105 Assisting with Dia nostics 1 50 3.0 25 25 CMA 106 Assisting with Diagnostics 11 60 3.0 30 30 CMA 107 Pharmacology 60 3.0 30 30 CMA108 Career PreparationlExternshIp 160 3.5 160 TOTAL 930 42 465 305 160 *Clinical Medical Terminology is taught continuously throughout the course Completion of this course could lead to a position in a Physician's Office, Managed Care Group, Clinic, Hospital, or Insurance Company. Job Titles include: Front Desk Receptionist, Front Office Medical Assistant, Unit Clerk, Clinical Medical Assistant, Medical Assistant, Medical Back Office Assistant, and Admissions Representative. SOC CODE: 31-9092 Prerequisite: Student must have a high school diploma or GED prior to enrolling in this course, and no felonies or misdemeanors. Equipment/Supplies include: Two sets of scrubs, stethoscope, and a laptop computer, if applicable. EN CLINICAL MEDICAL ASSISTANT (CMA) In -class / Hybrid (BACK OFFICE) Course Description 600 Clock Hours / 25.5 Credit Hours This six hundred hours (600), 25 week program prepares the student for entry level employment in a clinical/medical setting of a health facility or a physician's office. Students receive instruction in medical law and ethics, terminology, anatomy and physiology, human relations, use and care of diagnostic equipment, venipuncture, injections, pharmacology, universal precautions, vital signs, CPR, first aid, hematology, EKG's, stress testing, Holter monitor, urinalysis, and microbiology. Students will be required to participate in a 160-hour extern experience after completion of their classroom studies. Upon completion of this program, graduates will receive certification in BLS and AED, a certificate of completion, and are eligible to test for national certification. Course Course Name Clock Hours Unit Lecture Lab Extern AMA 100 Medical Assisting as a Career, Human Relations, Medical Law & Ethics 40 2.0 40 0 CMA 100 Exam & Treatment Areas, Anatomy & Physiology 1 50 2.5 25 25 CMA 101 Applied Anatomy & Physiology 11 50 2.5 30 20 CMA 102 Applied Physiology & Anatomy 1// 50 2.5 30 20 CMA 103 Clinical Practices 1 50 2.5 25 25 CMA 104 Clinical Practices 11 50 2.5 25 25 CMA 105 Assisting with Diagnostics 1 50 2.5 25 25 CMA 106 Assistingwith Diagnostics 11 50 2.5 25 25 CMA 107 Pharmacology50 2.5 25 25 CMA 108 Career Pre aration/Externshi 160 3.0 160 TOTAL 600 25 250 190 160 Completion of this course could lead to a position in a Physician's Office, Managed Care Group, Clinic, or Hospital. Job Titles include: Clinical Medical Assistant, Medical Assistant, and Medical Back Office Assistant, SOC CODE: 31-9092 Prerequisite: Student must have a high school diploma or GED priorto enrolling in this course, and no felonies or misdemeanors. Equipment/Supplies include: Two sets of scrubs, stethoscope, and a laptop computer, if applicable. 18 MEDICAL BILLING & CODING In Class / On-line / Hybrid Course Description 240 Clock Hours / 15 Semester Credit/units This two hundred forty hours (240), 12-week program is designed to provide the student with the skills and knowledge necessary to successfully perform multifaceted functions in a doctor's office. Knowledge of insurance providers is emphasized along with medical terminology, anatomy, and the training to perform basic techniques in billing and coding. Students are taught how to code using CPT, HCPCS, ICD-9, and ICD-10 resources. Extensive computer instruction and lab time is also provided in Windows 10, Electronic Medical Record, and other medical computer programs. Upon completion of this program, graduates will receive a Certificate of Completion. Course Course Name Clock Hours Units Lecture Lab MB 100 Medical Terminology & Human Anatomy 30 1.3 20 MB 101 The Origins of Health Insurance & Tools of the Trade: A Career as a Health Medical Insurance Professional 20 1.3 20 MB 102 The Legal and Ethical Side of Medical Insurance & Tvnes and Sources of Health Insurance 10 0.67 10 MB 103 Claim Submission Methods & Traditional Fee -for- Service/Private Plans 20 1.3 20 MB 104 Unraveling the Mysteries of Managed Care & UnderstandingMedicaid 20 1.3 20 MB 105 Conquering Medicare's Challenges 20 1.3 20 MB 106 Military Carriers 10 0.67 20 MB 107 Miscellaneous Carriers: Worker's Compensation and Disability Insurance 20 1.3 20 MB 108 Diagnostic Coding — ICD-9 & ICD-10 20 0.67 10 10 MB 109 Procedural, Evaluation and Management and HCPCS Codin 20 1.3 20 10 MB 110 The Patient 10 0.67 20 MB 111 Keys to Successful Claim Management & The Role of Computers in Health Insurance 20 0.67 MB 112 Reimbursement Procedures: Getting Paid & Hospital Billinq and the UB-04 20 1.3 20 TOTAL 240 15 220 20 Completion of this course could lead to a position in Medical Offices, Medical Billing Service Companies, Hospitals, Skilled Nursing Facilities, Clinics, Home Health Agencies, and Insurance Companies. Job Titles include: Medical Biller, Medical Insurance Biller, Medical Coder, Medical Collector, Healthcare Claims Examiner, Claims Processor, and Data Entry Clerk. SOC CODE: 29-2071 Prerequisite: Student must have a high school diploma or GED prior to enrolling in this course, and no felonies or misdemeanors. Equipment/Supplies include: Laptop computer, if applicable. 20 PHARMACY TECHNICIAN Hybrid or In -class Course Description 600 Clock Hours / 25 Credit Hours This six hundred (600) hour, 27-week program prepares the student for entry level employment as a Pharmacy Technician in different pharmacy settings. Students receive instruction in pharmacy law and drug legislation, drug nomenclature, dosage forms, weights, measures, and calculations. Emphasis is placed on terminology, anatomy, and physiology as it relates to various diagnosis, medications, drug classifications, chemotherapy and antibiotic, automated drug distribution, sterile preparation and extemporaneous compounding. Students are required to participate in a one hundred twenty (120) hour externship in an approved hospital or pharmacy where they perform various pharmacy functions. Upon completion of this program, the student will receive a certificate of completion, qualify to apply to California State Board of Pharmacy for registration/licensing, and are eligible to sit for a national certification exam if they desire. Course Course Name Clock Hours Unit Lecture Lab Extern PT 100 Pharmacy Law 50 3.0 50 PT 200 Pharmacy Operations 1 50 2.0 10 40 PT 300 Pharmacy Operations 11 50 2.0 10 40 PT 400 Internal Medicine 1 50 3.0 40 10 PT 500 Internal Medicine 11 50 3.0 40 10 PT 600 Hospital Procedures & Operations 50 2.0 10 40 PT 700 Pharmacology I 50 2.0 20 30 PT 800 Pharmacology /1 50 2.0 20 30 PT 900 Pharmacy Compounding 50 2.0 10 40 PT 920 Pre 30 1.5 15 15 PT 950 _Career Externship 120 1.75 120 TOTAL 600 25 225 255 120 Completion of this course could lead to a position in a retail pharmacy, hospital pharmacy, compounding pharmacy, or mail order pharmacy. Job Titles include: Pharmacy Technician SOC CODE: 29-2052 Prerequisite: Student must have a high school diploma or GED prior to enrolling in this course, and no felonies or misdemeanors. California State Board Requirements: • High school diploma or GED • Course completion certificate • Finger printing process (Live Scan clearance from DOJ and FBI) • Application and fees submitted to California State Board of Pharmacy Equipment/Supplies include: Lab coat, and a laptop computer, if applicable. 22 PHLEBOTOMY TECHNICIAN I (CONT.) In -class Completion of this course could lead to a position in a clinical laboratory, Hospital, Clinic, Medical Group, Research Company, Mobile Insurance Company, or Physician's Office. Job Titles include: Phlebotomy Technician I SOC CODE: 31-9097 Prerequisite: Student must have a high school diploma or GED prior to enrolling in this course, and no felonies or misdemeanors (See below). Requirements for State Certification/Licensure: • Must be 18 years of age and possess a valid High school diploma or GED • Must complete a State of California, Department of Health Services approved minimum of 80 hours Basic & Advanced Phlebotomy course that includes a mandatory forty (40) hour externship and students must have 100% attendance in order to graduate. • Applicants with misdemeanors and/or felonies are approved on a case by case basis and must be disclosed on the attestation page. Equipment/Supplies include: Two sets of scrubs, NHA Phlebotomy Technician National Exam, and State license fees. 24 EXHIBIT C Employment INFORMATION �np y- O N N 0 1p ` y� Development I N I" LO F$ M h9 1 A/ IM IY l/ ly 1 4 y' a Av Department Date: June 4, 2020 Number: WSIN19-48 State ° f Cali ff ° r n i a Expiration Date: 07/04/2020 �measr'xh` STATE NEGOTIATED PERFORMANCE GOALS PY 2020 and 2021 The Workforce Innovation and Opportunity Act (WIOA) Section 116(b) requires the state to reach an agreement with the US Department of Labor (DOL) on state -level performance goals for the Wagner-Peyser, and WIOA Title IB Adult, Dislocated Worker, and Youth programs every two years. In May 2020, the state negotiated the performance goals with the DOL for Program Years (PY) 2020 and 2021 using the Statistical Adjustment Model (SAM) as a baseline. PY 2020 and PY 2021 Negotiated Performance Goals Indicators Adults Dislocated Y®uth Wagner - Workers Peyser Employment Rate 2nd Quarter After Exit (Includes placement in g7,0% 71.9% 71.0% ° 61.4 /o education for Youth Employment Rate 4th Quarter After Exit (Includes placement in 66.0% 72.5% 71.0% 62.0% education for Youth Median Earnings 2nd $6,000 $8,070 $3,490 $6,689 Quarter After Exit Credential Attainment 60.0% 60.0% 60.0% N/A Measurable Skill 50.0% 50.0% 56.4% N/A Gains The Employment Development Department will negotiate levels of performance for five of the WIOA primary indicators of performance with Local Areas for PY 2020 and PY 2021. The state will take into account the following factors when negotiating performance goals with the Local Areas: The EDD is an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. Page 1 of 2 50:187 EXHIBIT C • How the levels Involved compare with the negotiated levels of performance established for the state. • Ensure that the negotiated levels account for the economic conditions and the participant characteristics based on the SAM. • The levels involved promote continuous Improvement of the indicators of performance. For more information on the Performance Negotiation process, please review the Workforce Services Directive State Level Performance Goals and Local Area Negotiations (WSD19-11 PDF). If you have questions related to this information, contact the Program Reporting and Analysis Unit at wsbmanageperformance@edd.ca.gov. /s/ JAIME L. GUTIERREZ, Chief Central Office Workforce Services Division Page 2 of 2 CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS LOANS and COOPERATIVE AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: 1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying." in accordance with its instructions. 3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including agreements) and that all subrecipient's shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure occurring on or before October 23, 1996, and of not less than $11,000 and not more than $110,000 for each such failure. HealthStaff Training InAtute Grantee/ContractorOrganizftion Program Title Signature Toni DePiano Name of Certifying Official Signature EXHIBIT D Certification Regarding Drug -Free Workplace Requirements The certification set out below is a material representation upon which reliance is placed by the U.S. Department of Housing and Urban Development in awarding the grant. If it is later determined that the contractor knowingly rendered a false certification, or otherwise violates the requirements of the Drug -Free Workplace Act, the U.S. Department of Housing and Urban Development, in addition to any other remedies available to the Federal Government, may take action authorized under the Drug -Free Workplace Act. CERTIFICATION A. The contractor certifies that it will provide a drug -free workplace by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the contractor's workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing a drug -free awareness program to inform employees about— (1) The dangers of drug abuse in the workplace; (2) The contractor's policy of maintaining a drug -free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance program; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c) Making it a requirement that each employee who will be engaged in the performance of the grant be given a copy of the statement required by paragraph (a); (d) Notifying the employee in the statement required by paragraph -(a) that, as a condition of employment under the contract, the employee will - (1) Abide by the terms of the statement; and (2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction. (e) Notifying the U.S. Department of Housing and Urban Development within ten days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction; EXHIBIT E (f) Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted - (1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; (g) Making a good faith effort to continue to maintain a drug -free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f). B. The contractor shall insert in the space provided on the attached 'Place of Performance" form the site(s) for the performance of work to be carried out with the grant funds (including street address, city, county, state, and zip code) .the contractor further certifies that, if it is subsequently determined that additional sites will be used for the performance of work under the contract, it shall notify the U.S. Department of Housing and Urban Development immediately upon the decision to use such additional sites by submitting a revised `Place of Performance" form. '/ 9 Date Program Operator Signature EXHIBIT E DIVISION OF EMPLOYMENT SERVICES PLACE OF PERFORMANCE FOR CERTIFICATION REGARDING DRUG -FREE WORKPLACE REQUIREMENTS Name: Toni DePiano Name of Contractor: HealthStaff Training Institute Contractor Number: Date: 11 /23/2020 The Contractor shall insert in the space provided below the site(s) expected to be used for the performance of work under the contract covered by the certification: Place of Performance (include street address, city, county, state, zip code for each site): 1970 Old Tustin Avenue, Suite C Santa Ana, CA 92705 Address EXHIBIT E Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions This certification Is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR part 98, Section 98.510, Participants' Responsibilities, The regulations were published as Part Vil of the May 16, 1988, Federal Register (Pages 19160.19211). (Before completing certification, read instructions which are an integral part of certification) 1. The prospective primary participant, (i.e. grantee) certifies to the best of Its knowledge and belief, that it and its principals: a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency; b. Have not within a three-year period preceding this proposal been convicted or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or contract under a public transaction; violation of federal or state antitrust statues or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property. c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and d. Have not within a three-year period preceding this application/proposal had one or more public transactions (federal, state or local) terminated for cause or default. 2. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. HealthStaff Training Institute Grantee/Contractor Organization Toni DePiano, Director Name and Title of Official Authorized to Certify On Behalf of the Grantee 11/23/2020 Date EXHIBIT F INSTRUCTION FOR CERTIFICATION 1. By signing and submitting this proposal, the prospective reciplent of Federal assistance funds is providing the certification as set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered Into. If it is later determined that the prospective recipient of Federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the Department of Labor (DOL) may pursue available remedies, Including suspension and/or debarment. 3. The prospective recipient of Federal assistance funds shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective recipient of Federal assistance funds learns that Its certification was erroneous whom submitted or has become erroneous by reason of changed circumstances. 4. The terms "covered transaction", "debarment", "suspended", "ineligible", "lower tier covered transaction", "participant", "person", "primary covered transaction", "principle", "proposal", and "voluntarily excluded", as used in this cause, have the meanings set out in the Definitions and Coverage sections of rules Implementing Executive Order 12549. You may contact the person to whom this proposal Is submitted for assistance in obtaining a copy of those regulations. 5. The prospective recipient of Federal assistance funds agrees by submitting this proposal that, should the proposed covered transaction be entered Into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared Ineligible, or voluntarily excluded from participation In this covered transaction, unless authorized by the DOL. 6. The prospective recipient of Federal assistance funds agrees by submitting this proposal, that It will include the clause title "Certification Regarding Debarment, Suspension, Ineligible, or voluntarily excluded from the covered transaction unless It knows that the certification iserroneous. 7. Nothing contained In the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required to exceed that which Is normally possessed by a prudent person in the ordinary course of business dealings. 8. Except for transactions authorized under paragraph 5 of these instructions, if a participant Ina covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, Ineligible, or voluntary excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the DOL may pursue avallable remedies, including suspension and/or debarment. EXHIBIT F Assurances & Certifications Selected providers will be required to sign and submit "actual" assurances and certificates as required by the City of Santa Ana and the Workforce Development Board on all contracts. I recognize that I must give assurances for each item below. Please initial each box indicating you have read and are providing assurance you are or will be in compliance with the following: SAWDB uses the CalJOBS ETPL Module for accepting applications from the providers to be listed on the ETPL, Local boards may authorize a single local board to act on their behalf in making determinations for initial and/or subsequent eligibility of providers. Contractors must enter program(s) of training services into C&IJDBS. The training provider should only enter the program(s) desired to be on the CA ETPL. If the program is offered with multiple modes of delivery, or course lengths, the program must be entered separately for each variation. SAWDB has authorized the South Bay WDB to make initial and subsequent eligibility determinations for applications submitted from providers. Contractors should contact the South Bay WDB 11539 Hawthorne Blvd., 51 Floor, Hawthorne, CA 90250, 310-970-7700, L CONTRACTOR is required to be in compliance with South Bay WDB Master agreement and SAWDB agreement. In cases where South Bay WDB has denied a provider's application, provider may submit the application to SAWDB for consideration and processing at 801 W. Civic Center Dr, 4200, Santa Ana, CA 92701 ATTN: SAWDB Staff. The submission must include completed ETPL training program applications and a copy of the letter from the South Bay WDB denying application. Local boards may establish local policies requiring performance above the state minimum standards for providers to be included on the ETPL. Acceptance and processing of an application does not constitute an agreement or relationship between the CONTRACTOR and SAWDB, nor does it guarantee any referrals to the provider by SAWDB, Applications will be process on an ongoing basis. CONTRACTOR must be in compliance with the State and Federal regulations, per Workforce Innovation and Opportunity Act (WIOA) Eligible CONTRACTOR List Policy and Procedure WSD15-07 or it's replacement. LEI CONTRACTORS must also meet one of the following criteria in order to have their programs listed on the ETPL: 1) Bureau of Private Postsecondary Education Approval to Operate, or Verification of Exemption by BPPE. EXHIBIT G 2) Accreditation by the Accrediting Commission for Senior Colleges and Universities, WASC, or the Accrediting Commission for Community and Junior Colleges, CSU, UC, and other WASC accredited institutions. This accreditation can be verified at: www.aceic.org] or www.wasesenior.org/. 3) Postsecondary institutions eligible under Title IV of the Higher Education Act (HEA) and offering programs leading toward an associate degree, baccalaureate degree, or certificate. 4) Approval by the California Department of Education. 5) Approval by the Chancellor's Office of the California Community Colleges (CCCCO). L. CONTRACTOR must puMly to be considered for subsequent approval on the ETPL and agrees to �jj provide the required performance and cost information data. CONTRACTOR must annually meet the state's minimum performance standards, however the SAWDB may set higher levels. Public Postsecondary Community Colleges, CSUs, and UCs are required to provide performance information for consideration of placement on the CA ETPL, but due to heavy state oversight, investment, and the inability to capture true program outcome data, these institution types are not required to meet a specific performance threshold to be listed on the CA ETPL, CONTRACTOR's BPPE accredited shall provide a copy of the provider's BPPE Annual Report (the Performance Fact Sheet) to document their achievement of the performance criteria if applicable. ALL Training on the ETPL must be for occupations in in -demand industry sectors identified by the state, regional or local workforce development boards. All Training on the ETPL must provide training services that lead to an industry -recognized credential, national or state certificate, or degree, including all industry appropriate competencies, licensing and/or certification requirements. CONTRACTOR understands that all performance data and data submitted on the ETPL must be made available for data verification by the SAWDB or the State EDD office. CONTRACTOR must maintain all the relevant records utilized to support the data submitted on ETPL for audit or monitoring purposes by the SAWDB or the State EDD office. CONTRACTOR that claim an exemption to BPPE (Section 94874 of the BPPE Act) must apply and receive a "Verification of Exemption" before being listed on the ETPL. Since it has been determined that any expenditure of public funds, state or federal, that directly benefits a student to be student financial assistance, we expect that instances of exemption will be very rare. CONTRACTOR must have all considered training programs listed with the BPPE, the SAWDB may p verity the data that was submitted to BPPE. [I� All new and current CONTRACTOR will be required to be registered in CaIJOBS11 and must have all considered training programs listed with the BPPE match on CaIJOBS. All CONTRACTOR are required to enter performance data for each program to be listed on the ETPL and provide evidence to the Local Board that they have met the minimum performance criteria required, Programs that do not include performance data will not be approved for listing on the ETPL. aCONTRACTOR must have their current course catalogs on file with the SAWDB. LL'J CONTRACTOR agrees to immediately notify (within 10 working dam) the SAWDB, in writing, of any changes in the information submitted with initial agreement, CONTRACTOR agrees to accept WIOA eligible referrals from the Santa Ana WORK Center on an individual referral basis. CONTRACTOR shall not accept nor enroll WIOA participants who do not meet the CONTRACTOR's entrance requirements, which are to be the same general entrance requirements required of public students, and agrees to submit a written notification to the Santa Ana WORK Center's Case Manager stating the reason(s) for non -acceptance. CONTRACTOR agrees to assist the W10A client in applying for PELL Grants and any other funds that might be available to offset the cost to WIOA and to work together with the WIOA client's Case Manager to ensure all other funding sources are investigated and those funds obtained before submitting the Vendor Voucher to the SAWDB for payment. UJ CONTRACTOR agrees to cross out sections of the student enrollment agreement that would hold the WIOA participant financially responsible for any training related expenses. Once accepted, CONTRACTOR agrees to enroll the WIOA participant in the course stipulated on the Vendor Voucher and no other. CONTRACTOR agrees to invoice the Santa Ana WORK Center, on a cost reimbursement basis, for third party testing (Microsoft, Novell, A+, etc.) and will provide a copy of the Pass/Pail results at that time. *Pre -Apprenticeship CONTRACTORS must include a letter of commitment from an approved apprenticeship program and meet the application policies and procedures required for the type of j program (e.g., community college, private post -secondary, adult education provider, etc,). CONTRACTOR Apprenticeship Programs registered under the National Apprenticeship Act (NAA) 'T or recognized by D"AS are exempt from initial eligibility procedures. Registered apprenticeship programs must be included and maintained on the list of eligible providers of training services as long as the corresponding program remains registered, as described at WIOA see.122(a)(3). CONTRACTOR agrees to allow SAWDB, Santa Ana WORK Center, the State of California, and the Department of Labor, the WIOA client and any of their duly authorized representatives' access to all the records regarding the WIOA client for monitoring purposes. The records include any books, documents, papers, files and computer data directly pertinent to the records of the WTOA participant. The right to records includes the right to make excerpts, transcripts and photocopies. The right also includes the right to have reasonable and timely access to personnel for the purpose of interviews and discussions related to the records of the WIOA participant. CONTRACTOR agrees to provide progress reports which indicate grades and test scores, as well as attendance reports, to the WIOA client's Case Manager on a monthly basis. 3 EXHIBIT G CONTRACTOR agrees to notify the WIOA client's Case Manager immediately (within 5 working days) if the WIOA client is absent for more than 3 days in a row, has sporadic attendance or drops out of school unless other arrangement are made in writing. CONTRACTOR agrees to provide a copy of the "reimbursement form" and issue a refund check to the "City of Santa Ana" for the number of unused training hours and any non -issued training/testing vouchers, books, tools, etc. due within 30 calendar days after the last day the WIOA client attended school or the day the school was notified that the WIOA client dropped. Said check to be mailed to the attention of the WIOA Case Manager, 801 W Civic Center Dr., #200, Santa Ana, CA 92701. CONTRACTOR agrees to provide the WIOA Case Manager a copy of the WIOA client's certificate of completion or diploma or official transcripts within 10 working days of the date of completion or graduation. CONTRACTOR agrees to provide the WIOA client with the same level of job search/placement assistance as provided to the public students and to provide the WIOA Case Manager with all the pertinent information regarding the placement of the WIOA client within 5 working days of the WIOA client's first day of employment. A WIOA client has 180 days after completing training to get a job for the CONTRACTOR to get credit for placement in employment. I am authorized by my Board of Directors, Trustees, other legally qualified officer, or as the owner of this agency or business to submit this proposal. CONTRACTOR is not currently on any Federal, State of California, or local Debarment list. CONTACTOR will provide records to show that we are fiscally solvent, if needed. CONTRACTOR has, or will have, all of the fiscal control and accounting procedures needed to ensure that WIOA funds will be used as required by law and contract. CONTRACTOR has additional funding sources and will not be dependent on WIOA funds alone. CONTRACTOR will meet the applicable Federal, State, and local compliance requirements. These FJude, but are not limited to: Records accurately reflect actual performance if applicable. Maintain record confidentiality, as required. financial, participant, and performance data, as required. Comply with State and Federal fiscal and program activity audits, Complying with Federal and State non-discrimination provisions. Meeting requirements of Section 504 of the Rehabilitation Act of 1973. Meeting requirements of the American's with Disabilities Act of 1990. (submit completed survey) EXHIBIT G j� Meeting all applicable labor law, including Child Labor Law standards. f lYJ Agree to provide a drug free workplace. ImAgree to insure the City of Santa Ana through General Liability Insurance and Automobile Liability Coverage in the amount of $1,000,000.00 policy. 10 Agree to provide all participants with Grievance Procedures. IN Agree to insure proposer's employees through Workers Compensation Insurance (including part-time employees) 61 Procurement policies and procedures are in place and meet federal guidelines. Use WIOA money to assist, promote, or deter union organizing. Use funds to employ or train of persons in sectarian activities. LEI Use funds for youth in the construction, operation, or maintenance of any part of a facility to be used j for sectarian instruction or religious worship. YJJ Use WIOA money under this contract to purchase any equipment. I hereby assure that all of the above are true. Director 11/23/2020 Name Title tlatp EXHIBIT G COMPLAINT HANDLING UNDER THE Workforce Innovation Opportunity Act Santa Ana Local Workforce Development Area Revised May 20, 2019 I;XHHIIT H Information Regarding Complaints A. Nondiscrimination and Equal Opportunity Complaints 1. Policy Statement In carrying out the purpose of the Workforce Innovation Opportunity Act (WIOA), the City of Santa Ana Local Workforce Development Area (LWDA) will establish programs to prepare youth and unskilled adults for entry into the labor force and to afford job training to those individuals facing serious barriers to employment. Every effort will be made to provide services necessary for eligible individuals to obtain productive employment. In implementing WIOA, all contractors in the Santa Ana LWDA will foster equal opportunity and non-discrimination, as provided in State and Federal equal opportunity and non-discrimination laws including, but not limited to: • Title VI of the Civil Rights Act of 1964 • Title VI of the Civil Rights Act of 1964 • The Age Discrimination Act of 1975, as amended • Section 503 of the Rehabilitation Act of 1973 • Section 504 of the Rehabilitation Act of 1973 • Title IX of the Education Amendments of 1972 • Section 188 of the Workforce Innovation Opportunity Act of 2014 In keeping with our commitment, no individual shall be excluded from participation in, denied benefits of, subjected to discrimination under, or denied employment, in the administration or of in connection with any WIOA funded program because of race, color, religion, sex, national origin, age, disability, or political affiliation or belief. Participation in programs and activities financially assisted in whole or in part under WIOA shall be open to citizens and nationals of the United States, lawfully admitted permanent resident aliens, lawfully admitted refugee, parolees, and other individuals authorized by the Attorney General to work in the United States. No individual will be intimidated, threatened, coerced, or discriminated against because of filing a complaint, furnishing information, or assisting or participating in any manner in an investigation, compliance review, hearing or any other activity related to the administration of WIOA. EXHIBIT H Prohibits discrimination based on disability. Title IX of the Education Amendments of 1972 Prohibits discrimination in any education or training program or activity receiving federal financial assistance. OTHER CIVIL RIGHTS LAWS: Title VII of the Civil Rights Acts of 1964 Prohibits discrimination in employment based on race, color, religion, sex, or national origin in all terms and conditions of employment and establishes the Equal Employment Opportunity Commission as the administrative agency. White House Executive Order no. 11246 as Amended by Executive Order No 11375 Creates the office of Federal Contract Compliance and prohibits discrimination based on race, color, sex, religion, or national origin. Department of Labor Secretary's Order no. 4-73 Prohibits discrimination based on sex. Equal Pay Act of 1963 Prohibits pay differential solely because of sex. Emergency Employment Act of 1971 Prohibits discrimination based on race, creed, national origin, political affiliation, or beliefs. 4. How to File Your Complaint a. Put your complaint in writing. b. Have it sworn to before a notary public, if possible. c. Provides details that tell what happened, where it happened and when it happened. d. Give the name and addresses of all persons who were present or who had anything to do with the matter. ...Complaints on the basis of race, color, or national origin, age, sex, religion, political affiliation or belief, retaliation and citizenship, must be filed within 180 days of the alleged occurrence directly with: EXHIBIT H recipients, applicants for participation, or financial assistance, labor unions, community based organizations, or any other persons. These procedures provide for resolution of non -criminal complaints arising from the operation of the Santa Ana LWDA. A complaint is defined here as a written expression by a party alleging a violation of the Act, regulations promulgated under the Act, recipient grants, sub agreements, or other specific agreements under the Act, including terms and conditions of employment of such participants in employment training programs. All complaints, amendments and withdrawals shall be in writing. These procedures are intended to resolve matters which concern policies, procedures or action(s) arising in connection with WIOA programs operated by each LWDA grant recipient and sub recipient under the Act. These procedures shall not be construed as affecting any other available legal remedy outside of the WIOA complaint process (i.e., disputes regarding terms and conditions of employment of any employee who is not a participant), either separately or simultaneously, that a person may wish to pursue in the resolution of a non-WIOA complaint. Also, these procedures do not restrict the LWDA grant recipient staff in carrying out informal discussion Procedures do not restrict the LWDA grant recipient staff in carrying out informal discussion and resolution of any problems outside of and without resort to the formal complaint procedure. A. The following principles and rules apply to all complaints at all steps of the complaint procedures: All complaints must be made in writing within 180 days of the alleged occurrence, except complaints alleging fraud or criminal activity. 2. All persons filing a complaint shall be free from restraint, coercion, reprisal, or discrimination. Good faith efforts shall be made to informally resolve the complaint prior to the scheduled hearing. Complainants have the right to withdraw their complaints (in writing) at any time prior to the hearing. A complainant may amend his/her complaint to correct technical deficiencies but not to add issues. 3. Complainants shall have the right to be represented at their own expense by person(s) of their choosing at all levels of the complaint process. 4. Upon enrollment into employment or training, participants shall be provided with a written description of these procedures, including notification of their right to file complaints and instructions for filing. An employer of participants, including private -for -profit employers of participants, may use this or other complaint resolution procedures so long as the participant is informed of the complaint resolution procedure they are to follow and the time frames governing review of complaints are met. EXHIBIT H e. Remedy sought by the complainant; and If the complainant is a private or public entity or corporation, and not a natural person, the filing of the complaint must be duly authorized by the governing body of such entity or corporation. The absence of any of the requested information shall not be a basis for dismissing the complaint. A copy of the complaint must be sent to the respondent and both parties notified of the opportunity for an informal resolution. At each step of the complaint process, the complainant must be notified in writing of the next procedural step. 2. Informal Conference Informal conferences will be utilized by the Santa Ana LWDA to resolve complaints; however, such informal conferences shall not extend the time within which a decision must be issued after receipt of a complaint. Attempts at informal resolution will commence with two (2) weeks of the date of filing of the complaint. The EEO Officer will review the case and ascertain facts prior to the conference so that appropriate resolution can take place at the time of this meeting whenever possible. Although the complainant should be encouraged to attend this conference, his/her failure to do so should not preclude his/her right to request a hearing on the matter. c. If mutually satisfactory resolution results and the Santa Ana LWDA concurs, the EEO Officer will write a brief report for the file stating the issues and resolution. The matter shall then be considered closed. d. If resolution does not result, the complainant shall be provided the necessary information and assistance to request a hearing if he/she so desires. 3. Request for Hearing As in the case of the complaint, the request for a hearing should be put in writing and be filed in person or by mail. A governing board resolution of authorization to appeal should also be submitted when appropriate. The request should be filled with: Jennifer Sommers Sr. Personnel Analyst — EEO Officer 20 Civic Center Drive, M-24 Santa Ana, CA 92701 (714)647-5348 EXHIBIT H 4. The burden of proof should be reasonable and flexible, dependent upon the circumstances of the case involved. The hearing officer determines the order of proof. Generally, the party making the complaint has the obligation of establishing his or her case and should be examined first. The party involved should have the right to be represented (at their own expense) if he/she so desires. Other he/she is limited to his/her own abilities and those to the hearing officer in obtaining testimony in the case. 6. It is important that the hearing officer obtain the fullest information for the record. If the parties involved, or their representatives, do not know how to ask the right or pertinent questions in pursuing their right to due process, it shall be necessary for the hearing officer to step in to have all the materials and relevant facts elicited. The practice in informal hearings is generally not to apply strict rules of evidence in obtaining facts. However, the quantity of evidence required to support a decision on an issue should be sufficiently credible that the state (or other appropriate agency), upon reviewing the decision, would conclude that the decision is supported by substantial evidence. 8. The hearing officer should attempt to negotiate a resolution of the issue at any time prior to the conclusion of the hearing. Within ten (10) days of the conclusion of the hearing, the hearing officer will issue a recommended decision to the LWDA for final determination. The recommended decision shall be in writing and may be accepted, rejected or modified by the Santa Ana Workforce Development Board. C. Issuance of Decision Within sixty (60) calendar days of filing of the complaint, the Santa Ana LWDA shall issue a written decision to all parties by first class mail. The final decision shall contain the following information: 1. The name of the parties involved. 2. A statement of the alleged violation and issues related to the alleged violation. 3. A statement of the facts. 4. The decision and the reasons for the decision. 5. A statement of corrective action, if any, to be taken. 6. Notice of the right to request, within ten (10) calendar days of receipt of the decision, a review of the decision by the State Review Panel. 11 EXHIBIT H established at the LWDA level and shall issue a decision based on the information contained therein. Complaints which may be initially filed at the State level will be heard by an independent hearing officer designated by the State Workforce Investment Division (WID). The hearing officer shall conduct a hearing and issue a recommended decision to the State Panel. The recommended decision shall be in writing and may be accepted, rejected or modified by the State Review Panel. A. Form and Filing of Complaint. 1. Request for State Review of LWDA Level Decisions On receipt of a complainant's request for review because of an unsatisfactory decision, the State shall provide for an independent state review. 2. Filing of Requests for State Review The State Review Panel shall review all LWDA level decisions when a request for review is filed within 10 days of receipt of the adverse decision. Such requests must be filed in writing with the Chief of the WID Office. The request for review should contain the following information: a. Full name, address, and telephone number of the party requesting the review b. Full name, address, and telephone number of the other party c. A copy of the decision d. Brief statement of reasons for review or the section of the LWDA decision to be reviewed including regulatory and statutory citations e. A statement of the relief sought. 3. Complainant Responsibility It is the responsibility of the complainant to include in the request for review a written statement setting forth the facts presented at the LWDA hearing which support the requested relief. The Chief, WID, shall mail a copy of the request for review to the other party and to the LWDA. It shall be the responsibility of the LWDA to submit the complete record including a typed record of the hearing to the Chief, WID, within ten (10) days. B. Conduct of Hearings. 1. Request for Hearing at the State Level 13 EXHIBIT H Decisions issued by this panel, under the authority of the Governor, are final. D. Issuance of State Review Decision. The State review will be limited to violations of the WIOA, implementing WIOA regulations or the grant agreement. This review shall be limited to the record established at the LWDA hearing. V. Procedures for Handling Discrimination Complaints by Participants. A. Complaints on the basis of race, color, or national origin, age, sex, religion, political affiliation or belief, retaliation, and citizenship, where appropriate, must be filed within 180 days of the alleged occurrence. 1. It is the responsibility of the Santa Ana LWDA's Equal Employment Opportunity (EEO) Officer to determine jurisdiction and to make the complainant aware of and provide assistance in filing a complaint in accordance with the Santa Ana LWDA's procedure under Section II (A). 15 EXHIBIT H 2. In cases where areas of authority overlap, it is the responsibility of the EEO Officer to advise the complainant of the existence of State, Federal and other proper action agencies, which may also have a bearing. 3. Complainants alleging discrimination under this part will be made aware of their right to file directly with the Office of Civil Rights (OCR), U.S. Department of Labor and applicable procedures. 4. Complainants must file their complaint directly with: Jennifer Sommers Sr. Personnel Analyst— EEO Officer 20 Civic Center Drive, M-24 Santa Ana, CA 92701 (714)647-5348 VI. Procedures for Handling Disability Complaints by Participants Complaints alleging discrimination on the basis of disability will be filed and processed under the Department of Labor regulations implementing Section 504 of the Rehabilitation Act of 1973 at 29 Code of Federal Regulations Section 32. 1. Complaints must exhaust the Santa Ana LWDA's informal resolution procedures before filing their complaint with OCR. 2. Complainants will be made aware of the 180 days requirement in which to file his/her complaint. A. Procedures at the LWDA Level The complainant shall file his/her complaint directly with the Santa Ana LWDA. Upon receipt of the complaint, the EEO Officer shall investigate and gather information concerning the complaint. 2. An informal conference will be held with the parties concerned in an effort to resolve the issue(s). The complainant has the right to be present and may be represented during the conference. 3. The Santa Ana LWDA shall issue in writing its decision to the complainant no later than thirty (30) days after the filing of the complaint. B. Procedures at the State Level 1. The complainant may appeal to the State if he/she is not satisfied with the decision of the Santa Ana LWDA. v EXHIBIT H PROCEDURES FOR HANDLING COMPLAINTS ON BASES OF DISABILITY No later than 180 days of alleged discrimination Filed within 30 days of LWDA/State Decision or 90 days from date of Initial filing of complaints Filing of complaint on the basis of Disability with LWDA Informal Resolution o o If no resolution reached o Request for Hearing Notice of Hearing Hearing Conducted LWDA Decision o o Unsatisfactory Decision or No Decision State Review Governor's Decision Appeal to Assistant Secretary Department of Labor Day 1 Day 145 Day 60 Days 19 EXHIBIT H JURISDICTION — Authority to investigate and resolve complaints against an institution subject to a law or statute which has been assigned to OCR for enforcement, i.e., Title VI, Title IX, etc. PARTICIPANT — Any applicant who has: (1) Been determined eligible for participation upon intake; and (2) Who is receiving subsidized employment, training or services (except post -termination services) funded under the Act, following intake, except for an individual who receives only outreach and/or intake and assessment services. 21 EXHIBIT H Digitally signed by Tor! Pierson Tori Pierson Date: 2022.01.26122907-08'00' KDEDU-1 OP ID: 01 '`'k� ' CERTIFICATE OF LIABILITY INSURANCE �..•--''' TE Y) 70112412022 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 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 Huntington Pacific Ins. Agency 7901 Professional Circle g y CONTACT Mark Heberden NAME: AIC, No, Ext :714-841-6283 FAX No): 714-842-2538 Huntington Beach, CA 92648 Mark Heberden E-MAIL ADDRESS: mark@huntpacificinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA :Great American Ins. Company 22136 INSURED KID Education, LLC INSURERB:Employers Preferred Ins. Co. 10346 dba: Health Staff Training Institute INSURERC : INSURERD: 601 S. Milliken Avenue, Ste Ontario, CA 91761 INSURERE : INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR 7ypE OF INSURANCE POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM1DDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X PAC 4614028-07 02/02/2022 02/02/2023 DAMAGE TO RENTED PREMISES (Ee occurrence) $ 100,000 CLAIMS -MADE. � OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,00 X Professional GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PEP PRODUCTS - COMP/OP AGG $ 2,000,00 X POLICY PECROT F7 LOC J Deduct $ 0 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ee accident) $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per. accident] $ NON-ONED HIRED AUTOS WAUTOS F PROPERTY DAMAGE (PER ACCIDENT) $ $ X UMBRELLA.LIAB. X OCCUR. EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 A EXCESS LIAR CLAIMS -MADE. UMB3962500 01 02/02/2022 02/02/2023 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPPIETORiPARTNER1EXECUTiVE Y 1 N EIG2'19667207 02/02/2022 02/02/2023 OT X !NCSTATU- H- TORY LIMITS ER E L EACH ACCIDENT $ 1,000,00 OFFICERfMEMBEREXCLUDED? (Mandatory in NH) NIA E L DISEASE - EA EMPLOYEE $ 1,000,00 fyes, .describe under DESCRIPTION OF OPERATIONS below EL.DISEASE -POLICY LIMIT $ 1,000,00 A AbuselMolestation PAC 4614028-07 02/02/2022 02/02/2023 300,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101,. Additional Remarks Schedule, if more space is required) City of Santa Ana, its officers, employees, agents and representatives are included as additional insured with respects to the general liability, per attached endorsement as required by written contract. This insurance is primary & Non-contributory. CERTIFICATE HOLDER CANCELLATION CITYSAA City of Santa Ana Risk Management Division 20 Civic Center Drive Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE RE%Ae&m & APPRavED H . © 1988-2010 ACORD CO _... _... _._ ._... __._ ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD S1 * 12/30/2021 * PAC 4614028'07 GREAT AMERICAN ASSURANCE COMPANY *DIB* 754023927 178469 CG 20 26 (Ed. 12119) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): CITY OF SANTA ANA 20 CIVIC CENTER PLAZA SANTA ANA, CA 92702 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you However: 1. The insurance afforded to such additional insured only applies to the extent permitted bylaw; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the Additional Insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. c0 Insurance Services Office, Inc., 2018 CG.20 26 (Ed. 12119) (Page 1 of 1) �< a. 6M. & PR8,. ��.�.� OF RYsk NYanagernena CY'erirvl'Aticfle S1 * 12/30/2021 * PAC 4614028'07 GREAT AMERICAN ASSURANCE COMPANY *D/B* 754023927 178469 CG 89 70 (Ed. 1 1 /14) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SIGNATURE GENERAL LIABILITY BROADENING ENDORSEMENT This Endorsement modifies and is subject to the insurance provided under the following form: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following extension only applies in the event that no other specific coverage for the indicated loss exposure is provided under this Policy. If other specific coverage applies, the terms, conditions and limits of that Coverage are the exclusive coverage applicable under this Policy, unless otherwise noted in this Endorsement. This is a summary of the various additional coverages and coverage modifications provided by this Endorsement. For complete details on specific coverages, consult the actual policy wording. Coverage Description Limit of Insurance Page Non -Owned Aircraft Included 2 Non -Owned Watercraft Included 2 Bodily Injury - Mental Injury, Mental Anguish, Humiliation or Shock Included 3 Medical Payments $ 20,000 3 Damage to Premises Rented to You $ 1,000,000 3 Supplementary Payments - Bail Bonds $ 3,000 4 Supplementary Payments - Loss of Earnings $ 1,000 per day 4 Newly Formed or Acquired Organizations Included 4 Unintentional Failure to Disclose Hazards Included 5 Knowledge of Occurrence, Claim or Suit Included 5 Property Damage Liability - Elevators Included 5 Property Damage Liability - Borrowed Equipment Included 5 Liberalization Clause Included 6 Amendment of Pollution Exclusion (Premises) Included 6 Limited Property Damage to Property of Others $ 5,000 6 Included Additional Insured - Manager or Lessor of Premises CG 89 70 (Ed. 11/14) (Page 1 of 12) S1 * 12/30/2021 * PAC 4614028'07 GREAT AMERICAN ASSURANCE COMPANY *DIB* 754023927 178469 Coverage Description Limit of Insurance Page Additional Insured - Funding Sources Included 7 Additional Insured - By Contract Included 8 Primary and Non -Contributory Additional Insured Extension Included 10 Additional Insureds - Protection of Your Limits Included 10 Blanket Waiver of Transfer of Rights of Recovery Against Others to Us (Subrogation) Included 11 Property Damage Extension With Voluntary Payments $ 1,000/$ 5,000 11 Who Is An Insured - Fellow Employee Extension - Management Employees Included 12 Broadened Personal and Advertising Injury Included 12 A. Non -Owned Aircraft Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability, exclusion g. Aircraft, Auto or Watercraft does not apply to an aircraft provided: 1. it is not owned by any insured; 2. it is hired, chartered or loaned with a trained paid crew; 3. the pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating him or her a commercial or airline pilot; and 4. it is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the Insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this Policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. Non -Owned Watercraft Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability, subparagraph (2) of exclusion g. Aircraft, Auto or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) less than 60 feet long; and 6 �< a. &PRavm a,r. � �.�� a , RYsk NYanagernena CY'erirvl'Aticfle CG 89 70 (Ed. 11114) (Page 2 of 12) S1 * 12/30/2021 * PAC 4614028'07 GREAT AMERICAN ASSURANCE COMPANY *DIB* 754023927 178469 (b) not being used to carry persons or property for a charge. C. Bodily Injury - Mental Injury, Mental Anguish, Humiliation or Shock Under SECTION V - DEFINITIONS, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness, or disease, including death of a person. "Bodily Injury" also means mental injury, mental anguish, humiliation, or shock if directly resulting from physical injury, sickness, or disease to that person. D. Medical Payments If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this Policy are amended as follows: The Medical Expense Limit in paragraph 7. of SECTION III - LIMITS OF INSURANCE is replaced by. the following Medical expense Limit: The Medical Expense Limit provided by this Policy shall be the greater of: a. $ 20,000; or b. the amount shown in the Declarations for Medical Expense Limit This provision 7. is subject to all the terms of SECTION III - LIMITS OF INSURANCE. E. Damage to Premises Rented to You If Damage to Premises Rented to You is not otherwise excluded from this Coverage Part: 1. Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability: 3. The Last paragraph of paragraph 2. Exclusions is deleted in its entirety and replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke; leakage from an automatic fire protection system or water to premises while rented to you or temporarily occupied by you with permission of the owner. A separate Limit of Insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. However, this insurance does not apply to damage to premises while rented to you, or temporarily occupied by you with the permission of the owner, caused by: i. rupture, bursting, or operation of pressure relief devices, ii. rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or resulting from water, iii. explosion of steam boilers, steam pipes, steam engines, or steam turbines; or iv. flood 2. Paragraph 6. Under SECTION III - LIMITS OF INSURANCE is deleted in its entirety and replaced with the following: r'Rooemm & APPRavm 8, . RYsk NYanagernena CY'erirvl'Aticfle CG 89 70 (Ed. 11114) (Page 3 of 12) S1 * 12/30/2021 * PAC 4614028'07 GREAT AMERICAN ASSURANCE COMPANY *DIB* 754023927 178469 6. Subject to paragraph 5. above, the most we will pay under Coverage A for damages because of "property damage to any one premises, while rented to you, or in the case of damage caused by fire; lightning, explosion, smoke, leakage from automatic fire protection system or water while rented to you or temporarily occupied by you with the permission of the owner, for all such damage caused by fire, lightning, explosion, smoke, leakage from automatic fire protection systems or water proximately caused by the same event, whether such damage results from fire, Lightning, explosion, smoke, leakage from automatic fire protection systems or water or any combination of the six, is the higher of $ 1,000,000 or the amount shown in the Declarations for the Damage to Premises Rented to You Limit. 3. Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, subsection 4. Other Insurance, paragraph b. Excess Insurance where the words "Fire insurance" appear they are changed to "insurance for fire, lightning, explosion, smoke, leakage from an automatic fire protection system or water." 4. As regards coverage provided by this provision I. Damage to Premises Rented to You - paragraph 9.a. of Definitions is replaced with the following: 9. a. a contract for a lease of premises. However; that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, leakage from automatic fire protection systems or water to premises while rented to you or temporarily occupied by you with the permission of the owner is not an "insured contract"; F. Supplementary Payments 1. In the Supplementary Payments - Coverages A and B provision, paragraph 1.b. is replaced with: b. Up to $ 3,000 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2 Paragraph 1.d. is replaced by the following: d. All reasonable expenses incurred by the Insured at our request to assist us in the investigation or defense of the claim or "suit," including actual loss of earnings up to $ 1,000 a day because of time off work. G. Newly Formed or Acquired Organizations Paragraph 3. of SECTION II - WHO IS AN INSURED is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest; will qualify as a named insured if there is no other similar insurance available to that organization. However; a. coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. coverage A does not apply to "bodily injury" or property damage that occurred before you acquired or formed the organization; and c. coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. Rowmm & APPRavm 8,. RYsk NYanagernena CY'erirvl'Aticfle CG 89 70 (Ed. 11114) (Page 4 of 12) S1 * 12/30/2021 * PAC 4614028'07 GREAT AMERICAN ASSURANCE COMPANY *DIB* 754023927 178469 d. records and descriptions of operations must be maintained by the first named insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a named insured in the Declarations or qualifies as an insured under this provision. H. Unintentional Failure to Disclose Hazards Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added to Condition 6. Representations: Failure of the Insured to disclose all hazards existing as of the inception date of this Policy shall not prejudice the insurance with respect to the coverage afforded by this Policy, provided such failure or omission is not intentional on the part of the Insured. I. Knowledge of Occurrence, Claim or Suit Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added to Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit: Knowledge of any occurrence, claim, or suit by any agent, servant or employee of the Named Insured does not in itself constitute knowledge by the Insured unless notice of such injury, claim or suit shall have been received by: a. you; if you are an individual; b. a partner, if you are a partnership c. an executive officer or insurance manager, if you are a corporation. J. Property Damage Liability - Elevators 1. Under paragraph 2. Exclusions of SECTION I - COVERAGE A Bodily Injury and Property Damage Liability, subparagraphs (3), (4) and (6) of exclusion j. Damage to Property do not apply if such property damage results from the use of elevators. 2. The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Condition 4. Other Insurance, paragraph b. Excess Insurance: The insurance afforded by this provision of this Endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. K. Property Damage Liability - Borrowed Equipment 1. Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability, subparagraph (4) of exclusion j.. Damage to Property does not apply to "property damage" to borrowed equipment while not being used to perform operations at a job site. 2. The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY Conditions, Condition 4. Other Insurance, paragraph b. Excess Insurance: The insurance afforded by this provision of this Endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. Rooemm & APPRavm 8,. a RYsk NYanagernena CY'erirvl'Aticfle CG 89 70 (Ed. 11114) (Page 5 of 12) S1 * 12/30/2021 * PAC 4614028'07 GREAT AMERICAN ASSURANCE COMPANY *DIB* 754023927 178469 L. Liberalization Clause If we revise this Signature General Liability Broadening Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the date the revision is effective in your state. M. Amendment of Pollution Exclusion (Premises) 1. The following is added to paragraph (1)(a) of Exclusion f. of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability: (iv) "Bodily injury" or "property damage" arising out of the actual discharge, dispersal, seepage, migration, release or escape of "pollutants." As used in this Endorsement, the actual discharge, dispersal, seepage, migration, release or escape of pollutants must: (aa) commence on a clearly identifiable day during the policy period; and (bb) end, in its entirety, within seventy-two (72) hours of the commencement of the discharge, dispersal, seepage, migration, release or escape of "pollutants", and (cc) be discovered and reported to us within fifteen (15) days of the clearly identifiable day that the discharge, dispersal, seepage, migration, release or escape of "pollutants" commences; and (dd) be neither expected nor intended from the standpoint of any insured; and (ee) be unrelated to any previous discharge, dispersal, seepage, migration, release or escape; and (ff) not originate at or from a storage tank or other container, duct or piping which: a. is below the surface of the ground or water; or b. at any time has been buried under the surface of the ground or water and then is subsequently exposed. 2. For the purposes of this coverage, the following is added to the definition of ''property damage" of SECTION V - DEFINITIONS and applies only as respects this coverage: Land or water, whether below ground level or not, is not tangible property. 3. Coverage provided hereunder does not apply to any discharge, dispersal, seepage, migration, release or escape that is merely threatened or alleged rather than shown to have actually occurred. N. Limited Property Damage to Property of Others The following is added under SECTION I - SUPPLEMENTARY PAYMENTS - COVERAGES A and B: 3. We will pay up to $ 5,000 for loss to personal property of others while in the temporary care, custody or control of an insured caused by any person participating in your organized activities. For the purpose of this supplementary payment, loss shall mean damage or destruction but does not include mysterious disappearance or loss of use. In the event of a theft, a police report must be filed. This supplementary payment does not apply if: & APPR 8,r. a. coverage is otherwise provided by the Property Coverage part (if any;&� Ri,kK... gernent Cl' i-l'AadF CG 89 70 (Ed. 11114) (Page 6 of 12) S1 * 12/30/2021 * PAC 4614028'07 GREAT AMERICAN ASSURANCE COMPANY *DIB* 754023927 178469 b. the loss is covered by any other insurance you have or by any insurance of such person who causes such loss. These payments will not reduce the Limits of Insurance. O. Additional Insured - Manager or Lessor of Premises 1. SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization from whom you lease or rent property and which requires you to add such person or organization as an additional insured on this Policy under: (a) a written contract; or (b) an oral agreement or contract where a Certificate of Insurance showing that person or organization as an additional insured has been issued; but the written or oral contract or agreement must be an "insured contract," and, (i) currently in effect or become effective during the term of this Policy; and (ii) executed prior to the "bodily injury," "property damage," "personal and advertising injury." 2. With respect to the insurance afforded to the Additional Insured identified in paragraph 1. above, the following additional provisions apply: (a) This insurance applies only with respect to the liability arising out of the ownership, maintenance or use of that part of the premises leased to you. (b) The Limits of Insurance applicable to the Additional Insured are the lesser of those specified in the written contract or agreement or in the Dec-larations for this Policy and subject to all the terms, conditions and exclusions for this Policy. The Limits of Insurance applicable to the Additional Insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. (c) In no event shall the coverages or Limits of Insurance in this Coverage Form be increased by such contract. (d) Coverage provided herein is excess over any other valid and collectible insurance available to the Additional Insured whether the other insurance is primary, excess, contingent or on any other basis unless a written contractual arrangement specifically requires this insurance to be primary. (e) This insurance applies only to the extent permitted by law. 3. This insurance does not apply to: (a) Any "occurrence or offense which takes place after you cease to be a tenant in that premises. (b) Structural alterations, new construction or demolition operations performed by or on behalf of the Additional Insured. P. Additional Insured - Funding Sources 1. SECTION II - WHO IS AN INSURED is amended to include as an additional insured any Funding Source which requires you in a written contract to name the Funding S insured but only with respect to liability arising out of:� 1Rowmm & APPRavED Hr. RYsk NYanagernena CY'erirvl'Aticfle CG 89 70 (Ed. 11114) (Page 7 of 12) S1 * 12/30/2021 * PAC 4614028'07 GREAT AMERICAN ASSURANCE COMPANY *DIB* 754023927 178469 a. your premises; or b. "your work" for such additional insured; or c. acts or omissions of such additional insured in connection with the general supervision of "your work" and only to the extent set forth as follows: a. The Limits of Insurance applicable to the Additional Insured are the lesser of those specified in the written contract or agreement or in the Declarations for this Policy and subject to all the terms, conditions and exclusions for this Policy. The Limits of Insurance applicable to the Additional Insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. b. The insurance afforded to the Additional Insured only applies to the extentpermittedby law c. If coverage provided to the Additional Insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. d. In no event shall the coverages or Limits of Insurance in this Coverage Form be increased by such contract. Q. Additional Insureds - By Contract 1. SECTION II - WHO IS AN INSURED is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" arising out of: a. your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the Additional Insured that are subject of the written contract or written agreement provided that the "bodily injury" or ''property damage occurs, or the "personal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or b. the maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or c. the Additional Insureds financial control of you; or d. operations performed by you or on your behalf for which the state or political subdivision has issued a permit However: 1. the insurance afforded to such additional insured only applies to the extent permitted by law; and 2. if coverage provided to the Additional Insured is required by contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide such additional insured. With respect to paragraph 1.a. above, a person's or organization's status E under this Endorsement ends when: rRE4Ae&m & APPRavm 8,r. a RYsk NYanagernena CY'erirvl'Aticfle CG 89 70 (Ed. 11114) (Page 8 of 12) S1 * 12/30/2021 * PAC 4614028'07 GREAT AMERICAN ASSURANCE COMPANY *DIB* 754023927 178469 (1) all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed for or on behalf of the Additional Insured(s) at the location of the covered operations has been completed; or (2) that portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as apart of the same project. With respect to paragraph 1.b. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this Endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage." We have no duty to defend an additional insured under this Endorsement until we receive written notice of a "suit" by the Additional Insured as required in paragraph b. of Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITION. 2 With respect to the insurance provided by paragraph 2. Exclusion's under SECTION Damage Liability: This insurance does not apply to: this Endorsement, the following are added to COVERAGE A - Bodily Injury and Property a. "Bodily injury" or "property damage" that occurs prior to your commencing operations at the location where such "bodily injury" or "property damage" occurs. b. "Bodily injury," "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, including: (1) the preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) supervisory; inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that Insured, if the "occurrence" which caused the "bodily injury or "property damage, or the offense which caused the "personal and advertising injury," involved the rendering of, or failure to render, any professional architectural, engineering or surveying services. c. "Bodily injury" or "property damage" occurring after: (1) all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed for or on behalf of the Additional Insured(s) at the location of the covered operations has been completed; or (2) that portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal project. RYsk NYanagernena CY'erirvl'Aticfle CG 89 70 (Ed. 11114) (Page 9 of 12) S1 * 12/30/2021 * PAC 4614028'07 GREAT AMERICAN ASSURANCE COMPANY *DIB* 754023927 178469 d. Any person or organization specifically designated as an additional insured for ongoing. operations by a separate additional insured endorsement issued by us and made part of this Policy. 3. With respect to the insurance afforded to these Additional Insureds, the following is added to SECTION III LIMITS OF INSURANCE: If coverage provided to the Additional Insured is required by a contract or agreement, the most we will pay on behalf of the Additional Insured is the amount of insurance: a. required by the contract or agreement; or b. available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This Endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. R. Primary and Non -Contributory Additional Insured Extension This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this Policy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: a. The following is added to paragraph a. Primary Insurance: This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) the Additional Insured is a named insured under such other insurance; and (2) you have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the Additional Insured. b. The following is added to paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises Lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the Additional Insured is designated as a named insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the Additional Insured has been added as an additional insured on other policies. S. Additional Insureds - Protection of Your Limits This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this Policy. 1. The following is added to Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit: & APPRavm 8,r. An additional insured under this Endorsement will as soon as practicable: Ri,kK... gernent Cl' i-l'AadF CG 89 70 (Ed. 11114) (Page 10 of 12) S1 * 12/30/2021 * PAC 4614028'07 GREAT AMERICAN ASSURANCE COMPANY *DIB* 754023927 178469 a. give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. tender the defense and indemnity of any claim or "suit to all insurers whom also have insurance available to the Additional Insured; and c. agree to make available any other insurance which the Additional Insured has for a loss we cover under this Coverage Part. d. we have no duty to defend or indemnify an additional insured under this Endorsement until we receive written notice of a "suit by the Additional Insured. 2. The Limits of Insurance applicable to the Additional Insured are those specified in a written contract or written agreement or the Limits of Insurance stated in the Declarations of this Policy and defined in SECTION III - LIMITS OF INSURANCE of this Policy, whichever are less. These limits are inclusive of and not in addition to the Limits of Insurance available under this Policy. T. Blanket Waiver of Transfer of Rights of Recovery Against Others to Us (Subrogation) Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added to Condition 8. Transfer of Rights of Recovery Against Others to Us: If required by a written contract or written agreement, we waive any right of recovery we may have against a person or organization because of payment we make for injury or damage arising out of your ongoing operations or "your work" done under a contract for that person or organization and included in the "products -completed operations hazard" provided that the injury or damage occurs subsequent to the execution of the written contract or written agreement. U. Property Damage Extension with Voluntary Payments 1. The following is added to paragraph 1. Insuring Agreement of SECTION I - COVERAGE A - Bodily Injury and Property Damage. Liability: At your request we will pay for "loss" to property of others caused by your business operations for which this Policy provides liability insurance. Such payment will be made without regard to your legal obligation to do so. The "loss" must occur during the policy period and must take place in the "coverage territory." 2. With respect to the coverage afforded under paragraph 1. above, paragraph 2. Exclusions of SECTION I - COVERAGES A - Bodily Injury and Property Damage Liability is amended as follows: Exclusions j.(3), j.(4), j.(5) and j.(6) are deleted. 3. As respects coverage afforded by this coverage, SECTION III - LIMITS OF INSURANCE is replaced by the following: Regardless of the number of insureds, claims made or "suits" brought or persons or organizations making claims or bring "suits"` 1. Subject to 2. Below, the most we will pay for one or more "loss" arising out of any one "occurrence" is $ 1,000.. 2. The aggregate amount we will pay for the sum of all "loss" in an annual period is $ 5,000. This aggregate amount is part of and not in addition to the General Aggregate Limit described in paragraph 2. of SECTION III - LIMITS OF INSURANCE. r' & PR8, . ,' 1 �1a,� RYsk NYanagernena CY'erirvl'Aticfle CG 89 70 (Ed. 11114) (Page 11 of 12) S1 * 12/30/2021 * PAC 4614028'07 GREAT AMERICAN ASSURANCE COMPANY *DIB* 754023927 178469 V. Who Is an Insured - Fellow Employee Extension - Management Employees 1. The following is added to paragraph 2.a.(1) of SECTION II - WHO IS AN INSURED: Paragraph (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, including the direct supervision of other "employee of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury," caused in whole or in part by their intoxication by liquor or controlled substances. This coverage is excess over any other valid and collectable insurance available to your "employee." W. Broadened Personal and Advertising Injury 1. Unless "Personal and Advertising Injury" is excluded from this Policy, the following is added to SECTION V - DEFINITIONS Item 14.: h. mental injury, mental anguish, humiliation, or shock, if directly resulting from Items 14.a. through 14.e. �< a. 6M. &PRavm 8,r. 70,ti OF RYsk NYanagernena CY'erirvl'Aticfle CG 89 70 (Ed. 11114) (Page 12 of 12) NOTICE OF COMPLIANCE CITY STAFF: PRINT THIS PAGE AND INCLUDE WITH AGREEMENT TO THE CLERK OF THE COUNCIL Contractor KD Education, LLC Name: Project A-2020-194-08 Number: Project Agreement For Workforce Training Name: The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the insurance requirements. No further action is required at this time. The compliant coverage(s) are: POLICY EXPIRATION TYPE OF INSURANCE COI DATE FILE NAME NUMBER DATE Healthstaff GENERAL LIABILITY PAC46140280I 02/02/2024 01/23/2023 Training GL 02.02.2024.pdf Healthstaff WORKERS COMPENSATION AND EIG219667208 02/02/2024 01/23/2023 Training GL EMPLOYERS' LIABILITY 02.02.2024.pdf Thank you, City of Santa Ana Risk Management Division in partnership with CTrax Plus Services Team 2/21/2023 4:31 PM