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HomeMy WebLinkAboutFAMILIES FORWARD (3)INSURANCL u.; tirL A-2620-251-05 WORK MAt r1,0ULL:l UNTIL IlvJurcn ; t EXPIRES 01.01.77 CLERK Ot t,u.,.rv,L DATE: JUL 13 O��IGREEMENI T BETWE4 EN THE CITY OF SANTA ANA AND 1 FAMH ES FORWARD FOR USE OF COMMUNITY DEVELOPMENT BLOCI( GRANT CORONAVHiUS (CDBG-M FUNDS (T: CDft(Mtkel(e�Ily)CI) T•T. This Agreement is hereby made and entered into this Jute �, 2021, by and between the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("CITY" J, and Families Forward ("SUBRI;CIPWNT1 . RECITALS: A. On March 27, 2020, a special allocation of Cornmur4 Development Block Grant C`CDBG'l fimds was authorized by the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act'), Public LAW 116-136, to prevent, prepare for, and respond to the eoronavirus C`COVID-19") pandemic. The CARES Act made available $5 billion in Community Development Block Grant Coronavirus ("CDBG-CV") funds. Of this amount, the United States Department of Housing and Urban Development C`HW) inurtediately allocated $2 billion based on the fiscal year 2020 CDBG formula, B. On April 2, 2020, the CITY received notice of an award of $3,374,017 in CDBG-CV funds from HUD in response to the COVID-19 pandemic. C. On September 11, 2020, HUD awarded the City with a special allocation of CDBG-CV3 program firnds in the amount of $3,520,919, as authorized by the CARPS Act, increasing the cumulative amount for at CDBG-CV allocation rounds to $6,894,836. For purposes of this Agreement, all rounds of allocation of CDBG-CV funds, including CDBG-CV3 funds, shall be referred to as CDBG-CV funds. D. CITY, as an entitlement recipient and grantee of the HUD CDBG Entitlement Program, Catalog of Federal Domestic Assistance ("CFDA') Number 14.218, and Federal Award Identification Number (FAIN) B-20-MC-06-0508, desires to enter into this Agreement with the SUBRECIPIENT for the expenditure of CDBG-CV funds in accordance with Title 24, Part 570 of Code of Federal Regulations 24 CFR 570.000, et seq. ("CDBG REGS"). E. CITY applies[ for and received CDBG funds from 1IUD pursuant to 'title 1 of the Housing and Community Development Act of 1974, Public Law 93-383, as amended C`AC ). F. SUBRECIPIENT has been selected by the CITY to receive CDBG-CV funds and administer such financial assistance; and to provide the services described in Exhibit A, in accordance with the Schedule of Performance included therein C'said program"). SUIBRECIPMNT represents that it is qualified and willing to operate said program and certifies that the activities carried out with funds provided under this Agreement will meet one or more of the CDBG program's National Objectives (24 C1R Part 570,208), including the CDBG-CV pmgram's objectives to respond to this historic COVID-19 public health crisis. Q. in response to the COVID-19 pandemic, SUBRECIPIENT, a nonprofit organization that serves low and moderate income persons, meets the nationat objective for the use of CDBG and CDBG-CV funds. H. SUBRECIPIENT agrees that it will adhere to the performance measurements and outcomes as indicated on Exhibit A (Schedule of Performance). Failure to follow the measurements and meet the stated outcomes may constitute breach of contract that could result in termination of this A&roament or serve as reason for the CIty to recapture the grant Raids awardotl to SUB RI?CIp1k3NI' pursuant to this AgrecruntiL WHEREFORE' it is agreed by and between the parties that the foregoing Recitals are a substantive part of this Agreement and the following tcrrm and conditions are approved and together with all exhibits aI attachments he oto; shall constihute the entire Agreement betweeuthe id CITY and SUBRECIPUINTt I. SUERECIPIENVS QVLr-GATIQNS A, Nonpro uaigg Rpresen Bons ands antic (a) Authority. SUBRECfPIENT is a duly organized acid existing nonprofit corporation in good standing and authorized to do business under the laws of the State of California. SUBRECiPIENT has full right, power and lawful authority to accept die funding hereunder and to undertake all obligations as provided herein and the execution, performance and delivery of this Agreement by SUBRFC1PIENT has boon fully authorized by all requisite actions on thepart of SUIIRFCIPIENT. (b) Exporlenee. SUBRECIPIEN'I` is a qualified provider of the services to be provided hereunder. (o) Familiarity With Setwices Required, BY executing this Agreerncut, SUBR17ClPlENT warrants that; (i) it has thoroughly investigated and considered the services to be performed and provided hereunder; (i) it has carefully considered flaw the services should be performed, and, (III) it folly understands the facilities, difficulties and restrictions attending performance of the services under this Agreement, (d) Na Conflict. To the best of SUBRBCIPIENT,s knowledge, SIJJ3IiEClPIBN f'S execution, delivery and perfornumoo of its obligations under this Agreement will not constituto a default or a breach under any contract, agreement or order to which SLIEIRECiPIENT is a party or by which it Is bound. (e) No Bankruptcy. SUHREICIPIENT is not the subject of ally current or threatened bankruptcy proceeding. (0 No Pending Legal proceedings, SUBRECIPIRNT is not the subject of a current or threatened litigation that would or may materially affect SUBRECIPMNT'S perforamanoe under this Agreement. (g) Application 'Veracity. All provisions of and information provided in SU'BRECOIENT's application for funding submitted to CITY; including any exhibits, are true and correct in all material mpects, (It) No Penning lnvestlgatioa. SUBRFCIPIENT has no knowledge that it is the subject of any current or threatened criminal or civil action Investigation by any public agettoy, hncludhtg without limitation a police agency or prosecuting authority, which would relate to or affect performance of the Agreement or provision of services hereunder. B- At?iouuy 9f inlloaYn and oarrly �i. ,anent. The amount granted to SUBREC:IPIENT for said program is Twenty -hive Thousand Dollars ($25,000) (CDBU-CV FUNDS"), for the term commencing on June 1, 2021 and eantiauing through May 31, 2021 This Agreement shall also cover any and all services provided by the SUBRECIPIENT to the CITY since the date the CDBv- CV Hands were awarded to the CITY, The Term of this Agreement may be extended by a writing executed by the City Manager, or his or her designee, and the City Attorney, The CDBG-CV FUNDS shall be disbursed by CITY to SUBRECIPIMNT on a quarterly basis, or as approved by CITY, subject to and upon receipt and approval of complete quarterly activity report from SUBREC rPIENT, with the final payment subject to the satisfaction of the condition precedent of submittal of complete reporting inforn€aition due oil or before July 15 of the applicable funding year, as hereinafter more fully set firth. SUBRECIPIENT shall be obligated to perform auch duties as would normally extend beyond the term, including, but not limited to, obligations with respect to indemnification, audits, reporting, data retentiontreporting, and accounting. Failure to provide any of the required documentation anti reporting WW cause CITY to withhold all or a portion of a request for troimbursement, or return the entire relinbursement package to SUC3ItCCIP11,W, until such documentation and reporting has been received and approved by CITY, The CTI"Y reserve, the right to reduce the amount of CDBG-CV FUNDS to SUBRF.CIPII;NT, or to completely terminate this Agreement, in the CITY's solo discretion, if there is a reduction in CD13t3-CV VUNDS provided to the CITY. The CITY reserves the right to reduce the grant application if the CITY's fiscal monitoring indicates that SUBRECIFIBNT's rate of expenditure will result in unspent Rinds at the end of the program years. Amendments in the grant allocation will be made after consultation with SUBRECIPIENT, C. TJsa of Iaunds. SUBRE?CIPIENT agrees to use all federal funds provided by CITY' to SIAMCI'IE pursuant to this Agreement to operate said program, as set forth in Exhibit A, attached hereto and by this reference incorporated herein. SUBRECIPII'sNT S failure to perfenn as required may, in addition to other rcmed ics sot forth in this Agrccrumt, result in riedinstruent of the amount of funds CITY is otherwise obligated to pay to SUBRECJFIBNThereunder. D. Allo,�, w,abte Qp s SU13RHCIPIENT agrees to complete said program within tine terns of this Agreement, and to use said funds to pay for necessary and reasonable costs allowable under the federal law and regulations to operate said program. Said amounts shall include, but not be limited to, wages, admbustrative casts, and employee benefits comparable to other similarly situated employees, and indirect costs, Other allowable program eosts are detailed in the budget, asset forth in Exhlbit B, attached hereto and by dais reference incorporated herein. SUBRECOMN'i' shall use all income received from said funds only for the same purposes for which said funds may be expended pursuant to the terms and conditions of this Agreement. SUBRECIPIENT has the ability to adjust fino item amounts in the budget with the written approval of the CITY's Executive Director of the Community Development Agency, or designee, so long as the total budget amount does not increase. Pursuant to 2 CTR §200.331(a)(4), the Indirect Cost Rate for the SUBRI3CIPIENT's award shall be an approved federally recognized indirect cast rate negotiated between the SUBRECIPIE3NT and the Federal government, or, if no such rate exists, the do minimis indirect cost rate as defined in 2 CrR §200414(b) Indirect (F&A) costs, For this Agreerae it, the do minimis indirect cost rate of 100/0 will apply, E. Iice, nsi a. SUBREC111113NT agrees to obtabn and malutain all required licenses, registrations, accreditation and inspections from all agencies governing its operations. SUi3RBCIP1 "1' shall ensure that its staff shall also obtain and maintain all required licenses, registrations, accreditation and inspections Ron, all agencies governing SIJBRBCIPIFNT's operations hereunder. Such licensing requirements include obtaining a City business license, as applicable. P. Zor `ng, SUBRECI }}iLNT agrees that any facility/property used in furtherance of said program shall be specifically zoned and permitted for such use(a) and activity(ies), Should SUBREciP11 NT fall to have the require(] land entitlement and/or permits, thus violating ally local, state or federal rules anti regulations relating thereto, SU11RECIPPM shall immediately make gaud -faith offorts to gain compliance with local, state or federal rtdes.and regulations following written notification of said violation(s) from the CITY or other authorized citing; agency. SUBRECIP1ENf shall notify CITY immediately of any pending violations. Failure to notify CITY of pending violations, or to remedy such known violation(a) OIWI result in termination of grant funding hereunder. SUBRECIPIENf must mace all corrections required to bring; the facllity/property Into compliance with the law within sixty (60) days of notification of the violation(s); failure to gain compliance within such tune shall result in termhratlon of grant funding hereunder. G. Sot}ar anon of Accounts, All funds received by STJBRPCIPIBINT from CITY pursuant to tlis Agreement shall be maintained far an account in a federally insured banking or savings and loan institution with record keeping of such accounts trtaintalned pursuant to applicable 2 CFR 200.302 requirements. SUBRBCIPIENT is not required to maintain separate depository accounts for CDBG-CV FUNDS; provided however, the SIJBI2l3C1 ENT must be able to account for receipt, obligation anti expenditure of CDB 3-cV FUNDS pursuant to applicable 2 CFR 200,302 requirements. IT. Audit Repnr[ itee1uiremg0t , SU13RECIPMNT agrees that if SUBRECIPIEsT expends Seven Hunched Fifty Thousand Dollars ($750,000) or more in federal funds, SUBRECIPMNT shall have an annual audit conducted by a certified public accountant in accordance with the standards as set forth and published by the United States Office of Management and Budget. SUBIkECIPIFNT shall provide CITY with a copy of said audit by April I of the year following the program year in which this Agreement is executed, L )Z 1C iI Iicporthtg, SUBRECIPIPNT shall kMT and rnaaitain complete and adeiluate records and reports on program participants to determine their initial and continuing eligibility far the poigiain services being; provided to assist CHY in meeting and maintaining. its record keeping respousibilitics under tho CDBG REDS, including the following: (1) Records it. Documentation evidencing, program income requirements in conformity with 24 CPR. 570,504(b)(2)(i), 00 and 24 CFR 570.503(b)(3) and 24 CFR 570:208(a)(2)(13) of the income level of persons and/or families participating in or benefiting by the SUBREC'.IPTENT program. b, Documentation of the number of persons and/or fturalics participating in or benefiting by the "U RECIPIENT prograim o. FIausehald information shall include number of persons, identification of head of household, modethnieity, and income verification of all household members ages 18 and over. d. Documentation of all CD13G-CV pliNDS received from CITY. e, Documentation of expanses as identified in the Budget Proposal, including evidonce of incurring the expense, hrvolees for goods or services, copies of any and all contracts or documentation pertaining to costs for subcontractors, phis all other invoices and proof of payment for which CDBG-CV FUNDS were expended, and any payments therefor, 4 £ Any such other related records as CITY shall reasonably require or as required to be maintained pursuant to the CDBG R1 GS. (2) It000rts a. Payment Request, Coneurrentty with the submittal of each report, SUBTtBClpIBNT shall sul»nit both: all Original invoice/request for reimbursement and true Copies -of Invoices, receipts, canceled checks, bank statements, credit card statements, procurement documentation for goods or services, timoshects, payroll records, benefit statements, agreements, contracts or documentation pertaining to costs for subcontractors, and/or other documentation supporting and evidencing how the CDAG-CV FUNDS have been expanded during the applicable term. b, Progress Reports. SUBFXCIPIENT agrees to keep records of all othnle and racial statistics of persons and families benefited by SLMRECIpIk?NT in lice porformanoe of its obligations under this Agreement, including, but not limited to, the number of low and moderate income persons and households assisted in accordance with federal income limits, tiles number of fernalo ]leads of households assisted, new program/ information and year-to-date program statistics oil expenditures, caseload and activities. Failure to provide any of the required document<,ttion and reporting will cause CrfY to withhold all or a portion of a request for reimbursement, or return the entire reimbursement package to SUIIRBCjPfl r, until such documinitatioan and reporting has been received and approved by CITY. J. Access to lteegrds, CITY and. the United States Goveroracnt and their representatives or attditats shad have access for purposes Of mo»itsring, auditing, and Oxamhnhcg SUBRECiplEN`I"s activities and performance, to books, documents and papers, and tho right to examine r000rds of SUBRErCIPIE NT's subcontractors, bookkcopars and accountants, employees and parlicipants in regard to said program. CITY and the United States Government and their representatives or auditors shall also schedule ou-site monitoring at their discretion, t' OOROring activities may Rise include, but are not limited to, questioning employees and participants In said program and onwring any premises or any sits in which any of the services or activities ficndod hereunder is conducted or in which any of the records of SUBREMPIENT are kept. Nothing herein shalt be ooaatruod to require access to any privileges] or confidontial information as set forth its federal or state law, K. Location of Recordsltteaui eed Lctcpth of Record Koenig. All accounting records, reports, and evidence pertaining to a]i costs, cxponses and the CDBG.CV FUNDS of sUBRLOPIENT and all documents related to this Agreement shall be maintained and kept available at SUBRECIPIENT'S office Or place. of business for the duration of the Agreement said thereafter for five (5) years from tiro date of final paymont under this Agreement, 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 or any other govonumntal agency takes exception, shall be retained beyond tbo five (S) years until complete resolution or dispositiOn Of such appeals, litigation claims, or exceptions. Ira the event SUBRRCTPMNT does not make the above-re€ere»ced documents available within tine city of Santa Ana, California, SUBRVCIPIi3NT 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, L, G MVIiance with l,4w/pEQ9 alp Ineomc. SUBRLUC"IpIEN'C Rcowtcdges that the fuunds boing provided by CITY for said program line received by CITY pursuant to the CARES Act and the ACT, as amended, and that expenditures of those funds shall be in accordance with the Cr R,]?S Ask, the ACT, and all pertinent regulations issued by agencies of the fodw•al government, including, but not lhnited to, all regulations found at Title 24 of the Code of Federal Regulations. Program income received by 5 SUBREC IPIENr sbait be returned to CITY, taxless otherwise provided for in this Agreement,SUBRECIPIENT agrees to comply fully with all federal, state and boat laws and court orders applicable to its operation whether or not referred to In this Agreement, M. Dqbarmont. To protect the public Interest and ensure the integrity of Federal programs, CITY may only conduct business with responsible persons and may not make any award or permit any award to any party which is debarred or suspended or is otherwise excluded £rem or tenet! itle for participation in Federal assistance programs under Execativo order 12549, "Debarment and Susponsion", See also 24 CFR 570.6M SUBRECIPMNT must review and sign Exhibit C "Debarment", wirloh is attached hereto and incorporated. herein by this reference, SIMREC1PIENT shall be in good standing, . without suspension by the California Secretary of State, Franchiso Tax Board or internal Revenue Service. Anychange In the corporate status Or suspension Of SUBRECiPUNT shall be reported immediately to CITY, N, Coltfide iahty. Without prejudice to any other provisions of this Agreement, SUBREUIPfi3N'I sba.1, where applicable, maintain the oonkldential nature of information provided to'lt concerning participants in accordance, with the rerluu-cnxents of federal and state law, Flowever, SUBRECIPIENT shall submit to CITY and or HUD or its representatives, all records requested, Including audit, examinations, monitoring and verifications of reports submitted by SUBRECIPIENT, costs incurred and services rendered hereunder. 0. Indc_onden( 9k1* for, SUBRECIPWNI' agr?= that the perfonnaree of obligations hereunder is rendered in its capacity as an independent contractor and dust it is in no way an Agent of CITY. P, Violation of Terxxss and C lit itiotxs. SUBRECIPIISNT agrees that if SUBRECIPMNT violates any of the tenses and conditions of €Isis Agreement or any prior Agreement whereby CDBG-CV feuds were receiver] by SUBIUCIPIENT, or if SIIHRLrCjpMNT reports Inaccurately, or if on audit there is a disallowance of certain expenditures, SUBRECll'IBNT awes to remedy the acts or onilssions causing the disallowahco and repay CITY all amounts spent in violation thareOC If SUBRECIPMNT engaged in fraudulent activity to Obtain and/or justify expenditure of the CDB(I-CV ftn7ds granted hereunder, SUBRECIPMNT shall be required to reinnburse the CITY of all such funds that were Obtained and/or spent under fraudulent circumstances. Q, B rdpWgWr SUBRECIPIENTagrees, to maintain a record for each items of lion -expendable parsOnal propetty acquired under the terms of this AgreomerrL Said record shall be made available to CITY upon request. The terra "non -expendable personal property" shall include lensed and purchased equipment. R. prohibited Usa, SUBRECINENr hereby certifies and agrees that it will not use (`rands provided through this Agreement to pay for entertainment, meals or gifts, or Other prohibited uses, S. lrgl byalug. SUBRECIPIEW certitles that It will comply with federal law (31 U.C. 1352) and regulations found at 24 CPR part $7, 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 comicotion with awarding of any federal contract, the making of any federal grunt or loan, entering into any cooperative agreement and the extension, renewal, amendmem or modification of any federal contract, grant, loan or cooperative agreement. SUBREGMUNr slsall sign a certification to that effect in a form as set forth in ni hiblt D, attached hereto and by tits reference incorporated herein. SUMCIPITNT 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 SUBRECIPIII?NT under the terms and conditions of this Agreement, If any ftazds 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 ally agency, a Member of Congress, at' officer or employee of Congress, Or auz employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agrccmcnt; the undersigned shall complete and submit a "Disclosure Form to Report Lobbying," iu accordance with its instructions (Ixbiblt D). SUl1f BOMEiNT shall require that the language of ails Certification be included in the award documents for all sub swards at all tiers (including subcontraotors, sub -grants, and contracts.uridej grants, loans, and cooperative agreements), and agrees to take all actions necessary to ensure that all subreolpients shall similarly eertify, and disclose accordingly, T. ! j' I tao al Interest. SUBR-HClp)VNT agrees that except for the use of CDBCi.CV funds to pay salaries and other rotated administrative or personnel coats, no persons who exercise or have exercised any function with respect to CI]BQ-CV activities assisted tinder the terms of this Agreement, or who are In a position to participate in a decision -narking process or gait' Inside information with regard to such activities, may obtain a financial interest or benefit front a CD130-8881sted activity of SUBRECIpMI\ f, either for themselves or those with whom they have family or business ties, during their tenure or for one you thereafter, This prohibition applies to any person who is an employee, agent, consultant, officer, or elected or appointed official of CITY, or of any designated public agenoy, or the SUBRBCIPIENT. U. Labor 9tand8Z&-. The SUBRECIPENp agrees to comply with the requirements of the Secretary of Labor in accordance with the Davla-Bacon Act as amended, the provisions of Contract Worse Hours anti Satiety Standards Act (40 U.S.C. 327 et serf.) and all other applicable Federal, state and local laws and regnladona pertaining to labor standards insofar as those acts apply to the performance of this Agreement. The "RECIPIENT agrees to comply with the Copeland AnH-Kick 13aek .Act (18 U.S.C. 874 et scq) and its implementing regulations of the'U.S. Department of Labor at 29 CFR Pant 5. The 8VBREsCIPTFNT shall maintain documentation that demonstrates compliance with hour and wage requirements of this part, Such documentation shall be made available to the CITY for review upon request. SUBPFCIPIBNC agrees that, except with respect to the rehabilitation or construction of residential property containing less than eight (8) units, at contractors engaged under contraots in excess Of $2,000,00 for construction„ renovation or repair work financed in whole or in part with assistance provided under this contract, shall comply with Federal requirements adopted by tite CITY pertaining to such contracts and with the applicable requirements of the regulations of the Department of Labor, under 29 CFR Parts 1, 3, 5 and 7 governing the payment of wages and ratio of apprentices and trainees to journey workers, provided that, if wage rates higher than those required under the regulations are imposed by state or local law, nothing hereunder is intended to relieve the SUBRECIPJENT of its obligation, if any, to require payment of the higher wage. 'file SUBRECIFl.ENT shall cause or require to be, inserted in Roll, in all such contracts subject to such regulations, provisions meeting the requirements of this paragraph. V. Section 3 a1 j szng and Urban' T3svclogrtzent Act of 19f8. SURItECIPFf�IT will mak every effort to provide training opportututi for low -and mockerate income persons resng within due community where the consuuction project is located and cottttsots awarded to local businesses tkzereho to the greatest extent feasible as requiic l trnclar the prxzvisiaus of Section 3 of the kfoushrg and Urban 1Jovelopnthe Act of 1968, the regulations art fnt$h ui 24 CFR 135, and all applicable rules and nrdet;s issneel hereunder ont prior to the extvaution of dila Agrcenzeat. Compt once wi0n U'e foregoing requirements enroll i'e a condition rider tho .federal financial assisnt co lunvlclerk under this Agreemout and binding an the SiJBR1 CIPEf3NT, Faof ilure to fzalf�ll these regndromeots shall subject tl'e S[),I3PFfifPIENT, it8 successors and designees, to those sanctions specifiod by tho Agreement through which federal assistance is provided, The SUER CIPUM, certifies and agrees that no contractual or other disability exists which would prevent complhuloe with these requirements. SUBRECIPIENT shalt make every effort to ensure that all projects funded wholly or in part by CDIIG-CV Funds shall provide equal employment opportuuatics for mirror9ties and wornerr, W ?-n7a I7ret! Workplace, SUBTii.C+ i M TI' agrees to provide a drug free workplace and to execute a certification as srx forth in Exhibit T attached hereto and incorporated her oitt by this reference, X Uniform Agalinistrative Requirements 2aLZ 'fir giples and Audit Itequfr®raients for > at Aw—kads, The following requirements and standards must be compiled with, 2 CFR Part 240et al. S-UBRECIPIENT shall procure all materials, property, or service$ in accordance with the requirements of 2 CFR 200,318-326. Y. art K of 24 CIrR St,1BRECIPWNT will early out its activities in compliance with the requiroments of Subpart If of 24 CFR 570, However, SUARWIFIENT does not assume the CI Y's enviromnental responsibilities or the responsibility for initiating the erivhonmental review process under 24 CFR Part 52, Z. omen- and Minority Cwned Businas�� SUBRBCIPIENT will use its best efforts to afford small businesses, minority business enterprises, and women's business enterprises the maximum practicable opportunity to participate in the performance of this Agreement in accordance with the requirements of 2 CFR 200.321 "Contraoting with small and minority businesses, worucn's business enterprises, and labor surplus area firms". As used in this Agreement, the term "small business„ means a business that meek the criteria set forthsu section 3(a) of the Email Business Act, as amended (15 U,S,C. 632), and "minority and wormen's business enterprise" means a business at least fifty-one percent (S l %) owned and controlled by minority group members or women. For the purpose of this definition "minority group members" are Air Aura -Americans, Spanish-speaking, Spanish surnamed or Spatrishy heritage Americans, Asian-Amorioam, and American Indians. SUBRECIPIENT may rely ors written representations by businesses regarding their status as minority and female business enterprises in lieu of an independent investigation, H. CrfYtS BLIG—A,TIONS A. P cr fi c� i�usds. On April 2, 2020, the CITY received notice of an award of $3,374,017 in Cl)BG-CV funds from HUD in response to the COVID-19 pandemic, Subject to the terms of this Agreement, CITY agrees to pay to SUBRECIPIENT when, if and to the cxtuvt federal funds are received a sum not to exceed 2'wonty-Five, Thousand Dollars ($2s,000) for SUBRBCIPIP.NT'S perforxiarrce in aecordarrc with the Budget attached hereto as Exhibit B during the tern of thus Abrcerment. Payments shall be made to SUBRECIPTENT through the submission of h1volecs/reimbursemeut requests, CITY shall pay such invoices/rehxibursemont requests within thirty (30) days after receipt thereof provided CITY is satisfied that such expenses have been Incurred and documented within the scope and provisions of this Agreement and that SU13RECIPILINT is in compliance with the terms and conditions of this Agreement. Failure to provide any of the required doernncutation and reporting will cause CITY to withhold all or a portion of n request for reimbursement, or return the entire reimbursement package to SUBRECIPIENT, until such documentation and reporting has beau received and approved by CITY, Documentation may include, but is not limited to, live copies of invoice,,;, receipts, eauceled checks, bar* statcments, credit card: statements, procurement documentation for goods or services, tinreshects, payroll records, benefit statements, agreements, contracts or documentation pertaining to costs for subcontractors, and/or other documentation supporting and evidencing flow the CDB(3-CV FUNDS have been expended during the applicable term, 13' Audi of Account. CITY slain include an audit of the account maintained by SUBRECIPIENT in CITY's audit of all CDBG-CV FUNDS in accordance with Title 24 of the Code of Federal Regulations and other applicable federal laws and regulations. C. Cgmmon Rt110: Pursuant to 2 CFR 200.328(a), the CITY manages the day-to-day operations of each grant and subgrant supported activities. CITY staff has detailed knowledge of the grant program requirements and monitor's grant and subgrant supported activities to assure compliance with Federal requirements. Such monitoring covers each program, function and activity and purformarrce goals titre reviewed.periadically, D5 Bnvaromnontttl evi©w: In accordance with 24 CFR 58, the CITY is responsible for undertaking onvitorunental review and malutainurg envhvnmc:ntal review records for each applicable Project. B. 'error trtce Monitoring: CITY shall monitor the performance of SUBRECIPIENT against goals and performance standards required herein. The SUBRE.CIPIBNT shall he responsible to accomplish the levels of performative as set forth in Lrxhibft A, and report such measures to the CITY. If the SUBRECIPIBNT estimates such goals will not be met, the SUBUCIPIENT is to contact the CITY, at which time the CITY will deterrnine if any adjustments to the grant award is appropriate. Substandard performance as determined by the CITY will constitute noncompliance with this Agreement. Should the CITY determine that the SUBRECIPIEN`I` has not performed its obligations as stated in this contract in a satisfactory manner, or if the CITY determines that insufficient supporting information has boon submitted, the CrfY shall notify the SUBRRCi IMrr in writing of its determination speoirying in bill detail the objections that it has to the SUDRl1CIPIPN'l"s performance. If action to correct such substandard perfiorrnance is not taken by the SUBRUCIPIENT after being notified by the CITY, within a reasonable period of time as stipulated in the written notification, contract suspension or tennination procedures will be initiated. III. NiOND_ISC.P.ii I NATION A. SUDRT?C IENT agrees to comply with Executive Older 11246, whielr requires that during the performance of this Agreement, SUBRECIPMNT agrees not to discriminate against any employee or applicant for employment because of race, religion, sox, color or Ikrtional origin. Such, action shall Include, but not be limited to the following; cntploymenk upgrading, demotion, or transfer, rates of pay or other forms of compensation, and selection For !raining, nclud ng apprenticeship. SIUBREC1PMKI' agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the SUBRUCIPIENTsotting forth the provisions of this nondiscrimination clause. B. SUB"CIPI€ NT agrees to comply with Title V1 of the Civil 'Rights Act of 1964, which indicates that no person shall, oil the ground of race, color or national origin,be excluded from participation In, be denied the benefits of, or be subject to discrimination under any Prognun of aotivity receiving federal financial assistance. C. NO person shall, on the grounds of race, sex, caved, color, religion, marital status, national origin, age, sexual orientation, or physical or marital handicap be excludcd from participation In, be refused the benefits of, or otherwise be subject to discrimination in any activities, programs or employment supported by this Agreement, SUBRECIPIENT is prohibited from discrimination on the basis of age or with respect to all otherwise qualified handicapped person as Provided for under Section 109 of the Housing and Conununity Development Act of 1974, as amended. D. SUBRECIPIENT agrees to comply with the Age Discrimination Act of 1975, which requireg that during the performance of this Agreement, SIIBRBCIPIEW agrees not to discriminate against any employee or applicant for employment because of age. Such action shall include, but not be limited to the fotiowing: employment upgrading, demotion, or tratrafer, rates of pay or other forms of compensation, and selection for training, including apprcilceahip. SUBRECIVIENI" agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by die SUEI2EC1Pff3NT setting forth the provisions of this age cliscrionstion clause, R SUBRBCMNT agrees to comply with Section $04 of the Rehabilitation Act of 1973, which requires bit no otherwise qualified individual with a disability in the United States, shall, solely by reason of his or• her diaability, be oxcluded.-Dorn the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance or under any program or activity conducted by any exect€tive agency or by the united States Postal Service, IV. Ct}M+I IC I" UIr TN1IrIti t Pursuant to the coufliot of interest requircmenta set forth in 24 CFR 570.611 and 2 CFR 200,112, SUBIMC".IPIENT certifies that no member, officer, employee, agent or assignee: of C. Y having direct or indirect control of any CDBG moires granted to the ClW, iuchlsiver of the subj act CDBG-GV FUNDS, shall serve as an officer of SUB1WciPwl', Nrdier, any cou4ict or potential conflict of interest of any officer of SUBR13CI MNT sbatl be fizlly disclosed in writing prior to the execution of this Agreement and said writing shall be attached and deemed fully incorporated as a hart hereof, No6co shall be sent by SUBRF.CIPILN'1' to C117Y regarding any changes or modifications to its board of directors and list of officers. V. SIM—ECLAL CER'ti ICATION F4ilt I2> J ICxI 3U4 V I'iTI1r1 S I€ SUBREC'I WNT is a religious entity, SUBRLCiPIC.NT hereby agrees that lit connection with the Provision of the services SUBRECIPII?VY shall provide with CURD -CV Rinds, In accordance with 24 Cult 570,2(ka): A. SUBRECH TENT shall not discriminate against ally employee or applicant for employment on the basis of religion and shall not limit employment or give preference in entpioymont to persons an the basis Of religion. B� SUBRhClPWf shall .not discritttittatc against any person applying for the services SUBILRCLI'M1r agrees to provide under the terms of this Agreement on the basis of religion and shall not limit such services or give preference to applicants for such services or t the basis of religion. C", SUBRECIPI ifilT shall Naf provide religious instruction or counseling, conduct any religious worship or services, or engage in any religious proselytizing, or exert any religious iatiuence in tho provision of the servicos in said program. The pattios agree that this covenant Is Intended to and shall be construed for the Unfitted parpow of assuring complianoo with respect to the use of CITY litnds by SUBRECIPIENT with applicable constitutional linnitations respecting the establlahmont of religlon as set forth In the establislultent clause under the First Amendment of the United States Constitution and Article 1, Section 4 of the California Constitution, and is not in any nrasnncr intended to restrict other activities of SIBRECIPIENT. U. The portion of a facility used to provide public services assisted in whole or in part under this Agreement shall contain; no sectarian or religious symbols, E, Where the services to be provided under said program are rendered on property owned by the primarily religious entity SUARECIPMNT, CDBG-CV litnds may also be used for minor repairs to such 10 Property, winch are directly related to the cost of rendering the services under said program, where the cost constitutes in dollar terms only an htcidental portion of the 0DBO-C V erpendiin for render ng the services under Raid program, VI. PIYDUMB TION,OFNEPOTISM . SUBRBCIPWNI" agrees not to hire or permit the hiring of any person to fill a position funded through this Agreement if a member or that person's hurnediate family is employed in an administrative capacity by SUBRBCIPIENT. For the purposes of this section, the teen "immediate family" rretat5 spouse chip, mother, fitlrer,.brothor, sister, brother-in-law, sister-in-law, father-in-law, mother-in-law, son-in-law, daughter-in-law, arum, uncle, niece, nephew, stepparent and stepobild. The term "administrative capacity, moans having selection, hiring, supervisor or management responsibilities. VII, NOUQ_FT i Notices to the parties flitch, unless otherwise requested in writing, be sent by U.S, Mail, postage prepaid, and addressed as follows. TO CITY: City of Santa Ana Community Development Agency (M-25) 20 Civic Canter Plaza P.O. Box 1988 Santa Ana, California 92702-1988 TO SUBRECIPIEN'1%. Madelynn Idirnolso Families Forward 8 Thomas Irvine, California 9261 $ Vill. AAMT Ai37LITX None of the duties of, or work to be performed by, SUBRFCIPIEN f under this Agreement shall be subcontracted or assigned to any agency, consultant, or person without the prior written consent or CITY, S`UBRECIPIUNT must submit all ubcowracts and other agreements that relato to this Agreement to CITY. No subcontract or assignment shall tortninatc or alter the legal obligations of SUBIMCIPIBNT pursuant to this Agreement, IX. HOLD FIAIMLESS SUBRECiPICNT shall indemnify, defend and save hartrttoss Crry, its officers, employees, agents, representatives and volunteers from and against any and all damages to or for loss of use of property and for injuries to or death of any person or persons, including property and employees or agents of CITY, and shall defend, indomnify and save harmless MY, its otiGcers, employees, agents, representatives and volunteers from and against any and ail claims, demands, suits, actions or proceedings of any kind or mature, including, but not by way of Ihnitation, workers crnmlxansation claims and including attorney fees and reasonable exponses for litigation or settlement, resulting from or arising out of the negligent or wrongful acts, errors or omissions of SUBRE3CIPIPNT, its officers, directors, employees, agents, subcontractors and suppliers arlsirrg out of SURRECIPIENT's perfonnance of this Agreement, II X. RMLR_ANQz 1. C_ came cia is %TLJ,iabifit L S1JI IRCIPIENT agreesto obtain and keep in force during the tern, of this Agreement a policy of comprehensive commercial public liability insurance insuring the CITY, and SUi3RECiPIRNI' against any liability far accident, injury or death arising out of or In consequence of this Agreement. Such iusw-encc shall be in an amount not less than Gnu Million Dollars ($1,000,000.00) for any hijury to or death of any person or persons in any single accident or occurrence, Said policy of comprehensive liability insurance shall be endorsed to provide to CITY at least thirty (30) days written notice prior to cancellation; name Orly, its officers, agents, employees, and _ volunteers, -additional_ insured; and state that Stich coverage is primary to any other coverage or self- insurance and CITY, Governmental entities may provide proof of self-insurance. (a) Such insurance shall: (1) name the City of Santa Ana, its offimi,3, agents, representatives, employees and volunteers as additional insureds; (2) be primary with respect to insurance or self-insurance programs maintained by the CITY; (3) contain standard separation of insured's provisions; and (4) give to CITY prompt and timely notice of claim made or suit instituted arlaing out of SI BRECIPUNT's operations horcunder, (b) SUPRECIPIENT shall: (1) prior to exorcising tray right under this Agreement, furnish properly executed certificates of insurance and additional insured endorsement to the CrrY which shall clearly evidence all coverages required above; (2) provide that such insurance shall not be materially changed or terminated except on 30 days prior written notice to the CITY; (3) maintahx Stich, insurances for the period covered by this Agreement; and (4) replace such certificates for policies expiring prior to the expiration of this Agreement 2, Ailtetstobito I iribiltty Coverage SUBRI CTITINT shall also obtain and maintain, during the effective, period of this Agreement, broad form automobile liability covorago with a $1,000,000 limit unless reduced by CITY, which applies to both owned/leased and non -owned automobiles used by °SUBREC1PIENT employees or partielpents in performance of this Agreement, or, in the event that SUBRRCIPIENT will not utilize such owned/leesed automobiles but intends to require employees, participants or other agents to utilize their own automobilcs its the performance of this Agreement„ SC713Ttl3WIE NT shall secure and maintain on file front all such employees, participants, ar agents as setf-certification of automobile insurance coverage. Governmental entities may provide proof of self- insurance. 3. If SCJBRECWIENT is an "employee,, 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., SIJBRRCIPIENT shall obtain and keep in force during tine tern, of this Agreement lull Workers' Compensation insurance coverage for inJuries, suffered by participants, said insuranee policy shall guarantec CITY at least thirty (30) days written notice of cancellation or modification. 4. Fquipment Coveraee. SUBRRCIPIRNT shall purchase a policy or policies of insurance covering; loss or damage to any and all Equipment provided to or purchased by SUBIWCIIrIEN9, in accordance with this Agreement, Said insurance shalt be in the amount of the full replacement value thereof, providing protection against the classification of fire, extended coverage, vandalism, malicious mischief, theft, and special extende€! perils. Governmental cnthics may substitute a certificate of self- insurance, im 5. 1tQq of Insurance, Certificates and endorsements must be submitted and approved by CITY prior to any work under this Agreement, S1J CIpIBN"f understands that CITY will make no payments under this Agreement until the required certificates and endorsements have been approved by CITY. XI. ICIt VU—§10N OF ASSETS A, upon the expiration of this Agreement, SUBRECIPIENT shall transfer to CITY any CDBCI-CV funds on hand at the time of the expiration of this Agreement as well as any accounts receivable attributable; to the use of CDBG-CV firtrds, [24 CFR 570.503(b)(7)] R. Any teal property under SUBUC IPil3NT% control that was acquired or unproved in whole or in part with CDBG-CV funds in excess of $25,000.00 must either be; 1. Used, where' CITY has given written approval, to meet one of the national objcotives stated in 24 CFR 570,208 until five (5) years after expiration of this Agreement, or for such longer period of time as determined to be appropdato by CITY, or 2. If not: used in accordance with subparagraph I above, SUi3RECIPIEW shall pay to CITY an amount equal to the current fair market value of the property Tess arty portion of Ilse value attributable to the expenditure of non-C'.DBG funds for acquisition of, or huprovement to, the property. Such payment is program hrcomo to CITY. C. Subject to the obligations set forth pre€eiu, titles to equipment acquired under the terms of this Agreement will vest capon acquisition in SUBRECIPIENT. When said equipment which has been acquired in accordance with this Agreement and all applicable regulations is no longer needed for said program, disposition of said equipment will be made as folloivs: 1. Items of equipment with a current per urii fair market value of less than $5,000,W may be retained, sold or otherwise disposed of with ao further obligation to C:i Y, 2. Items of equipment with a current fair market per emit value of $5,000,00 or more may be retained. or sold and CITY shall have the right to an amount calculated by multiplying the current market value or proceeds from the sale by CITY's share of federal funds used to acquire the equipment, in accordance with 2 CFR 200.313(e)(2). D. SUBItECIPiENT heresy agrees, upon the demand of CITY, to execute, acknowledge and deliver, or cause any person or entity who may have any claim to rights hereunder or under any document, iinstrrnnent or agreement executed in furtherance of the services and activities to be performed hereunder, to executo, acknowkdp and deliver, to CITY assignment(s), quit claim dccd(s) or such other and further instruments, documents and agreements as may be necessary, in the sole and absolute discretion of CITY, to vest in CITY all of SUBRECIPMNT's right, title and interest (if any it may have) in and to CITY, CDBG. CV or other federal, state and/or local accounts or program funds or allocation of 11mds to which CITY is or may be entitled, either for its own account or as fiduciary or trustee for others, which were obtained for the purpose of the performance of this Agreement or say previous agreements relating to the same subject matter or activities as this Agreement, together with any instruments, loans; grants or advances by SUBRBCiPIRhT on behalf of CITY, in furtherance of the activities hereunder or thereof, SUBRBCIPTBNT's obligations and responsibilities set forth In ails paragraph "x . REyBRSION 6F ASSETS," and in paragraph "XII, TMjAfiNATXM and other requirements pertaining to program income shall not be affected by the termination of this Agreement and shall survive the date of termination of this 13 Agreement for such period of time as CITY and/or lIUD deems neccasary far the responsibilities, duties and obligatlona to be performed and completed to the satisfaction of CITY and JnjD, XTf. TE NIINATICIN A. 'This Agreement may be terminated on thirty (30) days' written notice by either party. In the event of such termination, SUMMCIPIENT shall only be emitted to reirubursetnent for approved expenses Incurred to the effective date of termination, B, This Agreement may be suspended or terminated by CITY upon five (5) days' written notice for violation by SUIIRECWWNT of Federal Laws governing the use ofCDBG-CV Funds, In the event of such arspettsion or termination, SUBRECIPIENT shall only be entitled to reimbursoment for approved expenses incurred up to the effective date of suspension or termination, C, Pursuant to 2 CM 200,340, in the event SUBMCIP1I3NT defaults by Failing to fidfill aft or any of obligations hereunder, CTFY may declare a default and termination of this Agreement by written notice to SUBRECIPWr, 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 oured before, tho effective date of termination stated in such notice, If terminated for cause, CIT111 shall he relieved of furdier liability or responsibility under this Agreement, or as a result of the termination thereof, including the payment cif money, except for payment for approved expenses incurred for services satisfaetorify and timely pertornred prior to the mailing or service of the notice of termination, and except for rehnbursemerit of (1) any payments made for sarviocs net subsequently performed to a timely and satisfactory manner; and, (2) costs incurred by CITY in obtaining substitute performance. D. The grant of funds under this Agrecivaut may be terminated for convenience by chber the crl Y or SUBRECIPIENT, In whole or in part, by setting forth the reasons for such termination, the effective date, and, In the case of portion termination, their portion to be terminated, However, if in the case of a partial termination, the CITY detornu`nes that the tvinaming portion of the award will mot accomplish the purpose for which the award was made, the CITY way terminate the award In its entirety, E. The grant of funds under this Agreement may be terminated due to the non-performance of SUBRECIPIENT and/or failure of SUBRMIFENT to perform the work described in Exhibits A and B or failure to meet the performance standards and program goals set forth therein, F. Tho grant of Rinds tinder this Agremient may be terminated due to the failure of the crrY to reeeive sufficient or anticipated funding from IIUD for the CDBG-CV program for any term subject to this Agreement, R In the event this Agreement is termnated as set forth in subparagraphs XII.A. through XII.F ,, Inclusive, SUBRECIPIENT agrees to immediately return to CITY upon CTTY's demand acid prior to any adjudication of SUBRECIT'IEWl's rights, any and all Rands not used, and to comply with paragraph 11X1. 118VERSTON OP ASSI?TS,, of this Agreement. XCth LLMITATIQN OF FUNDS The United States of America, through HUD, may in the Mute place programmatic or fiscal limitationa on the use of CI BO-CV funds, which limitations are not presently anticipated, Accordingly, CITY reserves the right to rovlso this Agreement in order to take account of actions aff`ceting FIUI? program fanding, In the event of fundhig redaction, CITY inay, in its vale and absoli to discretion, reduee the budget of this Agreement as a whole or as to Masts category, may limit the ran; of SUBRECIPIENT's authority to 14 commit and spend fiends, or may restrict SUIIRECTI' ENT" s use of both its uncommitted and its unspent funds. 'Where T-MD has directed or requested CITY to lrnplemeat a reduction in 1Gnding, to whole or as to a cast category, wilb respect to lording for this Agreement, CITY's City Manager or delegate is authorized to act for CITY In implementing and effecting such a reduction and in revising, modliying, or amending the Agreement for such purposes. If such a reduction in flmding ocec^ SUIIRECIPIE?NT shall be permitted to de -scope accordingly, Whore CITY has reasonable grounds to question. S-UBRECIPWNT's fiscal accountability, financial soundness, or compliance with tills Agreement, CITY may suspend the operation of this Agreement for up to sixty (60) days upon five (6) days written notice to SUITRIit IPWNT of its intention to so act, pending an audit or other resolution of such questions. In no event, however, shall any revisions made by CITY affeot .expenditures and legally binding commitments made by SUBRECIIPIENT before it received notice of such revision, provided that such amounts have been eommitted in good faith and are otherwise allowable and that such commitments are consistent will'I-IUD cash withdrawal guidelines. XIV. EXCLUSIVITY AND AtFILND1417"NT OF n-CI FNlENT This Agreement supersedes any and all other agreements, either oral or in writing, between the parties hereto with respect to the use of CITY's CDBG-CV funds by STJBRECiPIP:NT and contains all the covenants and agreements between the parties with respect to such employment In any manner whatsoever. Each party to this Agreement acknowledges that na representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting our behalf of any party, whiell 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 SUBRLCIPIENT. XV. LAWS GOVEIE Lr~i(, TJIIS ACRI1 ,NFNT This Agreement shall be governed by and construed In accordance with the laws of the State of California, and all applicable federal laws and regulations. XV`L CLOSE-0 I° The SUBRECIPIEN`h' agrees to comply with the elosLout procedures detailed in 2 CPR §200,343, including the following I. SUBRECiPIEN1' must submit, no tutor than ninety (90) calendar days.after the end data, of the period of performance, all financial, performance, and other reports as required by the terrors and conditions of the Federal award; 2. Unless the CITY authorizes all extension, SUBRECIPIENT must liquidate till 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 tine Federal award; 3. SUBRECIPIENT must promptly refund any balances of unobhigated cash that the CITY paid in advance or paid and that is not authorized to be retained by gUBRBCIPIT3 r for use in other projects (See OMB Circular A-129 and 2 Clot §200,345); 4. SUBREC:IPIENT must account for any real and personal property acquired with Federal funds or received fitiotn the Federal govermuctit in accordance with 2 CFR §§200.310- 200.31 G and 200.329; and, 15 b, Alt Extrihits and Attachments refereliacd herein am attached hereto shaft be incorporated as if MY set forth in the body of this Agreement. (Upatures on jotfvwFngpage) 17 A-2020-251-05 IN WITNESS WHFRMF, the parties hereto have executed this Agreement as of the last date and year written below, DAISYGONfEZ Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney /a/jw- By: R N HODGE Assistan City Attorney FOR APPROVAL: STEVEN MENDOZA Executive Director Community Development Agency 18 CITY OF SANTA ANA KRISTINE RIDGE City Manager SUBRMPIL+'NT: rnet , Families Forward Tax 0 DDUNSS #: l t xt i�7J&nl LYrt,�i 61G10093825 382 U� ,Cerz, LXMBIT A SCOPE OF NVORK 19 City of Santa Ana CDBG-CV Scope of Work Program Year June 1, 2021 - May 31, 2022 Name ofNanixalfon Families Forward Name of Funded Program Santa Ana Motel Voucher Prot7ram fCase Management) Annual Accomplishment Goal Schedule of Performance (estimated) Quarter 1: JUL 1 . SEP 30 Quarter 2: OCT 1 - DEC 31 Quarter 3: JAN 1 - MAR 31 Quarter4: APR 1- JUN 30 Undupiloated Q Program and Funding Description contract period.. 17 Low Incono Participan� I 100�/.j Eattmated tnvolci 12 RAN000 � 5 25 Ot}D,04 Overview• For Purpose of this contract, families Served will be only those directly referred by the City of Santa Ana, Vde are currer estimating it to be 4-5 families however this number can increase crdecrease, Families Forward will provide Motel Vol 4-5 homeless families -approximately 17 Individuals- with ESG-CV funds during the time between the closure of the Lt Shelter and the opening of the new Carnegie Shelter. C[)SG•CVtunrJs will be used to provide those farniileswith light-t Case Management Services since they will not have access to these types of services due to the closure of the shelter.' include, but not be limited to, weekly case management meetings, housing navigation support, connection to commur resources, VI -SPRAT needs assessment, access to the Coordinated Entry System, and access to the OC Famlly Shelter 0 Reservation System. Supportive serviceslike case managementwill be offered as tong as families are staying at the me Keeping in mind the current funding amount, we anticipate each family will be able to stay In a motel up to Z months Outcomes: Four to five homeless families, approximately 17Individuals -will receive case management services and motel vouch• the opening of the Carnegie Shelter or until grant funds are exhausted. iiudnet: $25,000 Case Management Services EXHiBiT A EXHMIT B BUD GrE71 20 2021.2022 PROGRAM BUDGET Organization Name Familles Forward Program Name Santa Ana Motel Voucher Program {Case Management} EXPENDITURES Enter budget categories and Prolected exnendltures for the r,rnnn£Pri nrnvrnmr Expenditures Funded By Expenditures Total Santa Ana Funded By Program organization Category CDBG _ Other Sources Budget Budget Administrative Staff Salaries $ $0 Program Staff Salaries 22,727 $22,727 0 $0 $0 0 $0 $ OTAL Direct Costs $22,727 $0 $22,727 $0 indtrectCosts 10% $2,273 $2,273 TOTAL, iUDGET $25,000 $0 $250000 $0 " indirect cost rate: 1.0% Nan -Federal entity without federaly recognized negotiated Indirect cast rate, will charge a de minimis rate of 10% of modelled total direct costs. PROGRAM RESOURCES LIST ALL OTHER PROGRAM RESOURCES FOR 2020-2021 Funding Source Total must equal Program Budget Total listed above, FUNDING SOURCE AMOUNT Santa Ana COBG-CV $ 25,000 AS TOTAL $ M I 2D2t,-2022 CDBG-CV BUDGET LINE ITEMS ADMINISTRATIVE STAFF Position Title Annual Salary & Benefits CDBGFunds Requested Description PROGRAM STAFF Position Title Annual5aiary & Benefits COBG Funds Requested Description Case Mans er 1 $ 25,000 EXHIBIT nA EXHIBIT C DEBARMENT 21 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions This certification is required by the regulations implementing Executive Order 12549, Dobannent and Suspension, 29 CFR Part 98, Section 98.510, Participants' responsibilities. The regulations wore published as Part V11 of the May 26,1988 Federal Rea£stee` (pages 1916€}-19211). (BEFORE COMPLETING CERTIFICATION, READ INST12LiC'T'1ONS FOR CE1t'1'IFICA'1'lON = Attached) {1) no prosspective recipient of federal assistance funds cartifies, by submission of this proposal, that neither it nor its principals are presently debarred, suspended, proposed for debannent, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. (2) Where the prospective recipient of federal assistance funds is unablo to certify to any of the stateanents in this certification, such prospective participant shall attach an explanation to dais proposal. Signature f V EXHIBIT C Page t of 2 INSTRUCTIONS FOR CERTIFICATION By signing and submitting this proposal, the prospective recipient or federal assistance funds is providing the certification as set out below. 21 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 ati 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. The prospective recipient of federal assistanco fiords shall provide humediate written notice to the person to which this proposal is submitted if at any time the prospective recipient of federal assistance funds learns thatits certification was erroneous when submitted or has become erroneous by reason of changed circumstances. • The farms "coveredtransaoton,„ debarred,„" suspended,"„meligiblc,," lower tier covered transaction," "participant," "pe1-8011," "primary covered transaction," "principal," "proposal,,' and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules Implementing .Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective recipient of federal assistance funds agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction„ unless authorized by the DOL. 6. The prospective reolpient of federal assistance funds further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and voluntary exclusion - Lower Tier Covered Transactions;" without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, Of voluntarily excluded from the covered transaction, unless it knows that the certification is cnxxneous. A participant may decide the method and frequency by which it dctermfnes the eligibility of its principals. Each participant may, but is not required to check She List of Parties Excluded finm Procurement or NM f roouremont Programs. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of recants in order to render in good filth the certification required by this claum The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course ofbusiness dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered in,nsaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the DOL may pursue available remedies, including suspension and/or debarment. EXHIBIT C Page 2 of 2 M II 22 Certification Regarding Lobbying Certification for Contracts Crrants. Loans, and Coaperatfvo ecettts The undersigned certifies, to the hest of his or her knowledge and belief, that; (1) No Federal appropriated fturds 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, n Member of Congress, an officer or employee of Congroas, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the raking of any cooperative agreement, and the extension, contnuation, renewal, amendment, or modifration of any Federal contact, 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 Forth to Report Lobbying,` in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included In the award docinnents for all subawards at all tiers (including subcontract, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subtecipients shall certify and disclose accordingly. This certification is a material. representation of fact upon which reliance eras placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction unposed by Section 1352, Title 31, U. S. Code. Any person who fails to file the required certifioation shall be subject to a civil penalty of not loss than $10,000 and not more than $100,000 for each such failure. .%t�l�1�t�•�!/rQ�'t'. Grantee/Contactor Organization _ (,, Wm Title 'fit met rn". A Nanto of Certifying 6fficer Signature Date EXHIBIT f] Page 1 of SUi3RRCIPIENT warrants the following: 1, SUI3RRCiPI$NT will comply Willi Public taw 88-352, Title VI of the Civil Rights Act of 1464 (42 U, S. C, section 2000 et seq.) and implementing regulation in 24 CPR Part 1. 2. No person in the United States shall on the ground of race, color, religion, national origin, or sex, be excluded from participation in, or be denied the benefits otj ar be subjected to discrimination under any program or activity Raided in whole or in part with community development funds made available pursuant to the ACT. 3, All laborers and mechanics, employed by Contractors or subcontractors in the performance of construction work financed in whole or in part with community development funds shall be paid wages at rates not less than those prevailing on similar construction in the locality as dotarminal in accordance with the Davis -Bacon Act, as amended, 40 U. S. C. Sections 276 a 1-5, except for individuals who perform services for which they volunteered; do not reccive compensation for such services; or are paid expenses, reasonable benefits, or a nominal fee for such services; and are not otherwise employed at any time In oonstruetion work. 4, SUBRLCIPIRNT will comply with all Federal statutes applicable to projects ftuided with cominututy development fluids, except that (a) SUBRRCIPIENT does not assume CITY`S environmental responsibilities described at 24 CM 570,604, and (b) SUBRECIPIENT does not assume CITY'S responsibility for initiating the review process under Executive Order 12372, Page 2 of 2 DRUG -FREE WORTCPLAGE 23 Certification Regarding Drug -Free Worklace Re ulrements The certification set out below is a material representation upon which reliance is placed by the U.S. Department of Mousing 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 terns 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 Page 1 of 2 (f) Taking one of the following actions, within SO 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). S. 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 forthe 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 "Mace of Performance" form. The Contractor shall Insert in the space provided below the slta(s) expected to be used for the performance of vrork under the contract covered by the certification; Place of Performance (include street address, ofty, county, state, zip code for each sita); ram; ek- a/v\,,A.) ` 44) 1 cJ ` Ah-) 6rganization Authorized Signature Date Le 24i� EXHIBIT E Rage 2 of 2 F:JAl.l.(BIT I{ F EDERAL CONTRACT PROVISIONS During the performance of this contract, SIJ13RtECJPI IT (or "Vendor") shall comply with all applicable federal laws and regulations, including but not limited to, tite federal contract provisions In this Exhibit, in this Exhibit, the term "Agency" shall mean the CITY as the local agency entering into this contract with the Vendor, 1. CONTRACTING WITH SMALL AND MINORITY BIRiMIS, WOMM? S J)usI 88 ENTERPRISE AND LABOR SURPLUS AREA FRtMS (2 C.Ir.R. § 20(),3zi) (A) Vendor shall be subf oct to 2 CXA. § 200.321 and wilt take affirmative steps to assure that minority firms, women's business enterprises, and labor surplus area firths are used when possible aunt will not be discriminated against on the grounds of race, color, religious creed, sex, or national origin in consideration for an award, (B) Affrmadve steps shall include; 0) Placing qualified small and minority businesses and women'$ business enterprises on solicitation lists; (11) Assuring that small and minority businesses, and wornetAL business enterprises are solicited whenever they are potential sources; (111) Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by stnall and minority business, and womeds business enterprises; (lv) Establishing delivery schedules, where tho rMuiremcsrt permits, which encourage participation by small and minority business, and warnen's business enterprises; and (V) Using the services/assistance of the Small Business Adnunistration (SBA), and the Minority Business Development Agency (Mh3DA) of the Department of Commerce, Vendor shall submit evidence of compliance with the foregoing affirmative steps when requested by the Agency, Notwithstanding the foregoing, the affirmative steps requirements detailed above do not apply in the case of a noncompetitive procurement made under the emergency exeepticn/exigency exception to competitive prooutetnents, 2. COST PRINCIPLES (2 C.F.R. PART 200, SUBPART E) (A) If any indirect costs will be charged to the Agency under this contract, atalr costs must conform to the cost principles set forth under the Uniform Rules at 2 C.F.R, Part 200, subpart E ("Cast Principles"), Irt general, costs must (i) be necessary and reasonable; (it) MI allocable to the grant. swami; (ill) conforms to any limitations or exclusions set forth in the Coat Principles, (iv) be adequately documented; and (v) be determined in acocrdanoe with generally accepted accounting principles (" GAAP"), except, for state and local governments and Indian tribes only; as otherwise provided for in 2 C.F.R. Part 200, subpart B, '2 C.F.R. § 200,403, Costs that are determined unallowable pursuant to a federal audit are subject to repayment by Vendor, 31 ACG7;88 TO RE,CORDS & RECORD IM, TI NTION (2 C,F.R. 200.336) (A) Vendor shall ecniply with 2 C.F.R, § 200.336 and provide the l'ederal Agency, Inspectors General, the Comptroller General of the United States, Agency, and tine State of California or any. of their authorized representatives access, during normal business hours, .to documents, papers, books and records which are directly pertinent to this contract for the purposes of making and responding to audits, examinations, excerpts, and transcriptions, The right also includes timely and reasonable access to the Vendor's persomnol for the purpose ofintcrview and discussion related to the books and records. (B) The Vendor agrees to permit ally of the foregoing parties to reproduce by any means whatsoever or to copy excerpts and transcriptions as reasonably needed. (G) The Vendor agrees to provide the Federal Agenoy or its authorized representatives access to construction or other work sites pertaining to the work being completed under the Contract. d. REQUMED CONTRACT PROVISIONS IN ACCORDANCE V4'L H Al'MDIX 11 TO PART 200 T CONTRACT Pl OMIONS FOR NON-FI DF AI, EN'ITTY C0N`rRAC"I"S UNDER FEDERAL AWARDS (2 C.F.R.. § 200,326) (A) Tczuinatlorr f'ap Au4er otavenienoe. If the contract ,s in excess of $10,000 and the contract doca not inoludo provisions for both termination for cause and termination for convenience by the Agency, including the mannor by which it will be offected and the basis for settlement, then the following termination clauses shall apply. IP the contract is for more than the simplified acquisition threshold (sae 2 CYX § MOM) at the time the contract is executed and does not provide for administrative, contractual, or legal remedies in instances where. Contractor violates or breaches the terms of the contract, then the following termination clauses shall apply and have preccdonco over the contract. Otherwise, the following tcrrnination clauses shall not be applicable to the contract, (i) 'Dainnntion for Conveni�nco. The Agency pray, 6y written notice to Vendor, tenninato this contract for convenience, in whole or in part, at any time by giving written notice to Vendor of such termination, and specifying the effective date thereof (Notice of Termination for Convenience,), If the termination is' for tine convenience of the Agency, the Agency shall compensate Vendor for work or materials holly and adequately provided through the effective date of termination, No amount shall be paid for unperformed work or materials not provided, inoluding anticipated profit. Vendor shall provide documentation deemed adequate by the Agency to show the work actually completed or materials provided by Vendor prior to the effective date of termination. This contract shall terminate on the effective date of the Notice of Termination, 25 (11) Teta ination for Cause If Vendor falls to perform pursuant to the terms of this contract, the Agency shall provide written notice to Vendor specifying the default ("Notice of Default" . If Vendor does not cure such default within ten (10) calendar days of receipt of Notice of Default, the Agency may terminate this contract .for cause. If Vendor fails to cure a default as set forth above, the Agency may, by written notice to Vendor, terminate this contract for cause, in whole or in part, and specifying the effective date thereof ("Notice of Termination for Cause"), If the termination is for cause, Vendor shall be compensated for that pardon of the work or, materials provided which has been hilly and adequately completed and acoepted. by the Agency as of the date the Agency provides the Notice of Termination. In such case, the Agency shall have the right to take whatever steps it deems necessary to complete the project and correct Vendor's deficiencies and charge the cost thereof to Vendor, who shall be liable for the full cost of the Agency's corrective action, including reasonable overhead, profit and attorneys' fees, (ill) Fir lbursernent Darna rge The Agency shall be entitled to reimbursement for any compensation paid in excess of work rendered or materials provided and shall bo entitled to withhold compensation for defective work or other damages caused by Vendor's performance of the work. (Iv) Addhtional Termination Provhsin , Upon receipt of a Notice of Termination, either for cause or for convenience, Vendor shall promptly discontinue the work unless the Notice directs to the contrary. Vendor shall deliver to the Agency and transfer title (If necessary) to all provided materials and completed work, and work In progress including drafts, docmnents, plans, forms, maps, products, graphics, computer programs and reports, The rights and remedies of tho parties provided in this Section are in addition to any other rights and remedies provided by law or under this contract. Vendor acknowledges the Agency's right to terminate this contract with or without cause as provided in this Section, and hereby waives any and all chjl ns for damages that might arise from the Agency's termination of this contract:., The Agency shall not he liable for any costs other than the charges or portions thereof which are specified herein. Vendor shall not be entitled to payment for unperformed work or materials not provided, and shall not be enkitlaxt to damsgos or compensation for termination of work or supply of materials. If Agency terminates this contract for caaso, and it is later determined that the termination for cause was wrongful, the ternrinatlon shall automatically be converted to and treated as a termination for wevenionra. In such event, Vendor shall be entitled to receive only the amounts payable under this Section, and Vendor specifically waives any claim for any other amounts or damages, including, but not limited to, any claim for cotnaccluential damages or lost profits. The rights and remedies of the Agency provided in this Section shall not be exclusive and are in addition to any other rights and remedies provided by law, equity or under this o elmot including, but not limited Co, the right to specifle performance, (B) Appetldix 11 to Part 200 CQ-=- gnryl_llmlrltryment Octrortsr niiy; I3xcept as otherwise provided under 41 CY.lt, Fret 60, Vendor shall comply with the following equal opportunity clause, in accordance with Executive Order 11246 of September 24, 1965 entitled "Equal Employment Opportunity," as amended by Executive Order 11375 of October 13, 1 M and implementation regulations at 41 C.F.R. Chapter 60: 26 (1) Vendor will not diawiminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. Vendor will tape affirmative action to Insuro that applicants are employed and that employees are treated equally during employment, without regard to race, color, religion, sex, or national origin, Such action shall inolude, but not he limited to, the following: employment upgrading, demotion, transfer, reerultinent,. or rcorultnicnt advertiaing; layoff or termination; rates of pay or other forma of compensation, and selection for training including apprenticeship. Vendor agrees to post In conspicuous places, available to employees and applicants for employment, notices to be provided by the Agency setting forth the provisions of this nondiscrimination clause, (li) Vendor will, In all solicitations or advertisements for employees placed by or on behalf of Vendor, state that all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, or national origin. (Eli} Vendor will net discharge or in any other manner discriminate against any employee or applicant for employment beestwo such employee or applicant has inquired about, discussed, or disclosed the compensation of the employee or applicant or another employee or applicant. '1'hls provision shall not apply to instances in which an employee who has access to the compensation inforin ation of other employees or applicants as a part of such employee's essential Job functions disoloscs the compensation of such other employees or applicants to individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge, in furtherance of on iuveatlgation, proceeding, hearing, or action, including an investigation conducted by the employer, or is consistent with Vondoes legal duty to furnish information. (IV) Vendor will send to each labor union or representative of workers with which be has a collective bargaining agreement or other contract or understanding, a notice, to be, provided by the agency contracting officer, advising the labor union or workers' representative of the contractor's commitments under Section 202 of Fxecutive Order No. 11246 of September 24, 1965, and shall post copies of the notice In conspicuous places available to employees and applicants for cmploymomt, (V) - Vendor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Lnbor, (vi) Vendor will furnish all information and reports required by Executive Order No, 11246 of September 24, 1965, and by the rules, regulations, and orders of the Secretary of ,Gabor, or pursuant thereto, and will permit access to his books, records, and accounts by the contracting agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. (vii) In the event of Vendors noncompliance with the nondiscrimination clauses of this contmet or with any of such rules, regulations, or orders, this contract may be cancelled, tenninated or suspended In whole or in part and the contractor may be 27 declared ineligible, for further Government contracts to accordance with procedures authorized in Executive Order No,11246 of Sept. 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Exeoutivo Order No.11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law.. (vill) Vendor will include the provisions of paragraphs (i) through (vili) in every subcontract or purchase order unless exempted by roles, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order No, 11246 of September 24,1965, so that suoh_provisions will be binding upon each subcontractor or vendor. Vendor will take such action with respect to any subcontract or purchase order as may be directed by the Secretary of Labor as a means of enforoing such provisions including sanctions for noncompliance: Provided, however, that in the event Vender becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction, Vendor may request the United States to enter into such litigation to protect the Inteaests of the United States. (C) Aft y2emnclix IIto Pars 200 (Ill — Llgyjs Eaoon Act' Co tchmd Ate; Not applicable to this contract*. (C) pttendix LI to Part 200 Ch) -• Contract Work IlourS and Safety Standards Act' (1) If this contract is in excess of $100,000 and involves the employment of mechardes or laborers, Vendor shall comply with 40 U.S.C. 3702 and 3704, as supplemented by Depart€nent of Labor regulations (29 C.F.R. Part 5). Under 40 U.S,C 3702, each contractor must be required to compute the wages of every mcohanle and laborer nn the basis of a standard work week of 40 hours. Work In excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in excess of 40 hours In tho work week. The requirements of 40 U,S,C. 3704 are applicable to construction work and provide that no laborer or mechanic rant be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available ore the open market, or contracts for transportation or trans€uission of intelligence, (11) No contractor or subcontractor contracting for any part of the contract work which may require or involve, the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic recolves oornpensation at a rate not less than one and one- half times the basic rate, of pay for all hours worked in excess of forty hours in such workweek, (lit) In the, event of any violation of the clause set forth in paragraph (it) of this section the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages. In addition, such contractor and subcontractor shall be liable to tile, United Staten (in the case of work done under contract for tite District of .Columbia or a territory, to such District or to such territory), for liquidated (Inmates. Such liquidated damages shall be computed with respect to each individual laborer or mecbanic, 28 (E) (F) including watchmen and guards, employed ha violation of the clause set forth In Paragraph (ii) of this section, in the sum of $10 for each calendar day an which such individual was required or permitted to work in access of the standard workweek of forty hours without payment of the overtime wages requtred by the clause set forth in paragraph (li) of this section. (IV) The Agency shall upon its own action or upon written request of an authorized representative of the Deiaartment.of Labor withhold or cause to be withheld, from any m noys payable on account of work perfortned by the Vendor or subcontractor under any.suoh contract or any other Federal contract with the samo prime contractor, or any other federally -assisted contract subject to the Contract Wot1r Hours and Safety Standards Act, which is held by the same prime contractor, such sarzts as may be detcrutiued to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause sett forth in paragraph (iii) of this section, (v) The Vendor or subcontractor shall insert in any subcontracts the clauses set £tuba in Paragraph (ii) through (v) of this Section and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts, The Contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs (11) through (v) of this Section. Aonendix 11 to g2pt) tF?—.1cltts to lentfoade iJndor a Contract ar A reemmentl (I) 1f the Federal award meets the definition of "funding agreement" under 37 CZR, § 401.2(a) and the non -Federal entity wishes to enter We a contract with a small business firm or nonprofit organization regarding the substitution of parties, assigttmcnt or performance of experimental, developmental, or research work under that "funding agreentenE,„. the non -Federal entity must comply with the requirements of 37 CYK Part 401 (Rights to inventions Made by Nonprofit Organizations and Small Business Finns Under Government Grants, Contracts and Cooperative Agreements), and any haaplomenting regulations issued by the Agency. (ii) 'rho regulation at 37 C.F.1t. § 401,2(a) currently defines "funding agreement" as any contract, grant, or cooperative agreement entered Into between any Federal agency, other than the Tonnossee Valley Authority, and any contractor for the performance of oxpotimental, developmental, or research work 6inded in whole or in part by the Pedornl government This tern also includes any assignment, substitution of parties, or subcontract of any type entered into for the performance of .experimental, developmental, ar research work under it funding agrectnent as dofined in the first sentence of this paragraph, (ill) This requirement does not apply to the Public Assistance, Hazard Mitigation Grant Program, rive Management Assistance Grant Program, Crisis Counseling Assistance and Training Grant Program, Disaster Case Mar agement Grant Program, and Federal Assistance to Individuals and Households — Other Needs Assistance Grant Program, as FPMA awards under these programs do not moot the definition of "funding agreement," c,tuia nnu l+ener Voter 1'ollu;f{un Contmij If contract is in excess of $150,000, Vendor shall comply with all applicable standards, 29 orders, or requirements issued pursuant to the Glean Air Act (42 U.S.C, 7401-7671q) and the Federal WatcrPoliution Control Act as amended (33 U.S.G. 1251-1387). (t) Pursuant to the Clean Air Act, (1) Vendor agrees to comply with all applicable, standards, orders or regulations issued pursuant to the Clean Air Act, as amended, 42 U.S.G. § 7401 et seq., (2) Vendor agrees to report each violation to the Agency and understands and agrees that the Agency will, in turn, report each violation as required to aasuro notification to the Federal awarding agency and the appropriate Environmental Frotection Agency Regional Ofgee, and (3) Vendor agrees to include these requirements in each subcontract exceeding $150,000. (11) Pursuant to the Federal Water Pollution Control Act, (1) Vendor agrees to comply with all applicable standards, orders or regulations issued pursuant to the Federal Water Pollution Control Act, as amended, 33 U.S,C, 1251 et seq,, (2) Vendor agrees to report each violation to the Agency and understands and agrees that the Agency. wilt, in tnm, report each violation as required to assum notification to the Federal awarding agency and the appropriate linvironnnentai Protection Agency Regional Office, and (3) Vendor agrees to include these requirements In each subcontract exceeding $150,000. (G) Appendix 11 to Part MUM) — Deb 7ltent and Suspension; A eontract award (see 2 C F.R. § 180.220) must not be made to parties listed on the government wide exclusions in the System for Award Management (SAM), in accordance with the OMB guidelines at 2 CPR 180 that impleinent Executive Orders 12549 (3 C.F.R. part 1986 Camp,, p. 189) and 12689 (3 C.F.R. part 1989 Comp,, p. 235), "Debarment and Suspension." SAM Exclusions contains the names of patties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549, (1) This contract is a covered transaction for purposes of 2 C.F.R, pt. 180 and 2 C.F,R. pt, 3000. As such Vendor Is required to verify that none of the Vendor, its principals (defined at 2 C.F.R. § 180.995), or its aftlliates (defined at 2 C.F.R. § 180.905) are excluded (defined at 2 C.F.R. § 180.940) or disqualified (defined at 2 C,F.R.§ 180.935). (il) Vendor must comply with 2 C.F.R, pt. 180, subpart C and 2 C.P.R. pt. 3000, subpart C and must include a raquirement to comply with these regulations iu any lower tier covered transaction it onters Into. (ill) This certification is a material mprosentation of fact relied upon by Agency. If it is hater determined that Vendor did not comply with 2 C.F.R, pt. 180, subpart C and 2 C,F.R: pt. 3000, subpart C, in addition to remedies available to the Agency, the Federal Government may pursue available remedies, Including but not limited to suspension and/or debarment. (Iv) Vendor warrants that it is not debarred, anspended, or otherwise excluded front or ineligible for participation in any federal programs. Vendor also agrees to verify that all subcontractors performing work under this contract are not debruTed, disqualified, or otherwise prohibited from participation !it accordance with the requirements above, Vendor further agrees to notify the Agency in writing 30 immediately if Vendor or its subcontractors are not in compliance during the term of this contract. . (H) Appendix 11 to Part 2QQ (D,—,5yrd Antidahbyipg Act: If this contract is in excess of $100,000, Vendor shall have submitted and Filed die required oortilloation pursuant to the Byrd Anti -Lobbying Amendment (31 U.S,C. § 1353), if at any time during the contract term funding exceeds $100,000.00, Vendor shall file with the Agency the Federal Standard Form LLL titled "ilisolosure Form to Report Lobbying." " Venders that apply or bid for an award exceeding. $100,000 must file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress s in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier must also disclose any lobbying with- non-Vederal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded flan tier to tier up to the recipient, Q) �� I)51o,�trrt,t 00 tl ;;,Procurement oCRecavere Mxtarials (1) Vender shall comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (BPA) at 40 C.F.R. part 242 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where the purchase price of the item exceeds $10,000 or the value of the quantity acquired during the preceding fiscal year exceeded $10,000, procuring solid vraste mana,;ement services in a manner that maximize» energy and reaoruao recovery; and estaolislung an affirmative proeur•emcnt, (11) in the performance of this contract, the Vendor shall make maximum useor products containing recovered materials that are EPA -designated items unless the product cannot be acquired; Competitively within a timeframe providing for compliance with the contract performance schedule; Meeting contract performance requirements; or At a reasonable price, (ill) lttforrnation about this requirement„ along with the list of EPA-desiguate items, is available at .F.,PA's Ccmprohensive procurement Guidelines web site, https;/Iwww,epa.gov/smtuleatnprehansiveproaurement-guideline-epg-program. 5. NCts(2TyLLANEOUS PROV)[SIONS (A) The Vendor shall not use the DHS seal(a), logos, orests, or reproductions of flags or likenesses of DIIS agency officials without specific FFd41A preapproval. (13) This is an acknowledgement that FEMA fnrancnd assistance will be used to fund the, contract only, The Vendor will comply with all applicable• federal law, regulations, executive orders, PPMI A policies, procedures, and dire Uves. (C) Vender acknowledges that 31 U.S.C, Chapter 38 (Administrative Remedies for False Claims and Statements) applies to the Vendor's actions pertaining to this contract, 31 (t7) The Federal Clovertnnent is not a party to this contract and is not subject to any. obligations or liabilities to the Agency, Vendor, any subcontractors or tiny other party portaiming to any matter resulting from the contract. (E) Cienar nyi , ddIAlg t[ve E enses d l}ro it For Tim --And Maul C t• (i) Ocacral and administrative expenses shall be negotiated and mist conform to the Cost Principles, (Ii) profit shall be negotiated as a separate element of the cost. To establish a fair and reasonable profit, consideration must be given to the complexity of the work to be performed, the risk borne by the Vendor, the Vendor's investment, the amount of subcontracting, the quality of its record of past performance, and induatry profit rates In the surrounding geographical area for similar work. (ill) Any agreernent, amendtuent or cbange order for work performed on a time and materials basis shall include a ceiling price that Vendor exceeds at its own risk, 32 Memorandum of Understanding (MOU) between Families :forward and The City o, f Santa Ana KOIR11C Center 1. PARTILS., The parties to this Memorandum of Understanding (MOU) are Families Forward and the City of Santa Ana W/O/RIK Center ("Work Center"), 2. PURPOSE; The Work Center, in conjunction with Families Forward, endeavors to establish a cooperative working relationship between the parties In order to provide program beneficiaries with information about Work Center opportunities to find better jobs and careers. The MOU serves to establish the framework for providing services to employees, job seokers and others needing workforce services. The goal is to vnsuro that all program beneficiaries have been provided an opportunity to connect with the Work Center and be assisted with the tools and knowledge necessary to enter the workforce or obtain a lilgher- paaying job. 3. 11ESPONSIBILITIES: A) The Work Center shut] perform the following: 1) Accept referrals to the Work Center. B) Families Forward shall perform the following: 1) Provide Work Center information to participants and their famities; and, 2) Refer participants in need of employment, training, or career counseling to the Work Center utilizing the referral form attached hereto as Attachment 1 and incorporated herein by reference. A. DURATION- This MOU shall commence oil June 1, 2021, and shall remain in effect through May 31, 2022. 5. AMENDMENTS: Either party may propose amendments to this MOU at any time by providing written notice to the other party. Amendments to this MOU shall require the approval of the City Manager, or her/his designee ("City Manager"), on behalf of the Work Center, 6. CONCIDEN`I`IALITY: If Families Forward receives information, which due to the nature of such information is reasonably understood to be confidential and/or proprietary, such information shall not be used or disclosed except in the performance of this MOU, and Families Forward agrees to exercise tho same degree of care it uses to protect its own Information of like importance, but in no event less than reasonable care. "Confidential Information" shalt include all non-public information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other nteam, Con£rdentinl information disclosed to either party by any subsidiary and/or agent of the other party is covered by this MOU. The foregoing obligations of non.use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of Families Forward disclosed in a publicly available source; (c) is in rightful possession of Families Forward without an obligation of confidentiality, (d) is required to be disolosed by operation of law, or (a) is independently, developed by Families Forward without reference to infonmation disclosed by the City of Santa Ana. 7. ACCESSABILITY:17"Res Forward will assure that its services and premises are accessible to persons with disabilities pursuant to the requirements of the Americans with Disabilities Act 8. HOLD HARMLESS CLAUSE: Each party to this MOU agrees to indemnify and hold harnnless the other parties, their officers, agents, employees, and volunteers from and against any and all loss or darnago, and from any and all suits, actions and claims filed or brought by any person or persons arising out of acts or omissions of the party or its ofiicors, agents, employees or volunteers In the performance of this MOU. % DISPUTES: Tito parties shall first attempt to resolve all disputes informally. Any party may call a meeting of all parties to discuss and resolve disputes, Should informal resolution efforts fail, the dispute shall be referred to the City Manager to act as mediator, to attempt to resolve the dispnto by holding € n informal hearing with presentations by both parties, if the City Manager's resolution efforts fail, any party may file a grievance with the City Manager for review and hearing. The parties agree to be bound by the final determination resulting from that procedure. Bach party to bear its own costs associated with any grievance procedures. IQ, DISCRIMINATION: Families forward shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the rocruitment, selection, training, utilization, promotion, termination or other employment related activities, Families Forward -affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 11. SLrVERADILITY: If any part of this MOU is found to be null and void, or is otherwise stricken, the test of this MOU shall remain in force. 12, JURISDICTION: Jurisdiction over any disputes arising under this MOU shall reside in Orange County, California. 13. AUTI-IORVI Y.AND SIGNATURES: The individuals signing this MOLD or its attachments have the authority to coramit the party they represent to the terms of this MOIJ, and do so commit by signing. IN WITNESS WHEREOF, the parties hereto have executed this Memorandum of Understanding the date and year first above written. FNN I Daisy Gomez Clerk of the Council APPROVED AS TO FORM: Sonia R. Carvalho City Attorney Q V�� By: Ryadge Assistant ity Attorney RECOMMENDED FOR APPROVAL: Steven Mendoza Community Development Executive Director CITY OF SANTA ANA a municipal corporation of the State of California Kristine Ridge City Manager Families Forward -4A irneise ei?o YYtlth,ei� S,��L� DI9%'y signed by Francine p, Francine R. Villareal vuNrzal oaleR02107.1210:43:55 W'N' '? rHNnruR-u1 A� CERTIFICATE OF LIABILITY INSURANCE STONG DAT3012021 6/3019DIYYYV) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Llcerl UM10410 NO CT Armstrong/RobitaillelRlegle Business and Insurance Solutions 830 Roosevelt, Suite 200 Irvine, CA 92620 PHONE FAX Alc, No, EM): (949) 381-7700 A/C, No :(949) 487-6151 XriuAlL . arrinfo@aleragroup.com INSURERS AFFORDING COVERAGE NAIC a INSURER A: Philadelphia indemnity Ins Co 18058 INSURED INSURER 5, ComigWest Insurance Company 12177 INSURER C: Families Forward 8 Thomas Irvine, CA 92618 INSURER D INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER, REVISION NU M BER. 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. ILTRNSR TYPE OF INSURANCE ADDL SUB. POLICYNUMBER POLICY EFF MMIUDIYYYYI POLICY E%P (Mill LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DREMI9ETO RENcImo,u 100,000 CLAIMS -MADE �X OCCUR X PHPK2293752 7/112021 711/2022 VIED EXP (Anyone person $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY of � GENERAL AGGREGATE $ 3,000,000 GEN'L PRODUCTS-COMP/OPAGG $ 31000,000 Lee SEXUAL ABUSE 1,000,000 OTHER: A AUTOMOBILE LIABILITY CEOMaBINED SINGLE LIMIT $ 1,000,000 X ANYAUTO PHPK2293752 711/2021 7/112022 BODILY INJURY Per person $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Peraccident $ X AiIT OS ONLY X AUTOS ONLY Rp P. accIdent AMACE $ A UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 4,000,000 X AGGREGATE 4,000,000 EXCESSLIAB CLAIMS -MADE PHUB774554 71112021 71112022 DED I X I RETENTION$ 10,000 B ANDEPLVRSELBIMOEIALIITY X PER YIN ANVCERIMEETOR/PARTNDED? CUTIVE ❑ WCV550516100 71112021 71112022 STATUTE EORN E.L. EACH ACCIDENT 1,000,000 qMandaRry InN REXCLUOEDY Mandatory In NH) `f NIA E.L. DISEASE - EA EMPLOYE 1,000,Og0 If Yes, describe under E.L. DISEASE -POLICY LIMIT 1 1,000,000 Kes DESCRIPTION OF OPERATIONS below A Professional (E&O) PHPK2293752 7111202, 711/2/122 Occurrence 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (AC ORD 101, Additional Remarks Schedule, may be attached if more space Is required) The City of Santa Ana, Its officers, employees, agents, and representatives are named as Additional Insured on Primary and Nan-Contribory basis with respect to General Liability coverage per attached forms as required In a written contract, agreement, or memorandum of understanding. 30 Days Cancellation Notice unless 10 Days for Non-Paymant. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE =tiy RlskMarrege11entDlyislon ��GMn ILP .__yam `XRIVVIEWED&APrRcrvm Br. ACORD 25 (2016/03) ©7988-2015 ACORD C I rnaus.a The ACORD name and logo are registered marks of ACORD auk Management analyst Policy Number: PHPK2293752 PI-GLD-HS (10/11) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY GENERAL LIABILITY DELUXE ENDORSEMENT: HUMAN SERVICES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE It is understood and agreed that the following extensions only apply in the event that no other specific coverage for the indicated loss exposure is provided under this policy. If such specific coverage applies, the terms, conditions and limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this endorsement. For complete details on specific coverages, consult the policy contract wording. Coverage Applicable Limit of Insurance Page # Extended Property Damage Included 2 Limited Rental Lease Agreement Contractual Liability $50,000 limit 2 Non -Owned Watercraft Less than 58 feet 2 Damage to Property You Own, Rent, or Occupy $30,000 limit 2 Damage to Premises Rented to You $1,000,000 3 HIPAA Clarification 4 Medical Payments $20,000 5 Medical Payments — Extended Reporting Period 3 years 5 Athletic Activities Amended 5 Supplementary Payments — Bail Bonds $5,000 5 Supplementary Payment — Loss of Earnings $1,000 per day 5 Employee Indemnification Defense Coverage $25,000 5 Key and Lock Replacement — Janitorial Services Client Coverage $10,000 limit - 6 Additional Insured — Newly Acquired Time Period Amended 6 Additional Insured — Medical Directors and Administrators Included 7 Additional Insured — Managers and Supervisors (with Fellow Employee Coverage) Included 7 Additional Insured — Broadened Named Insured Included 7 Additional Insured — FundingSource Included 7 Additional Insured — Home Care Providers Included 7 Additional Insured — Managers, Landlords, or Lessors of Premises Included 7 Additional Insured — Lessor of Leased Equipment Included 7 Additional Insured — Grantor of Permits Included 8 Additional Insured — Vendor Included 8 Additional Insured —Franchisor Included g Additional Insured — When Required by Contract Included g Additional Insured — Owners, Lessees, or Contractors - Included g Additional Insured —State or Political Subdivisions Included 10 Page 1 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pe �„, t�knla Dvlalon © 2011 Philadelphia Indemnity Insurance Company REVIEWED &&APPROVED Syr aNeaaP,v Risk Management Analyst PI-GLD-HS (10/11) Duties in the Event of Occurrence, Claim or Suit Included 10 Unintentional Failure to Disclose Hazards Included 10 Transfer of Rights of Recovery Against Others To Us Clarification 10 Liberalization Included 11 Bodily Injury— includes Mental Anguish Included 11 Personal and Advertising Injury — includes Abuse of Process, Discrimination Included 11 A. Extended Property Damage SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted in its entirety and replaced by the following: a. Expected or Intended Injury "Bodily injury" or property damage' expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage' resulting from the use of reasonable force to protect persons or property. B. Limited Rental Lease Agreement Contractual Liability SECTION I — COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph b. Contractual Liability is amended to include the following: (3) Based on the named insured's request at the time of claim, we agree to indemnify the named insured for their liability assumed in a contract or agreement regarding the rental or lease of a premises on behalf of their client, up to $50,000. This coverage extension only applies to rental lease agreements. This coverage is excess over any renter's liability insurance of the client. C. Non -Owned Watercraft SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is deleted in its entirety and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 58 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person, who with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess or contingent. D. Damage to Property You Own, Rent or Occupy SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE Page 2 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pei © 2011 Philadelphia Indemnity Insurance Company xlekMwugmwaDMslon 8� REVIEWED&APPRovm By: Ruk Management Mallpt PI-GLD-HS (10/11) LIABILITY, Subsection 2. Exclusions, Paragraph j. Damage to Property, Item (1) is deleted in its entirety and replaced with the following: (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property, unless the damage to property is caused by your client, up to a $30,000 limit. A client is defined as a person under your direct care and supervision. E. Damage to Premises Rented to You 1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the word "fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire protective systems" where it appears in: a. The last paragraph of SECTION I —COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Subsection 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, or leakage from automatic fire protective systems 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. b. SECTION III — LIMITS OF INSURANCE, Paragraph 6. is deleted in its entirety and replaced by the following: Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is 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 by fire, lightning, explosion, smoke, or leakage from automatic fire protective systems while rented to you or temporarily occupied by you with permission of the owner. c. SECTION V — DEFINITIONS, Paragraph 9.a., is deleted in its entirety and replaced by the following: 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, or leakage from automatic fire protective systems to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; 2. SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other Insurance, Paragraph b. Excess Insurance, (1) (a) (I) is deleted in its entirety and replaced by the following: That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire protective systems for premises rented to you or temporarily occupied by you with permission of the owner; 3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the greater of: Page 3 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pe „ wekM.nage nenenlWs on © 2011 Philadelphia Indemnity Insurance Company s Reny&APPROVED BY. -'---^'' RUR M,anagementAnalyrt PI-GLD-HS (10/11) a. $1,000,000; or b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit. This is the most we will pay for all damage proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective systems or any combination thereof. =:II J_Ya1 SECTION I — COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, is amended as follows: 1. Paragraph 1. Insuring Agreement is amended to include the following: We will pay those sums that the insured becomes legally obligated to pay as damages because of a "violation(s)" of the Health Insurance Portability and Accountability Act (HIPAA), We have the right and the duty to defend the insured against any "suit," "investigation," or "civil proceeding' seeking these damages. However, we will have no duty to defend the insured against any "suit' seeking damages, "investigation," or "civil proceeding' to which this insurance does not apply. 2. Paragraph 2. Exclusions is amended to include the following additional exclusions: This insurance does not apply to: a. Intentional, Willful, or Deliberate Violations Any willful, intentional, or deliberate "violation(s)" by any insured. b. Criminal Acts Any "violation" which results in any criminal penalties under the HIPAA. c. Other Remedies Any remedy other than monetary damages for penalties assessed. d. Compliance Reviews or Audits Any compliance reviews by the Department of Health and Human Services. 3. SECTION V — DEFINITIONS is amended to include the following additional definitions: a. "Civil proceeding" means an action by the Department of Health and Human Services (HHS) arising out of "violations." b. `Investigation" means an examination of an actual or alleged "violation(s)" by HHS. However, "investigation" does not include a Compliance Review. c. "Violation" means the actual or alleged failure to comply with the regulations included in the HIPAA. Page 4 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pel PJAMarugewmAD all ©2011 Philadelphia Indemnity Insurance Company ,�"� REaenD&APPROVD)6Y. all v 49----1-4 MSXManagementAnalyst PI-GLD-HS (10/11) G. Medical Payments — Limit Increased to $20,000, Extended Reporting Period If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit is changed subject to all of the terms of SECTION III - LIMITS OF INSURANCE to the greater of: a. $20,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. 2. SECTION I —COVERAGE, COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, a. (3) (b) is deleted in its entirety and replaced by the following: (b) The expenses are incurred and reported to us within three years of the date of the accident. H. Athletic Activities SECTION I — COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 2. Exclusions, Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following: e. Athletic Activities To a person injured while taking part in athletics. I. Supplementary Payments SECTION I — COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGE A AND B are amended as follows: 1. b. is deleted in its entirety and replaced by the following: 1. b. Up to $5000 for 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. 1.d. is deleted in its entirety and replaced by the following: 1. 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 from work. J. Employee Indemnification Defense Coverage SECTION I — COVERAGES, SUPPLEMENTARY PAYMENTS — COVERAGES A AND B the following is added: We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding occurring in the course of employment. The most we will pay for any "employee" who is alleged to be directly involved in a criminal proceeding is $25,000 regardless of the numbers of "employees," claims or "suits" brought or persons or organizations making claims or bringing "suits. Page 5 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pe © 2011 Philadelphia Indemnity Insurance Company tRAMvwgpmaAD1viaion REmEWFD& APPROVMBY,* o Y Rak Mimgeme,nt Analyst PI-GLD-HS (10/11) K. Key and Lock Replacement —Janitorial Services Client Coverage SECTION I — COVERAGES, SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is amended to include the following: We will pay for the cost to replace keys and locks at the "clients" premises due to theft or other loss to keys entrusted to you by your "client," up to a $10,000 limit per occurrence and $10,000 policy aggregate. We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that you or any of your partners, members, officers, "employees "managers", directors, trustees, authorized representatives or any one to whom you entrust the keys of a "client' for any purpose commit, whether acting alone or in collusion with other persons. The following, when used on this coverage, are defined as follows: a. "Client' means an individual, company or organization with whom you have a written contract or work order for your services for a described premises and have billed for your services. b. "Employee" means (1) Any natural person: (a) While in your service or for 30 days after termination of service; (b) Who you compensate directly by salary, wages or commissions; and (c) Who you have the right to direct and control while performing services for you; or (2) Any natural person who is furnished temporarily to you: (a) To substitute for a permanent "employee" as defined in Paragraph (1) above, who is on leave; or (b) To meet seasonal or short-term workload conditions; while that person is subject to your direction and control and performing services for you. (3) "Employee" does not mean: (a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission merchant, consignee, independent contractor or representative of the same general character; or (b) Any "manager," director or trustee except while performing acts coming within the scope of the usual duties of an "employee." c. "Manager" means a person serving in a directorial capacity for a limited liability company. L. Additional Insureds SECTION II —WHO IS AN INSURED is amended as follows: 1. If coverage for newly acquired or formed organizations is not otherwise excluded from this Page 6 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pe s. ; WekMannp,�rotentDivision © 2011 Philadelphia Indemnity Insurance Company a;� RWMED&APPROVED BY. tll�+�.' RN Management Analyst PI-GLD-HS (10/11) Coverage Part, Paragraph 3.a. is deleted in its entirely and replaced by the following: a. Coverage under this provision is afforded until the end of the policy period. 2. Each of the following is also an insured: a. Medical Directors and Administrators —Your medical directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient. b. Managers and Supervisors — Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your "employees" are also insureds for "bodily injury" to a co - "employee" while in the course of his or her employment by you or performing duties related to the conduct of your business. This provision does not change Item 2.a.(1)(a) as it applies to managers of a limited liability company. c. Broadened Named Insured — Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. d. Funding Source — Any person or organization with respect to their liability arising out of: (1) Their financial control of you; or (2) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Home Care Providers — At the first Named Insured's option, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled. f. Managers, Landlords, or Lessors of Premises — Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization. g. Lessor of Leased Equipment —Automatic Status When Required in Lease Agreement With You — Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or Page 7 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pei © 2011 Philadelphia Indemnity Insurance Company �y`�v RiekManagcmunt Divielon REVIEWER&IWPROVaMBY: Risk Management Analyst PI-GLD-HS (10/11) organization is an insured only with respect to liability for "bodily injury," "property damage" or 'personal and advertising injury' caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any"occurrence" which takes place after the equipment lease expires. h. Grantors of Permits — Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision: (1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. I. Vendors — Only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: (1) The insurance afforded the vendor does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (a) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; Page 8 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pe wekMrocgmnio tdion ©2011 Philadelphia Indemnity Insurance Company REAEwEo 6 APPRovm BY. Risk Management Analyst PI-GLD-HS (10/11) (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Sub -paragraphs (d) or (f); or (ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing. j. Franchisor — Any person or organization with respect to their liability as the grantor of a franchise to you. k. As Required by Contract — Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for "bodily injury," "property damage" or "personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations I. Owners, Lessees or Contractors — Any person or organization, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured when required by a contract. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: (a) 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 by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (b) 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 a part of the same project. Page 9 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pei © 2011 Philadelphia Indemnity Insurance Company RiekMansgmwtDhAs1m �j REVIEWED&APPROVED Br a ll11"V f ftk Management Analyst PI-GLD-HS (10/11) m. State or Political Subdivisions — Any state or political subdivision as required, subject to the following provisions: (1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract. (2) This insurance does not apply to: (a) 'Bodily injury," "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or (b) 'Bodily injury' or "property damage" included within the "products -completed operations hazard." M. Duties in the Event of Occurrence, Claim or Suit SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows: a. is amended to include: This condition applies only when the "occurrence" or offense is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. b. is amended to include: This condition will not be considered breached unless the breach occurs after such claim or "suit' is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. N. Unintentional Failure To Disclose Hazards SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 6. Representations is amended to include the following: It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure, O. Transfer of Rights of Recovery Against Others To Us SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of Page 10 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pei © 2011 Philadelphia Indemnity Insurance Company �r-9"+a Wait mmo`xmte ",M.* REVIEWED 6 APPROVED Br. J. �' ftuk Management AnaltAt PI-GLD-HS (10/11) Recovery Against Others To Us is deleted in its entirety and replaced by the following: If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. Therefore, the insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. P. Liberalization SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following: If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. Q. BodilyInjury— MentalAnguish SECTION V — DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following: "Bodily injury" means: a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time. R. Personal and Advertising Injury —Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of "personal and advertising injury" is amended as follows: 1. SECTION V — DEFINITIONS, Paragraph 14.b. is deleted in its entirety and replaced by the following: b. Malicious prosecution or abuse of process; 2. SECTION V— DEFINITIONS, Paragraph 14. is amended by adding the following: Discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (1) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insured; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; Page 11 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pe av ]UskManagtmo Mvtsimt © 2011 Philadelphia Indemnity Insurance Company REvleMXo&APPRavm BY: I�i. Risk Manag meat Analyst PI-GLD-HS (10/11) c. Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or d. Insurance for such discrimination is prohibited by or held in violation of law, public policy, legislation, court decision or administrative ruling. The above does not apply to fines or penalties imposed because of discrimination. Page 12 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its pe © 2011 Philadelphia Indemnity Insurance Company unno, RtekMx»�eenmtDiviston � @REVIEWED & ArveovM BY.. Pock Management Analyst Policy Number: PHPK2293752 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory 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. CG 20 01 0413 © Insurance Services Office, Inc., 2012 Risk ManaganentDmalm `` REVIEWED&APPROVED BY.' �"------� Ruk ManagewntAmlyst WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 03 13 C (Ed. 7-09) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this, endorsement shall be $ 500 Schedule Any person or organization that you perform work for that is liable for an injury, covered by this policy, that prior to the injury has written contract requiring a waiver of our right to recover from them. Person or Organization Job Description This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy,) Endorsement Effective 07/01/2021 Polley No.WCV 5505162 Endorsement No. 000 Insured FAMILIES FORWARD, INC. Insurance Company COMPWEST INSURANCE COMPANY Countersigned by WC990313C (Ed. 7-09) s �v ��°. ltluk iMnnaganenEDlvleloa REVIEWEDS�APPROVED BY: I�i Ruk ManagementAnrlysk Policy Number: PHPK2293752 PI-CA-004 10/14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY CLAUSE ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The following is added to SECTION IV -BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Otherinsurance: The insurance provided by this policy for any additional insured endorsement attached to this policy is primary when primary coverage is required in a written contract. In addition, we will not seek contribution from any insurer when insurance on a non-contributing basis is required in a written contract for any additional insured endorsement attached to this policy. For coverage to apply, the written contract must have been executed prior to the occurrence of "loss." This endorsement supersedes anything to the contrary. Page 1 of 1 9)2014 Philadelphia Consolidated Holding Corp. e x,. Ri®kMwvgem dDivlsim L REMEWED&APPRovED13r.. 1 , �---J ft"isk ManageWnt Analyst