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HomeMy WebLinkAboutCHARITABLE VENTURES OF ORANGE COUNTY, INC. (2)INSURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES CLERK OF COUNCIL DATE: A-2021-209 AGREEMENT TO PROVIDE BICYCLE AND �'•. �w (} C pUbtV1 � A5 CA Z),Y DESTRIAN SAFETY OUTREACH SERVICES THIS AGREEMENT is made and entered into this 19th day of October, 2021, by and between Charitable Ventures of Orange County, hic., as fiscal sponsor for Santa Ana Active Streets ("Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws ofthe State of California ("City"). C= a RECITALS N A. The Santa Ana Public Works Agency has been awarded a $100,000 grant from the State of California Office of Traffic Safety (OTS) for a program to address bicycle and pedestrian safety through a series of bicycle safety education workshops and events. The goal of the program is to reduce the number of persons killed or injured in collisions involving bicycles. B. The City desires to retain a consultant to provide such a program. C. Consultant represents that it is able and willing to provide such services to the City. D. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonablybe expected from aprofessional consulting firm inthefield. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall provide bicycle and pedestrian safety education services that are described in Exhibit A to this Agreement and incorporated by reference as though fully set forth herein. Consultant may provide such services through the community - based coalition known as "Santa Ana Active Streets" (SAAS). 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit B. The total sum to be expended under this Agreement shall not exceed $100,000. b. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. Page 1 of 13 3. TERM The term of this Agreement shall commence on the date stated above and continue through October 31, 2022, unless earlier terminated as set forth in Section 14, below. 4. INDEPENDENT CONTRACTOR Consultant shall during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the manner in which Consultant performs the services required by this Agreement. However, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's Social Security taxes, unemployment insurance, and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. OWNERSHIP OF REPORTS AND DOCUMENTS Upon completion of all work under this Agreement, ownership and title to all reports, documents, tracings, plans, specifications, estimates and maps prepared or obtained under the terms of this Agreement shall be delivered to, and become the property of City. Basic survey notes and sketches, charts, computations, and other data prepared or obtained pursuant to this Agreement shall be made available upon request of the City without restriction or limitation on their use. Consultant shall furnish the City all necessary copies of data needed to complete the review and approval process. 6. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. 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 the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. Page 2 of 13 WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies. S. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination ofthis Agreement. 9. NON-DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information, or military and veteran status, age, national origin, ancestry, or disability, as defined and prohibited by applicable law or in connection with any activities under this Agreement. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 10. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interest and shall not have interests, direct or indirect, which would conflict in any manner with performance of services. 11. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: 1) Commercial General Liability f"CGL" Insurance- Insurance Services Officer Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury, personal and advertising injury with limits no less than $1,000,000 per occurrence. If a general aggregate limit applies, either general aggregate limit shall apply separately to this project/location (ISO CG 25 03 or 25 04) or the general aggregate limit shall be twice the required occurrence limit. Page 3 of 13 2) Automobile Liability Insurance- Insurance Services Office Form Number CA 0001 covering, Code 1 (any auto), or if Consultant has no owned autos, Code 8 (hired) and 9 (non -owned), with limits no less than $1,000,000 per accident for bodily injury and property damage. 3) Sexual Abuse or Molestation (SAM) Liability: If the CGL policy referenced above is not endorsed to include affirmative coverage for sexual abuse or molestation, Contractor shall obtain and maintain a policy covering Sexual Abuse and Molestationwith a limit no less than $1,000,000 per occurrence or claim. 4) Workers' Compensation Insurance- as required by the State of California, with statutory limits and employer's liability insurance with limits of no less than $1,000,000 per accident for bodily injury and disease. 5) Professional Liability Insurance (Errors and Omissions)- Consultant will maintain professional liability insurance appropriate to their profession with limits no less than $2,000,000 per occurrence or claim and $2,000,000 aggregate. A. If the Consultant maintains broader coverage and/or higher limits than the minimums shown above, the City requires and shall be entitled to the broader coverage and/or the higher limits maintained by Consultant. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage, shall be available to the City. B. The insurance policies required by this Agreement are to contain, or be endorsed to contain, the following provisions: 1) Additional Insured Status- the City, its officers, officials, employees and volunteers shall be covered as additional insureds on the CGL policy with respect to liability arising out of the work or operations performed by or on behalf of Consultant including materials, parts or equipment furnished in connection with such work or operations. General liability coverage can be provided in the form of an endorsement to the Consultant's insurance (at least as broad as ISO Form CG 20 10 11 85 or both CG 20 10, CG 20 26, CG 20 33, or CG 20 38 and CG 20 37 forms if later revisions used.) 2) Primary Coverage- for an claims related to this Agreement, the Consultant's insurance coverage shall be primary insurance and primary coverage at least as broad as ISO CG 20 0104 13 with respect to the City, its officers, officials, employees and volunteers. Any insurance or self-insurance maintained by the City, its officers, officials, employees or volunteers shall be excess of the Consultant's insurance and shall not contribute to it. 3) Notice of Cancellation- Each insurance policy required above shall state that coverage shall not be cancelled except with notice to the City. 4) Waiver of Subrogation- Consultant hereby grants to City a waiver of any right to subrogation, which any insurer of said Consultant may acquire against the City by virtue of the payment of any loss under such insurance. Consultant agrees to obtain any endorsement that may be necessary to affect this waiver Page 4 of 13 of subrogation but this provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer. 5) Self -Insured Retentions- Self -insured retentions must be declared and approved by the City. The City may require the Consultant to purchase coverage with a lower retention or provide proof of ability to pay losses and related investigations, claims administration and defense expenses within the retention. The policy language shall provide or be endorsed to provide, that the self -insured retention may be satisfied by either the names inured or the City. 6) Acceptability of Insurers- Insurance is to be placed with insurers authorized to conduct business in the State of California with a current A.M. Best's rating of no less than A:VII, unless otherwise acceptable to the City. 7) Claims Made Policies- If any of the required policies provide coverage on a claims -made basis: i. The Retroactive Date must be shown and must be before the date of the agreement of the beginning of the agreement work; ii. Insurance must be maintained and evidence of insurance provided for at least five (5) years after completion of work under this agreement; iii. If coverage is canceled or non -renewed, and not replaced with another claims -made policy form with a Retroactive Date prior to the agreement effective date, the Consultant must purchase "extended reporting" coverage for a minimum of five (5) years after completion of agreement work. 8) Verification of Coverage- Consultant shall furnish to City with original certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effective coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to Entity before work begins. However, failure to obtain the required documents prior to work beginning shall not waive the Consultant's obligation to provide them. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. 9) Subcontractors- Consultant shall require and verify that all subcontractors maintain insurance meeting all of the requirements stated herein. Contractor shall ensure that City is an additional insured on insurance required from subcontractors. 10) Special Risks or Circumstances- City reserves the right to modify these requirements, including limits, based upon the nature of the risk, prior experience, insurer, coverage or other special circumstances. Page 5 of 13 12 INDEMNIFICATION Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the operations of the Consultant or its Consultants, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Consultant's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant. 13. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Copies to: Public Works Agency -Executive Director City Hall -Ross Annex -4th Floor 20 Civic Center Plaza (M-21) Santa Ana, California 92702 Consultant: Charitable Ventures of Orange County 1505 E. 17th Street, Suite 101 Santa Ana, CA 92705 Page 6 of 13 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 14. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, th e Executive Director may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 15. COMPLIANCE WITH APPLICABLE LAWS AND REGULATIONS a. Consultant shall perform all requirements under this Agreement in strict observance and in compliance with all applicable environmental, traffic, safety and any other laws, regulations, ordinances, codes and any other legislative or statutory requirements. b. Consultant warrants that the performance of services under this Agreement shall be compliant with the current requirements of the Highway Safety Grant Management Manual and as it maybe amended orupdated throughout the term of this Agreement. C. During the performance of this contract/funding agreement, the Consultant agrees and will ask any subcontracts to agree in writing that- (1) To comply with all Federal nondiscrimination laws and regulations, as may be amended from time to time; (2) Not to participate directly or indirectly in the discrimination prohibited by any Federal non-discrimination law or regulation, as set forth in appendix B of 49 CFR part 21 and herein; (3) To permit access to its books, records, accounts other sources of Page 7 of 13 information, and its facilities as required by the State highway safety office, US DOT or NHTSA; (4) That in the event Consultant fails to comply with any nondiscrimination provisions in this contract/funding agreement, the State highway safety agency will have the right to impose such contract/agreement sanctions as it or NHTSA determine are appropriate, including but not limited to withholding payments to the Consultant under the contract/agreement until the Consultant complies; and/or canceling, terminating or suspending a contract or funding agreement, in whole or in part. d. Consultant certifies that it shall comply with the following regulations, as required by the State of California Office of Traffic Safety: e. Audit Records - With respect to all matters covered by this agreement all records shall be made available for audit and inspection by the City, the grant agency and/or their duly authorized representatives for a period of four (4) years from the termination of this Agreement. For a period of three years after final delivery hereunder or until all claims related to this Agreement are finally settled, whichever is later, Consultant shall preserve and maintain all documents, papers and records relevant to the services provided in accordance with this Agreement, including the Attachments hereto. For the same time period, Consultant shall make said documents, papers and records available to City and the agency from which City received grant funds or their duly authorized representative(s), for examination, copying, or mechanical reproduction on or off the premises of Consultant, upon request during usual working hours. f. Certification Regarding Federal Lobbvine- (1) Consultant certifies that no federal appropriated funds will be paid, by or on behalf of Consultant to any person for influencing or attempting to influence an officer or employee of any agency, Member of Congress, an officer of employee of Congress or any employee of a Member of Congress, in connection with the awarding of any Federal contract, the making on any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of a federal contract, grant, loan or cooperative agreement; (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influences an officer or employee of any agency, 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 Consultant shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions; Page 8 of 13 (3) Consultant shall requires that the language of this certification be included in the award documents of all sub -awards at all tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly; and (4) This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to civil penalty of not less than $10,000 and not more than $100,000 for each such failure. g. Restriction on State Lobbyine- None of the funds under this Agreement will be used for any activity specifically designated to urge or influence a State or local legislator to favor or oppose the adoption of any specific legislative proposal pending before any State or local legislative body. Such activities include both direct and indirect (e.g. grassroots) lobbying activities, with one exception. This does not preclude a State official whose salary is supported with NHTSA funds from engaging in direct communications with State or local legislative officials in accordance with custom State practice, even if such communications urge legislative officials to favor or oppose the adoption of a specific pending legislative proposal. h. Consultant shall provide to City all records and information requested by City for inclusion in quarterly reports and such other reports or records as City may be required to provide to the agency from which City received grant funds or other persons or agencies. i. Section 504 of the Rehabilitation Act of 1973 - All recipients of federal funds must comply with Section 504 of the Rehabilitation Act of 1973 (The Act). Therefore, the federal funds recipient pursuant to the requirements of The Act hereby gives assurance that no otherwise qualified handicapped person shall, solely by reason of handicap be excluded from the participation in, be denied the benefits of or be subject to discrimination, including discrimination in employment, in any program or activity that receives or benefits from federal financial assistance. The Consultant agrees it will ensure that requirements of The Act shall be included in the agreements with and be binding on all of its contractors, subcontractors, assignees or successors. j. Americans with Disabilities Act of 1990 - (ADA) Consultant must comply with all requirements of the Americans with Disabilities Act of 1990 (ADA), as applicable. k. Political Activity - None of the funds, materials, property, or services provided directly or indirectly under this Agreement shall be used for any partisan political activity, or to further the election or defeat of any candidate Page 9 of 13 for public office, or otherwise in violation of the provisions of the "Hatch Act". 1. Civil Rights Compliance and Notification of Findings - Consultant, and all its contractors (or sub -recipients) will comply with the nondiscrimination requirements of the Omnibus Crime Control and Safe Streets Act of 1968, as amended, 42 USC 3789 (d), or Victims of Crime Act (as appropriate); Title VI of the Civil Rights Act of 1964, as amended; Section 504 of the Rehabilitation Act of 1964, as amended; Subtitle A, Title II of the Americans with Disabilities Act (ADA) (1990); Title IX of the Education Amendments of 1972; the Age Discrimination Act of 1975; Department of Justice Non - Discrimination Regulations, 28 CPR Part 42, Subparts C, D, E, and G; and Department of Justice regulations on disability discrimination, 28 CPR Part 35 and 39. In the event a Federal or State court, Federal or State administrative agency, or the Consultant makes a finding of discrimination after a due process hearing on the grounds of race, color, religion, national origin, sex, or disability against a recipient of funds, the Consultant will forward a copy of the findings to the City which will, in turn, submit the findings to the Office of Civil Rights, Office of Justice Programs, U.S. Department of Justice. in. Consultant, and all its contractors (or sub -recipients) will comply with all requirements of the Executive Order 11246 of September 24, 1965, entitled "Equal Employment Opportunity," as amended by Executive Order 11375 of October 13, 1967, and as supplemented in Department of Labor regulations (41 CPR chapter 60), as applicable. n. Consultant, and all its contractors (or sub -recipients) will comply with all requirements of the Copeland "Anti -Kickback" Act (18 U.S.C. 874) as supplemented in Department of Labor regulations (29 CPR Part 3), as applicable. o. Consultant, and all its contractors (or sub -recipients) will comply with all requirements of the Davis -Bacon Act (40 U.S.C. 276a to 276a-7) as supplemented by Department of Labor regulations (29 CPR Part 5), as applicable. P. Consultant, and all its contractors (or sub -recipients) will comply with all requirements of Sections 103 and 107 of the Contract Work and Safety Standards Act (40 U.S.C. 327-330) as supplemented by Department of Labor regulations (29 CPR Part 5), as applicable. q. Consultant, and all its contractors (or sub -recipients) will comply with all applicable standards, orders or requirements issued under s e ction 306 of the Clean Air Act (42 U.S.C. 1857(h)), Section 508 of the Clean Water Act (33 U.S.C. 1368), Executive Order 11738, and the Environmental Protection Agency regulations (40 CPR part 15), as applicable. Page 10 of 13 r. Consultant, and all its contractors (or sub -recipients) will comply with all requirements of the Energy Policy and Conservation Act (Pub. L. 94-163, 89 Stat. 871), (53 FR 8078, 8087, Mar. 11, 1988, as amended at 60 FR 19639, 19645, Apr. 19, 1995), as applicable. S. Consultant, and all its contractors (or sub -recipients) will comply with all requirements of the Department of Housing and Urban Development, Community Development Block Grant Regulatory Code 24 CPR Part 570. t. Consultant agrees that the State of California Office of Traffic Safety shall have the authority to seek patent rights for any process, product, invention or discovery developed and paid for with funding through this Agreement. U. Consultant may not copyright any books, publications or other materials developed in the course of or under this Agreement. The federal awarding agency, State Administrative Agency (SAA) and City reserve any rights to copyright, reproduce, publish or otherwise use, and to authorize others to use, for federal government, SAA or City purpose any work developed through this Agreement. V. Consultant is not proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from participation in this Agreement. 16. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant regarding the subject matter therein, and supersedes any and all other agreements, oral or written, between the parties. hi the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. V. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. Page 11 of 13 18. JURISDICTION -VENUE This Agreement has been executed and delivered in the State of California and the validity, Interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 19. FINES The Consultant shall be liable for all violation fines levied against the City by federal, state, or local agencies with regulatory authority related to Consultant provided services. 20. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorneys fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Attachments referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: DAISY GOMEZ erk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: d lxunca A _ Re'- 1 Laura A. Rossini Chief Assistant City Attorney [Signatures continue on the next page] CITY OF SANTA ANA KRTSTINE City Manager Page 12 of 13 RECOMMENDED FOR APPROVAL: R f, (' NABIL SABA, PE Executive Director Public Works Agency CONSULTANT mPmpo NAME: Ted Kim TIRE: COO Page 13 of 13 Exhibit A City of Santa Ana — Pedestrian and Bicycle Safety Program — Scope of Work Task 1: Pedestrian and Bicycle Safety Education Workshops and Classes to help support increased knowledge and understanding of safety. Workshop and classes may be in -person or virtual to account for applicable health and safety restrictions. Task 1a: Conduct Four (4) Bicycling Basics Classes in the City of Santa Ana. At least two (2) of these classes will be taught in Spanish. Bicycling Basics classes are geared towards new riders to teach them basic skills and give them the confidence to begin riding a bicycle. All classes will be taught by trained League Cycling Instructors (LCIs). The target students are people who have never ridden before and/or who have not ridden since childhood. The class is designed to increase bicyclist's safety awareness of common car/bike collisions, teach ways to prevent and avoid crashes and collisions, and emphasize the importance of helmet use when riding a bicycle. This class covers bicyclist rules of the road, basic principles of bicycling in traffic, common hazards encountered by bicyclists and how to deal with them, simple steps to ensure your bike is in good condition, and proper helmet fit and adjustment. Each participant will receive a certificate of completion upon mastering the course. Task la Deliverables: • Four (4) Bicycling Basics Classes. At least two (2) class will be taught in Spanish. • Sign -in sheets and surveys collected from participants Task 1b: Conduct Four (4) Wrench and Ride programs in the City of Santa Ana. At classes will be taught in English or Spanish, with Vietnamese as needed Wrench and Ride is a program hosted at The Bicycle Tree in which participants learn about bicycle anatomy, bike safety, and maintenance. As part of the program, people select a used bike, which they then repair using the skills they have learned. Participants also receive a helmet, lock, and lights to go with their bike. In addition to attending the Wrench and Ride classes, participants are required to take an ATLP Pledge, attend two ATLP presentations or workshops, and volunteer four hours at an ATLP event. There will be a wrench and ride offered to women, and one offered for youth. Task 1 b Deliverables: • Four (4) Wrench and Ride Programs • Sign -in sheet and surveys collected from participants Task 1c: Host one (1) Build Your Own Skateboard education workshops Skateboarding is a popular form of transportation, especially amongst the youth population in Santa Ana. The target students are people who have never skated before, who have not ridden since childhood, and/or who have limited experience but lack the financial means to obtain a skateboard. The one day workshop is designed to increase skateboarders safety awareness of common car/skate collisions, teach ways to prevent and avoid crashes and collisions, and emphasize the importance of helmet use when riding a skateboard. This workshop will teach participants about the individual skateboard parts, how they work together; how to skate safely and confidently throughout the city, and end with a group skate on the sidewalk or street. The build a 1IPage Exhibit A skateboard workshop will be two hours long where they will put together a blank skate deck with all its components. The safety class will cover skating rules of the road, basic principles of bicycling on the street and on the sidewalk, common hazards encountered by skateboarders and how to deal with them, simple steps to ensure your skateboard is in good condition, and proper helmet fit and adjustment. Each participant will receive a certificate of completion upon mastering the course and completion of a skateboard build. Task 1c Deliverables: • Host One (1) Build Your Own Skateboard workshops (flyer with date, time, and location (virtual or in -person); One workshop will be for youth, one will be for female, queer and nonbinary folks • Host 1 Skateboard Safety Workshops • Host 1 Group Skate Rides • Sign -in sheets • https://drive.google.com/drive/u/O/folders/104rZel6l-TYvmBBottlodYcnvmioBsiW Task 1d: Organize and Host a League Cycling Instructor (LCI) Certification Seminar SAAS will work with the City and the League of American Bicyclists (LAB) to schedule and host an LCI Certification Seminar to train and certify at least 12 and up to 15 community members as League Cycling Instructors (LCIs). The seminar will take place prior to the final month of the grant cycle to provide continuity of the bicycle education program in Santa Ana. SAAS has several affiliated LCls to assist with the implementation of the seminar. SAAS staff will coordinate logistics, such as finding an indoor meeting/classroom space, promote the seminar to interested individuals, and remain in contact with the LCI Coach. Priority for acceptance into the seminar will be given to participants of this project's TS-101 classes held earlier in the year who are also committed to making cycling safe and accessible in Santa Ana. SAAS will coordinate proper payment of the LAB and the Master Instructor. Task 1d Deliverable: • One (1) League Cycling Instructor Training Seminar SAAS will coordinate and facilitate a series of community meetings for participants to identify education, encouragement, and engagement activities that would help inform and advance the City's pedestrian and bicycle safety improvement efforts. Community workshops will include one (1) community -led walking and biking assessments or collection of pedestrian/bicycle counts; two (2) action planning sessions where participants will identify their desired infrastructure and non - infrastructure solutions to address their pedestrian and bicycle safety concerns; two (2) stakeholder engagement meetings with key city stakeholders responsible for traffic safety improvements where participants will share their active transportation experiences, concerns, and needs; one (1) photo/voice and video voice training and project.; and one (1) community roundtable where 2 1 P a g e Exhibit A participants will share/present what they've learned in the program to their fellow residents and city staff;. Task 2a: Walking and Biking Assessment - Organize one (1) community -led walking and biking assessment or collection of pedestrian/bicycle counts. Task 2b: Action Planning Sessions - Conduct two (2) action planning sessions. Workshops will focus on quantitative and/or qualitative data collection and collision data analysis for walking and biking. Task 2c: Stakeholder Engagement Meetings - Conduct two (2) stakeholder engagement meetings. Engagement meetings with key city stakeholders responsible for traffic safety improvements where participants will share their active transportation experiences, concerns, and needs. Task 2d: PhotoN!deo Voice - Conduct one (1) photo/voice and video voice training and project Task 2e: Community Roundtable - Host one (1) community round table. The community open house where participants will share/present what they've learned in the program to their fellow residents and city staff. . Task 3a: Conduct four (4) family cycling education classes in the City of Santa Ana. At least two (2) of these classes will be available in Spanish. The class will merge the traditional Traffic Skills curriculum developed by the League of American Bicyclists with the basic skills taught to youth in a bike rodeo. The target population for students is families that seek to ride as a family and give them the confidence to begin riding a bicycle together. Riders will learn the rules of the road for entering traffic at intersections and riding in the street. The class is designed to increase bicyclist's safety awareness of common car/bike collisions, teach ways to prevent and avoid crashes and collisions, and emphasize the importance of helmet use when riding a bicycle. Each participant will receive a certificate of completion upon mastering the course. The on -bike training will consist of a family group riding exercise where participants will have the opportunity to test their new skills in a fun, safe, and family -friendly setting. Following each class surveys will be conducted to collect comments and ideas from both students and instructors to improve and expand future classes. Task 3a Deliverable: • Four (4) family cycling education classes (Flyer with date and time) • Sign -in sheets Task 3b: Conduct four (4) ILuces Vivas! Events to help encourage and provide education for walking and riding safely at night. iLuces Vivas! is an education and night light distribution program intended to provide education and encouragement for riding bikes and walking in Santa Ana safely at night. Our goal is to seek 3 1 P a g e Exhibit A out people riding or walking without lights for various reasons, especially those who may not have the means or time to acquire lights on their own. SAAS and community partners will organize iLuces Vivas! to meet for four (4) street distributions at undisclosed locations throughout Santa Ana where night-time bicycle ridership and pedestrian activity is expected to be high and where the City has seen a history of incidents involving bicyclists and pedestrians at night. iLuces Vivas! members will provide bilingual education and encouragement activities to support the safety of pedestrians and bicyclists. Additionally, cyclists who are not wearing helmets will be fitted and provided a helmet. SAAS will be responsible for procuring front and rear bike lights and bike helmets that meet the OTS Buy America requirements. The number of units are reflected in the agreed upon budget. It is expected that 75-120 light sets, reflective vests, and/or helmets will be distributed at each event, depending on expected bicyclist and pedestrian volume. Our goal will be to distribute all the lights and helmets allocated for each event. Task 3b Deliverable: Four (4) iLuces Vivas! Events (Flyer with date and time) Task 3c Conduct two (2) Pedestrian and Bicycle Traffic Safety Fairs SAAS will conduct two (2) pedestrian and bicycle traffic safety fairs. Each Traffic Safety Fair will teach participants how to safely, efficiently, and confidently interact with the roadway and traffic. These traffic safety fairs will cover everything from using the different intersection devices, bicycling in the roadway, bicycle safety inspections, and helmet fit. SAAS will use a combination of traffic simulations and hands-on training to teach participants how to make safe decisions while walking or riding within the roadway. SAAS will coordinate the execution of these events in appropriate areas of local public parks and/or school grounds. Age -appropriate bicycles will be made available for youth that do not have their bicycle with them. Students that complete both the pedestrian and bicycle section will receive a free helmet and lights. Task 3c Deliverable: Two (2) Pedestrian and Bicycle Traffic Safety Fairs 4 1 P a g e EXHIBIT B Task # Task Item Quantity Unit Cost Total Cost 1a 1b 1c 1d Bici Basics Wrench and Ride Program Skateboard Education Workshops LCI Seminar Walking and Bike Assessment Action Planning Sessions Stakeholder Engagement Meetings PhotoNideo Voice Project Community Roundtable Family Cycling Education Classes Luces Vivas Events (Helmet and Light Distribution) Traffic Safety Fairs Bicycle Helmets Bicycle Safety Items $4,100.0( $4,800.0( $7,500.0( $5,800.0( $2,000.0( $1,600.0( $1,700.0( $2,1 $19,200.00 $7,500.00 $5,800.00 $2,000.00 $3,200.00 $4, $2, $12, $9, $4, 4651 $10.00I $4,5 1 $5,150.00 $5,1 TOTAL: $100,0 ACORO CERTIFICATE OF LIABILITY INSURANCE L/ DATE(MMIDDIYYYY) 1 08/27/2021 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 poltcy(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 endorsements . PRODUCER Dickerson Insurance Services an Alera Group Company 1918 Riverside Drive, Los Angeles, CA 90039 License#OM29112 CONTACT Nora Wolkoff NAME: PHONE 323-805-2918 PUC Net nuD Nora@dickerson-group.cem INSURERS AFFORDING COVERAGE NAICM INSURER A: Philadelphia Indemnity Insurance Company 21044 INSURED INSURER B: Technology Insurance Company 42376 Charitable Ventures of Orange County INSURER c: Hiscox Insurance Agency 10200 1505 E. 17th Street, Suite 101 INSURER D: Santa Ana, CA 92705 INSURER E: INSURER F: CUVEHAGES CERTIFICATE NUMBER: RFVICInN NIIMRF:a 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. ILTR TYPE OF INSURANCE ADDL Men SUBR wVnPOLICY NUMBER POUCYEFF NIN POLICY UP MMIDD LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ® OCCUR Abuse & Molestation (A&M) EACH OCCURRENCE $ 1,000,000 TO PREMIS P REMISEES S( RENTEDEe accunence $ 100,000 MED UP (Any one person) $ 5,000 Professional Liability(Prof. Liab) PERSONALAAOVINJURY $ 1,000,000 A X1 Y Y PHPK2302279 07/15/2021 07/01/2022 AGGREGATE LIMIT APPLIES PER: POLICY JEST LOC GENERAL AGGREGATE $ 2,000,000 GENT PRODUCTS-COMP/OP AGG $ 2,000,000 $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Par person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Y Y PHPK2302279 07115/2021 07/01/2022 BODILY INJURY accident Per ( ) $ PROPERTY DAMAGE Per accident $ $ U MBRELLA MB OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 A I EXCESS Me CLAIMS -MADE Y Y PHUB777844 07/15/2021 07/01/2022 DED X1 RETENTIONa 10,000 A&M and Prof. Liab. $ Included B WORKERS COMPENSATION AND EMPLOYERS'MBILRY YIN ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? F-Y] NIA Y TWC4004913 07/15/2021 07/01/2022 PER OTH- STATUTE ER EL EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS betel E.L DISEASE -POLICY LIMB $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD let, Additional Remarks schedule, may be attached if more apace is required) RE: Santa Ana Active Streets project City of Santa Ana, its officers, employees, volunteers, agents and representatives are named as Additional Insureds, on a primary and non-contributory basis, as respects to the above mentioned General Liability and Automobile Liability coverages as required by written contract, subject to policy terms and conditions. Notice of Cancellation - Each insurance policy required above shall provide that coverage shall not be Canceled, except with notice to the Entity. City will be mailed 30 days written notice. Workers' Compensation is evidence of insurance only. City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD V POLICY NUMBER: PHPK2302279 NAMED INSURED : Charitable Ventures of Orange County Commercial General Liability (CG 20 26 04 13) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ORGANIZATION This endorsement modifies insurance provided under the following: SCHEDULE Name Of Additional Insured Person(s) Or Organization Is): Re: Santa Ana Active Streets Project City of Santa Ana, for any claims related to this contract, the Contractor's insurance coverage shall be primary coverage as respects the Entity, it's officers, officials, employees, and volunteers. Any Insurance or self -insurance maintained by the Entity, its officers, officials, employees, or volunteers shall be excess of the Contractor's insurance and shall not contribute with it. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section C. — Who Is An Insured is amended to B. include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 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(s) at the location(s) designated above. 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: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Form CG20 26 0413 Risk m"'%aioif0i" Process Date: 8/27/2021`A'"�e 1. BSI ?1 I:1` Rink Maru9rnn,[ Cln,cilAitle © 2011 (Includes copyrighted material of Insurance Services Office, Inc., wit COMMERCIAL AND GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, Charitable Ventures of Oranae Countv ;MFA:2:112W� PRIMARY AND NON-CONTRIBUTORY INSURANCE OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Effective Date: 07/15/2021 Name of Person or Organization: City of Santa Ana For any claims related to this contract, the Contractor's insurance coverage shall be primary coverage at least as broad as ISO CG 20 0104 13 as respects the Entity, its officers, officials, employees, and volunteers. Any insurance or self-insurance maintained by the Entity, its officers, officials, employees, or volunteers shall be excess of the Contractor's insurance and shall not contribute with it. SECTION II —WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the endorsement Schedule, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" arising out of or relating to your negligence in the performance of "your work" for such person(s) or organization(s) that occurs on or after the effective date shown in the endorsement Schedule. This insurance is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or "occurrence" we cover for this Additional Insured. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III — LIMITS OF INSURANCE. All other terms, conditions, and exclusions under the policy are applicable to this endorsement and remain unchanged. Includes copyrighted material of Insurance Services Office, Inc., with its per 1 ` �"'®`""" BY. 'IP. ' Tort purnax COMMERCIAL AND GENERAL LIABILITY amp ade CG 20 01 0413 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed.4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 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 07/15/2021 Policy No. TWC4004913 Endorsement No. 001 Insured Charitable Ventures of Orange County Endorsement Premium Insurance Company Technology Insurance Company Countersigned WC 00 03 13 (Ed. 4-84) l , IhNlYrID6AarPwIDBY:.. 7olt �%icxaa[ -' Risk Maru9er�me[ImrulNAe POLICY NUMBER: PHUB777844 PHILADELPHIA INSURANCE COMPANIES A b1ember or LlIc Tokio Marine Group PI-CXL-002 (05119) One Bala Plaza, Suite 100 Bala Cynwyd, Pennsylvania 19004 610.617.7900 Fax 610.617.7940 PHLY.com COMMERCIAL UMBRELLA LIABILITY INSURANCE POLICY DECLARATIONS 117637 Dickerson Employee Benefits, an Alera 1918 Riverside Dr Philadelphia Indemnity Insurance Company Los Angeles, CA 90039 (323)662-7200 NAMED INSURED: Charitable Ventures of orange County DBA San Gorgonio Outdoor Science School MAILING ADDRESS: 1505 E. 17th Street Suite 101 Santa Ana, CA 92705 POLICY PERIOD: FROM 07/15/2021 TO 07/01/2022 AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. EACH OCCURRENCE LIMIT (LIABILITY COVERAGE) LIMITS OF $ 4,000,000 PERSONAL & ADVERTISING INJURY LIMIT $ 4,000,000 Anv one person or PRODUCTS COMPLETED OPERATIONS AGGREGATE LIMIT $ 4,000,000 GENERAL AGGREGATE LIMIT (LIABILITY COVERAGE) (except with respect to Auto Liability and Products Completed Operations) $ 4,000,000 1:0111/_WMIII II1TAIII PI-CXL-002 (05/19) $ 10,000 ili:l':- IRineaID6 --ar ® 7au p4M'arz --`— — Risk Marwgrnxm ClbiulAitle Page 1 of 5 Includes copyrighted material of Insurance Services Office, Inc., with permission. POLICY NUMBER: Pxos777844 PREMIUM PREMIUM SUBTOTAL STATE TAXES, FEES, SURCHARGES (if applicable) PI-CXL-002 (05/19) Not 3,734.001 PREMIUM TOTAL(including Taxes, Fees, Surcharges) $ 3,734.00 AUDIT PERIOD: 112 NOTAPPLICABLE 10 ANNUALLY ❑ SEMI-ANNUALLY ❑ QUARTERLY1 ❑ MONTHLY OF BUSINESS FORM OF BUSINESS: NON PROFIT ORGANIZATION BUSINESS DESCRIPTION: Non -Profit umbrella PI-CXL-002 (05119) Rid. M.vg.L Df ( �nesID6AreRavID Br. 'W� L /OSC )]iCLON RukN „a9er,m� C1m W AiAe Page 2 of 5 Includes copyrighted material of Insurance Services Office, Inc., with permission. PI-CXL-002 (05/19) POLICY NUMBER: PHUB777e44 SCHEDULE OF UNDERLYING INSURANCE Employers' Liability Company: Policy Number: Policy Period: Minimum Applicable Limits Bodily injury by accident $ Each Accident Bodily injury by disease $ Each Employee Bodily injury by disease $ Policy Limit Commercial General Liability I@ Occurrence ❑ Claims -Made Company: Philadelphia Indemnity Insurance Company Policy Number: PHPK2302279 Policy Period: 07/15/2021 07/01/2022 Retroactive Date: Not Applicable Minimum Applicable Limits: General Aggregate $ 2,000,000 Products -Completed Operations Aggregate $ 2,000,000 Personal And Advertising Injury $ 1,000,000 Each Occurrence $ 11000,000 Commercial Auto Liability Company: Philadelphia Indemnity Insurance Company Policy Number: PHPK2302279 Policy Period: 07/15/2021 07/01/2022 Minimum Applicable Limits Garage Aggregate Limit For Other Than Autos (if applicable) $ Not Applicable Each Accident $ 1,000,000 Professional Liability ® Occurrence ❑ Claims -Made Company: Philadelphia Indemnity Insurance Company Policy Number: PHPK2302279 Policy Period: 07/15/2021 07/01/2022 Retroactive Date: Not Applicable Minimum Applicable Limits Each Professional Incident $ 1,000,000 Agorecate $ 2,000,000 PI-CXL-002 (05/19) Nhk Mo�tOigtlan '. tt IR+nEVRn6T/1PPRW07 Sr. k 01 RiskManagerrm�Omol/Vtle Page 3 of 5 Includes copyrighted material of Insurance Services Office, Inc., with permission. PI-CXL-002 (05/19) POLICY NUMBER: PHUB777844 Employee Benefits Liability ❑ Occurrence ❑ Claims -Made Company: Policy Number: Policy Period: Retroactive Date: Minimum Applicable Limits Abusive Conduct Liability ❑ Occurrence ❑ Claims -Made Company: Policy Number: Policy Period: Retroactive Date: Minimum Applicable Limits Directors & Officers Liability ❑ Occurrence ❑ Claims -Made Company: Policy Number: Policy Period: Retroactive Date: Minimum Applicable Limits Liquor Liability ❑ Occurrence ❑ Claims -Made Company: Policy Number: Policy Period: Retroactive Date: Minimum Applicable Limits PI-CXL-002 (05/19) RiA M. age [ 01�ivm Ren 6AFrxoren BY: It ?ou Fek Ma,ta9emm[ClmrzlNtle Page 4 of 5 Includes copyrighted material of Insurance Services Office, Inc., with permission. POLICY NUMBER: PHUB777844 Watercraft Liability Company: Policy Number: Policy Period: Retroactive Date: Minimum Applicable Limits PI-CXL-002 (05/19) El Occurrence ❑Claims -Made Other Coverages Not Included in Above ❑ Occurrence ❑ Claims -Made Company: Policy Number: Policy Period: Retroactive Date: Minimum Applicable Limits THESE DECLARATIONS, TOGETHER WITH THE COMMON POLICY CONDITIONS AND COVERAGE FORM(S) AND ANY ENDORSEMENT(S), COMPLETE THE ABOVE NUMBERED POLICY. Countersigned: ey: (Date) (Authorized Representative) IN WITNESS WHEREOF, we have caused this policy to be executed and attested, and, if required by state law, this policy shall not be valid unless countersigned by our authorized representative. V4� John W. Glomb, Jr. Secretary President & CEO whr�m.ge�ron;om ,.5w Ren6 &Arvxw® ,Br: PI-CXL-002 (05/19) rs�kn a=�, aR iaae Page 5 of 5 Includes copyrighted material of Insurance Services Office, Inc., with permission. State of California — Office of Traffic Safety GRANT AGREEMENT GRANT NUMBER PS22025 1. GRANT TITLE Pedestrian and Bicycle Safety Program 2. NAME OF AGENCY 3. Grant Period Santa Ana From: 10/01/2021 To: 09/30/2022 4. AGENCY UNIT To ADMINISTER GRANT Santa Ana Public Works Agency 5. GRANT DESCRIPTION Best practice strategies will be conducted to reduce the number of persons killed and injured in crashes involving pedestrians and bicyclists. The funded strategies may include classroom education, bicycle rodeos, community events, presentations, and workshops. These countermeasures should be conducted in communities with high numbers of pedestrian- and/or bicycle -related crashes including underserved communities, older adults, and school -aged children. Coordinated efforts such as Safe Routes to School initiatives, Vision Zero campaigns, and working with community -based organizations are highly encouraged to prevent fatalities and injuries of vulnerable non -motorized road users. 6. Federal Funds Allocated Under This Agreement Shall Not Exceed: $100,000.00 7. TERMS AND CONDITIONS: The parties agree to comply with the terms and conditions of the following which are by this reference made a part of the Agreement: • Schedule A — Problem Statement, Goals and Objectives and Method of Procedure • Schedule B — Detailed Budget Estimate and Sub -Budget Estimate (if applicable) • Schedule B-1 — Budget Narrative and Sub -Budget Narrative (if applicable) • Exhibit A — Certifications and Assurances • Exhibit B* — OTS Grant Program Manual • Exhibit C — Grant Electronic Management System (GEMS) Access *Items shown with an asterisk (*), are hereby incorporated by reference and made a part of this agreement as if attached hereto. These documents can be viewed at the OTS home web page under Grants: www.ots.ca.0ov. We, the officials named below, hereby swear under penalty of perjury under the laws of the State of California that we are duly authorized to legally bind the Grant recipient to the above described Grant terms and conditions. IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto. 8. Approval Signatures A. GRANT DIRECTOR B. AUTHORIZING OFFICIAL NAME: Zed Kekula ADDRESS: Kristine Ridge TITLE: Principal Civil Engineer City Manager EMAIL: zkekula@santa-ana.org kridge@santa-ana.org PHONE: (714)647-5606 (714)647-5200 ADDRESS: 20 Civic Center Plaza 20 Civic Center Plaza Santa Ana, CA 92702 Santa Ana, CA 92702 Oct 25, 2021 Arirtlaa, rik'o Oct 28, 2021 (Signature) (Date) (Signature) (Date) C. FISCAL OFFICIAL D. AUTHORIZING OFFICIAL OF OFFICE OF TRAFFIC SAFETY ADDRESS: Kathryn Downs ADDRESS: Barbara Rooney Executive Director of Finance 8 Management Director Services barbara.rooney@ots.ca.gov kdowns@santa-ana.org (916) 509-3030 (714) 647-5420 2208 Kausen Drive, Suite 300 20 Civic Center Plaza M-17 Elk Grove, CA 95758 Santa Ana, CA 92702 Oct 25, 2021- Nov 1, 2021 (Signature) (Date) (Signature) (Date) 9/20/2021 9:06:55 AM Page 1 of 18 OF OFFICE OF TRAFFIC SAFETY 19. SAM INFORMATION NAME: Carolyn Vu SAM#: KZE9G2M4GRX9 ADDRESS: 2208 Kausen Drive, Suite 300 REGISTERED Elk Grove, CA 95758 ADDRESS: 20 Civic Center Plaza, 8th Floor CITY: Santa Ana ZIP+4: 927014058 10. PROJECTED EXPENDITURES FUND CFDA ITEM/APPROPRIATION F.Y. CHAPTER STATUTE PROJECTED EXPENDITURES 402PS-22 20.600 0521-0890-101 2021 21/21 BA121 $100,000.00 AGREEMENT TOTAL $100,000.00 AMOUNT ENCUMBERED BY THIS DOCUMENT $100,000.00 I funds for heupon cur my own personal knowledge that the budgeted funds for the current budget year are available for the period and purpose of the expenditure stated above. PRIOR AMOUNT ENCUMBERED FOR THIS AGREEMENT $ 0.00 OTS ACCOUNTING OFFICER'S SIGNATURE DATE SIGNED TOTAL AMOUNT ENCUMBERED TO DATE �«✓ Oct 29,2021 $100,000.00 9/20/2021 9:06:55 AM Page 2 of 18 State of California — Office of Traffic Safety GRANT AGREEMENT Schedule A GRANT NUMBER PS22025 1. PROBLEM STATEMENT The City of Santa Ana has a mobility challenge within its community. Covering an area of 27.1 square miles with a population of approximately 330,000, its residential density is one of the highest in the state, among the top 14 in California. Consequently, it has a large volume of motor vehicle traffic with arterials carrying 30,000 to 40,000 vehicles per day, including 4 freeways that converge within the city and a total of 450 miles of surface streets. An analysis of census data by the Vision Zero project, comparing household size with number of automobiles per household, showed that 55 percent of Santa Ana's residents lack sufficient access to an automobile. These figures also show that 28 percent of the residents are aged under 18 with a young median age of 29.7 years, the youngest of the seven largest cities in Orange County. Orange County Transportation Authority (OCTA) bus transit ridership is also among the highest in Orange County, with 55 of its 100 busiest bus stops located within Santa Ana's city limits. To meet these demands on local transportation, the City of Santa Ana has been developing an ever-expanding network of local bicyclist and pedestrian facilities. As a result of the region's climate and demographics, Santa Ana has a relatively high bicycle -dependent population when compared with other communities around the state. In addition to having relative income levels that are significantly lower than statewide averages, a significant portion of the adult bicyclists may not speak English well or fully understand the rules -of -the -road. Identified as a 'Focus City' by the Federal Highway Administration, the urgent need to make Immediate traffic safety improvements for all of Santa Ana's residents is a priority for our community, especially for children walking to and from school. Our proposed Pedestrian and Bicyclist Safety Education Program aims to increase awareness in order to ultimately reduce the number of pedestrian- and bicyclist -involved crashes within our city. 2. PERFORMANCE MEASURES A. Goals: 1. Reduce the number of persons killed in traffic crashes. 2. Reduce the number of persons injured in traffic crashes. 3. Reduce the number of pedestrians killed in traffic crashes. 4. Reduce the number of pedestrians injured in traffic crashes. 5. Reduce the number of pedestrians killed under age 15 in traffic crashes. 6. Reduce the number of pedestrians injured under age 15 in traffic crashes. 7. Reduce the number of pedestrians killed over age 65 in traffic crashes. 8. Reduce the number of pedestrians injured over age 65 in traffic crashes. 9. Reduce the number of bicyclists killed in traffic crashes. 10. Reduce the number of bicyclists injured in traffic crashes. 11. Reduce the number of bicyclists under age 15 killed in traffic crashes. 12. Reduce the number of bicyclists under age 15 injured in traffic crashes. 13. Increase bicycle helmet usage. B. Objectives: Target Number 1. Issue a press release announcing the kick-off of the grant by November 15. The 1 kick-off press releases and media advisories, alerts, and materials must be emailed to the OTS Public Information Officer at pio@ots.ca.gov, and copied to your OTS Coordinator, for approval 14 days prior to the issuance date of the release. 2. Participate in traffic safety fairs and/or community events with an effort to reach 1 individuals. 3. Work closely with community -based organizations at both the neighborhood and 1 community level with an effort to reach individuals. 4. Participate in the following campaigns: National Walk to School Day, National 4 Bicycle Safety Month, California's Pedestrian Safety Month and National Pedestrian Safety Month. 9/20/2021 9:06:55 AM Page 3 of 18 5. Conduct pedestrian and/or bicycle safety presentations at community groups with 1 an effort to reach individuals. 6. Conduct pedestrian and/or bicycle safety presentations with an effort to reach 1 youth. 7. Distribute pedestrian safety equipment to children that may include reflective 1 armbands and/or zipper pulls. 8. Distribute bicycle headlights and tail lights during bicycle safety community events 1 or bicycle safety courses. 9. Develop bicycle and pedestrian safety educational materials to be distributed 1 during classroom presentations, workshops, and community events. 10. Conduct pedestrian Walking Field Trips with an effort to reach adults. 1 11. Conduct community outreach events with an effort to reach adults. 1 12. Conduct pre and post -grant activities bicycle helmet usage surveys during the 2 months of October (start of the grant) and September (end of the grant). A pre - survey will be required to determine the base year helmet use rate and a post - survey will be required to determine the operational rate. 13. Distribute and properly fit bicycle helmets at bicycle rodeos, schools, workshops, 455 and community events. 14. Purchase bicycle helmets 455 15. Conduct bicycle helmet inspections and make necessary adjustments at schools 3 and community events. 16. Train individuals to be League Certified Instructors. 1 17. Conduct community bicycle rides promoting safe bicycling in the community with 4 an effort to reach bicyclists. 18. Hold quarterly meetings with countywide pedestrian and/or bicycle safety 2 stakeholders to collaborate on events, share best practices, and leverage resources. 19. Upload a copy of the executed subcontract. 1 3. METHOD OF PROCEDURE A. Phase 1 — Program Preparation (111 Quarter of Grant Year) • Develop operational plans to implement the "best practice" strategies outlined in the objectives section. • Finalize OTS related paperwork in order to receive funds. • Negotiate and finalize subcontract and purchase order agreements. • Train staff on program responsibilities and reporting procedures. • Purchase safety supplies. • Order educational materials needed to initiate programming. • Create calendar of outreach, education and training events. Media Requirements • Issue a press release approved by the OTS PIO announcing the kick-off of the grant by November 15, but no sooner than October 1. The kick-off release must be approved by the OTS PIO and only distributed after the grant is fully signed and executed. If you are unable to meet the November 15 deadline to issue a kick-off press release, communicate reasons to your OTS coordinator and OTS PIO. B. Phase 2 — Program Operations (Throughout Grant Year) • Complete ordering of safety supplies. • Coordinate distribution of safety supplies. • Conduct outreach, education and training events. The following services for the Pedestrian and Bicyclist Safety Education program will be provided by a local community provider subcontracted with the City of Santa Ana. Subcontractor was selected through a competitive procurement process for FFY21-22: 9/20/2021 9:06:55 AM Page 4 of 18 Task 1 - Conduct the following Pedestrian and Bicycle Safety Education Workshops/Classes to help increase the knowledge and understanding of traffic safety by the residents of Santa Ana: • Conduct 4 Bicycling Basics Classes in the City of Santa Ana. At least 1 of these classes will be taught in Spanish. • Conduct 4 Wrench and Ride Workshops in the City of Santa Ana. Classes will be taught in English, Spanish or Vietnamese, as needed. • Host 1 Build Your Own Skateboard Education Workshop. • Organize and host a League Cycling Instructor (LCI) Certification Seminar. Task 2 - Conduct the following activities for the Active Transportation Champions Cohort: Plan and deliver meetings, training and a community roundtable to cultivate a cohort of 10-20 residents who will identify and develop pedestrian and bicyclist safety education, encouragement and civic engagement activities to strengthen and advance Santa Ana's existing safety infrastructure improvements and non - infrastructure strategies: • Walking and Biking Assessment - Organize 1 community -led Walking and Biking Sssessment or collection of pedestrian/bicyclist counts. • Action Planning Sessions - Conduct 2 Action Planning Sessions. Workshops will focus on quantitative and/or qualitative data collection and crash data analysis for walking and biking. • Stakeholder Engagement Meetings - Conduct 2 Stakeholder Engagement Meetings. Enabling participants to share their active transportation experiences, concerns and needs with key city stakeholders responsible for traffic safety improvements. • PhotoNideo Voice - Conduct 1 Photo/Voice and Video Voice training and project. • Community Roundtable - Host 1 Community Roundtable. Enabling participants to share/present what they've learned through the program with fellow residents and City staff. Task 3 - Conduct the following Community Encouragement Activities to support increase the use of active transportation within the City of Santa Ana: • Conduct 4 Family Cycling Education Classes in the City of Santa Ana. At least 2 of which will be available in Spanish. • Conduct 4 iLuces Vivas! Events. To help encourage and provide education for walking and riding safely at night. • Conduct/participate in 2 Pedestrian and Bicycle Traffic Safety Fairs. Media Requirements • Send all media advisories, alerts, videos, graphics, artwork, posters, radio/PSA/video scripts, storyboards, digital and/or print educational materials for grant -related activities to the OTS PIO at pio@ots.ca.gov for approval and copy your OTS coordinator. Optimum lead time would be 7 days before the scheduled release but at least 3 business days prior to the scheduled release date for review and approval is appreciated. • If an OTS-supplied template, educational material, social media graphic, post or video is substantially changed, the changes shall be sent to the OTS PIO at pio@ots.ca.gov for approval and copy to your OTS Coordinator. Optimum lead time would be 7 days prior to the scheduled release date, but at least 3 business days prior to the scheduled release date for review and approval is appreciated. • Press releases, social media posts and alerts on platforms such as NextDoor and Nixie reporting immediate and time -sensitive grant activities (e.g. enforcement operations, day of event highlights or announcements, event invites) are exempt from the OTS PIO approval process. The OTS PIO and your Coordinator should still be notified when the grant -related activity is happening (e.g. car seat checks, bicycle rodeos, community presentations, DUI checkpoints, etc.). • Enforcement activities such as warrant and probation sweeps, court stings, etc. that are embargoed or could impact operations by publicizing in advance are exempt from the PIO approval process. However, announcements and results of activities should still be copied to the 9/20/2021 9:06:55 AM Page 5 of 18 OTS PIO at pio@ots.ca.gov and your Coordinator with embargoed date and time or with "INTERAL ONLY: DO NOT RELEASE" message in subject line of email. • Any earned or paid media campaigns for TV, radio, digital or social media that are part of a specific grant objective, using OTS grant funds, or designed and developed using contractual services by a subgrantee, requires prior approval. Please send to the OTS PIO at pio@ots.ca.gov for approval and copy your grant coordinator at least 3 business days prior to the scheduled release date. • Social media posts highlighting state or national traffic safety campaigns (Distracted Driving Month, Motorcycle Safety Awareness Month, etc.), enforcement operations (DUI checkpoints, etc.), or any other grant -related activity such as Bicycle rodeos, presentations, or events, are highly encouraged but do not require prior approval. • Submit a draft or rough -cut of all digital, printed, recorded or video material (brochures, posters, scripts, artwork, trailer graphics, digital graphics, Social posts connected to an earned or paid media campaign grant objective) to the OTS PIO at pio@ots.ca.gov and copy your OTS Coordinator for approval prior to the production or duplication. • Use the following standard language in all press, media, and printed materials, space permitting: Funding for this program was provided by a grant from the California Office of Traffic Safety, through the National Highway Traffic Safety Administration. • Space permitting, include the OTS logo on all grant -funded print materials, graphics and paid or earned social media campaign grant objective; consult your OTS Coordinator for specifics, format -appropriate logos, or if space does not permit the use of the OTS logo. • Email the OTS PIO at pio@ots.ca.gov and copy your OTS Coordinator at least 21 days in advance, or when first confirmed, a short description of any significant grant -related traffic safety event or program, particularly events that are highly publicized beforehand with anticipated media coverage so OTS has sufficient notice to arrange for attendance and/or participation in the event. If unable to attend, email the OTS PIO and coordinator brief highlights and/or results, including any media coverage (broadcast, digital, print) of event within 7 days following significant grant - related event or program. Media and program highlights are to be reflected in QPRs. • Any press releases, work plans, scripts, storyboards, artwork, graphics, videos or any educational or informational materials that received PIO approval in a prior grant year needs to be resubmitted for approval in the current grant year. • Contact the OTS PIO or your OTS Coordinator for consultation when changes from any of the above requirements might be warranted. C. Phase 3 — Data Collection & Reporting (Throughout Grant Year) 1. Prepare and submit invoice claims (due January 30, April 30, July 30, and October 30)2. 2. Prepare and submit Quarterly Performance Reports (QPR) (due January 30, April 30, July 30, and October 30) • Collect and report quarterly, appropriate data that supports the progress of goals and objectives. • Provide a brief list of activity conducted, procurement of grant -funded items, and significant media activities. Include status of grant -funded personnel, status of contracts, challenges, or special accomplishments. • Provide a brief summary of quarterly accomplishments and explanations for objectives not completed or plans for upcoming activities. • Collect, analyze and report statistical data relating to the grant goals and objectives. 4. METHOD OF EVALUATION Using the data compiled during the grant, the Grant Director will complete the "Final Evaluation" section in the fourth/final Quarterly Performance Report (QPR). The Final Evaluation should provide a brief summary of the grant's accomplishments, challenges and significant activities. This narrative should also include whether goals and objectives were met, exceeded, or an explanation of why objectives were not completed. 5. ADMINISTRATIVE SUPPORT This program has full administrative support, and every effort will be made to continue the grant activities after grant conclusion. 9/20/2021 9:06:55 AM Page 6 of 18 State of California —Office of Traffic Safety GRANT AGREEMENT Schedule B GRANT NUMBER PS22025 FUND NUMBER CATALOG FUND DESCRIPTION TOTAL AMOUNT NUMBER CFDA 402PS-22 20.600 State and Community Highway $100,000.00 Safet COST CATEGORY FUND NUMBER UNIT COST OR RATE UNITS TOTAL COST TO GRANT A. PERSONNEL COSTS Straieht Time $0.00 Overtime $0.00 Category Sub -Total $0.00 B. TRAVEL EXPENSES $0.00 $0.00 Category Sub -Total $0.00 C. CONTRACTUAL SERVICES Pedestrian and Bicyclist Safety Education Program $100,000 402PS-22 $0.00 1 $0.00 Task la: Bici Basics Classes 402PS-22 $4,100.00 4 $16,400.00 Task lb: Wrench and Ride Workshops 402PS-22 $4,800.00 4 $19,200.00 Task lc: Skateboard Education Workshop 402PS-22 $7,500.00 1 $7,500.00 Task 1d: LCI Seminar 402PS-22 $5,800.00 1 $5,800.00 Task 2a: Walking and Biking Assessment 402PS-22 $2,000.00 1 $2,000.00 Task 2b: Action Planning Sessions 402PS-22 $1,600.00 2 $3,200.00 Task 2c: Stakeholder Meetings 402PS-22 $1,700.00 2 $3,400.00 Task 2d: PhotoNideo Voice Project 402PS-22 $4,300.00 1 $4,300.00 Task 2e: Community Roundtable 402PS-22 $2,100.00 1 $2,100.00 Task 3a: Family Cycling Classes 402PS-22 $3,000.00 4 $12,000.00 Task 3b: Luces Vivas Events 402PS-22 $2,400.00 4 $9,600.00 Task 3c: Traffic Safety Fairs 402PS-22 $2,400.00 2 $4,800.00 Bicycle Helmets 402PS-22 $10.00 455 $4,550.00 Bicycle Safety Equipment 402PS-22 $5,150.00 1 $5,150.00 Category Sub -Total $100,000.00 D. EQUIPMENT $0.00 Category Sub -Total $0.00 E. OTHER DIRECT COSTS $0.00 Category Sub -Total $0.00 F. INDIRECT COSTS $0,00 Category Sub -Total $0.00 GRANT TOTAL $100,000.00 9/20/2021 9:06:65 AM Page 7 of 18 9/20/2021 9:06:55 AM Page 8 of 18 State of California— Office of Traffic Safety GRANT AGREEMENT Schedule B-1 GRANT NUMBER PS22025 BUDGET NARRATIVE PERSONNEL COSTS TRAVEL EXPENSES CONTRACTUAL SERVICES Pedestrian and Bicyclist Safety Education Program ($100,000) -A local community provider was subcontracted through a competitive procurement process for FFY20-21 to provide the following services for the Pedestrian and Bicyclist Safety Education program for the Santa Ana Public Works Agency. Task 1a: Bic! Basics Classes - Cost to include planning and conducting 4 Bicycling Basics Classes. A minimum of 1 is to be taught in Spanish. $4,100 x 4 = $16,400 Task 1 b: Wrench and Ride Workshops - Cost to include planning and conducting 4 Wrench and Ride Workshops. To be taught in English, Spanish or Vietnamese as needed. $4,800 x 4 = $19,200 Task 1c: Skateboard Education Workshop - Cost to include planning and conducting a Build Your Own Skateboard Education Workshop. $7,500 x 1 = $7,500 Task 1d: LCI Seminar - Cost to include planning and conducting a League Cycling Instructor (LCI) Certification Seminar. $5,800 x 1 = $5,800 Task 2a: Walking and Biking Assessment - Cost to include planning and conducting a community -led Walking and Biking Assessment or collection of community pedestrian/bicyclist counts. $2,000 x 1 = $2,000 Task 2b: Action Planning Sessions - Cost to include planning and conducting 2 Action Planning Sessions that will focus on quantitative and/or qualitative data collection and crash data analysis of pedestrian- and bicyclist -involved traffic crashes. $1,600 x 2 = $3,200 Task 2c: Stakeholder Meetings - Cost to include planning and conducting 2 Stakeholder Engagement Meetings with key City stakeholders responsible for traffic safety improvements. $1,700 x 2 = $3,400 Task 2d: Photo/Video Voice Project - Cost to include planning and conducting a Photo/Video Voice and/or video voice training and project. $4,300 x 1 = $4,300 Task 2e: Community Roundtable - Cost to include planning and conducting a Community Roundtable, an open house where community participants will share/present what they have learned through the program with fellow residents and City staff. $2,100 x 1 = $2,100 Task 3a: Family Cycling Classes - Cost to include planning and conducting 4 Family Cycling Education Classes. A minimum of 2 are to be made available for the city's Spanish-speaking community. 9/20/2021 9:06:55 AM Page 9 of 18 $3,000 x 4 = $12,000 Task 3b: Luces Vivas Events - Cost to include planning and conducting 4 iLuces Vivas! Events to provide education for walking and riding safely at night. $2,400 x 4 = $9,600 Task 3c: Traffic Safety Fairs - Cost to include planning and participating in 2 Pedestrian and Bicyclist Traffic Safety Fairs. $2,400 x 2 = $4,800 Bicycle Helmets - Helmets to be distributed during bicycle rodeos and other bicycle safety related events. Cost per helmet not to exceed a maximum average price of $10, before adding shipping, handling and tax. More expensive helmets may be purchased if preapproved by OTS. Bicycle Safety Equipment - Safety equipment such as bicycle headlights/taillights, reflectors, and reflective arm and leg bands to be distributed during bicycle rodeos and other bicycle safety related events. Additional items may be purchased if approved by OTS. EQUIPMENT OTHER DIRECT COSTS INDIRECT COSTS STATEMENTS/DISCLAIMERS There will be no program income generated from this grant. 9/20/2021 9:06:55 AM Page 10 of 18 State of California — Office of Traffic Safety GRANT NUMBER GRANT AGREEMENT PS22025 Exhibit A CERTIFICATIONS AND ASSURANCES FOR HIGHWAY SAFETY GRANTS (23 U.S.C. Chapter 4; Sec. 1906, Pub. L. 109-59, As Amended By Sec. 4011, Pub. L. 114-94) The officials named on the grant agreement, certify byway of signature on the grant agreement signature page, that the Grantee Agency complies with all applicable Federal statutes, regulations, and directives and State rules, guidelines, policies and laws in effect with respect to the periods for which it receives grant funding. Applicable provisions include, but are not limited to, the following: GENERAL REQUIREMENTS • 23 U.S.C. Chapter 4 — Highway Safety Act of 1966, as amended • Sec. 1906, Pub. L. 109-59, as amended by Sec. 4011, Pub. L. 114-94 • 23 CFR part 1300 — Uniform Procedures for State Highway Safety Grant Programs • 2 CFR part 200 — Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards • 2 CFR part 1201 — Department of Transportation, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards NONDISCRIMINATION (applies to subrecipients as well as States) The State highway safety agency will comply with all Federal statutes and implementing regulations relating to nondiscrimination ("Federal Nondiscrimination Authorities"). These include but are not limited to: • Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq., 78 stat. 252), (prohibits discrimination on the basis of race, color, national origin) and 49 CFR part 21; • The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C. 4601), (prohibits unfair treatment of persons displaced or whose property has been acquired because of Federal or Federal -aid programs and projects); • Federal -Aid Highway Act of 1973, (23 U.S.C. 324 et seq.), and Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681-1683 and 1685-1686) (prohibit discrimination on the basis of sex); • Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. 794 et seq.), as amended, (prohibits discrimination on the basis of disability) and 49 CFR part 27; • The Age Discrimination Act of 1975, as amended, (42 U.S.C. 6101 et seq.), (prohibits discrimination on the basis of age); • The Civil Rights Restoration Act of 1987, (Pub. L. 100-209), (broadens scope, coverage and applicability of Title VI of the Civil Rights Act of 1964, The Age Discrimination Act of 1975 and Section 504 of the Rehabilitation Act of 1973, by expanding the definition of the terms "programs or activities" to include all of the programs or activities of the Federal aid recipients, subrecipients and contractors, whether such programs or activities are Federally -funded or not); • Titles 11 and III of the Americans with Disabilities Act (42 U.S.C. 12131-12189) (prohibits discrimination on the basis of disability in the operation of public entities, public and private transportation systems, places of public accommodation, and certain testing) and 49 CFR parts 37 and 38; • Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low - Income Populations (prevents discrimination against minority populations by discouraging programs, policies, and activities with disproportionately high and adverse human health or environmental effects on minority and low-income populations); and • Executive Order 13166, Improving Access to Services for Persons with Limited English Proficiency (guards against Title VI national origin discrimination/discrimination because of limited English proficiency (LEP) by ensuring that funding recipients take reasonable steps to ensure that LEP persons have meaningful access to programs (70 FIR 74087-74100). The Subgrantee- • Will take all measures necessary to ensure that no person in the United States shall, on the grounds of race, color, national origin, disability, sex, age, limited English proficiency, or membership in any other class protected by Federal Nondiscrimination Authorities, be excluded from participation in, be denied the benefits of, 9/20/2021 9:06:65 AM Page 11 of 18 or be otherwise subjected to discrimination under any of its programs or activities, so long as any portion of the program is Federally -assisted; • Will administer the program in a manner that reasonably ensures that any of its subrecipients, contractors, subcontractors, and consultants receiving Federal financial assistance under this program will comply with all requirements of the Non -Discrimination Authorities identified in this Assurance; • Agrees to comply (and require its subrecipients, contractors, subcontractors, and consultants to comply) with all applicable provisions of law or regulation governing US DOT's or NHTSA's access to records, accounts, documents, information, facilities, and staff, and to cooperate and comply with any program or compliance reviews, and/or complaint investigations conducted by US DOT or NHTSA under any Federal Nondiscrimination Authority; • Acknowledges that the United States has a right to seek judicial enforcement with regard to any matter arising under these Non -Discrimination Authorities and this Assurance; • Agrees to insert in all contracts and funding agreements with other State or private entities the following clause: "During the performance of this contract/funding agreement, the contractor/funding recipient agrees — a. To comply with all Federal nondiscrimination laws and regulations, as may be amended from time to time; b. Not to participate directly or indirectly in the discrimination prohibited by any Federal non-discrimination law or regulation, as set forth in appendix B of 49 CFR part 21 and herein; c. To permit access to its books, records, accounts, other sources of information, and its facilities as required by the State highway safety office, US DOT or NHTSA; d. That, in event a contractor/funding recipient fails to comply with any nondiscrimination provisions in this contract/funding agreement, the State highway safety agency will have the right to impose such contract/agreement sanctions as it or NHTSA determine are appropriate, including but not limited to withholding payments to the contractor/funding recipient under the contract/agreement until the contractor/funding recipient complies; and/or cancelling, terminating, or suspending a contract or funding agreement, in whole or in part; and e. To insert this clause, including paragraphs (a) through (a), in every subcontract and sub agreement and in every solicitation for a subcontract or sub -agreement, that receives Federal funds under this program. POLITICAL ACTIVITY (HATCH ACT) (applies to subrecipients as well as States) The State will comply with provisions of the Hatch Act (5 U.S.C. 1501-1508), which limits the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. CERTIFICATION REGARDING FEDERAL LOBBYING (applies to subreciptents as well as States) Certification for Contracts, Grants, Loans, and Cooperative Agreements The undersigned certifies, to the best of his or her knowledge and belief, that 1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of 9/20/2021 9:06:55 AM Page 12 of 18 any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement; 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions; 3. The undersigned shall require that the language of this certification be included in the award documents for all sub -award at all tiers (including subcontracts, subgrants, and contracts under grant, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. RESTRICTION ON STATE LOBBYING (applies to subrecipients as well as States) None of the funds under this program will be used for any activity specifically designed to urge or influence a State or local legislator to favor or oppose the adoption of any specific legislative proposal pending before any State or local legislative body. Such activities include both direct and indirect (e.g., "grassroots") lobbying activities, with one exception. This does not preclude a State official whose salary Is supported with NHTSA funds from engaging in direct communications with State or local legislative officials, in accordance with customary State practice, even if such communications urge legislative officials to favor or oppose the adoption of a specific pending legislative proposal. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION (applies to subrecipients as well as States) Instructions for Primary Tier Participant Certification (States 1. By signing and submitting this proposal, the prospective primary tier participant is providing the certification set out below and agrees to comply with the requirements of 2 CFR parts 180 and 1200. 2. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective primary tier participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary tier participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. 3. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default or may pursue suspension or debarment. 4. The prospective primary tier participant shall provide immediate written notice to the department or agency to which this proposal is submitted if at any time the prospective primary tier participant learns its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 5. The terms covered transaction, civil judgment, debarment, suspension, ineligible, participant, person, principal, and voluntarily excluded, as used in this clause, are defined in 2 CFR parts 180 and 1200. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of those regulations. 6. The prospective primary tier participant 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 9/20/2021 9:06:55 AM Page 13 of 18 who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction. 7. The prospective primary tier participant further agrees by submitting this proposal that it will include the clause titled `Instructions for Lower Tier Participant Certification" including the "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion —Lower Tier Covered Transaction," provided by the department or agency entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions and will require lower tier participants to comply with 2 CFR parts 180 and 1200. 8. 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 proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any prospective lower tier participants, each participant may, but is not required to, check the System for Award Management Exclusions website (https://www.sam.gov/). 9. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 10. Except for transactions authorized under paragraph 6 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal government, the department or agency may terminate the transaction for cause or default. Certification Regarding Debarment, Suspension, and Other Responsibility Matters -Primary Tier Covered Transactions (1) The prospective primary tier participant certifies to the best of its knowledge and belief, that it and its principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in covered transactions by any Federal department or agency; (b) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or Local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and (d) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. (2) Where the prospective primary tier participant is unable to certify to any of the Statements in this certification, such prospective participant shall attach an explanation to this proposal. Instructions for Lower Tier Participant Certification 1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below and agrees to comply with the requirements of 2 CFR parts 180 and 1200. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered in to. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal government, the 9/20/2021 9:06:55 AM Page 14 of 18 department or agency with which this transaction originated may pursue available remedies, including suspension or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms covered transaction, civil judgment, debarment, suspension, ineligible, participant, person, principal, and voluntarily excluded, as used in this clause, are defined in 2 CFR parts 180 and 1200. You may contact the person to whom this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant 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 proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this proposal that it will include the clause titled 'Instructions for Lower Tier Participant Certification" including the "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion — Lower Tier Covered Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions and will require lower tier participants to comply with 2 CFR parts 180 and 1200. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any prospective lower tier participants, each participant may, but is not required to, check the System for Award Management Exclusions website (https://www.sam.gov/). 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension or debarment. Certification Regarding Debarment, Suspension. Ineligibility and Voluntary Exclusion -- Lower Tier Covered Transactions: 1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in covered transactions by any Federal department or agency. 2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. BUY AMERICA ACT (applies to subrecipients as well as States) The State and each subrecipient will comply with the Buy America requirement (23 U.S.C. 313) when purchasing items using Federal funds. Buy America requires a State, or subrecipient, to purchase with Federal funds only steel, iron and manufactured products produced in the United States, unless the Secretary of Transportation determines that such domestically produced items would be inconsistent with the public interest, that such materials are not reasonably available and of a satisfactory quality, or that inclusion of domestic materials will increase the cost of the overall project contract by more than 25 percent. In order to use Federal 9/20/2021 9:06:55 AM Page 15 of 18 funds to purchase foreign produced items, the State must submit a waiver request that provides an adequate basis and justification for approval by the Secretary of Transportation. PROHIBITION ON USING GRANT FUNDS TO CHECK FOR HELMET USAGE (applies to subrecipients as well as States) The State and each subrecipient will not use 23 U.S.C. Chapter 4 grant funds for programs to check helmet usage or to create checkpoints that specifically target motorcyclists. POLICY ON SEAT BELT USE In accordance with Executive Order 13043, Increasing Seat Belt Use in the United States, dated April 16, 1997, the Grantee is encouraged to adopt and enforce on-the-job seat belt use policies and programs for its employees when operating company -owned, rented, or personally -owned vehicles. The National Highway Traffic Safety Administration (NHTSA) is responsible for providing leadership and guidance in support of this Presidential initiative. For information and resources on traffic safety programs and policies for employers, please contact the Network of Employers for Traffic Safety (NETS), a public -private partnership dedicated to improving the traffic safety practices of employers and employees. You can download information on seat belt programs, costs of motor vehicle crashes to employers, and other traffic safety initiatives at www.trafficsafety.org. The NHTSA website (www.nhtsa.gov) also provides information on statistics, campaigns, and program evaluations and references. POLICY ON BANNING TEXT MESSAGING WHILE DRIVING In accordance with Executive Order 13513, Federal Leadership On Reducing Text Messaging While Driving, and DOT Order 3902.10, Text Messaging While Driving, States are encouraged to adopt and enforce workplace safety policies to decrease crashes caused by distracted driving, including policies to ban text messaging while driving company -owned or rented vehicles, Government -owned, leased or rented vehicles, or privately -owned vehicles when on official Government business or when performing any work on or behalf of the Government. States are also encouraged to conduct workplace safety initiatives in a manner commensurate with the size of the business, such as establishment of new rules and programs or re-evaluation of existing programs to prohibit text messaging while driving, and education, awareness, and other outreach to employees about the safety risks associated with texting while driving. 9/20/2021 9:06:55 AM Page 16 of 18 GRANT NUMBER PS22025 State of California — Office of Traffic Safety OTS-55 Grant Electronic Management System (GEMS) Access Exhibit C INSTRUCTIONS FOR ADDING OR UPDATING GEMS USERS 1. Each agency is allowed a total of FIVE (5) GEMS Users. 2. GEMS Users listed on this form will be authorized to login to GEMS to complete and submit Quarterly Performance Reports (APRs) and reimbursement claims. 3. Complete the form if adding, removing or editing a GEMS user(s). 4. The Grant Director must sign this form and return it with the Grant Agreement. GRANT DETAILS Grant Number: PS22025 Agency Name: Santa Ana Public Works Agency Grant Title: Pedestrian and Bicycle Safety Program Agreement Total: $100,000.00 Authorizing Official: Kristine Ridge Fiscal Official: Kathryn Downs CURRENT GEMS USER(S) 1. Ruben Castaneda Title: Assistant Engineer Media Contact: Yes Phone: (714) 647-5621 Email: rcastaneda@santa-ana.org 2. Mauricio Castaneda Title: Assistant Engineer Media Contact: Yes Phone:714-647-5643 Email: mcastaneda@santa-ana.org 9/20/2021 9:06:55 AM Page 17 of 18 Complete the below information if adding, removing or editing a GEMS user(s) GEMS User 1 Add as a media contact? Yes © No[:] Add/Change © Remove Access ❑ Ruben Castaneda Associate Engineer Name Job Title rastaneda@santa-ana.org 7146475621 Email address Phone number GEMS User 2 Add as a media contact? Yes © No ❑ Add/Change © Remove Access ❑ Mauricio Castaneda Assistant Engineer Name Job Title mcastaneda@santa-ana.org 7146475643 Email address Phone number GEMS User 3 Add as a media contact? Yes © No ❑ Add/Change © Remove Access ❑ Michelle Micallef Community Liaison Name Job Title mmicallef@santa-ana.org 7146475091 Email address Phone number GEMS User 4 Add as a media contact? Yes © No ❑ Add/Change © Remove Access ❑ Zdenek Kekula Principal Civil Engineer Name Job Title zkekula@santa-ana.org 7146475606 Email address Phone number GEMS User 5 Add as a media contact? Yes ❑ No ❑ Add/Change ❑ Remove Access ❑ Name Job Title Email address Phone number Form completed by: M;^,, Date: Oct 25, 2021 As a signatory I hereby authorize the listed individual(s) to represent and have GEMS user access. Zdenek Kekula Signature Name Oct 25, 2021 Grant Director Date Title 9/20/2021 9:06:55 AM Page 18 of 18 A� " CERTIFICATE OF LIABILITY INSUAngie DlgltdiiySgn tE(M4/2D/YYYY) b Angie 07/14/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO GHTS UPON - IF, Td@CATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER C6VE1RDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSU '2'RER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 2022.08.1 1 IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have QDITIONP.L. INSU11020i! W7s-&rW r 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 CONTACT Nora Wolkoff NAME: AI.. . Ext : FAX A/C No): Dickerson Insurance Services an Alera Group Company 1918 Riverside Drive, Los Angeles, CA 90039 ADMDRRESS: Nora@dickerson-group.com INSURERS AFFORDING COVERAGE NAIC # License #OM29112 INSURER A: Philadelphia Indemnity Insurance Company 18058 INSURED INSURER B : SERVICE AMERICAN INDEMNITY COMPANY 39152 INSURERC: Charitable Ventures of Orange County INSURER D : 1505 E. 17th Street, Suite 101 INSURER E : Santa Ana, CA 92705 INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INM SUPOLICY D POLICY NUMBER EFF MM DD/YYYY POLICY EXP MM DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE IX OCCUR DAMAGEORENTED PREMISESSEa occurrence $ 100,000 MED EXP (Any one person) $ 5,000 Abuse & Molestation (A&M) X Professional Liability (Prof. Liab) PERSONAL & ADV INJURY $ 1,000,000 A Y PHPK2419226 07/01/2022 07/01/2023 GEN1 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y PHPK2419226 07/01/2022 07/01/2023 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 A EXCESS LIAB CLAIMS -MADE Y PHUB816379 07/01/2022 07/01/2023 DED 1XI RETENTION$ 10,000 A&M and Prof. Liab. $ Included B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? ❑Y (Mandatory in NH) N / A Y SATIS0511000 07/01/2022 07/01/2023 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1 ,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Clerk of the City Council City of Santa Ana is recognized as an additional insured with respect to the operations for the name insured subject to policy terms and conditions. Evidence only as respects to Workers Compensation. We may cancel this Policy by mailing or delivering to the first Named Insured written notice of cancellation at least: Ten (10) days before the effective date of cancellation if we cancel for non-payment of premium; or Thirty (30) days before the effective date of cancellation if we cancel for any other reason. CERTIFICATE HOLDER CANCELLATION Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE NORA WOLKOFF @ 1988-2015 ACORD ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD , a � ivtant�ernenc vrwsi0n Ali c REVIEWED &APPROVED BY. Aa *44 Risk Management Specialist POLICY NUMBER: PHPK2419226 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, CONTRACTORS - (FORM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 LESSEES OR B) (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 Ali c REVIEWED &APPROVED BY. -'= Risk Management Specialist POLICY NUMBER: PHPK2419226 COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Charitable Ventures of Orange Count Endorsement Effective Date: 07/01/2022 SCHEDULE Name(s) Of Person(s) Or Organization(s): City of Santa Ana It's officers, officials, employees and volunteers are includeds as required by written contract 20 Civic Center Plaza Santa Ana, CA 92702 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Oth- ers To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "ac- cident" or the "loss" under a contract with that person or organization. CA 04 44 03 10 © Insurance Services Office, Inc., 2009 Ali c REVIEWED &APPROVED BY. nl A A -'= Risk Management Specialist