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HomeMy WebLinkAboutILLUMINATION FOUNDATION (21)tiLLE ROCE o A-2021-228 aURAiuCE EXPIRES �JF COUNCIL SECOND AMENDMENT TO OPERATING AGREEMENT WITH THE ILLUMINATION FOUNDATION FOR USE OF CDR UJ THE FULLERTON RECUPERATIVE CARE CENTER ( KIK,?It-11Yn`i6jr THIS SECOND AMENDMENT to the above -referenced agreement is entered into on November 16, 2021, by and between The Illumination Foundation ("Contractor"), and the City of Santa Ana, oa charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). C%A 0 RECITALS G A. The parties entered into Agreement No..A-2021-046, dated April 6, 2021, by which Contractor agreed to administer and operate a portion of the Fullerton Recuperative Care Center to temporarily house clients referred by the City and Street Outreach teams ("Agreement'). B. The parties entered into a First Amendment to said Agreement No. A-2021-174 dated September 8, 2021, in order to extend the Term of said Agreement and to increase the maximum amount of Compensation for said Agreement. C. In accordance with the terms and conditions of said Agreement, as amended, the Parties desire to amend Section 2 — Effectiveness and Term of Agreement, to extend the Term of said Agreement. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions of said Agreement, as amended, except as herein modified, the parties agree as follows: 1. Section 2(b), Effectiveness and Tenn of Agreement, shall be amended to extend the potential no later than end date of the Tenn of said Agreement from November 30, 2021., to January 31, 2022. 2. Except as modified by this Second Amendment, all terms and conditions of said Agreement, as modified by the First Amendment, shall remain in full force and effect. {Signatures on following page) Page 1 of 2 A-2021-228 IN WITNESS WHEREOF, the Parties hereto have executed this Second Amendment to said Agreement on the date and year first written above. ATTEST DAISY GOMEZ `Clerk of the Council APPROVED AS TO FORM SONIA R. CARVALHO City Atty By: RYA DGE Assis t City Attorney FOR APPROVAL STEVEN A. MENDOZA Executive Director Community Development Agency CITY OF SANTA ANA KRI8TINE RIDGE City Manager THE ILLUMINATION FOUNDATION Name:JOHN H. ING Title: Chief Financial Officer Page 2 of 2 Francine R. ® Villareal A� b CERTIFICATE OF LIABILITY INSURANCE Digitally signed by Francine R. Villareal DATE(MM/OOIYYYY) 9r13r2021` THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Bowermaster & Associates 10805 Holder St Ste 350 Cypress CA90630 CONTACT NAME: LlZelle OfOZCO PHONE 714-733-6248 acNo:' E-MAIL ADDRESS: lorozco@bowermaster.com INSURERS AFFORDING COVERAGE NAIC# INSURER A: Philadelphia Indemnity Insurance 18058 INSURED ILLUFOU-01 Illumination Foundation 1091 N. Batavia Street INSURERS: Redwood Fire & Casualty Insurance 11673 INSURERC: Nonprofits' Insurance Alliance of California 11384 INSURERD: Orange CA 92867 - INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 622568538 REVISION NUMRFR- 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 ADDLSUBR POUCYNUMBER POLICY EFF MM/DDIYYVY POLICY EXP MMID Y'n LIMITS C X COMMERCIALGENERAL LIABILITY CLAIMS -MADE � OCCUR Y 2021-24712 9/15/2021 9/16/2022 EACHOCCURRENCE $1,000,000 DAMAGERENTED RENT occurrence) PREMISESS(Ea $500,000 X MED EXP(Anyone person) $20,000 Prof Liability PERSONAL &ADV INJURY $1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY JET LOC GENERALAGGREGATE $3,000,000 PRODUCTS-COMP/OPAGG $3,000,000 $ OTHER: C AUTOMOBILE LIABILITY 2021-24712 9/15/2021 9/15/2022 COMBINED SINGLE LIMIT Ea accldenl $1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Par accldenl) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accldenl $ C X UMBRELLA LIAR OCCUR 2021-24712-UMB 9/15/2021 9115/2022 EACH OCCURRENCE $7,000,000 N AGGREGATE $7,000,000 EXCESS LIAR CLAIMS -MADE DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNERlEXECUTIVE OFFICEWMEMBEREXCLUDED9 ❑ NIA ILWC209336 - 1/11/2021 1/1/2022 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory In NH) If yes, describe under - - E.L. DISEASE - POLICY LIMIT $1.000.000 DESCRIPTION OF OPERATIONS be. A C Commercial Cyber Liability Improper Sexual Conduct PHSD1576498. 2021-24712 9/15/2021 9/15/2021 9/15/2022 9/15/2022 Agg:$3,000,000/Each Agg:$1,000,000/Each $1,000,000 $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re Location: 3535 W. Commonwealth Ave, Fullerton CA City of Santa Ana, It's officers, employees, agents, and volunteers are Additional Insured with respects to General Liability per attached endorsement form; Primary and Non -Contributory wording applies per attached endorsement form. 30-day notice of cancellation is provided per policy provisions. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 Civic Center Plaza, 4th Floor AUTHORI ED REPRESENTATIVE Santa Ana CA 92701 IthkMallsgeiderADIAs[on ... 7411 REVIEWED&APPROVED BY,1988-2015 ACORD CACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORDRisk Management Analyst POLICY NUMBER: 2021-24712 COMMERCIAL GENERAL LIABILITY CG 20 26 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Blanket as required by written contract Wor agreement A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law: and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 26 12 19 © Insurance Services Office, Inc., 2018 M�, RlekMmugpmentDfWeion s� ` REVIEWED&APPROVED Sr �A Risk Management Analyst NONPROFITS INSURANCE �■ ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprof/ts. POLICY NUMBER: 2021-24712 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT FOR PUBLIC ENTITIES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: A. Section II — WHO IS AN INSURED is amended to include: 4. Any public entity as an additional insured, and the officers, officials, employees, agents and/or volunteers of that public entity, as applicable, who may be named in the Schedule above, when you have agreed in a written contract or written agreement presently in effect or becoming effective during the term of this policy, that such public entity and/or its officers, officials, employees, agents and/or volunteers be added as an additional insured(s) on your policy, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your negligent acts or omissions; or b. The negligent acts or omissions of those acting on your behalf; in the performance of your ongoing operations. No such public entity or individual is an additional insured for liability arising out of the sole negligence by that public entity or its designated individuals. The additional insured status will not be afforded with respect to"liability arising out of or related to your activities as a real estate manager for that person or organization. B. Section III — LIMITS OF INSURANCE is amended to include: 8. The limits of insurance applicable to the public entity and applicable individuals identified as an additional insured(s) pursuant to Provision A.4. above, are those specified in the written contract between you and that public entity, or the limits available under this policy, whichever are less. These limits are part of and not in addition to the limits of insurance under this policy. C. With respect to the insurance provided to the additional insured(s), Condition 4. Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Other Insurance a. Primary Insurance This insurance is primary if you have agreed in a written contract or written agreement: (1) That this Insurance be primary. If other insurance is also primary, we will share with all that other insurance as described in c, below; or N IAC-E61 02 19 ,r-ovn}p Riek WnApwfltDIV1,1M REVIEWED&APPROVmaY: @ 8 �d' i "1+k4drkM6 P, VWMa 1 "���' Risk Management Analyst NONPROFITS INSURANCE off ALLIANCE OF CALIFORNIA A Head for Insurance. A Hoart for Nanprof/ts, POLICY NUMBER: 2021-24712 (2) The coverage afforded by this insurance is primary and non-contributory with the additional insured(s)' own insurance. Paragraphs (1) and (2) do not apply to other insurance to which the additional insured(s) has been added as an additional insured or to other insurance described in paragraph b. below. b. Excess Insurance This insurance is excess over: 1. Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work'; (b) That is fire, lightning, or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises temporarily occupled by you with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION I — COVERAGE A— BODILY INJURY AND PROPERTY DAMAGE. (e) Any other insurance available to an additional insured(s) under this Endorsement covering liability for damages which are subject to this endorsement and for which the additional insured(s) has been added as an additional insured by that other insurance. (1) When this Insurance is excess, we will have no duty under Coverages A or B to defend the additional insured(s) against any "suit" if any other insurer has a duty to defend the additional insured(s) against that "suit'. If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured(s)' rights against all those other Insurers. (2) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self -insured amounts under all that other insurance. (3) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Methods of Sharing If all of the other insurance available to the additional insured(s) permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any other the other insurance available to the additional insured(s) does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. NIAC-E61 02 19 s. Risk Mmmgtmen0hielon gREVIEWm&PAPPROVem8W Risk ManageMentAnalyst NONPROFITS INSURANCE �W ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) www.i ns uranceforn on p rofits.org COMMERCIAL UMBRELLA POLICY DECLARATIONS PRODUCER: POLICY NUMBER: 2021-24712-UMB Bowermaster & Associates Insurance Agency, Inc..- 10805 Holder St. Ste. 350 RENEWAL OF NUMBER: 2020-24712-UMB-NPO Cypress, CA 90630 Item 1 NAME OF INSURED AND MAILING ADDRESS: Illumination Foundation; Integrated Community Healthcare Solutions; Home4Health Broadway, LLC; Illumination Housing, LLC 1091 N. Batavia Street Orange, CA 92867 Item 2 POLICY PERIOD: FROM 9/15/2021 TO 9/15/2022 AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION: Providesservicesand temporary housing for the homeless IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY. Item 3 THE ANNUAL AND MINIMUM PREMIUM DUE AT INCEPTION: Item 4 LIMITS OF INSURANCE: $51,864 a. Occurrence / Accident / Injury / Claim Limits (where applicable): ............................................ 7,000,000 1) Each Occurrence - Commercial General Liability and Products - Completed Operations Liability ii) Each Accident - Business Auto Liability ili) Each Injury- Liquor Liability iv) Each Claim - Employee Benefits Liability b. Each Claim - Directors and Officers Liability.......................................................................... 7,000,000 C. Each Claim - Improper Sexual Conduct and Physical Abuse Liability ..................................... 2,000,000 d. Each Claim - Social Service Professional Liability.................................................................. 7,000,000 - Aggregate limits: e. Commercial General Liability, Business Auto Liability, Products- Completed Operations Liability, Liquor Liability, and Employee Benefits Liability Aggregate (where applicable): .................................................................................................................. 7,000,000 f. Directors and Officers Liability Aggregate................................................................................ 7,000,000 g. Improper Sexual Conduct and Physical Abuse Liability Aggregate ........................................ 2,000,000 IL Social Service Professional Liability Aggregate....................................................................... 7,000,000 Item 5 RETROACTIVE DATES -SEE SCHEDULE OF UNDERLYING INSURANCE FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY AT INCEPTION (NUMBER AND EDITION DATE): CU 21 33 01 15, NIAC-EO03 UMB 08 20, NIAC-E133 UMB 05 20, NIAC-E180 UMB 0121, NIAC-E253 UMB 08 21, NIAC-E42 UMB 09 19, SCHEDULE A 01 80, UMB 231 06 16, UMB 232 06 16, UMB-100 05 21, UMB61 05 13 COUNTERSIGNED: 9/20/2021 BY (AUTHORIZED REPRESENTATIVE) THESE DECLARATIONS, THE ATTACHED SCHEDULE OF UNDERLYING INSURANCE, TOGETHER WITH THE ATTACHED SCHEDULE OF FORMS AND ENDORSEMENTS, AND ANY FORMS AND ENDORSEMENTS WE MAY LATER ATTACH TO REFLECT CHANGES, MAKE UP AND COMPLETE THE ABOVE NUMBERED POLICY, Notice: This risk pooling contract is issued by a pooling arrangement authorized by California Cor 5005.1. The pooling arrangement is not subject to all of the insurance laws of the State of Califor regulation by the Insurance Commissioner. Insurance guaranty funds are not available to pay clal becomes insolvent. NIAC - UMB /2-99 ev, RiekManagt�nenEllMalon 0sRhVIEWFJI&APPROVED BY: � �4�Fr.r�,r� 1. V:.tt�4t Ru1a ManagemantAnaigsY NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) www.insurancefornonprofits.org SCHEDULE A - SCHEDULE OF UNDERLYING INSURANCE POLICY NUMBER: 2021-24712-UMB CONTROL NUMBER: 24712 - NAME OF INSURED: Illumination Foundation; Integrated Community Healthcare Solutions; Home4Health Broadway, LLC; Illumination Housing, LLC TYPE OF POLICY APPLICABLE LIMITS INSURER APPLICABLE PERIOD POLICY # (A) Automobile Bodily Injury and Property Damage NIAC 09/15/2021 to 09/15/2022 Liability Combined Single Limit ........................................ $1,000,000 2021-24712 - Business Uninsured/Underinsured Motorist ....................... N/A Auto (Does not include:Terrorism Coverage - Certified Acts) (B) Commercial- Each Occurrence Limit .................................. $1,000,000 NIAC 09115/2021 to 09/15/2022 General General Aggregate Limit . ................................ $3,000,000 2021-24712 Liability Products/Completed Operations Aggregate Lim! $3,000,000 Personal & Advertising Injury Limit .................... $1,000,000 Damage to Premises Rented to You .................... N/A (any one premises) - (Does not include:Terrorism Coverage - Certified Acts) (C) Social Each Occurrence Limit ................................... $1,000,000 NIAC. 09/15/2021 to 09/15/2022 Service Aggregate Limit ................................. $3,000,000 2021-24712 Professional Liability (Does not include:Terrorism Coverage - Certified Acts) (D) Standard Coverage B - Employers Liability Workers Compensation & Employers Bodily Injury by Accident ..................................... N/A Each Accident Liability Bodily Injury by Disease ..................................... N/A Each Employee - Bodily Injury by Disease ..................................... NIA Policy Limit (E) Improper Each Occurrence Limit ...................................... $1,000,000 NIAC 09/15/2021 to 09/15/2022 Sexual General Aggregate Limit ................................. $1,000,000 2021-24712 Conduct and Physical Abuse (Does not include:Terrorism Coverage- Certified Acts) (F) Directors' Each Wrongful Act Limit . ................................. $1,000,000 NIAC 09/15/2021 to 09/15/2622 And Aggregate Limit ................................................ $2,000,000 2021-24712-DO Officers' - (Does not Include:Terrorism Coverage - Certified Acts) (G) Liquor - Each Common Cause Limit ............................ $1,000,000 NIAC 09/15/2021 to 09/1512022 Liability Aggregate Limit ................................................ $1,000,000 2021-24712 (H) Employee Each Employee Benefits Aggregate Limit Liability (Does not include:Terrorism Coverage - Certified Acts) ................................................ $1,000,000 NIAC ................................................ $3,000,000 2021,24712 (Does not include:Terrorlsm Cover 09/15/2021 to 09/15/2022 yse, RtekMan0g0nMiD1Vt8IM 66 REVIEWED&APPRovED By. Risk Management Analyst