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HomeMy WebLinkAboutWORKING WARDROBEINSURANCE NOT ON FILE WORK MAY NOT PROCEED A-2024-022 CITY CLERK DATE; PRISON TO EMPLOYMENT INITIATIVE 0 CQA CIO SUBCONTRACTOR AGREEMENT BETWEEN CC THE CITY OF SANTA ANA AND WORKING WARDROBES THIS PRISON TO EMPLOYMENT INITIATIVE GRANT AGREEMENT ("P2E Agreement"), is hereby made and entered into this 6' day of February, 2024, by and between the d City of Santa Ana, a charter city and municipal corporation of the State of California z ("Contractor"), and Working Wardrobes, a California nonprofit organization ("Subcontractor"). a RECITALS: A. On June 20, 2022, the State of California issued a request for applications for the purposes of advancing the California Workforce Development Board ("CWDB") Strategic Plan goals, specifically the Prison to Employment Initiative ("P2E"). Contractor was awarded funding under Grant #G-0326. B. Funds awarded under this grant are designed to address the personal development, training, and employment needs of California's justice -involved and formerly incarcerated populations C. Contractor is the recipient of P2E funds from the State of California. In 2023, Contractor entered into CWDB Contract Number M90462-7120 commencing on April 1, 2023, through December 31, 2025, in a total amount not to exceed $927,341.16 ("State P2E Agreement"). A true and correct copy of the State P2E Agreement is attached hereto as Exhibit A and incorporated herein by this reference. D. Subcontractor has been made aware of the State P2E Agreement and agrees to comply with all the conditions of the State- P2E Agreement and the applicable State requirements governing the use of P2E grant funds. E. Contractor now approves the provision of P2E grant funds to Subcontractor in an amount not to exceed $742,000.00 to be used in compliance with the P2E objectives defined herein. F. Subcontractor represents that it has the requisite qualifications, expertise, and experience to use said P2E grant funds to operate pursuant to P2E objectives. G. This P2E Agreement is contingent upon the award of P2E grant funds from the State of California. H. Contractor and Subcontractor have duly executed this P2E Agreement for the expenditure and utilization of said P2E funds. 1 NOW THEREFORE, it is agreed by and between the parties that the foregoing Recitals are a substantive part of this P2E Agreement, and the following terms and conditions are approved and together with all exhibits and attachments hereto, shall constitute the entire P2E Agreement between the Contractor and Subcontractor: 1. SCOPE OF SERVICES Subcontractor shall perform during the term of this P2E Agreement, the tasks and obligations including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately complete the services necessary for the P2E objectives, as detailed in the Program and Budget Narrative attached hereto as Exhibit B and incorporated herein by reference ("Program"). 2. TERM This P2E Agreement shall take effect on the date first written above and shall terminate on December 31, 2025, unless otherwise terminated, cancelled or modified according to the terms of this P2E Agreement. 3. DISBURSEMENT AND FUNDS A. Contractor was allocated $927,341.16 in P2E grant funds from the State of California to be expended by December 31, 2025. Contractor agrees to pay to Subcontractor when, if and to the extent State P2E grant funds are received a sum not to exceed $742,000.00 for Subcontractor's performance of the Program through the term of this P2E Agreement. Said sum shall be paid after Contractor receives invoices submitted by Subcontractor as provided herein. B. Subcontractor shall submit monthly invoices (on or before the 15' day of each - month) in a -form prescribed -by -the -Contractor, detailing such expenses: -Such -schedule -may be modifiedwith the approval of the Contractor. C. Payment is subject to the receipt and approval of such invoices and monthly activity reports. Contractor shall pay such invoices within thirty (30) days after receipt thereof, provided Contractor is satisfied that such expenses have been incurred within the scope of this P2E Agreement and that the Subcontractor is in compliance with the terms and conditions of this P2E Agreement. The thirty (30) day period will discontinue if the reimbursement request is determined to be incomplete and will restart the thirty -day timeline once the remaining required elements have been submitted. Failure to provide any of the required documentation will cause the Contractor to withhold all or a portion of a request for reimbursement until such documentation has been received and approved by the Contractor. D. Subcontractor agrees to use said funds pursuant to this P2E Agreement to pay for necessary and reasonable costs allowable under state law and regulations to operate said P2E Program only. Subcontractor's failure to perform as required may, in addition to other remedies set forth in this P2E Agreement, result in readjustment of the amount of funds the Contractor is otherwise obligated to pay to the Subcontractor pursuant to the terms hereof, or termination of this P2E Agreement. E. Contractor and Subcontractor agree that all payments due and owning under this P2E Agreement shall be made through Automated Clearing House (ACH) transfers. Subcontractor agrees to execute the Contractor's standard ACH Vendor Payment Authorization and provide required documentation. Upon verification of the data provided, Contractor will be authorized to deposit payments directly into Subcontractor's account(s) with financial institutions. 4. STATE P2E AGREEMENT Contractor entered into CWDB Contract Number M90462-7120 with the State of California receiving and recognizing $927,341.16 in P2E grant funds to be used by Contractor to address career services for former prisoners and parolees. A true and correct copy of the State P2E Agreement is attached hereto as Exhibit A and incorporated herein by this reference. Subcontractor has been made aware of the State P2E Agreement and agrees to comply with all the conditions of the State P2E Agreement and the applicable State requirements governing the use of P2E grant funds. 5. INDEPENDENT CONTRACTOR Subcontractor shall, during the entire term of this P2E Agreement, be construed to be an independent contractor and not an employee of the Contractor. This P2E Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the Contractor to exercise discretion or control over the professional manner in which Subcontractor performs the services which are the subject matter of this P2E Agreement; however, the services to be provided by Subcontractor shall be provided in a manner consistent with all applicable standards and regulations governing such services. Subcontractor 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. 6. OWNERSHIP OF MATERIALS This P2E Agreement creates a non-exclusive and perpetual license for Contractor to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Subcontractor under this P2E Agreement ("Documents & Data"). Subcontractor shall require all subcontractors to agree in writing that Contractor is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this P2E Agreement. Subcontractor represents and warrants that Subcontractor has the legal right to license any and all Documents & Data. Subcontractor makes no such representation and warranty in regard to Documents & Data which were provided to Subcontractor by the Contractor. Contractor shall not be limited in any way in its use of the 3 Documents and Data at any time, provided that any such use not within the purposes intended by this P2E Agreement shall be at Contractor's sole risk. 7. INSURANCE Subcontractor shall procure and maintain for the duration of the contract insurance against claims forinjuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder and the results of that work by the Subcontractor, his agents, representatives, employees or subcontractors. MINIMUM SCOPE AND LIMIT OF INSURANCE Coverage shall be at least as broad as: • Commercial General Liability (CGL): Insurance Services Office Form CG 00 01 covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence, and $2,000,000 in the aggregate. If a general aggregate limit applies, either the 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. • Automobile Liability: ISO Form Number CA 00 01 covering any auto (Code 1), or if Subcontractor has no owned autos, hired, (Code 8) and non -owned autos (Code 9), with limitno less than $1,000,000 per accident for bodily injury and property damage. • Workers' Compensation: as required by the State of California, with Statutory Limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident for bodily injury or disease. • Sexual Abuse or Molestation (SAM) Liability: If the work will include contact with minors, and the CGL policy referenced above is not endorsed to include affirmative coverage for sexual abuse or molestation, Subcontractor shall obtain and maintain a - policycoveringSexual Abuse and Molestation -with a limit no -less than $1,000,000 per occurrence or claim. If the Subcontractor maintains broader coverage and/or higher limits than the minimums shown above, the Contractor requires and shall be entitled to the broader coverage and/or the higher limits maintained by the Subcontractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the Contractor. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions: Additional Insured Status The Contractor, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of the Subcontractor including materials, parts, or equipment furnished in connectionwith such work or operations. General liability coverage can be provided in the form of an endorsement to the Subcontractor's insurance (at least as broad as ISO Form CG 20 10 11 85 or ifnotavailable, through the addition of both CG 20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 2037 if a later edition is used). Primary Coverage For any claims related to this contract, the Subcontractor's insurance coverage shall be primary coverage at least as broad as ISO CG 20 01 04 13 as respects the Contractor, its officers, officials, employees, and volunteers. Any insurance or self-insurance maintained by the Contractor, its officers, officials, employees, or volunteers shall be excess of the Subcontractor's insurance and shall not contribute with it. Notice of Cancellation Each insurance policy required above shall provide that coverage shall not be canceled, except with notice to the Contractor. Waiver of Subrogation Subcontractor hereby grants to Contractor a waiver of any right to subrogation which any insurer of said Subcontractor may acquire against the Contractor by virtue of the payment of any loss under such insurance. Subcontractor agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether or not the Contractor has received a waiver of subrogation endorsement from the insurer. Self -Insured Retentions Self -insured retentions must be declared to and approved by the Contractor. The Contractor may require the Subcontractor to purchase coverage with a lower retention or provide proof of ability to pay losses and related investigations, claim 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 named insured or Contractor. Acceptability oflnsurers Insurance is to be placed with insurers authorized to conduct business in the state with a current - A.M.-Best's rating of no less than ANII,unless otherwise acceptable -to -the Contractor.- -- -- Verification of Coverage Subcontractor shall furnish the Contractor with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage requiredby this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing allpolicy endorsements to Contractor before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive the Subcontractor's obligation to provide them. The Contractor reserves the right to require complete, certified copies of all required insurance policies,including endorsements required by these specifications, at any time. Subcontractors Subcontractor shall require and verify that all subcontractors maintain insurance meeting all the requirements stated herein, and Subcontractor shall ensure that Contractor is an additional insured on insurance required from subcontractors. 5 Special Risks or Circumstances Contractor reserves the right to modify these requirements, including limits, based on the nature of therisk, prior experience, insurer, coverage, or other special circumstances. 8. INDEMNIFICATION Subcontractor agrees to defend, and shall indemnify and hold harmless the Contractor, its officers, agents, employees, contractors, 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 negligent operations of the Subcontractor, its subcontractors, agents, employees, or other persons acting on its behalf which relates to the services described in section 1 of this P2E 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 P2E 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 P2E Agreement. The Subcontractor further agrees to indemnify, hold harmless, and pay all costs for the defense of the Contractor, including fees and costs for special counsel to be selected by the Contractor, regarding any action by a third party challenging the validity of this P2E 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 P2E Agreement. Contractor may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Subcontractor'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 out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Subcontractor. ___ __ _- -__ _ _ --- ---- Subcontractor shall keep records and invoices in connection with the work to be performed under this P2E Agreement. Subcontractor shall maintain complete and accurate records with respect to the costs incurred under this P2E Agreement and any services, expenditures, and disbursements charged to the Contractor for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Subcontractor under this P2E Agreement. All such records and invoices shall be clearly identifiable. Subcontractor shall allow a representative of the Contractor to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this P2E Agreement during regular business hours. Subcontractor shall allow inspection of all work, data, documents, proceedings, and activities related to this P2E Agreement for a period of three (3) years from the date of final payment to Subcontractor under this P2E Agreement. 0 10. CONFIDENTIALITY If Subcontractor receives from the Contractor information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Subcontractor agrees that it shall not use or disclose such information except in the performance of this P2E 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 P2E 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 Subcontractor disclosed in a publicly available source; (c) is in rightful possession of the Subcontractor without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Subcontractor without reference to information disclosed by the Contractor. 11. CONFLICT OF INTEREST CLAUSE Subcontractor covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this P2E Agreement. 12. NON-DISCRIMINATION Subcontractor shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information, military and veteran status, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, including the Workforce Innovation and Opportunity Act (29 CFR, Parts 37 and 38), in the recruitment, selection, training, utilization, promotion, termination or -other -employment related -activities. Subcontractor affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 13. EXCLUSIVITY AND AMENDMENT This P2E Agreement and the State P2E Agreement represent the complete and exclusive statements between the Contractor and Subcontractor, and supersede any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this P2E Agreement and the State P2E Agreement, the terms of the State P2E Agreement shall prevail. This P2E Agreement may not be modified except by written instrument signed by the Contractor and by an authorized representative of Subcontractor. 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 Subcontractor or the Contractor. Each party to this P2E 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 is not embodied herein. 7 14. ASSIGNMENT Inasmuch as this P2E Agreement is intended to secure the specialized services of Subcontractor, Subcontractor may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the Contractor and any such assignment, transfer, delegation or subcontract without the Contractor's prior written consent shall be considered null and void. Nothing in this P2E Agreement shall be construed to limit the Contractor's ability to have any of the services which are the subject to this P2E Agreement performed by Contractor personnel or by other Subcontractors retained by Contractor. 15. TERMINATION This P2E Agreement may be terminated by the Contractor upon thirty (30) days written notice of termination. In such event, Subcontractor shall be entitled to receive and the Contractor shall pay Subcontractor compensation for all services performed by Subcontractor prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Subcontractor to deliver to the Contractor all work product(s) completed as of such date, and in such case such work product shall be the property of the Contractor unless prohibited by law, and Subcontractor consents to the Contractor's use thereof for such purposes as the Contractor deems appropriate. b. Payment need not be made for work that fails to meet the standard of performance specified in the Recitals of this P2E Agreement. 16. WAIVER -- No waiver of --breach, -failure-of-any condition or -any right or remedy contained in or granted by the provisions of this P2E 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. 17. JURISDICTION - VENUE This P2E 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 P2E 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 P2E Agreement. 18. PROFESSIONAL LICENSES Subcontractor shall, throughout the term of this P2E 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. Subcontractor shall notify the Contractor immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this P2E Agreement. 19. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this P2E 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, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: To Contractor: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. BOX 1988 Santa Ana, CA 92702-1988 Fax: 714- 647-6956 With courtesy copies to: Executive Director, Community Development Agency City of Santa Ana 20 Civic Center Plaza (M-xx) P.O. Box 1988 Santa Ana, California 92702 Fax:714-647-6549 To Subcontractor: Working Wardrobes P.O. Box 413 92 Corporate Park #C Irvine, CA 92606 714-210-2460 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. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 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 P2E Agreement, and shall indemnify Contractor fully, including reasonable costs and attorney's fees, for any injuries or damages to Contractor in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this P2E Agreement. IN WITNESS WHEREOF, the parties hereto have executed this P2E Agreement on the date and year first written above. ATTEST APPROVED AS TO FORM SONIA R. CARVALHO City Attorney 3��44Ll ANDREA GARCIA-MILLER Assistant City Attorney FOR APPROVAL )d A� - MICITAEL GAR IA Executive Director Community Development Agency 10 CITY OF SANTA ANA W,�, 10;K THOMAS R. HA CH Interim City Manager WORKING WARDROBES go Tit Title: EXHIBIT A STATE P2E AGREEMENT CWDB CONTRACT NUMBER M90462-7120 11 STATE OF CALIFORNIA- DEPARTMENT OF GENERAL SERVICES STANDARD AGREEMENT STD 213 (Rev. 04/2020) CONTRACTING AGENCY NAME SCO ID: 7120-M904627120 AGREEMENT NUMBER PURCHASING AUTHORITY NUMBER Uf Applicable) M90462-7120 I EDD-7100 California Workforce Development Board CONTRACTOR NAME Santa Ana Workforce Development Board 2. The term of this Agreement is: START DATE April 1, 2023, or upon final approval, whichever is later THROUGH END DATE December 31, 2025 3. The maximum a mounter this Agreement is: $927,341.16 Nine Hundred Twenty -Seven Thousand Three Hundred Forty -One Dollars and Sixteen Cents 4. The parties agree to comply with the terms and conditions of the followingexhibits, which are by this reference made apart of the greem� enE-- Exhibits Title Pages Exhibit A Scope of Work Budget Detail and Payment Provisions 1 Exhibit B 2 1 Attachment B-1 Budget Summary + Attachment B-2 Budget Narrative 3 + Attachment B-3 Supplemental Budget 2 _ Exhibit C" General Terms and Conditions GTC 04/2017 Exhibit D Special Terms and Conditions 4 _-- Exhibit vinF nn Solicitation Background :.. m...L la n...u....n...n.n red6.....L,....a.. .... .....w.......•..n4.. .. •�..r�u_-�-iL I lamevFnu:n ................ ....n........0 ,,,...,,rv. w�n.w.y...0v'm. ,o,ic u,m... —pa" u, mu uy,ccmvn uan at...... nvcrv. These documents can beviewedothttosYl/ .dos.caAov/OLS/Resources IN WITNESS WHEREOF,THLSAGREEMENT HAS BEEN EXECUTED BY THE PARTIES HERETO. - --- CONTRACTOR - - - -- CONTRACTOR NAME (if other than an individual, state whether a corporation, partnership, Santa Ana Workforce Development Board 801 W. Civic Center Plaza R200 PRINTED NAME OF PERSON SIGNING Kristine Ridge APPROVED AS TO FORM Andrea Garcia -Miller Assistant City Attorney Santa Ana ICA 192701 City Manager DATE SIGNED RECOMMENDED FOR APPROVAL Michael L. Garcia Executive Director Community Development Agency Page 1 of 2 STATE OF CALIFORNIA- DEPARTMENT OP GENERAL SERVICES STANDARD AGREEMENT STD 213 (Rev. 04/2020) CONTRACTING AGENCY NAME California Workforce Development Board SCO ID: 7120-M904627120 AGREEMENT NUMBER PURCHASING AUTHORITY NUMBER (if Applicable) M90462-7120 I EDD-7100 CONTRACTING AGENCY ADDRESS CITY STATE ZIP 800 Capitol Mall, Suite 1022, MIC 45 Sacramento CA 95614 PRINTED NAME OF PERSON SIGNING TITLE Myke Griseta Grants Development Manager CONTRACTING AGENCY AUTHORIZED SIGNATURE DATE SIGNED CALIFORNIA DEPARTMENT OF GENERALSERVICES APPROVAL EXEMPTION (IEApplicahle) SCM Vol, 14.06 Page 2 of 2 CWDB Contract No. M90462-7120 CWDB/Santa Ana WDB Page 1 of 1 EXHIBIT A SCOPE OF WORK (Standard Agreement) 1. This Agreement is entered into by and between the California Workforce Development Board, hereinafter referred to as CWDB, and Santa Ana Workforce Development Board, hereinafter referred to as the Contractor, for the purpose of providing workforce training services in accordance with the Prison to Employment (P2E) 2.0 Regional Partnership and Technical Assistance Grants program. 2. The Project Representatives during the term of this Agreement will be: California Workforce Development Board Attn: Myke Griseta 800 Capitol Mall, Suite 1022. MIC 45 Sacramento, CA 95814 Phone: (916) 764-6544 E-Mail: myke.ariseta0cwdb.ca.cov Contractor Santa Ana Workforce Development Board Attn: Deborah Sanchez 801 W. Civic Center Plaza #200 Santa Ana, CA 92701 Phone: (714) 565-2622 E-Mail: dsancheznc Santa-ana.oro 3. Changes to the Project Representatives will not require an amendment to the Contract. CWDB Contract No. M90462-7120 CWDB%Santa Ana WDS Page 1 of 2 EXHIBIT B BUDGET DETAIL. AND PAYMENT PROVISIONS (Standard Agreement) Lvapig 1 ale'= ueII 1. For services satisfactorily rendered and upon receipt'and approval of the Invoices, the CWDB agrees to compensate the Contractor in accordance with Attachments 13-11 Budget Summary and B�2, Budget Narrative. The total amount of this Agreement shal not. exceed NI a l4undred Twenty -Seven Thousand Three Hundred Forty -Ono 2. Invoices shall Include the CWDB Contract Number M90402.7120 and shall be submitted monthly in triplicate, in arrears to: California Workforce Investment Board 800 Capitol Mall, Suite 1022, MIC 45 Sacramento, CA 95814 Attn: James Hill 3, The Contractor Is responsible for ensuring that invoices submitted to the CWDF3 claim actual expenditures for eligible project costs under Attachments B-1 and B-2. The Contractor shall, upon demand, remit to the CWDB any grant funds not expended for eligible project costs or an amount equal to any grant funds expended by the Contractor _,..in vlolaten of the to me provisions, oondltions{ or commitments of this Agreement 1.11l tin emr. uc : "n -:, ��• 1. The CWDB and the EDD may withhold all or any portion of the grant funds provided for by this Agreement in the event that that the Contractor has materially and substantially breached the terms and conditions of this Agreement, including submission of required - - reports and data. __ -- 2, The CWDB and the EDD will not reimburse the Contractor for costs Identified as Ineligible for grant funding. If grant funds have been provided for costs subsequently discovered to be ineligible, the CWDB and the EDD may either withhold an equal amount from subsequent payments to the Contractor or require repayment of an equal amount to the CWDB by the Contractor. 3. In the event that grant funds are withheld from the Contractor, the CWDB's Executive Director or designee shall notify the Contractor of the reasons for withholding and advise the Contractor of the time within which the Contractor may remedy the situation leading to the withholding. C. Budget Contincencv Clays) It Is mutually understood between the parties that this Agreement may have been written before ascertaining the availability of congressional and legislative appropriation of funds, for the mutual benefit of both parties, In order.to avoid program and fiscal delays which would occur if the Agreement were executed after that determination was made. CWDB Contract No. M90402.7120 CWDBISanto Ana WDB Page 2 of 2 EXHIBIT B BUDGET DETAIL AND PAYMENT PROVISIONS (Standard Agreement) This Agreement is valid and enforceable only if (1) sufflclent funds are made available by the State Budget Act of the appropriate State Fiscal Year(s) covered by this Agreement for the purposes of this program; and (2) .sufficient funds are made available to the State by the United States Government or by the State of California for the Fiscal Year(s) covered by this Agreement for the purposes of this program. In addition, this Agreement is subject to any additional restrictions, limitations or conditions established by the United States Government and/or the State of California, or any statute enacted by the Congress and Legislature, which may affect the provisions, terms or funding of the Agreement In any manner. The parties mutually agree that if the Congress and/or Legislature does not appropriate sufficient funds for the program, this agreement shall be amended to reflect any reduction In funds. The CWDB has the option to terminate the agreement under the 30-day termination clause or to amend the Agreement to reflect any reduction of funds. D, California Promot Payment Clause Payment will be made in accordance with and within the time specified in Government Code section 927, at seq. CWDB Contract No. M90462-7120 ATTACHMENT B-1 CWDB/Santa Ana WDB BUDGET SUMMARY Page 1 of 1 (Standard Agreement) prison EMPLOYMENT Prison to Employment Initiative 2.0 Budget Summary Organization Santa Ana Workforce Development Board Project Name JOCWORKS Line Item Budget Line Item Grant Funds Leveraged Funtls (Match( Total Project Butlget Sourceof Leveraged Funtls Type of Leveraged Funds A. Staff Salarles $106,999.20 $50,000.00 1 $156,999.20WIOA In Kind B. Number of full-time equivalents: 0.3 C. Staff Benefit Cost $12,219.00 Isom $12,219.000 D. Staff Benefit Rate( Percent): 33.99 E. Staff Travel $3,000.00 $O 00 53,000,000 F. 10perating Expenses $12,167.61 $0.00 $12,167.610 G. Furniture and Equipment g Small Purchase(Unit cost of under$5,000) $000 $0.00 $0.000 Equipment Purchase (See Exhibit G) $0.00 $0,00 $0.00 0 Leased Equipment(See Exhibit G) $0.00 $0.00 $0.00 0 H. Consumable Testing and lnstmctlonal Materials $0.00 Saw $0.000 I. Training Tuition Payments/Vouchers $0.00 $100,0MOO $100,000.00 WIOA In Kind J. On -The -Job Training $0100 $0.00 $0.000 K. Participant Wages and Fringe Benefits $10D.OK)000 $0.00 $100,000.000 L. Participant Support5erviceS $54,110.15 $0.00 5S4,110.15 0 M. "Contractual Servlcas(mustmmpiete Supplemental Budget) $0.00 $0.00 $0.000 N. "Subreciplent[must complete Supplemental Budget) $626,898.00 $50.00040 $676,899.00 other Grant Funds In Kind 0. Indirect costs (complete items 1 and 2 below) $11,947.20 $0.00 $11,947.20 0 P. !Other (describe) $0.00 $0.00 $0.00 a Q. TOTAL FUNDING' $927,34116 $200,000.00 $1,127,341.16 " See Exhibit G for definitions for Subrecipient vs Contractors Total Award $927,341.16 •+•Administrative Costs $119,218.Z0 Program Costs $808.122.96 -indirect Cost Rate must be negatlaled and approved by Cognizant Agency, per Appendices In or IV to Uniform Guidance 2CFRPart200. 1 Indirect cost Rate (Percent): 14.92 2 Name ofcognitant Agency: HH5 •'A maximum of 20%of the total project budget will be allowed for administrative costs. The definition of adminlstumve casts is provided in Appendix A of the RFA. ATTACHMENT B-2 BUDGET NARRATIVE (Standard Agreement) > prison EMP OYM EAP Prison to Employment Initiative 2.0 Budget Narrative lorgerizathur Santa Are Workforce Development Board Praan Nama DCWORKS CWDB Contract No. M90462-7120 CWDB/Santa Ana WDB Page 1 of 3 Staff Salaries & Benefits lob Titles of Staff& Roles and Responsibilities M Monthly Saory Mariann Toa15a1bry Bananas amount% Tend staHSaladosa Broader Ewnomk Development Specialist IIFDir¢ts, co edlnates, monRors and evaluates pragram. Conducts research and analysis. Analyzes eapemaead pactldpan[ plans. Reapondhle far 010 512,459.00 36 541,852.40 $2,591.00 5.73 $07,423.40 reporting and contractual requlreme,e. Senior Accounting Assistant. Responsible dedcal work processing documents involved In 0.05 $4,648.09 36 $$366.40 $2.844.00 3199 $31,21040 gnanrlal tmnsacaons and prepares and maintains financial and greatcoat records. Senior Management Analyst -plum, manages and supervises the development end operation of systems far outlasting, accounting, payroll, 0.10 $10,29JM 36 $37,W7.60 $4.379.00 11.82 $4441860 personnel and/or other administrative functions for PIE grant. Senior Accountant Under general direction, provides a varlet, of complex professional amended services, administers 0nanda1 0.05 $91296.00 36 $16231.W $1,42MO 14.49 $19,19,g0 trew5actlaas, and prepares woous financial statements and reports. Tmal Soory $106,99910 Toml Benefr, $1$219.00 Staff Salaries & Benefits Total $119,218.20 Staff Travel Ust staff traveling, destlnatlon/event, and of hamportallan• Note: Stan Travel b for employees of the subrselphat entity only. Anyone else listed under Staff Travel would be an unallowable cast. $3,000.00 Commenan should budget their own travel Into their contracts and cannot be included under subredport entity travel costs. Conhxtdin should budget their own ravel Into chair someone and cannot be needed under submcipient entity towel wits. T_ovel taCallomia Workforce AssodatlOn WORKCAN Cenfererce-learn bes[workorce program bemprectices In helter3erveJwa[ice immlye_dpeople The WORKCON conference IS held annually and the best minds olworkforeedevelopment across the State of Clef ernW come together m share best practices. This one nem wn slow the ORPU to send staff attached to P2E m attend <Inteanca. $3,000.00 Operating ERpenses Proulds breakdown tefapemNn9 expenses in sorb ofthe motoram, items below (if opp8ca61e) $1i, 167.61 'accurate, M for Pmoram Story Rent for shore of rent for P2E program $10,007.61 matmirce $0.00 Accounting lPayrai Services) and RutllM $0.00 Consumable OHIa Supplies Printing $0.60 communized... 1p6ones, whicerylon, etc.) One Own Claud Smogs Collaboration Tool-572D Annually. The taalwdl anneal userficema<munnervke Pmvideo of the RPO. $2,160.00 Meiling and Delivery $0.00 Ours antl Memberships $0.00 outreach $0.00 Furniture and Equipment $0.00 Small Amount of Equipment and Fumiture Pooled Items Its than S5,0110 per unit, Include cost allocation -list name of Item, cast, and quantity ATTACHMENT B•2 CWDB Contract No, M90462-7120 BUDGET NARRATIVE CWDB/Santa Ana N1DB (Standard Aareatnent) Page 2 of a eryulIenentand Fumiture Greater lhardB4ODai fist nbmeadflmm, pout, andsiopMlty W Uopuwhosed-prior approval $0.00 reryulmd end nddad to pnblUllacSupplemental Budget .� Loosed anuipmant Pmwda a resolution olwhot is being laoaed, $O,W length of time and Its $00 981116lt afarleatlYq IMmmntbn Consumable Testing and )nstyuctlonel Materialist ANAla npurpose undpPond¢dldeglnng uylhbrenhdown ojlntlNldudlmswrolNlpg to total 11" kom plamtlon $bOC $p.BB TrelningTWtlon, Paymente, a/ouchool Fecall[mislarprngrmnsanderapnen[(its tmfnlnp and rertljRafaprpgrums(Indude name alraeorrkmfaal, as nvNostmMlnp cartslorvutsWa'Insuring $0.00 praWdcnloolocaM se-flamtloo) Fa an training (and ambelmv), read'rounlogSaryleau moo 00he4cbl' piMng the "Players goo Industrial paRnerfagin the Oirs. brvaloorrefmbausemdmalatrmaing bYpn eraldelar that is Prodded to aPalo paUWpant Wma,entrained In pro tiou nwaMlnalre door 0provides knneduch rWatch resdnbarwlfroNOnndadoyuaNporJornw,rce ajtho/ow 6l krod, mcdloblo UaoughapeogmrethstpraWdeemlmaverementtoit. orMfoRe afwp tobaprmantofthsWage rate ojthe pon1dpn4#XWPfaiprouldod $000 Msewso,M4(ej(3)h4 of the wIOAFlndllink far l6p aptmordinary.eansajpraelding the training a ndaddlllonw(rlmaruislnn related to the training; nod s) N Ilmltodhi dumtfonnsappropriate mthe cenophdanfor wkldl the pprPduottithninBtrcpad,Mk7nginto aecoanitlsrmntgotalthe UBlaing, thepdawah oapodmlm atone parrOdhoodl, nod the smvlm nmwgYNeha padldpony aeappmsn9ate. Pmttipant Wakes and Fringe Benefits State plamlodnumborMportNfpants to MOOR wagesand benelts and give catch of work hpmiwfm or RatrefivaUobs ofong whis bmakdown a(Individual $100p06.08 mats hnookeg to war Mae gem agaradmo To be utilised for subddhed amptapn¢nteppoeturclea. The f tod'e would cover 100%e/the wages In.mtletto lnemnse the opppnunlNae for Pao nears; partklpants Program panldpsetswN paywPalaverthe Calltamla mlmmum wawa U. $100,0ag,00 Supportive Services' Gpsmrd;buspaasey hoong, or day oddfdonnlhnmodlato osS/slamonotamgatile through may mhorscafm ocerdba thespocilfcmrutmspapwlflonowdo along $54,110.15 with Mahrookdown ojlndwlMmtrons ramling to fatal Ilneltem allocation - So' servlaesam baseden indl¢Idual nee sass¢ermom amvicee necesseryta enablean lndivafual l0 avermme herders la penes anddavelpg thplraaradY gems. SupperOve seMcesma4 hdude but nYe nofllmltadta erzlatanmwltialrorapprtatlan, chadcereand depeMbntcarp, haadngasrleanre,clotang,.medlcal mMotNBr $54,130.15 sem7ce5 thatare nor[essarytoeneble an lndNldualropamdpaminthavarlousa[dvidas contractual services AesrAbemrHces provldedbymcll mntra[td4 cast oflMlNduai Yontrac4 andnanre a(aganlmtlon/Indhdduplmrolm prouHRn OtOe <ontraoM dsfpba groaned, MsttypeaJprandemant and ehresrLopmddmeehecontrad'wMlhe awarded Uponowatdr updated/n(wmedonnwstbosubrMged m CwDwfiDDMa $0.00 entered addhit ai Supplemental Budget date themneren wlBbe awarded. Upon award, UpdatedinlwttmtfonmurtAwuUmiltad to Gwaa/60014 a revised dhlblt G, SuppMmental8udpet. $0.00 Subreelplent AesaWepmBmmsemlarprawded sY rocfi subrery/en4 ^mount 01o9reaman4 and More al pragmmsewhaprodder, Ifpromrumert menfr oocauh list type of pmmrRmeM andehe enlmateddote the pgreementwoUbdoworded. Upon owerd, uAAmedlnjormorbn mmtbesubmlftadtdCWBB/EDGhlamwsedBxhkitQ $ggB,Bgg.60 SupPlemonml Bodgeh ATTACHMENT B-2 CWDB Contract No, M90462.7120 BUDGET NARRATIVE CWDBISanta Ana WDB (Standard Aaraetnp2ntl Pespme a ran n ProlaotNlnshlpP.rogramwlll servehistim Involved workforce devClopmansand edueatlonprogrone, Inaluding letter.;" pnellces;lobtra rtni, and weathered mppart wemkoc bad ease npadetament mMmr oilemd to Indynduals with HIM rlesof cant endrorrmlke system InvalwmontlThs main ob2ectives are, a)oigaor plmving, work madlnaesskill bunkfint, tralnlM, and anlllemiom;2}Jab dsyslapmangimanslvacaso management. S7A9,966.OD Working Wordrahea-Working Wardrobes hsuemed the lusilm-Imobed population for ova, 23yeam and has suttesmllydeveloped abelanum targeted spadllcapY to thalneprwmked, raaently mlemed, and bath Inand o#baf cum dyjob seekers. Parthh Inidadye, Wmklm Wardrobes wlll'provide case martap.nmenv a lot .. mindless, trelnlnm Job tralmng, and sottakllls modules tabmht the men and womon with multiple sooners to employment that am to due pranms of pmreleoa, $206,966.00 Chrysaht-Progmmwfll ebhtjustlee•InWleed Indlylduek'tramltlan InWparmnnentemployment to oreampllsh the goal of mlfsu6ldency, An In Musa sodel ontorprhe pre rplas tmnskloimlamplarmenefar themwlthaemre bmork n to omploymens Mclvdingindhiduab In thocrlmmoIjuslice system, Chrysalis agrees to provide; onean onacam mnagamant focused on senyhing ampluymnh.Job readiness chums;return# preparationlantl lntamhw,this training. $r061966,010 Indirect costs (complete Items lend 2 balm) NMI Iowa approval P1090mnt A9anch,, 511,9a7,2q mdIramh at 14A2%far PY 22-B Cognizant Agerw 0s lealthand Human uml'as $s2,sar.zq Other(destrlbeJ hkpkln these roalg which daeatrftlate the medpeOaeRem Mte9Mlat shave. $0,00 Grant Awe to Total S9R7rS4&.16 ATTACHMENT B-3 SUPPLEMENTAL BUDGET (Standard Agreement) )� prison'; ; EMPLOYMENT Prison to Employment Initiative 2.0 Supplemental Budget CWDB Contract No. M90462-7120 CWDB/Santa Ana WDB Page 1 of 2 I. Equipment Ustequipment items with a useful life of more than one year and/or with a unit acquisition cost of $5,000 or more charged to the project. The approval of the budget plan contained in the grant does not constitute approval of the purchase of equipment or request. A separate requestto purchase equipment must be submitted to the state for prior approval. If leasing equipment is being considered, it mustbe Included in the procurement analysis. Item Description Cost Per Item Quantity Total Cost %Charged to Project Total Cost Charged to Project TOTAL Sandi $0.001 1$0.00 Subreciplents and Contractors II, Contractual Services - Providing Goods or Services that are required to conduct a state program. **If procurement needs to occur and T13D, provide selection timeframe. All contractual services must be competitively procured in accordance with state procurement regulations and policies. Description -Type of Service Cost Service Provider Type of Procurement TOTALI $0.00 III. Subrecipient -Carries out a portion of the state program and Is required to meet all programmatic compliance requirements. Upon review, the State may determine that a subcontractor is a contractor. If this occurs, procurement would be required. Program Service Activities Cost Agency Name Working Wardrobes_ Working Wardrobes has served the justice - Involved population for over 25 years, and has successfully developed curriculum targeted specifically to the incarcerated. recently released, and both in -and out-of- custodyjob seekers. For this initiative, Working Wardrobes will provide case management, workforce readiness training, job training, and soft skills modules to assist the men and women with multiple barriers to employment that are in the process of prerelease. $208,966.00 ATTACHMENT B-3 CWDB Contract No. M90462-7120 CWDB/Santa Ana WDB SUPPLEMENTAL BUDGET Page 2 of 2 (Standard Agreement) Chrysalis Program will assist lusnce-InvoNed Individuals' transition into permanent employment to accomplish the goal of self- sufflclency. An in house social enterprise provides transitional employment for those with severe barriers to employment. Including individuals in the criminal justice system. Chrysalis agrees to provide; one- on-one case management focused on securing employment; job readiness classes; resume preparation; and interview skills training $208,966.00 Project Kinship Program will serve justice involved workforce development and education programs, including restorative practices; job training and vocational support services; and case management services offered to individuals with histories of gang and/orjustice system involvement.iThe main objectives are: 1) career planning, work readiness skill building, training, and certifications; 2) job development, Intensive case management. $208,966.00 TOTAL $626,898.00 CWDB Contract No. M90462-7120 CWDB/Santa Ana WDB Page 1 of 4 EXHIBIT D SPECIAL TERMS AND CONDITIONS (Standard Agreement) 1. Subcontractors or Grantees Nothing contained in this Agreement or otherwise, shall create any contractual relationship between the CWDB and any subcontractors or grantees, and no subcontract or grant shall relieve the Contractor of their responsibilities and obligations hereunder. The Contractor agrees to be as fully responsible to the CWDB for the acts and omissions of its subcontractors or grantees and of persons either directly or indirectly employed by the Contractor. The Contractor's obligation to pay its subcontractors or grantees is an independent obligation from the CWDB's obligation to make payments to the Contractor. As a result, the CWDB shall have no obligation to pay or to enforce the payment of any monies to any subcontractor or grantee. 2. Consultant -Staff Expenses The Contractor represents that it has or shall secure at its own expense, all staff required to perform the services described in this Agreement. Such personnel shall not be employees of or have contractual relationship with any governmental entity. 3. Public Contract Code (Consultant Services) The Contractor Is advised that it has certain duties, obligations, and rights under Public Contract Code sections 10335 - 10381 and 10410 - 10412, with which the Contractor should be familiar. These Public Contract Code sections can be viewed at: https //Ieainfo.legislature.ca.gov/faces/codes displavText xhtml?lawCode=PCC&division=2.&title=&p art--2 &chapter-2.&article=4. https /lleginfo legislature.ca.gov/faces/codes disolavText xhtml?lawCode=PCC&division=2.&tltle=&p art=2 &chapter-2.&article=8. 4. Contractor Evaluation Within sixty (60) days after the completion of this Agreement, the Contract Manager shall complete a written evaluation of the Contractor's performance under this Agreement. If the Contractor did not satisfactorily perform the work, a copy of the evaluation will be sent to the Department of General Services, Office of Legal Services within five working days of the completion of the evaluation, and to the Contractor within 15 working days of the filing of the evaluation with DGS. (PCC § 10369) 5. Termination Clause This Agreement may be terminated by CWDB by giving written notice 30 days prior to the effective date of such termination. 6. Advance Work Should the Contractor begin work before receiving a copy of the approved Agreement, any work performed before approval shall be considered as having been done at the Contractor's own risk and as a volunteer. CWDB Contract No. M90462-7120 CWDBl5ante Ana WDB Page 2 of 4 EXHIBIT D SPECIAL TERMS AND CONDITIONS (Standard Agreement) UNWORMUTIMm- Neither party shall be liable to the other for any delay In or failure of performance, not shall any such delay in or failure of performance constitute. default, if such delay or failure is caused by "Force Majeure," As used In this section, "Force Majeure" is defined as follows: Acts of war and acts of God such as earthquakes, floods and other natural disasters such that performance is impossible. 8. Change in Contractor Staf( Should a Contractor's team member(s) become unavailable prior to a start date agreed upon with CWDB, the Contractor will propose an equally well -qualified replacement consultant after consultation with the CWDB. All replacements are subject to the CWDB's approval. Switching staff that were identified In the Contractor's proposal with alternates immediately, or soon thereafter, after execution of this Agreement, are grounds for termination of this Contract. The CWDB has the right to request removal and/or replacement of Contractor resources. 9. Avoidance of Conflicts of inj@rest by the Contractor A. The Contractor agrees that all reasonable efforts will be made to ensure that no conflict m - oFeresfexs s e vdeen is o rears, agerrte; employees; cans�tlfants, or members of its governing body, B. The Contractor shall prevent its officers, agents, employees, consultants, or members of Its governing body from using their positions for purposes that are, or give the appearance of being, motivated by a desire for private gain for themselves or others .such as those with whom they have family, business, or other ties. -- -- - - C. In the event that the CWDB determines that a conflict of interest situation exists, any cost associated with the conflict may constitute grounds for termination of this Agreement. This provision shall not be construed to prohibit the employment of persons with whom the Contractor's officers, agents, or employees have family, business, or other ties so long as the employment of suoh persons does not result in increased costs over those associated with the employment of any other equally qualified applicant and such persons have successfully competed for employment with other applicants on a merit basis. D. Certain consultants designated by the EDD's Conflict of Interest Code are required to file a Statement of Economic Interests, Form 700. The Contractor agrees that 9 the Director of EDD determines that a Statement of Economic Interests, Form 700, is required, the consultant shall obtain the Form 700 and filing instructions from the EDD Personnel office. 10. Travel Clause The travel and per diem shall be set in accordance with Department of Personnel Administration for comparable classes and that no travel outside the State of California shall be reimbursed unless prior written authorization is obtained from the CWDB. CWDB Contract No. M90462.7120 CWDB/Santa Ana WDB Page 3 of 4 EXHIBIT D SPECIAL TERMS AND CONDITIONS (Standard Agreement) 11. Workforce Innovation and Opportunity Act The Contractor agroes to conform to nondiscrimination provisions of the Workforce Innovation and Opportunity Act W0A) and other federal nondiscrimination requirements as referenced in 29 CFR parts 37 and 38. 12. Disputes If the Contractor disputes an action of the CWDB In the administration of this Agreement, the Contractor may appeal to the CWDB's Executive Director or designee. Such appeals shall be filed within 30 calendar days of the notification from the Contractor of such. dispute. The appeal shall be in writing and 1) state the basis for the appeal, 2) state the action being requested of the Executive Director, and 3) include any documentation relating to the dispute. The CWDB Executive Director will review the correspondence and related documentation and render a decision of the appeal within 30 calendar days, except In those cases where the Contractor withdraws or abandons the appeal. The procedural Ume requirement may be waived with the mutual consent of the Contractor and the Executive Director, 13. The Contractor shall cooperate with the CWDB with regard to the performance of this Agreement., ------- ....... ...... ..- ------ 1.__........ .... 14. The Contractor shall cooperate with the CWDB to provide timely responses to any requests for data and/or reports the CWDB deems necessary for the evaluation of the grant program. Such data may include individual program participant data. The Contractor further understands and agrees that this date will be shared with the CWDB and any other stakeholders. W The Contractor is responsible for the project activities Identified In the original Grant Proposal submitted to the CWDB, which is incorporated by reference and made a part of this Agreement as if attached hereto. Review and approval by the CWDB is solely for the purpose of proper administration of grant funds by the EDD and shall not be deemed to relieve or restrict the Contractor's responsibility. 16, The Contractor shall fulfill all assurances, declarations, representations, and statements made by the Contractor in the Grant Proposal, documents, amendments, approved modifications, and communications filed in support of fts request for grant funds. 17. The Contractor agrees to procure all permits and licenses necessary to complete the project, pay all charges and fees, and give all notices necessary or Incidental to the due and lawful proceeding of the project work. CWDB Contract No, M90462-7120 CWDB/Santa Ana WDB Page 4 of 4 EXHIBIT D SPECIAL TERMS AND CONDITIONS (Standard Agreement) 18. Executive Order N-6-22— Russia Sanctions On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (the EO) regarding Economic Sanctions against Russia and Russian entitles and individuals. "Economic Sanctions" refers to sanctions Imposed. by the U.S, government In response to Russia's actions to Ukraine, as well as any sanctions Imposed under state law. The EO directs state agencies to terminate contracts with, and to refrain from entering any new contracts with, individuals or entitles that are determined to be a target of Economic Sanctions, Accordingly, should the State determine Contractor is a target of Economic Sanctions or is conducting prohibited transactions with sanctioned individuals or entitles that shall be grounds for termination of this Agreement. The State shall provide Contractor advance written notice of such termination, allowing Contractor at least 30 calendar days to provide a written response. Termination shall be at the sole discretion of the State. CWDB Contract No. M90462-7120 CWDB/Banta Ana WDB Page 1 of 1 EXHIBIT E SOLICITATION BACKGROUND (Standard Agreement) A fink to the solioitation document or relevant statutory language Is provided for reference purposes below, Attachments B-1, Budget Summary, and B-2, Budget Narrative are to serve as the control documents for the purpose ofthis Agreement'a review by EDD. DocumentTiNe: Prison to Employment (M) 2.0 Regldnal Partnership and Technical Assistance Grants Request for Applications Document Link: https:Hcwdb,ca.gov/wp-content/uploads/sites/43/2022/06/P2E.2.0-Sofcitatlon- Pi NAl- _ACCES618 LE. pdf STATE OF CALIFORNIA DEPARTMENT OF GENERAL SERVICES CALIFORNIA CIVIL RIGHTS LAWS ATTACHMENT OFFICE OF LEGAL SERVICES Dab OLS 04 (Rev. 01117) Pursuant to Public Contract Code section 2010, a person that submits a bid or proposal to, or otherwise proposes to enter Into or renew a contract with, a state agency with respect to any contract In the amount of $100,000 or above shall certify, under penalty of perjury, at the time the bid or proposal is submitted or the contract is renewed, all of thefollowing,. 1. CALIFORNIA CIVIL RIGHTS LAWS: For contracts executed or renewed after January 1, 2017, the contractor certifies compliance with the Unruh Civil Rights Act (Section 51 of the Civil Code) and the Fair Employment and Housing Act (Section 12t360 of the Government Code); and 2. EMPLOYER DISCRIMINATORY POLICIES; For contracts executed or renewed after January 1, 2017, if a Contractor has an internal policy against a sovereign nation or peoples recognized by the United States government, the Contractor certifies that such policies arenot used in violation of the Unruh Civil Rights Act (Section 51 of the Civil Code) or the Fair Employment and Housing Act (Section 12960 of the Government Code). the official named below, certify under penalty of perjury under the laws of the State of Proposer/Bidder Firm Name (Printed) City of Santa Ana Liy (Authorized sl natur L�/ Michael Garcia, Executive Director Community povelopmentAgency Orange W�, a7, 4-o2� Federal ID Number 95-6000785 CA CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS The undersigned certifies, to the beat 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 an 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 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 Farm-LLL, "Disclosure Form to Report Lobbying," in accordance with its Instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all" subawards at all tiers (including subcontracts, subgrants and contracts under grants, 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-inte-f.his-traneaction-Imposed-by-Seotion 9352-Title-81-U7&.-Gode. Any -person -who -falls -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. City, of Santa Ana Pdson to EmployOj Program -Grantee/Contractor Organization - Program/Title- - - *Note: In these Instances, 'All," In the Final Rule Is expected to be clarified to show that it applies to covered contract/grant transactions over $100,000 (per 29 CFR 93.110). F0016 (Rev. 07121/2010) DISCLOSURE OF LOBBYING ACTIVITIES Complele this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 (See reverse for public burden disclosure) a. contract a. md/offer/applicatlon a. Initial filing b. grant b. Initial award b. material change o, cooperative agreement c, post -award For Material Chungs Only, d, loan year quarter e. loan guarantee date of last report f. loan Insurance 4. Name and Address of Reporting Entity: 6. If Reporting Entity in No, d Is a Subawardeo, Prime Subawardee Enter Name and Address of Prime: Tier , if known; Congressional Distriat, ff known: Congressional District, If known., 6, Federal Department/Agency: 7. Federal Program Name/Description. CFDA Number if applloable: S, Federal Action Number, lfknown: g. Award Amount, Ifknown: 10,a. Name and Address of Lobbying Entity (if individual, last name, first name, MI): 11. Amount of 12, Form of Payment (check all that a. cash b. In -kind; specify: nature _ value or offlcor(s), employea(s) or If different from No. b, one-time fee r,, commission d, contingentfee a. deferred f. other: sWeclfv: Payment Indicated on Item 11: ress 16. information requested through this form In authorized by Title 31 U,S.C. Section 1952, This disclosure of Signature: lobbying activiffes Is a material representation of foot upon which reliance was placed by the der above whom print Name: this transaction was made or entered into. This dis- dosure Ia required pursuant to 31 U.S.C. 1352. This Title: information will be reported to the Congress semi- annually and will be available for public htspecllon. Any person who falls to file the required disclosure shall be Telephone No.: Date: subject to a civil penalty of not less than $10,000 and not more than $100,000 far each such fafiure, INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES Federal Use Only: Authorized for Local IZmproduotlon Standard Form - LLLA (Rev. 7-97) This disclosure fort shall be completed by the reporting entity, whether aubawardee or prime Federal recipient, at the Initiation or receipt of a covered Federal aotlon, or a material change to u provious filing, pursuant to title 31 U,S,C, Section 1362, The filing of a form Is required fureach payment or agreement to make payment to any lobbying entity far 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 Congress, or an employes of a Member of Congress In connectlon with a covered Federal action, Use the SF-LLL-A Continuation Sheet for addflionol information if the apace on the form Ia Inadequate, Complete all Items that apply for both the Initial filing and material change report. Refer to the Implementing guidance published by the Office of Management and Budget for additional Information. 1. Identify the type of covered Federal action for which lobbying activity Is and/or has been secured to Influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this Is a follow-up report caused by a material change to the Information previously reported, enter the year and quarter In which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action, 4. Enter the full name, address, city, state, and zip code of the reporfing entity, Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates If It Is, or expects to be, a prime or subaward recipient identify the tier of the aubawardee, e,g„ the first subowardee, of the prime Is the let tiler. Subawards inolude but are not limited to subcontracts, subgranto and contract awards under grants. 6. If the organization filing the report In Item 4 checks "Subawardes", then enterthe full name, address, city, state, Find zip code of the prime Federal recipient, Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. lncluda at least one organizational level below agency name, If known, For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal aotlon (Item 1). If known, enter the full Catalog of Federal Domeallo Asalstar (CFDA) number for grants, cooperative agreements, loans and loan oommltrl 0. Enter the most appropriate Federal Identifying number available for the Federal action Identified In Item 1 (a,g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract, grant, or loan award number, the appllcatior 1prepasal control number assigned by the Federal agency). Include prefixes, e,g., "RFD"l 9. For a covered Federal action where there has been on award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity Identiflod In Item 4 or 6. 10, (a) Enter the full name, address, city, state, and zip We of the lobbying entity engaged by the reporting entity Identified In Item 4 to influence the covered Federal action. (b) Enter the full names of the Individual(s) performing services, and Include full address If different from 10 (a), Enter Last Name, First Name, end Middle Initial (MI). 11, Enter the amount of componsation paid or reasonably expected to be paid by the reporting entity (Item 4) to the lobbying entity (Item 10). Indicate whathar tho payment has been made (actual) or will be made (planned). Chook all boxes that apply. If this Is a material change report, enter the cumulative amount of payment made or planned to be made, 12. Check the appropriate box(es). Check all boxes that apply, tf payment Is made through an In -kind contribution, specify the nature and value of the In -kind payment, 13, Check the appropriate box(es). Check all boxes that apply, M other, specify nature. 14, Provide a specific and detafled description of the services that the lobbylat has performed, or will be expected to perform, and the date(s) of any services rendered. Include all preparatory and related activity, not)ustdmo spent In actual contact with Federal officials. Identify the Federal offlclal(s) or omployce(s) contacted or the offlcer(s), employee(a), or Mamber(s) of Congress that were contacted. 16. Check whether or not a SF-LLL-A Continuation Sheets) is attached. 10. The certifying ofgclal shall sign and date the form, print his/her name, title, and telephone number. A Federal Use Only: Aulhorized for Looal Roproduntlon Standard norm • LLL•A (Rvv, 7.97) STATE OF CALIFORNIA FEDERAL DEBARMENT CERTIFICATION FORM DGS PD 2 (Rev,12119) DEPARTMENT OF OUNWI. SERVICES PROCUREMENT DIVISION Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions This Certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR part 98, Section 98.610, Participant's responsibilities. The regulations were published as Part VII of the May 26, 198E Federal Reoister (pages 10160-19211). (BEFORE COMPLETING CERTIFICATION, READ THE INSTRUCTIONS ON THE, NEXT PAGE WHICH ARE AN INTEGRAL PART OF THE CERTIFICATION) I. The prospective recipient of Federal assistance funds certifies, by submission of this IFB/RFP Response, that neither it nor Its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department oragenCy. 2. Where the prospective recipient of Federal assistance funds Is unable to certify to any of the statements In this certification, such prospective participant shall attach an explanation to this IFBIRFP Response, Pape f of 2 FEDERAL DEBARMENT CERTIFICATION FORM (CONTINUED) Instructions for Certification 1. By signing and submitting this IFB Response, the prospective recipient of Federal assistance funds Is providing the certiflcation as set out below. 2. The certification in this class Is a material representation of fact upon which reliance was placed when this transaction was entered into. If It Is later determined that the prospective reciplent of Federal assistance funds knowingly rendered an erroneous certification, In addition to other remedies available to the Federal Government, the Department of Labor (DOL) may pursue available remedies, including suspension andlor debarment. 3. The. prospective recipient of Federal asslstance funds shall provide immediate written notice to the person to which this RFP Response is submitted If at any time the prospective recipient of Federal assistance funds learns that Its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms "covered transaction," "debarred," "suspended," "Ineligible," "lower tier covered transaction," "participant," "person, "primary covered transaction; "principal," "RFP Response," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules Implementing Executive Order 12549. You may contact the person to which this RFP Response Is submitted for assistance In obtaining a copy of those regulations. 5. The prospective recipient of Federal assistance funds agrees by submitting this RFP Response that, should I the proposed covered transaction be entered into, it shall not knowingly enter Into any lower tier covered transacdowWth a_pemot. who_is-debarred,suspended declared -Ineligible or-voluntarily-sxcluded-from - participation in this covered transaction, unless authorized by the DOL. 6. The prospective recipient of Federal assistance funds further agrees by submitting this RFP Response that it will Include the clausettiled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," without modification, In all lower tier covered transactions and In all solicitations for lower tier covered transactions. 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 debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which It determines the ollgibliity of its principals. Each participant may but is not required to check the List. of Parties Excluded from Procurement or Non-ProouremerZt Pronrams. B. Nothing contained In the foregoing shall be construed to require establishment of a system of records in order to render in good faith the oertiticatlon 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 partlolpent Ina covered transaction knowingly enters Into a lower tier covered transaction with a person who is suspended, debarred, Ineligible, or voluntarily excluded from participation In this transaction, in addition to other remedies available to the Federal Government, the DOL may pursue available remedies, including suspension andlor debarment. Page 2 of 2 AAu of Cirreeda—sepe tMMtaf coamei xei~Mrumment WMW Sordidlon NumWr__ 65Pbaa-tAtgIFVOe/a9) BIDDER DECLARATION 1. Prime bldderinformation(RaWawattachad Bidder Declaration Instructions pdor to completion of this tram); a. Identify current California eertifeatlon(s) IWO, tNVSA, DVAEls or Mono II (If"Nane;gotnitem M2) 'b. Will subcontractors be used for this contract? Yesf]No❑(Ifyes,Indlcate the distinct element of work your firm will perform In this contract e.g„ list the proposed product's produced by your firm,state If your fine owns the transportation vehicles that will dellverthe products to the State, Identify which solicited services your firm will peftm,etc.). Use additional sheets, as necessary, c, Ifyou area California certified OV611: (1) Are you a broker or (2) If the contractlnclud provided In this contract 7.. If no subcontractors will be usod, skip to (UtIficatlon below, Otherwise, list all subcontractors for this contract.(Attadf additional noes if nacacsa,v4 S cmhacerNane(W%c[Pesan, Phone Number&fax Number Subcanuauarbldress &Anall Address Wistpkadan(MQSli, NVS4,Marli ne) Walkpedmnedorgoodsprovlded mthisastrao rarmspoeding %of bid prkm riaod Standing St% RastaR 0% ❑ 0% CkBTIFICATION: Byslgning the bid rusponsa,l cwrdfy under penalty of perjurythat the information provided is up" and Correct, atat0af Calaorr7a--Ueperlment6fGm"ral nm4keij4 uvemedt DMdM MPMS-aM lmV Oaew latruvt o, DIDDOR DRCI,ARATION I„stgudcdons All pdmeLlJdns; Oat firmsubmitdngtheMd)mostMmpletethe Bidder Decimal to idahtlfyall commit ragfitatlensNBiad byiha State offal8omla. Ifthepdmr dddahesno(Aftarah amfimgonbi,dmckthe line h4eled°Nane"and fa medta Its 11, If IflepdmaNldderpomessesonom enamel the fallawlnpmrrybmtlonbantmtire epolrogla[atlBeatloo(s)anthefti • Mkmb4slnass(Mo) SmdlmainessIx • wdnylafitYaMranSadreAgmq(NVSA) • pBaMedVetemnBuslnesSEnterprhe(WBq 7.h, MatkdNmr'Ym"ar"Na°roldend(iVAlcthm+aLmntradasswlll bomadfalho<ontrad.IFth2mslronseis 'No,promedmltemn.0 If"4es;enbrondteknethedWndehmatt' ofworkmnwlneJlnlhenaltratt at beperformed ormegoods tobeprowJed ay, the prime bidden Donatle ludegoodsorsemlcestobe plmided Ly amLromimlam, BlddemtedlBalaSM65D,NVSh,anrVer WBEmuNpmddea mmmandallymefukNntUonas defined ti MlNtaryandlkmrmvtodeStrdm999farDMBFsand gwemmmtCode 4edlon 14837(d)(4)1A)fase)JU mitrdladnasm, Note:Asdmmttmder bar anypomon,11na,corporation, aaeganlratlan wnlmttingtouniform pnrt aftlmydmeaenlrart 1.c lhls4em BanlyloLmtanplded hybuslnesSeswtlAed byfallfanlaaza BVBp. (1) bedarewhetherIlia prime higher a broker oregmtbymaddnp41flaWYa"a"NI. The Military and Yetaansfade5edlm9vg,gfdl deMea"braka"oragml'asamrllfiod WBUemractaorsu4rom imtrorihat daesoothavetdgpamasswabmnfml,anddskoflasaf matedals,vapplieAsemltm,m aqupment pmvhkdmanawardngdeparlmankion essonea(mare aflhe dmble limeft Often _...ImsatlNst51-peNentownashhathequmtglymol ualuau(ihmreturlaLsuPDllas,mrrkesnod of ea th plae of aq ulpureat IrartJnl mrdm toe <onhmt (d)UMdidgrenmlitiotitm eflheequlpmemprauMed(quantlty and wine). Ifnatbidding renWequlpmeagmark'Illefor%ol apfdkhae r x. InuoruhtoMmdamare pmpased,donmemplomthewhle, Bead Its mrldraVonatthebottamoltlte faun and tanplew'Page„_,,,of,_,"on Ihn farm. Ifsubtomr+nonw0 beusod,mmplewdmwWellsingallsWmnhatunn. Urecessary,aNads adllUenal pages and oempietetke"Pate_ of„_,"aceldlenly 7,(tmanaed)foLrmn Iahols Sabmntmtwrflame<antadPmsmUW+adeNumher&FratNdmhoY•—llss auto donotntfosof suMmnhndas, 51rLros+aactordddren&fmalMddrers--lnmrWe addmssondlFavagahk anCrealleddreu. " maNAratWn imsm,AWA, Vgfo(None}-Nthrsu4mmratmsposition a(mrartSuite of fallfemNmdMmtlanDl,vaNyaa thlswdslle fBMNtunrnure.ndAm.muorl, ' WardyrxlorrdsdoYgaodspresddedfoYUsfsaomraR--adedlfythedlstlnddemem of wommir tamed to the embattle too p reign d orthegoods to beprro lded byeach54(onaecroa Ce dfial tom adan mustpmddeammmenNlly usefulfundlan Cortha mntrad. (See paraymph t.bakom Mededwtlom mgadingdaa dodnlllonof [ommerdagyUSBNI Wntpon,}IfarallAedsubmidmcW Isfurlher suixoniratF big agreaterporter afthewalkorgoomprovidedmrthermuitlnp ronaurtWnwodd6e eep oli dby omrrad admhypractkef,aNach a sepawteshaet dpaperenplalnlnplhesltuagon, formmpa+dA+g%Wbldpdm—frderilia corresponding perem%emthe until Mdlobe farthegionk audlasavlmsmbepraddedbyaadt sudcantrarunr. Denotemaa Jdlaramant. 6aad5tandhgF--Praddae respomeforeadasuhomratmrNat¢d UaleoeMtM"Yea"ar"No"tolMkate that thepdnm bolder has vaMisI the mhcomaatlor(s) B In goad swndng for all dlh0 fdlowing: f4%Bvnmlr—ihL pwtalmtadseappl4aMlltyafrentdequ¢anem, "on the folhwdngpammerors, cote(elmm"NfM(notapplidalej,"Yes"a"No"For each smmmmatmllsuN Emd"NlA9ffl o: ' SudronlmrlorlcNBfnWBE(mgaMless ofwhmherornotrental eguipmmllspmvided bytNe • SubemrmmrlsNDTprowdNgrentalequipmcnl(rtyardoln dwbeWcranmsubronaeclol lsa WBe) Enter"Yes"If IhewLmrrtradar4afagfondamllBed gdBEprdAdirg mnmlequfpnent nndthe sidcmnrmtomwmat least 51%ofdierontalequlpment(quenlllyendveluo) NOR providing for iheaonaad. Enter" Whitton Warrantor msNBed UYBEpraddin9ienwl equipment but Ihawb• conaactardcesNBlownatknst 51%ofdne gone equlpmaat(quaagtyandvolue) [twill be providing Read thecertlfleatlon at the bottom of the pngoand complain tha"Pago_of._,"accordingly, Contractor Certification. Clauses CCC 04/20`17 CERTIFICATION I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally bind the prospective Contractor to the clause(s) listed below. This certification is made under the laws of the State of California, City of Santa Ana 95-6000785 Michael Garcia Executive Director Community Development Agency Printed Name and Title of Person Signing CONTRACTOR CERTIFICATION CLAUSES 1, STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with the nondiscrimination program requirements. (Gov, Code §12900 (a-f) and CCR, Title 2, Section 11102) (Not applicable to public entities.) 2. DRUG -FREE WORKPLACE REQUIREMENTS: Contractor will comply with the requirements of the Drug -Free Workplace Act of 1990 and will provide a drug4ree workplace by taking the following actions: a. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations. b. Establish a Drug -Free Awareness Program to inform employees about: 1) the dangers of drug abuse in the workplace; 2) the person's or organization's policy of maintaining a drug -free workplace; 3) any available counseling, rehabilitation and employee assistance programs; and, 4) penalties that may be imposed upon employees for drug abuse violations, c. Every employee who works on the proposed Agreement will; 1) receive a copy of the company's drug -free workplace policy statement; and, 2) agree to abide by the terms of the company's statement as a condition of employment on the Agreement. Failure to comply with these requirements may result in suspension of payments under the Agreement or termination of the Agreement or both and Contractor may be Ineligible for award of any future State agreements if the department determines that any of the following has occurred: the Contractor has made false certification, or violated the certification by falling to carry out the requirements as noted above. (Gov. Code §0360 et seq.) 3. NATIONAL LABOR RELQTIgNS BOARD CERTIFICATION: Contractor certifies that no more than one (1). final unappealable finding of contempt of court by a Federal court has been issued against Contractor within the immediately preceding two-year period because of Contractor's failure to comply with an order of a Federal court, which orders Contractor to comply with an order of the National Labor Relations Board, (Pub. Contract Code §10296) (Not applicable to public entities,) 4. CONTRACTS FOR LEGAL SERVICES $50,000 OR MQRE- PRO BONO REQUIREMENT: Contractor hereby certifies that Contractor will comply with the requirements of Section 6072 of the Business and Professions Code, effective January 1, 2003, Contractor agrees to make a good faith effort to provide a minimum number of hours of pro bono legal services during each year of the contract equal to the lessor of 30 multiplied by the number of full time attorneys in the firm's offices in the State, with the number of hours prorated on an actual day basis for any contract period of less than a full .-year-or40%-of its contract-with-thewtate�.....--.. Failure to make a good faith effort may be cause for non -renewal of a state contract for legal services, and may be taken into account when determining the award of future contracts with the State for legal services. 5. EXPATRIATE CORPORATIONS: Contractor hereby declares that It is -not an expatriate corporation or subsidiary of an expatriate corporation within the meaning of Public Contract Code Section 10286 and 10286.1, and is eligible to contract with the State of California. 6. SWEATFREE CODE OF CONDUCT: a. All Contractors contracting for the procurement or laundering of apparel, garments or corresponding accessories, or the procurement of equipment, materials, or supplies, other than procurement related to a publicworks contract, declare under penalty of perjury that no apparel, garments or corresponding accessories, equipment, materials, or supplies furnished to the state pursuant to the contract have been laundered or produced in whole or in part by sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor, or with the benefit of sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor. The contractor further declares under penalty of perjury that they adhere to the Sweatfree Code of Conduct as set forth on the California Department of Industrial Relations website located at www.dlr.ca,gov, and Public Contract Code Section 6108, b. The contractor agrees to cooperate fully in providing reasonable access to the contractor's records, documents, agents or employees, or premises if reasonably required by authorized offielals of the contracting agency, the Department of Industrial Relations, or the Department of Justice to determine the contractor's compliance with the requirements under paragraph (a). 7. DOMESTIC PARTNERS: For contracts of $100,000 or more, Contractor certifies that Contractor Is In compliance with Public Contract Code section 10295.3. 8. GENDER IDENTITY: For contracts of $100,000 or more, Contractor certifies that Contractor is in compliance with Public Contract Code section 10296,35, DOING BUSINESS WITH THE STATE OF CALIFORNIA The following laws apply to persons or entitles doing business with the State of California 1. CONFLICT OF INTEREST; Contractor needs to be aware of the following provisions regarding current or former state employees, If Contractor has any questions on the status of any person rendering services or involved with the Agreement, the awarding agency must be contacted Immediately for clarification. Current State Employees (Pub. Contract Code §10410): 1). No officer or employee shall engage in any employment, activity or enterprise from which the officer or employee receives compensation or has a financial interest and which is sponsored or funded by any state agency, unless the employment, activity or 2). No officer or employee shall contract on his or her own behalf as an Independent contractor with any state agency to provide goods or services. Former State Employees (Pub, Contract Code §10411): 1). For the two-year period from the date he or she left state employment, no former state officer or employee may enter into a contract in which he or she engaged In any of the negotiations, transactions, planning, arrangements or any part of the decision -making process relevant to the contract while employed In any capacity by any state agency, 2). For the twelve-month period from the date he or she left state employment, no former state officer or employee may enter into a contract with any state agency If he or she was employed by that state agency in a policy -making position in the same general subject area as the proposed contract within.the 12-month period prior to his or her leaving state service. If Contractor violates any provisions of above paragraphs, such action by Contractor shall render this Agreement void. (Pub, Contract Code §10420) Members of boards and commissions are exempt from this section if they do not receive payment other than payment of each meeting of the board or commission, payment for preparatory time and payment for per diem. (Pub. Contract Code §10430 (e)) 2. LABOR CODENVORKERS' COMPENSATION: Contractor needs to be aware of the provisions which require every employer to be insured against liability for Worker's Compensation or to undertake self-insurance in accordance with the provisions, and Contractor affirms to comply with such provisions before commencing the performance of the work of this Agreement. (Labor Code Section 3700) 3. (AMERICANS WITH DISABILITIES ACT: Contractor assures the State that it complies with the Americans with Disabilities Act (ADA) of 1090, which prohibits discrimination on the basis of disability, as well as all applicable regulations and guidelines issued pursuant to the ADA. (42 U.S.C. 12101 et seq.) 4. CONTRACTOR NAME CHANGE: An amendment Is required to change the Contractor's name as listed on this Agreement. Upon receipt of legal documentation of the name change the State will process the amendment. Payment of Invoices presented with a new name cannot be paid prior to approval of said amendment. 5. CORPORATE QUALIFICATIONS TO DO BUSINESS IN CALIPORNIA: a. When agreements are to be performed In the state by corporations, the contracting agencies will be verifying that the contractor is currently qualified to do business in California in order to ensure that all obligations due to the state are fulfilled. b. "Doing business" is defined in R&TC Section 23101 as actively engaging In any transaction for the purpose of financial or pecuniary gain or profit. Although there are some statutory exceptions to taxation, rarely will a corporate contractor performing within the state not be subject to the franchise tax. c. Both domestic and foreign corporations (those incorporated outside of California) must be in good standing in order to be qualified to do business in California. Agencies will of State. B. RESOLUTION: A county, city, district, or other local public body must provide the State with a copy of a resolution, order, motion, or ordinance of the local governing body which by law has authority to enter into an agreement, authorizing execution of the agreement. 7. AIR OR WATER POLLUTION VIOLATION: Under the State laws, the Contractor shall not be: (1) In violation of any order or resolution not subject to review promulgated by the State Air Resources Board or an air pollution control district; (2) subject to cease and desist order not subject to review issued pursuant to Section 13301 of the Water Code for violation of waste discharge requirements or discharge prohibitions; or (3) finally determined to be in violation of provisions of federal law relating to air or water pollution. 9. PAYEE DATA RECORD FORM STD. 204: This form must be completed by all contractors that are not another state agency or other govemmental entity. STATE OF CALIFORNIA-ONPARTWNT OF FINANCE PAYEE DATA RECORD (Required when reoelving payment from the State of California In Iiau of IRS R-g or w-7) STD 204 (RaV. 03021) NAME (This Is required, `Do not leave this line blank. Must match the payee's federal tax return) BUSINESS NAME, DBA NAME or DISREGARDED SINGLE MEMBER LLC NAME (if different from above) MAILING ADDRIUS (number, street, apt. or suite no.) (See Instructions on Page a) CITY, STATE, ZIP CODE ❑ SINGLE MEMBER LLC Disregarded Enf/ly owned by an IndMdual ❑ PARTNERSHIP El ESTATE OR TRUST E-MAIL ADDRESS ❑ MEDICAL (e.g„ dentistry, uhlropractlo, eta) 0 LEGAL (e.g., atfomoysenBces) 0 EXEMPT (e.g„ nanpmng M ALL OTHERS match the name given In Section 1 of this form. Do not provide more then ohs (1) TIP The TIN is a 9-digit number. NOW: Payment will not be processed without a TIN. • For Individuals, enter SSN. • If you are a Resident Allen, and you do not lava and are not eligible to got an SSN, enter your ITIN. • Grantor Trusts (such as a Revocable Living Trust while the grantors are Ove) me not have a separate FEIN. Those trusts must enter the Individual grantor's SSN. • For Sole proprietor or Single Member LLC (disregarded entity), In which the Social Security Number ISSN) or Individual Tax Identification Number (ITIN) OR Federal Employer Identification Number prefers BEN). • For Single Member MG (dieregarded entity), In which the sole member is a — -----,--- business entity, enter the owner entitys FEIN. Do not use the disregarded entity's FEIN. • For all other entities Including LLC that is taxed as a corporation or partnership, estateslfrusts (with F6iNs), enter the entity's FEIN. fU CALIFORNIA RESIDENT.. Qualified to do business In Colifornla or maintains a permanent place of business In California. 11 CALIFORNIA NONRESIDENT - Payments to nonresidents for services may be subject to state Income tax withholding. ©No services performed In California ElCopy of Franchise Tax Board waiver of state withholding Is attached. ,Xy„ : :, �;.. iy ,• z, 1, >agwe�'ta'�rt w " � ' `,A'➢`S�'$§'tCitY �4 f r r41dYl' � r;fa 1u'awk -a (' Y t hereby certify underponatty of perjury that the Information provided on this document Is trite and correct Should Loy rostdoney status change, I w111 Promptly notifIr the stats agency below. NAME OF AUTHORIZED PAYEE REPRESENTATIVE TITLE E-MAIL ADDRESS SIGNATURE I DATE I TELEPHONE (Inclado area code) -"f rr. Please return completed form to: STATE AGENCYIDEPARTMGNTOFFIC15 UNITISECTION MAILING ADDRESS FAX TELEPHONE (hwlade area code) CITY STATE ZIP CODE E-MAIL ADDRESS STATE OF CALIFORNIA -DEPARTMENT OF FINANCE PAYEE DATA RECORD (Required when receiving payment from the Slate of California in lieu of IRS W-9 or W-7) STD 204 (Rev. 03/2021) GENERAL INSTRUCTIONS Type or print the Information on the Payee Data Record, STD 204 form. Sign, date, and return to the stale agency/department office address shown in Section 6. Prompt return of this fully completed form will prevent delays when processing payments. Information provided in this form will be used by California state agencies/departments to prepare Information Returns (Form1099). NOTE: Completion of this form Is optional for Government entities, i.e. federal, stale, local, and special districts. A completed Payee Data Record, STD 204 form, Is required for all payees (non -governmental entities or individuals) entering into a transaction that may lead to a payment from the state. Each state agency requires a completed, signed, and dated STD 204 on file; therefore, It Is possible for you to recelve this forth from multiple stale agencies with which you do business. Payees who do not wish to complete the STD 204 may elect not to do business with the slate. If the payee does not complete the STD 204 and the required payee data is not otherwise provided, payment may be reduced for federal and state backup withholding. Amounts reported on Information Returns (Form 1099) are in accordance with the Internal Revenue Code (IRC) and the California Revenue and Taxation Code (R&TC). Section t - Payee Information Name - Enter the name that appears on the payee's federal tax return. The name provided shall be the tax liable party and is subject to IRS TIN matching (when applicable). • Sole ProprielorllndividuagRevocable Trusts - enter the name shown on your federal tax retum. • Single Member limited Liability Companies (EEGs) that is disregarded as an entity separate from Its owner for federal tax purposes - enter the name of the individual or business entity that is tax liable for the business in section 1. Enter the DBA, LLC name, trade, or fictitious name under Business Name. • Note: for the State of California tax purposes, a Single Member LLC is not disregarded from its owner, even if they may be disregarded at the Federal level. • Partnerships, EstatesTrusts, or Corporations - enter the entity name as shown an the entity's federal tax return. The name provided in Section 1 must match to the TIN provided in section 3. Enter any DBA, trade, or fictitious business names under Business Name, Business Name - Enter the business name, DBA name, Made or fictitious name, or disregarded LLC name. Mailing Address - The mailing address is the address where the payee will receive information returns. Use form STD 205, Payee Data Record Supplement to provide a remittance address If different from the mailing address for information returns, or make subsequent changes to the remittance address. Section 2 - Entity Type If the Payee in Section 1 is sin)... THEN Select the Box for... 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However, an individual who comes to perform a particular contract of short duration will be considered a nonresident. For information on Nonresident Withholding, contact the Franchise Tax Board at the numbers listed below: Withholding Services and Compliance Section: 1-888-792-4900 E-mail address: mu.gen@ftb.ca.gov For hearing impaired with TDD, call: 1-800-822-6268 Website: www.ftb.ca.00v Section 5 —Certification Provide the name, title, email address, signature, and telephone number of Individual completing this form and date completed. In the event that a SSN or ITIN is provided, the individual identified as the tax liable party must certify the form. Note: the signee may differ from the tax liable party In this situation if the signee can provide a power of attorney documented for the individual. Section 6 — Paying State Agency This section must be completed by the state agency/department requesting the STD 204. 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All questions should be referred to the requesting slate agency listed on the bottom front of this form. STATE OF OALWORNIA DARFIIR CONTRACTING ACT CERTIFICATION DOS PD 1 (Rev. 12110) DEPARTMENT OF GENERAL SERVICES PROCUREMENT DIVISION Pubile Contract Code Sections 10475-10481 applies to any company that currently or within the previous three years has had business activities or other operations outside of the United States. For such a company to bid on or submit a proposal for a State of California contract, the company must certify that it is either a) not a scrutinized company; or b) a scrutinized company that has been granted permission by the Department of General Services to submit a proposal. If your company has not, within the previous three years, had any business activities or other operations outside of the United States, you do not need to complete this form. OPTION #1 - CERTIFICATION If your company, within the previous three years, has had business activities. or other operations outside of the United States, in order to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number and complete the certification below. I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that a) the prospective proposer/bidder named below is not a scrutinized company per Public Contract Code 10476; and b) I am duly authorized to legally bind the prospective proposerlbidder named below. This certification is made under the laws of the State of CompanyNandorName (Printed) By (Authorized Signature) Printed Name and Title of Parson Signing Federal Q Number ORTION #2 —WRITTEN PERMISSION FR IW DGS Pursuant to Public Contract Code Section 10477(b), the Director of the Department of General Services may permit a scrutinized company, on a case -by -case basis, to bid on or submit a proposal for a contract with a state agency for goods or services, if it is in the best interests of the state. If you area scrutinized company that has obtained written permission from the DGS to submit a bid or proposal, complete the information below. Pago 1 of 2 We are a scrutinized company as defined in Public Contract Code section 10476, but we have received written permission from the Department of General Services to submit a bid or proposal pursuant to Public Contract Code section 10477(b). A copy of the written permission from DGS is Included with our bid or proposal. Company/Vendor Name (Printed) By (Authorized Signature) Printed Name and Title of Person Signing Page 2 of 2 ' EXHIBIT B PROGRAM AND BUDGET NARRATIVE 12 WORKING WARDROBES FORA NEW START REQUEST FOR PROPOSALS (RFP) NO.23-106A SERVICES PROVIDED December 20, 2023 Working Wardrobes for A New Start proposes providing workforce development services for eighty-four (84) formerly incarcerated and justice involved individuals through the Project New Start - Career Development Program Serving Justice Involved Individuals program. The program will incorporate job readiness training, skills development, supportive services, and employment placement assistance to help participants successfully re-enter society, avoid recidivism, become financially independent, and lead productive lives. Eligible participants will be justice involved individuals as defined in Penal Code §1234(d) and/or under the jurisdiction of a county or the California Department of Corrections and Rehabilitation. Participants may also include individuals who are on county informal probation, county deferred entry of judgement, or any other county diversion program such as drug courts, veterans' courts, community courts, or other specialty courts. Participants will be at least 18 years of age and be authorized to work in the United States. Working Wardrobes will identify and recruit participants through our relationships with Orange County correctional facilities including the Theo Lacy facility in Orange and the Orange County Central Men's and Women's Jails in Santa Ana, the Orange County Sheriff Programs Team, State Division of Adult Parole Operations (DAPO) field units, Orange County Probation and Parole Departments, and through our participation in monthly Orange County Police and Corrections Team (PACT) meetings. We will also conduct recruitment through our core Rebuilding Careers workforce skills training program by identifying eligible participants who may already be enrolled in one or more of our services but would benefit from the specialized services provided through this program. In addition, we will build public awareness of the program through our comprehensive network of over 185 government, social services, educational, and faith - based partners throughout Orange County, many of which also serve this population. Working Wardrobes will conduct a comprehensive intake process that will confirm each participant's eligibility, their understanding of the program's services, their commitment to achieving their individual life and employment goals, and facilitate their co -enrollment in Workforce Innovation and Opportunity Act (WIOA) services offered by the Orange County Workforce Solutions Centers network. Following completion of the intake process, Working Wardrobes will provide the following program services for participants: Job Readiness Training: The program will include 8 to 10 week cycles of workforce and life skills training workshops with a focus on transitioning from incarceration to mainstream society. The workshops will be offered to incarcerated individuals at the Theo Lacy facility and the Central Men's and Women's Jails, and to other eligible participants both at Working Wardrobes and virtually through an online self -paced curriculum for those with transportation, childcare, health, or other challenges. Workshop topics will include Self - Assessment Strategies, Resume Skill Building, Job Search Skill Building, Pre -Interview Skill Building, Interview Skill Building, Power of Your Image, Navigating Success in the Workplace, Work Culture and Effective Communication, Time Management, and Financial Literacy. Each workshop will be approximately two hours in duration, with three workshops conducted each week for a total of 150 workshops over the one year program term. A portion of the training workshops will be held at correctional facilities and a portion at the Working Wardrobes Career Success Center in SantaAna. Skills Development: The program will offer skills development opportunities that will assist participants' ability to acquire knowledge and training to find and maintain meaningful employment in high -demand industries with opportunities for advancement. We will assist participants in selecting, enrolling, and Page 1 of 6 completing classroom skills training, entering pre -apprenticeship and apprenticeship programs, and enrolling in post -secondary education as distinct paths to obtaining skills in high -wage, high -demand industries including Trades (Construction), Manufacturing, Information Technology, Culinary Arts, and Transportation (Truck Driving). We will utilize training providers included in the State Eligible Providers List (ETPL) to match participants with State -approved classroom skills training programs that meet their needs and goals. We will also assist participants in identifying and enrolling in pre -apprenticeship and apprenticeship programs that may offer subsidized "learn and earn" employment opportunities. Participants will also have the opportunity to enroll in post -secondary education at local colleges and universities to pursue degree or certificate programs that will lead to employment opportunities in high -demand occupations. Career Coach: All participants will be assigned to a Career Navigator, who will conduct intake and assessment activities, help to develop life and employment goals, prepare an Individualized Employment Plan (IEP), identify supportive services to address basic and immediate issues including housing, legal, mental and physical health, and other federal, state, and local assistance programs, and offer individualized, compassionate, and client -focused guidance to maximize participants' potential to achieve their individual goals. They will be supported by our volunteer force of Career Coaches, who will assist participants in developing resumes, assessing communication and interview skills, reviewing labor market information, identifying career opportunities, and assisting the Career Navigators. Participants will also be provided with open access to the state-of-the-art Working Wardrobes job search lab, which is located at our Career Success Center in Santa Ana and is equipped with computers, printers, and resource materials to help them produce resumes, research occupational and employment opportunities, and identify other employment -related resources. Vocational Assessment: The program's Career Navigators will work closely with each participant to help them identify basic skills, interests, abilities, and values to determine suitable career paths. Assessment tools will include True Colors, O*Net Online, and a career inventory to identify occupational interests and skill sets. The results of the assessments will inform the development of each participant's IEP and establish a clear plan for training and employment goals and supportive services needs. The Career Navigators will meet with each participant on a biweekly basis to review progress, revise goals, and offer additional assistance as needed. Job Placement Assistance: The program's Job Developer will work closely with the Workforce Solutions Centers, the State Employment Development Department, Orange County Business Council, Chambers of Commerce, employment agencies, and local employers to identify job opportunities for participants with a focus on high demand occupations including Trades (Construction), Manufacturing, Information Technology, Culinary Arts, and Transportation (Truck Driving). The program's goal is to help participants secure employment as soon as possible to help them achieve financial stability, especially for those enrolled in skills training programs and post -secondary education. The Career Navigators will match participants with job openings based on their skills, interests, and training and support their job search process through assistance in completing job applications, referring them to job openings, and providing coaching and encouragement to support their success in securing employment. Working Wardrobes will also hold periodic in -person Hiring Events which will offer in -person networking opportunities with local employers to facilitate access to available job openings. Supportive Services: The program will provide participants with direct financial aid to help them address transportation needs (through the provision of gasoline debit cards and bus passes) and other incidental needs addressing barriers to employment (such as identification/credentials, background checks, grooming, etc.) and support their ability to access services and employment opportunities. Page 2 of 6 The program will also provide each participant with a professional outfit (including a suit, shirt or blouse, shoes, and accessories) for interviews and on -the job to help them build their confidence and make a good first impression with potential employers. They will receive one-on-one assistance by our Wardrobe Specialist to select outfits that best meet their needs. Incentives will also be provided to encourage participants to achieve program milestones and reward them for their success. A payment of $125 will be awarded to participants who complete the full complement of workforce skills training activities, $125 will be awarded to those attaining an industry -recognized certificate or completion (whether through Working Wardrobes or another training provider), and $250 will be awarded upon attainment of employment. The maximum value of incentives to be provided to an individual client is $500. Follow -Up Support: Whether or not they have completed the full range of program services or secured employment, participants will have continued access to all Working Wardrobes activities including coaching, advice, and guidance to help them identify and obtain additional skills training and supportive services, and ensure that they achieve their individual goals, maintain their employment, and continue to progress in their careers. The goal of the program is to serve eighty-four (84) justice involved individuals over the initial program term and support their ability to gain valuable workforce and occupational skills, achieve success in the job market, contribute to the growth and success of businesses and the economy, avoid recidivism, and build successful and self-sufficient lives. The following minimum performance outcomes and measurements to be achieved are as follows: Outcome Measurement Enrolled in program 84 participants Enrolled in training 40 participants Completed training 30 participants Attained industry -identified certificate or credential 20 participants Placed in post -secondary education 13 participants Placed in state approved apprenticeship 13 participants Employed 40 participants Page 3 of 6 WORKING WARDROBES FOR A NEW START REQUEST FOR PROPOSALS (RFP) NO.23-106A FIRM AND TEAM EXPERIENCE December 20, 2023 Working Wardrobes for a New Start is a nonprofit organization founded in 1990. Over the past 33 years we have provided comprehensive and impactful workforce and life skills training, job placement assistance, and professional wardrobing for over 120,000 individuals. Our mission statement is: We help people overcome barriers to gainful employment. Our target service population is low-income persons from marginalized groups seeking to enter the workforce or achieve career advancement, with a focus on assisting persons of color, veterans, seniors, andjustice involved individuals as well as those who have faced major life crises including homelessness, substance abuse, domestic violence, chronic illness, and/or long-term unemployment. In 2022 alone, Working Wardrobes provided assistance to a total of 4,420 clients receiving 16,575 units of service. Our 2023 organizational budget is $5,432,640 and we employ a staff of 40 employees. Our impressive record of longevity, sustainability, and success demonstrates our ability and commitment to helping our clients realize "The Power of a Paycheck." 4.00 full-time equivalent (FTE) employees will be working directly on this program, including our Director of Client Services (0.50 FTE), two (2) Career Navigators (total 2.00 FTE), Client Services Administrator (0.25 FTE), Job Developer (1.00 FTE), and Wardrobe Specialist (0.25 FTE). The Working Wardrobes corporate headquarters and Career Success Center are located at 2000 E. McFadden Ave., Santa Ana, CA 92705. Working Wardrobes serves all of Orange County and the surrounding regions of southern California. The supervising Project Manager will be Bianca Herrera, Director of Client Services. She is based at the Working Wardrobes headquarters in Santa Ana. Her email address is biancah@workingwardrobes.org and her phone number is 714-210-2460. The following Working Wardrobes positions will be assigned to this program: Director of Client Services Career Navigator #1 Career Navigator #2 Client Services Administrator Job Developer Wardrobe Specialist All staff members filling these positions will be qualified to fulfill their job responsibilities and execute the program's services. The specific responsibilities of each position as related to this program are identified within the Budget and Narrative (Attachment C). Working Wardrobes confirms our commitment that personnel as identified in this proposal will be available throughout the program/contract term. Working Wardrobes has assisted justice involved individuals throughout our 33 years of service to Orange County and the surrounding regions of southern California. We began providing workforce skills training and job placement assistance focused on the challenges and needs of this population in 2013 by conducting workshops at the Orange County Men's and Women's Jails and the Theo Lacy facility, and we have since expanded our experience and reach through our execution of three government contracts: 1) Orange County Page 4 of 6 Community Services: Linking Employment Activity Pre-Release-2 (LEAP-2) program with term of July 1, 2016 through December 3, 2018; 2) City of Santa Ana: Prison to Employment program with term of October 1, 2019 through March 31, 2022; and 3) Board of State and Community Corrections: Adult Reentry Program with term of October 1, 2022 through April 30, 2026. Further, our core Rebuilding Careers workforce training program includes justice involved individuals as a target population. In total, Working Wardrobes has helped approximately 3,500 justice involved individuals gain workforce and life skills and find quality jobs. Page 5 of 6 WORKING WARDROBES FORA NEW START REQUEST FOR PROPOSALS (RFP) NO.23-106A PROPOSED WORK PLAN AND TIMELINE December 20, 2023 All program activities and services will be conducted and available to participants on an open, ongoing basis throughout the program period. The following activities will be offered and milestones/outcomes achieved as follows, with cumulative outcomes metrics to be reached by the contract end date. Number of participants Quarter Quarter Quarter Quarter Quarter Activity Milestone 1 2 3 4 5 Total Program Participants complete 0 21 21 21 21 84 enrollment program intake process including AJCC co -enrollment Training Participants are 0 10 10 10 10 40 enrollment assigned to a Career Navigator and develop an IEP to identify training and supportive services needs and set goals Training Participants complete 0 6 8 8 8 30 completion job readiness skills training Certificate or Participants complete 0 0 6 7 7 20 credential certificate or attainment credential training program Post- Participants enter 0 — 2 3 4 4 13 secondary post -secondary education education programs placement at community colleges State approved Participants enter 0 2 3 4 4 13 apprenticeship State -approved placement apprenticeship program s Employment Participants secure 0 4 12 12 12 40 placement employment NOTE: Quarter 1 will be utilized as a program preparation period to hire and orient program staff, establish program services protocols, and initiate relationships with correctional agencies, training providers, and educational institutions. Page 6 of 6 WORKING WARDROBES FOR ANEW START PROJECT NEW START - CAREER DEVELOPMENT PROGRAM SERVING JUSTICE -INVOLVED INDIVIDUALS BUDGET NARRATIVE December 20, 2023 PERSONNEL SALARIES 1. Director of Client Services: 50% FTE for 12 months = $42,500 Dedicate 50% of time to program for 12 months. Provide management and quality control of program services and staff, ensure compliance with contract requirements, coordinate partnerships with correctional agencies, Workforce Solutions Centers, and training providers. 2. Career Navigators (2): 100% FTE ea. for 12 months = $54,995 ea. x 2 = $109,990 Dedicate 100% of time to program for 12 months. Coordinate participant outreach, intake, and enrollment, provide case management/career navigation for participants, facilitate referrals and enrollment for supportive services, occupational skills training, certification programs, educational opportunities, and job placement. 3. Client Services Administrator: 25% FTE for 12 months = $16,875 Dedicate 25% of time to program for 12 months. Process and track participant incentives, supportive services, and skills development payments, maintain program data, coordinate reporting tasks, provide support to Director of Client Services and Career Navigators. 4. Job Developer: 100% FTE for 12 months = $56,160 Dedicate 100% of time to program for 12 months. Work with local employers to identify job opportunities for participants, assist Career Navigators in matching participants with job openings and apprenticeship programs. 5. Wardrobe Specialist: 25% FTE for 12 months = $13,250 Dedicate 25% of time to program for 12 months. Schedule and provide professional wardrobe services for clients, manage volunteer Personal Shoppers. TOTAL PERSONNEL SALARIES = $239,045 PERSONNEL BENEFITS 1. Director of Client Services: 12.64% of salary (blended rate including Social Security, Medicare, SUI, health insurance, and workers compensation) _ $42,500 x 12.64% _ $5,372 2. Careers Navigators (2): 12.64% of salary (blended rate including Social Security, Medicare, SUI, health insurance, and workers compensation) _ $54,995 ea. x 2 = $109,990 x 12.64%= $13,902 3. Client Services Administrator: 12.64% of salary (blended rate including Social Security, Medicare, SUI, health insurance, and workers compensation) _ $16,875 x 12.64%= $2,133 4. Job Developer - Vacant: 12.64% of salary (blended rate including Social Security, Medicare, SUI, health insurance, and workers compensation) _ $56,160 x 12.64% _ $7,099 5. Wardrobe Specialist: 12.64% of salary (blended rate including Social Security, Medicare, SUI, health insurance, and workers compensation) _ $13,520 x 12.64%= $1,709 TOTAL PERSONNEL BENEFITS = $30,215 TOTAL PERSONNEL SALARIES & BENEFITS = $269,260 Page 1 of 3 OPERATING EXPENSES Office Expenses Casebook CRM system subscription to manage program and client data (25% of total annual expense allocated to this program) = $2,500 Flash drives for participants to store program materials; paper, pens, printer ink, file folders, other miscellaneous supplies for program staff= $1,100 Printing of program marketing/outreach flyers and brochures and skills workshops curriculum materials = $1,900 Total Office Expenses = $5,500 Indirect Cost Per Negotiated Indirect Cost Rate Agreement with U.S. Department of Labor for period 01/01/23 to 12/31/23 @ 21.06%. Direct services total costs of $612,919 x 21.06%= $129,081 Total Indirect Cost = $129,081 Participant Skills Development (Training) Payment of tuition and training -related expenses (tools, uniforms, books, etc.) for participants enrolled in certificate or credential programs or post -secondary education 33 participants @ $5,636/ea. (average) = $136,000 (program cost) + $50,000 (matching funds from City of Santa Ana WORK Center) = $186,000 Total Participant Skills Development (Training) = $186,000 ($136,000 program cost + $50,000 matching funds from City of Santa Ana WORK Center) Professional Services Training Coordinator (independent contractor) Conduct Job Readiness Workforce/Life Skills Workshops at correctional facilities and Working Wardrobes 20 hours/week x 50 weeks @ $35.00/hr. = $35,000 Total Professional Services = $35,000 Staff Travel/Mileage Mileage reimbursement for staff travel to and from correctional facilities and partner agencies. 2,588 mi. @ $0.67/mi. (2024 IRS business rate) = $1,734 Total Staff Travel/Mileage = $1,734 Supportive Services Financial Assistance Prepaid gasoline cards and bus passes along with payment of incidental needs addressing barriers to employment such as identification/credentials, background checks, grooming, etc. 84 participants @ $250/ea. (average) = $21,000 Job Readiness Workforce/Life Skills Workshops Presentation of workforce and life skills workshops for program participants (topics include Self - Assessment Strategies, Resume Skill Building, Job Search Skill Building, Pre -Interview Skill Building, Interview Skill Building, Power of Your Image, Navigating Success in the Workplace, Work Culture and Effective Communication, Time Management, and Financial Literacy). Each client will participate in a 8 to 10 week cycle of workshops. 3 workshops/week x 50 weeks @ $600 ea. = $90,000 Page 2 of 3 Wardrobe Services One professional and two business casual outfits (including accessories and shoes) to each participant for interviews and on-the-job. 50 regular size participants @ $420/ea. = $21,000 34 plus size participants @ $450/ea. = $15,300 Total Wardrobe Services = $36,300 Total Supportive Services = $147,300 Participant Incentives Payments to participants achieving program outcomes. $500 maximum in payments to each participant. Completion of full cycle of workforce/life skills training workshops: 40 participants @ $125/ea. _ $5,000 Attainment of skills training certificate or credential: 25 participants @ $125/ea. = $3,125 Attainment of employment: 40 participants @ $250/ea. = $10,000 Total Participant Incentives = $18,125 TOTAL OPERATING EXPENSES = $662,919 ($612,919 program cost + $50,000 matching funds from City of Santa Ana WORK Center) GRAND TOTAL = $792,000 ($742,000 program cost + $50,000 matching funds) Program staff will document and track requests, approvals, and payments of Participant Incentives payments to verify eligibility, ensure that individual participants are not paid above the $500 maximum, and that the total line item budget is not exceeded. Incentives payments will be provided to participants in the form of Visa/MasterCard gift cards or company checks. No cash will be distributed to participants. All Participant Supportive Services payments for transportation and other incidental needs addressing barriers to employment and Participant Skills Development (Training) tuition and training -related expenses will also be carefully controlled by the program staff to maintain fiscal integrity and adherence to the program budget. Gasoline and public transportation assistance will be provided to clients in the form of gas company debit cards or bus line pass cards that will be distributed to participants once eligibility and need is endorsed by a Career Navigator. The need and value of other Supportive Services and Skills Development (Training) expenses will be documented through bills, invoices, receipts, quotes, or other documents supporting each request that are secured by either the program staff or participants and confirmed with the appropriate vendor prior to payment. All payment requests will be originated by the program's Career Navigators, reviewed and confirmed by the Client Services Administrator, and approved by the Director of Client Services before disbursements are issued. Payments will be issued as Working Wardrobes company checks made payable to and delivered directly to service providers, with no payments provided directly to participants. Page 3 of 3 CITY OF SANTA ANA BUDGETFORM Organization Name: Working Wardrobes for a New Start Administrative Cost (Not to Exceed 10%) Total Program Cost Total Cost Match/In Kind =,personnel Salaries 1 Director of Client Services (0.50 FTE) $42,500 $42,500 2 Career Navigator (1.00 FTE) $54,995 $54,995 3 Career Navigator (1.00 FTE) $54,995 $54,995 4 Client Services Administrator (0.25 FTE) $16,875 $16,875 5 Job Developer (1,00 FTE) $56,160 $56,160 6 Wardrobe Specialist (0.25 FTE) $13,520 $13,520 Personnel Benefits; 1 Director of Client Services (0.50 FTE) $5,372 $5,372 2 Career Navigator (1,00 FTE) $6,951 $13,902 3 Career Navigator (1.00 FTE) $6,951 $13,902 4 Client Services Administrator (0.25 FTE) $2,133 $2,133 5 Job Developer (1.00 FTE) $7,099 $7,099 6 Wardrobe Specialist (0.25 FTE) $1,709 $1,709 Total Personnel Salaries & Benefits $269,260 $269,260 Operating =<Expenses Rent Utilities Phones Internet Fees Parking Fees Security Maintenance Insurance Equipment rental fees Accounting Services Vehicle lease Office expenses $5,500 $5,500 Legal Services Auditing Services Indirect Cost $129,081 $129,801 Staff Training Staff Conferences Staff Travel/Mileage $1,734 $1,734 Participant Wages Supportive Services $147,300 $147,300 Participant Incentives $18,125 $18,125 Participant Skills Development $136,000 $136,000 $50,000 Professional Services $35,000 $35,000 Total Operating Expenses $472,740 $472,740 GRAND TOTAL (Personnei+operating) $742,000 $742,000 $50,000 A� O`er CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/07/2023 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 ma require an endorsement. A statement on this certificate does not confer rights to the certificate holde - in e r PRODUCER NA AC Ikki Evaniuck ms &Associatellnsurance B ers Acev Ext: (800) 578-8802 a/c, No: (818) 449-9321 L e�n e 0 4 Q A c e v e d o E-MAIL nevaniuck@pomsassoc.com 57 �arTbg�e'�S Date• IN U ER( ) AGE NAIC# Woodland Hills CA 9136 MSURERA: •Nonprofits Ins. Alliance of CA (NIAC) 160 INSURED NSURER B Working Wardrobes ForA New Start INSURER C : 2000 E. McFadden Ave INSURER D : Suite 100 INSURER E : Santa Ana CA 92705 INSURER F COVERAGES CERTIFICATE NUMBER: 23-24 GLAD UMB 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREM SES Ea o.urrrence $ 500,000 MED EXP (Any one person) $ 20,000 PERSONAL &ADV INJURY $ 1,000,000 A Y Y 2023-49231 09/17/2023 09/17/2024 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 El PRO JECT LOC PRODUCTS-COMP/OPAGG 2,000,000P1 $POLICY Liquor Liability - Common $ 1,000,000 OTHER: AUTOMOBILE LIABILITY 56*H3rNED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y Y 2023-49231 09/17/2023 09/17/2024 BODILY INJURY (Pe r accide nt) $ X PROPERTY DAMAGE Per accident $ HIRED �/ NON -OWNED AUTOS ONLY /� AUTOS ONLY Uninsured Motorist $ 1,000,000 X UMBRELLA LIAB X OCCUR EACHOCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 A EXCESS LAB CLAIMS -MADE 2023-49231-UMB 09/17/2023 09/17/2024 DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ElN OFFICER/MEMBER EXCLUDED? /A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Improper Sexual Conduct & Physical Abuse 2023-49231 09/17/2023 09/17/2024 General Aggregate $2,000,000 Each Claim Limit $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of the Contractor including materials, parts, or equipment furnished in connection with such work or operations. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and noncontributory. Waiver of Subrogation applies per the attached forms. 30 day notice of cancellation (except for 10 day notice of cancellation for non-payment) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana Risk Management Division ACCORDANCE WITH THE POLICY PRO\ , Risk ManagementDiviaian 20 Civic Center Plaza E REVIEWED & APPROVED BY. AUTHORIZED REPRESENTATIVE 1"All IL av Santa Ana CA 92702 F c i 1 " Disk Management Specialist @ 1988-2015 ACOF ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 00017425 LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY Poms &Associates Insurance Brokers NAMED INSURED POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 2022-49231 FORM: NIAC-E26 11 17 NAMED INSURED: Working Wardrobes for A New Start dba: Working Wardrobes A Head for Insurance. A Heart for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM Name of Person or Organization - Where you are so required in a written contract or agreement currently in effect or becoming effective during the term of this policy, we waive any right of recovery we may have against that person or organization, who may be named in the schedule above, because of payments we make for injury or damage. Risk Mouganent DMslcn REVIEWED & APPROVED BY. 1"All � 11L A*fg Aezv4�a Risk Management Specialist NIAC-E26 11 17 Page -1 ol I NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance, A Heart far Nonprofits, POLICY NUMBER: 2022-49231 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: City Of Santa Ana, officers, agents, employees and volunteers 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 other insurance as described in c. below; or sh oR,N a RAManaganentDMsian REVIEWED & APPROVED BY. Afg Aezv 1" Risk Management Specialist N IAC-E61 02 19 NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance, A Heart far Nonprofits, POLICY NUMBER: 2022-49231 (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 occupied 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. oR,N a RAManaganentDMsian °� f ' REVIEWED & APPROVED BY. Aezv 1" Risk Management Specialist N IAC-E61 02 19 ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 07/31 /2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT AP Intego Insurance Group, LLC PHONE 888_289 2939 FAX A/C No Ext : A/C No): AP INTEGO INSURANCE GROUP, LLC 375 Woodcliff Dr. E-MAIL ADDRESS: certs@apintego.com INSURER(S) AFFORDING COVERAGE NAIC # Suite 103 INSURER A: Hartford Casualty Insurance Company 29424 Fairport NY 14450 INSURED WORKING WARDROBES FOR A NAngie INSURER � E Mcfadden Ave Ste 10C Acev n �-Q _2000 I I INSURER E : INSURER F: Santa Ana CA 92705 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ CLAIMS-MADE1:1 OCCUR PIED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ IRO—LOC POLICY JECT $ AUTOMOBILE LIABILITY F F COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE APer accident $ $ UMBRELLA LIAB OCCUR I r r I EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE — OFFICE/MEMBER EXCLUDED? N / A F— 76WEGAT9Z3W 08/30/2024 08/30/2025 X WCTORLIMITS OT ER- E. L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ 1,000,000 r I r I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION City of Santa Ana Risk Management Division null 20 Civic Center Plaza Santa Ana ACORD 25 (2010/05) CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL RE DELIVERED IN ACCORDANCE WITH THE POLICY PR( Riak Managanent DMsian AUTHORIZED REPRESENTATIVE �?'� REVIEWED & APPRCYVED BY: °i 4g:e f}eev44 ® Risk Management Specialist @ 1988-2010 ACORD The ACORD name and logo are registered marks of ACORD Clear All A` "R" CERTIFICATE OF LIABILITY INSURANCE F DATE (MM/DD/YYYY) 09/20/2024 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 CONTACT Marci Davis NAME: Poms &Associates Insurance Brokers (800) 578-8802 FA/X (818) 449-9321 aICNN. Ext : No : CA License #0814733 E-MAIL mdavis@pomsassoc.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # 4500 Park Granada, Suite 206 Calabasas CA 91302 INSURERA: Nonprofits Ins. Alliance of CA (NIAC) 160 INSURED INSURER B Working Wardrobes For A New Start INSURER C : INSURER D : 2000 E. McFadden Ave Suite 100 INSURER E Santa Ana CA 92705 INSURER F : COVERAGES CERTIFICATE NUMBER: 24-25 GLAU LIMB REVISION NUMBER: THIS IS TO CERTIFYTHAT 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADDL INSD UBR WVD POLICY NUMBER M� DD YYYYMLICY EFF ICY EXP O DD YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 � OCCUR DAMAGE PREM SESORENTEEa occur ence $ 500,000 _7CLAIMS-MADE MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 A Y Y 2024-49231 09/17/2024 09/17/2025 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PRO ❑ JECT LOC PRODUCTS - COMP/OPAGG 2,000,000 $ Liquor Liability- Common $ 1,000,000 OTHER: AUTOMOBILE LIABILITY C�flPr}BtNED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y Y 2024-49231 09/17/2024 09/17/2025 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY /� AUTOS ONLY Uninsured Motorist $ 1,000,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 HCLAIMS-MADE AGGREGATE $ 2,000,000 A EXCESS LIAB 2024-49231-UMB 09/17/2024 09/17/2025 DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE El OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ A Improper Sexual Conduct &Physical Abuse 2024-49231 09/17/2024 09/17/2025 General Aggregate Each Claim Limit $2,000,000 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of the Contractor including materials, parts, or equipment furnished in connection with such work or operations. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and noncontributory. Waiver of Subrogation applies per the attached forms. 30 day notice of cancellation (except for 10 day notice of cancellation for non-payment) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana Risk Management Division ACCORDANCE WITH THE POLICY PRO) 20 Civic Center Plaza R[eleManag>'rnentDmsbrt AUTHORIZED REPRESENTATIVE REVIEWED & APPROVED BY: Santa Ana CA 92702 ®' Risk Management Specialist © 1988-2015 ACOF ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 00017425 LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY Poms & Associates Insurance Brokers NAMED INSURED Working Wardrobes For A New Start POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance certificate supersedes all previously issued certificates. Riek Mw agernenf DMsian �?- REVIEWED & APPRCYVED BY: ® Risk P.1anagement Specialist ACORD 101 (2008/01) © 2008AC The ACORD name and logo are registered marks of ACORD Additional Named Insureds Other Named Insureds The Hanger Working Wardrobes Doing Business As Doing Business As Risk Management DMsian �?- REVIEWED & APPROVED BY: °1 111C I 119 1" A-s-g�e Acevedo ® Risk Management Specialist OFAPPINF (02/2007) InNONPROFITS POLICY NUMBER: 2024-49231 FORM: NIAGE26 11 17 NAMED INSURED: Working Wardrobes for A New Start dba: Working INSURANCE Wardrobes ALLIANCE OF CALIFOKNIA A Head for Insurance. A Heart for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organization: Where you are so required in a written contract or agreement currently in effect or becoming effective during the term of this policy, we waive any right of recovery we may have against that person or organization, who may be named in the schedule above, because of payments we make for injury or damage. Risk Management Divisiort t. REVIEWED APPROVED & APPROVBY. A Acevzdo ®� Risk Management Specialist NIAC-E26 11 17 NMINONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. POLICY NUMBER: 2024-49231 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: City Of Santa Ana, officers, agents, employees and volunteers 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 publicentity 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 other insurance as described in c. below; or N IAC-E61 02 19 sh Rink Management I)Msion REVIEWED & APPROVED BY. ® Risk Management Specialist Fage NMINONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. POLICY NUMBER: 2024-49231 (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 occupied 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. N IAC-E61 02 19 Risk Management Division REVIEWED & APPROVED BY. ® Risk Management Specialist 0 POLICY NUMBER: 2024-49231 COMMERCIAL AUTO CA04441013 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: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization with whom you have a written contract currently in effect or becoming effective during the term of this policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others 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 "accident' or the "loss" under a contract with that person or organization. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Rink Management DMsim �?- REVIEWED & APPROVED BY. A-s-g�e Acevedo ® Risk Management Specialist Page 1 of 1 POLICY NUMBER: 2024-49231 I = NONPROFITS INSURANCE ALLIANr-F OF CALIFORNIA A Head for Insurance- A Heartfor Mpnpraj ts. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY - FOR DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. 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. 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 "damages" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf in the performance of your ongoing operations. The insurance extended by this endorsement is primary coverage when you have so agreed in a written contract or agreement and will be considered non-contributory with the additional insured(s) own insurance. ►1F-IT""X111ErA Rile Management DMsim REVIEWED & APPROVED BY. ® Risk Management Specialist POLICY NUMBER: 2024-49231 COMMERCIAL GENERAL LIABILITY Named Insured: Working Wardrobes for A New Start dba: Working War CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED 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) Location(s) Of Covered Operations Any person or organization that you are required to All insured premises and operations. add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. 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. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury', "property damage" or "personal and advertising injury" caused, in whole or in part, by: 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. 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 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 Rink Management DMsian �?- REVIEWED & APPROVED BY. °I 111C I 119 1" A-s-g�e Acevedo ® Risk Management Specialist CG20101219 © Insurance Services Office, Inc., 2012 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. C. 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Rink Management DMsim �?- REVIEWED & APPROVED BY. °I 111C I 119 1" A-s-g�e Acevedo ® Risk Management Specialist CG20101219 © Insurance Services Office, Inc., 2012 / A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 09/18/2025 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 CONTACT Marci Davis NAME: Poms &Associates Insurance Brokers HCNE. (800) 578-8802 FAAc, (818) 449-9321 Ext: No: CA License #0814733 E-MAIL mdavis@pomsassoc.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # 4500 Park Granada, Suite 206 Calabasas CA 91302 INSDRERA : Nonprofits Ins. Alliance of CA (NIAC) 160 INSURED INSURER B Working Wardrobes ForA New Start INSURER C : 2000 E. McFadden Ave INSURER D : Suite 100 INSURER E : Santa Ana CA 92705 INSURER F : COVERAGES CERTIFICATE NUMBER: 25-26 MASTER 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 INSD WVD POLICY NUMBER POLICY EFF MWDD/YYYY POLICY EXP MWDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO PRRETED SES Ea occurrrence $ 500,000 MED EXP (Any one person) $ 20,000 PERSONAL &ADV INJURY $ 1,000,000 A Y Y 2024-49231 09/17/2025 09/17/2026 LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PRO ❑ LOC JECT: MOTHER PRODUCTS-COMP/OPAGG $ 2,000,000 Liquor Liability - Common $ 1,000,000 AUTOMOBILE LIABILITY 5&*eWED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y Y 2024-49231 09/17/2025 09/17/2026 BODILY INJURY (Pe r accide nt) $ X PROPERTY DAMAGE Per accident $ HIRED �/ NON -OWNED AUTOS ONLY X AUTOS ONLY Uninsured Motorist $ 1,000,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 HCLAIMS-MADE AGGREGATE $ 3,000,000 A EXCESS LAB 2024-49231-UMB 09/17/2025 09/17/2026 DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? N/A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Improper Sexual Conduct &Physical Abuse 2024-49231 09/17/2025 09/17/2026 General Aggregate Each Claim $2,000,000 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Santa Ana, its officers, officials, employees, and volunteers are to be covered as additional insureds on the CGL policy with respect to liability arising out of work or operations performed by or on behalf of the Contractor including materials, parts, or equipment furnished in connection with such work or operations. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City shall be excess and noncontributory. Waiver of Subrogation applies per the attached forms. Digitally signed by TU Tran 30 day notice of cancellation (except for 10 day notice of cancellation for non-payment) Tu Tran Nguyen Date: z°�004Nguyeno� [APPROVED CERTIFICATE HOLDER CANCELLATION I By Tu Tran Nguyen of 7:25 am, Sep 24, 2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ATTN: Audrey Goodson ACCORDANCE WITH THE POLICY PROVISIONS. 801 W. Civic Center Dr. AUTHORIZED REPRESENTATIVE Suite 200 Santa Ana CA 92701 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 00017425 LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY Poms &Associates Insurance Brokers NAMED INSURED Working Wardrobes For New Start POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance `This certificate supersedes all previously issued certificates. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NMNONPROFITS POLICY NUMBER: 2024-49231 FORM: NIAC-E26 11 17 NAMED INSURED: Working Wardrobes for A New Start dba: Working INSURANCE Wardrobes ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organization: Where you are so required in a written contract or agreement currently in effect or becoming effective during the term of this policy, we waive any right of recovery we may have against that person or organization, who may be named in the schedule above, because of payments we make for injury or damage. NIAC-E26 11 17 Page 1 of 1 NMINONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. POLICY NUMBER: 2024-49231 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: City Of Santa Ana, officers, agents, employees and volunteers 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 NIAC-E61 02 19 Page 1 of 2 NMINONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. POLICY NUMBER: 2024-49231 (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 occupied 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 Page 2 of 2 POLICY NUMBER: 2024-49231 COMMERCIAL AUTO CA 04 44 10 13 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: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization with whom you have a written contract currently in effect or becoming effective during the term of this policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others 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 "accident" or the "loss" under a contract with that person or organization. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER: 2024-49231 COMMERCIAL GENERAL LIABILITY Named Insured: Working Wardrobes for A New Start dba: Working War CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -SCHEDULED 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) Location(s) Of Covered Operations Any person or organization that you are required to All insured premises and operations. add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. 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. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 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. 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 additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 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 CG 20 10 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 2 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. C. 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 10 12 19 © Insurance Services Office, Inc., 2012 Page 2 of 2 ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/30/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT AP Intego Insurance Group, LLC AP INTEGO INSURANCE GROUP, LLC PHONE 888.289-2939 FAX A/C No Ext : A/C No): 375 Woodcliff Dr. E-MAIL ADDRESS: certs@apintego.com INSURER(S) AFFORDING COVERAGE NAIC # Suite 103 INSURERA: National Specialty Insurance Company 22608 Fairport NY 14450 INSURED WORKING WARDROBES FOR A NEW ST INSURER B INSURER C 2000 E Mcfadden Ave Ste 100 INSURER D INSURER E INSURER F: Santa Ana CA 92705 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE1:1 OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO LOC JECT $ AUTOMOBILE LIABILITY F F COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR I r r I EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION X WC STATU OT AND EMPLOYERS' LIABILITY Y TORLIMITS ER A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICE/MEMBER EXCLUDED? N / A NXTRWKKV3Q-01-WC 08/30/2025 08/30/2026 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 F F DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Waiver of Subrogation is granted in favor of City of Santa Ana in regard to the Workers' Compensation as their interest may appear by written contract. Tu Tran T�T,a'�YN9 YebY Date: 2025.10.02 Nguyen 08:59:50-0700 APPROVED �By Tu Tran Nguyen at 8:59 am, Oct 02, 2025 CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE 62s _ @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Clear All WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 89 06 00 B (Ed. 7-01) POLICY INFORMATION PAGE ENDORSEMENT The following item(s) F1 Insured's Name (WC 89 06 01) F1 Policy Number (WC 89 06 02) F1 Effective Date (WC 89 06 03) u Expiration Date (WC 89 06 04) u Insured's Mailing Address (WC 89 06 05) u Experience Modification (WC 89 04 06) u Producer's Name (WC 89 06 07) u Change in Workplace of Insured (WC 89 06 08) u Insured's Legal Status (WC 89 06 10) u Item 3.A. States (WC 89 06 11) is changed to read: It is understood and agreed that: — Item 33. Limits (WC 89 06 12) — Item 3.C. States (WC 89 06 13) X- Item 3.D. Endorsement Numbers (WC 89 06 14) Item 4.* Class, Rate, Other (WC 89 04 15) Interim Adjustment of Premium (WC 89 04 16) Carrier Servicing Office (WC 89 06 17) Interstate/Intrastate Risk ID Number (WC 89 06 18) Carrier Number (WC 89 06 19) Issuing Agency/Producer Office Address (WC 89 06 25) The following forms are added: WC 00 03 13 - Waiver Of Our Right To Recover From Others Endorsement All other terms and conditions remain unchanged. *Item 3.D. Change to Form Number WC 89 06 00 B (07-01) WC 04 03 06 WC 89 06 OOB (Ed. 7-01) Form Title Policy Information Page Endorsement Waiver of Our Right to Recover from Others Endorsement -- California © 2001 National Council on Compensation Insurance, Inc. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 89 06 00 B (Ed. 7-01) POLICY INFORMATION PAGE ENDORSEMENT (CONTINUED) *Item 4. Change To: Premium Basis Rate Per $100 Classifications Code Total Estimated of Estimated No. Annual Annual Premium Remuneration Remuneration WC 89 06 OOB (Ed. 7-01) 0 2001 National Council on Compensation Insurance, Inc. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 89 06 00 B (Ed. 7-01) POLICY INFORMATION PAGE ENDORSEMENT ELI Increased Limits Charge Safety Factor Drug -Free Workplace Factor Experience Rating Premium Waiver of Subrogation Premium Deductible Premium Total State Surcharges Total Estimated Annual Premium $ 12,392.00 Total Amount Due 12,392.00 Minimum Premium $ 1,057.00 Deposit Premium $ 0.00 All other terms and conditions of this policy remain unchanged. $665.00 $594.00 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 Effective08/30/2025 Policy No. NXTRWKKV3Q-01-WC 01 Endorsement No. Insured WORKING WARDROBES FOR A NEW ST Premium $ 12,392.00 Insurance Company National Specialty Insurance Company Countersigned by WC 89 06 OOB (Ed. 7-01) C 1987 National Council on Compensation Insurance, Inc. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA (Ed. 04-84) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. 2 The additional premium for this endorsement shall be _ on such remuneration. Person or Organization % of the California workers' compensation premium otherwise due Schedule Job Description This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Insured Policy No. Insurance Company Countersigned By Endorsement No. WC 04 03 06 (Ed. 04-84)