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HomeMy WebLinkAboutINTERVAL HOUSE (17) INSURANCE ON FILE WORK MAY PROCEED A-2024-090-02 UNTIL INSURANCE EXPIRES 10I1I0-i CITY CLERK JUL 0 1 2011 DATE: • C D 1°' C91) EMERGENCY SOLUTIONS GRANT (���ea'�na�.So\t E,,�.,,,,,�� SUBRECIPIENTTH CITY O AGREEMENTBETWEEN SANTA ANA AND INTERVAL HOUSE (24 CFR Parts 91 and 576) THIS GRANT AGREEMENT, is hereby made and entered into this, by and between the City of Santa Ana, a charter city and municipal corporation of the State of California, herein called the "CITY", and Interval House, a California nonprofit organization,herein called the "SUBRECIPIENT". RECITALS: 1. The CITY is the recipient of Emergency Solutions Grant("ESG") funds from the United States Department of Housing and Urban Development("HUD"), pursuant to subtitle B of title IV of the McKinney-Vento Homeless Assistance Act[42 U.S.C. 11371-11378],for the rehabilitation or conversion of buildings for use as emergency shelter for the homeless, for the payment of certain expenses related to operating emergency shelters, for essential services related to emergency shelters and street outreach for the homeless, and for homelessness prevention and rapid re-housing assistance. Catalogue of Federal Domestic Assistance ("CFDA") 14.231 and Federal Award Identification Number(FAIN) E-24-MC-06- 0508. 2. The CITY has approved the provision of federal funds under the ESG to be used in the operation of an emergency solutions program ("program") for the homeless or at-risk of homelessness of the City of Santa Ana as further described by Exhibit A, Scope of Work, attached hereto and by this reference incorporated herein. 3. The SUBRECIPIENT represents that it has the requisite qualifications, expertise, and experience in the provision of emergency solutions programs for the homeless or at-risk of homelessness and is willing to use said federal funds to operate said program. 4. The SUBRECIPIENT agrees to assist individuals and families that are homeless or at risk of homelessness in obtaining appropriate supportive services including, but not limited to: temporary and permanent housing, relocation and stabilization services, rapid re-housing assistance, medical and mental health treatment,counseling supervision,and other services essential for achieving independent living. 5. The SUBRECIPIENT has agreed to be reimbursed for the above services in an amount not to exceed $76,197 in grant funding for Shelter, Outreach Services, Rapid Re-Housing or Homeless Prevention. 6. This AGREEMENT is contingent upon the award of Emergency Solutions Grant funds from the United States Department of Housing and Urban Development. 7. The CITY and the SUBRECIPIENT have duly executed this AGREEMENT for the expenditure and utilization of said funds. NOW THEREFORE, it is agreed by and between the parties that the foregoing Recitals are a substantive part of this AGREEMENT and the following terms and conditions are approved and together with all exhibits and attachments hereto, shall constitute the entire AGREEMENT between the CITY and the SUBRECIPIENT: Page 1 of 23 SCOPE OF PROGRAM A. General Administration The SUBRECIPIENT agrees to implement this activity as set forth in detail in Exhibit A, Scope of Work, which shall provide a description of each activity, including the services to be performed, the person or entity providing the service, the estimated number of recipients of the service,and the manner and means of the services. B. Levels of Accomplishment—Goals and Performance Measures The SUBRECIPIENT shall be responsible to accomplish the levels of performance as set forth in Exhibit A and report such measures quarterly to the CITY. If the SUBRECIPIENT estimates such goals will not be met, the SUBRECIPIENT is to contact the CITY, at which time the CITY will determine if any adjustments to the grant award is appropriate. C. Staffing The SUBRECIPIENT shall ensure adequate and appropriate staffing is allocated to each ESG activity. Nothing contained in this AGREEMENT is intended to, or shall be construed in any manner, as creating or establishing the relationship of employer/employee between the parties. IL TERM OF AGREEMENT This AGREEMENT shall take effect on July 1, 2024, and shall terminate on June 30, 2025, unless otherwise cancelled or modified according to the terms of this AGREEMENT. III. DISBURSEMENT AND FUNDS The City was allocated $422,578 in Emergency Solutions Grant funds under the McKinney- Vento Homeless Assistance Act for fiscal year 2024-2025 from the Department of Housing and Urban Development. CITY agrees to pay to SUBRECIPIENT when, if and to the extent federal funds are received under provisions of the Act a sum not to exceed $76,197 for SUBRECIPIENT'S performance in accordance with the Budget attached hereto as "Exhibit B" during the period of this Agreement. Said sum shall be paid after CITY receives invoices submitted by SUBRECIPIENT as provided hereinabove. A. Amount and Expenditure End Date The CITY agrees to reimburse the SUBRECIPIENT a maximum amount not to exceed $76,197 from Emergency Solutions Grant (ESG) funds, as outlined in Exhibit B, Final Budget, and such funds shall be expended by the SUBRECIPIENT on or before June 30, 2025. SUBRECIPIENT has the ability to adjust line item amounts in the Budget with the written approval of the CITY's Executive Director of the Community Development Agency, so long as the total Budget amount does not increase. B. Invoicing Procedures Page 2 of 23 The SUBRECIPIENT shall submit quarterly invoices (on or before the 15°1 day of October, January, April, and July) in a form prescribed by the CITY, detailing such expenses. Such schedule may be modified with the approval of the CITY. C. Payment Payment is subject to the receipt and approval of such invoices and quarterly activity reports, as hereinafter more fully set forth below under Reporting, with the final payment subject to the satisfaction of the condition precedent of submittal of complete invoicing and reporting information due on or before July 15 of the applicable funding year. The CITY shall pay such invoices within thirty (30) days after receipt thereof, provided the CITY is satisfied that such expenses have been incurred within the scope of this AGREEMENT and that the SUBRECIPIENT is in compliance with the terms and conditions of this 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 and reporting will cause the CITY to withhold all or a portion of a request for reimbursement until such documentation and reporting has been received and approved by the CITY. D. Use of Funds The SUBRECIPIENT agrees to use said funds pursuant to this AGREEMENT to pay for necessary and reasonable costs allowable under federal law and regulations to operate said program only. Said amounts shall include and will be limited to, street outreach, emergency shelter,homelessness prevention, rapid re-housing assistance,housing relocation and stabilization services, short-term and medium-term rental assistance, and Homeless Management Information Systems ("HMIS") data contribution as set forth in 24 CFR § 576.101 — § 576.107. Allowable program costs are detailed in the Budget, as set forth in Exhibit B, attached hereto and by this reference incorporated herein. The SUBRECIPIENT'S failure to perform as required may, in addition to other remedies set forth in this AGREEMENT,result in readjustment of the amount of funds the CITY is otherwise obligated to pay to the SUBRECIPIENT pursuant to the terms hereof. The SUBRECIPIENT agrees that the homeless shelter/services under said program shall be available for the entire period during which said funds are provided. E. Condition of Funding (1) The CITY advises the SUBRECIPIENT that a significant change in entitlement funding may result in a change in the current process utilized by the CITY to determine funding allocations. The SUBRECIPIENT acknowledges that the obligation of the CITY is contingent upon the availability of Federal, State or Local government funds, which are appropriated or allocated for the payment of such an obligation. If funding levels are significantly affected by Federal budgeting or if funds are not allocated and available for the continuance of the function performed by the SUBRECIPIENT, this AGREEMENT may be terminated by the CITY at the end of the period for which funds are available. At the earliest opportunity,the CITY shall notify the SUBRECIPIENT of any service which may be affected by a shortage of funds. No penalty shall accrue to the CITY in the event this provision is exercised and the CITY shall not be liable for any damages as a result of termination under this provision of this AGREEMENT. Nothing herein shall be construed as obligating the CITY to expend funds in excess of appropriations authorized by law. Page 3 of 23 (2) The SUBRECIPIENT shall allow representatives of the CITY or HUD to inspect facilities which are used in connection with the AGREEMENT or which implement programs funded under this AGREEMENT. F. Matching The SUBRECIPIENT is required to make matching contributions to supplement the ESG program in an amount that equals or exceeds the amount of ESG funds provided by HUD through the CITY. Such contributions shall be entirely consistent with the Matching Requirements as outlined by 24 CFR § 576.201. The anticipated source and amount of all matching funds contributed by the SUBRECIPIENT will be enumerated in Exhibit B, Final Budget. G. Program Income (1) Definition. Program income means, as provided by 2 CFR 200.1, gross income earned by the SUBRECIPIENT that is directly generated by a grant supported activity, or earned only as a result of the grant agreement during the grant period. For purposes of ESG, program income will also include any amount of a security or utility deposit returned to the SUBRECIPIENT. (2) Use. The SUBRECIPIENT shall use all income received from said funds only for the same purposes for which said funds may be expended pursuant to the terms and conditions of this AGREEMENT. (3) Counts toward Matching. Costs paid by program income may count toward meeting the matching requirements, provided the costs are eligible ESG costs that supplement the program. H. Separation of Accounts All funds received by the SUBRECIPIENT from the CITY pursuant to this AGREEMENT shall be maintained separate and apart from any other funds of the SUBRECIPIENT, or of any principal or member of the SUBRECIPIENT, in an account (the "Account") at a federally insured banking or savings and loan institution with record keeping of such Accounts maintained pursuant to applicable legal requirements. The SUBRECIPIENT shall keep all records of the Account in a manner that is consistent with generally accepted accounting principles. No monies shall be withdrawn from the Account except for expenditures relating to essential services, homeless prevention, and/or operations costs, as authorized hereunder. All disbursements from the Account shall be for obligations incurred in the performance of this AGREEMENT and shall be supported by contracts, invoices, vouchers, and other data, as appropriate, evidencing the necessity of such expenditure. The CITY may withhold payment allocation requests if the SUBRECIPIENT fails to comply with the above requirements until such compliance is demonstrated. I. Expenditure of Funds Much like how HUD requires the CITY, pursuant to 24 CFR 576.203, to expend all of the grant funds for eligible activity costs within 24 months after the date that HUD signs the grant agreement with the CITY, it is a requirement for the SUBRECIPIENT to expend all of the grant funds for eligible activity costs within the aforementioned period. For the purposes of this paragraph, expenditure means either an actual cash disbursement for a direct charge for a good/service or an indirect cost, or the accrual of a direct charge for a good/service or an indirect cost.Failure to expend said funds within said timeframe can result in a reallocation of funds. Page 4 of 23 J. Prohibited Use (1) Generally. The SUBRECIPIENT hereby certifies and agrees that it will not use funds provided through this AGREEMENT to pay for meals for persons other than those identified as homeless or at risk of homelessness. Said funds shall not be used for entertainment purposes or for gifts. The SUBRECIPIENT certifies that it will not use said funds for illegal or dishonest conduct, rather, fund use will remain in compliance with all applicable federal, state, and local laws, including applicable laws not outlined in this AGREEMENT. (2) Lobbying. The SUBRECIPIENT certifies and agrees that it will comply with federal law (31 U.S.C. 1352) and regulations found at 24 CFR Part 87, which provide that no appropriated funds may be expended by the recipient of a federal contract, grant, loan, or cooperative agreement to pay any person for influencing or attempting to influence an officer or employee of any agency, Member of Congress, or an officer or employee of a Member of Congress in connection with awarding of any federal contract, the making of any federal grant or loan, entering into any cooperative agreement and the extension, renewal, amendment, or modification of any federal contract, grant, loan,or cooperative agreement.The SUBRECIPIENT shall sign a certification to that effect in a form as set forth in Exhibit C, attached hereto and by this reference incorporated herein. The SUBRECIPIENT shall submit said signed certification to the CITY prior to performing any of its obligations under this AGREEMENT and prior to any obligation arising on the part of the CITY to pay any sums to the SUBRECIPIENT under the terms and conditions of this AGREEMENT. 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 a "Disclosure Form to Report Lobbying," in accordance with its instructions(see Exhibit D). IV. NOTICES The SUBRECIPIENT and the CITY agree that all notices required by this AGREEMENT shall be made in writing and delivered via mail (postage prepaid); commercial courier; personal delivery; or sent by facsimile or other electronic means (provided that receipt is confirmed). Any notice delivered or sent as aforesaid shall be effective on the date of delivery or sending. All notices and other written communications under this AGREEMENT shall be addressed to the individuals in the capacities indicated below,unless modified by subsequent written notice. Communication and details concerning the AGREEMENT shall be delivered to the office of, and directed to,the following representatives: CITY: SUBRECIPIENT: Community Development Analyst Carol Williams City of Santa Ana Executive Director Community Development Agency(M-25) Interval House 20 Civic Center Plaza P.O.Box 1988 Santa Ana, CA 92702-1988 P.O. Box 3356 (714)667-2256 Seal Beach, CA 90740 (714)647-6549 FAX 562-594-9492 Page 5 of 23 V. GENERAL CONDITIONS A. Coordination with Continuum of Care The SUBRECIPIENT must work with the Continuum of Care ("CoC") to ensure the screening,assessment, and referral of program participants are consistent with the CITY's written standards for providing ESG assistance as described in its consolidated plan. The SUBRECIPIENT must keep documentation evidencing the use of, and written intake procedures for, the centralized or coordinated assessment system(s) developed by the CoC in accordance with the requirements established by HUD. See 24 CFR 576.400. B. Evaluation of Program Participants Eligibility and Needs The SUBRECIPIENT must conduct evaluations and re-evaluations to determine the eligibility of each individual or family's eligibility for ESG assistance in accordance with 24 CFR 576.401. C. Terminating Assistance If a program participant violates program requirements, the SUBRECIPIENT may terminate the assistance in accordance with a formal process established by the SUBRECIPIENT that recognizes the rights of individuals affected. See 24 CFR 576.402 D. Shelter and Housing Standards The SUBRECIPIENT certifies that shelters and housing supported by ESG funds and used by ESG beneficiaries will conform to 24 CFR 576.403. E. Homeless Involvement The SUBRECIPIENT certifies that it will involve, to the maximum extent practicable, homeless individuals and families in constructing, renovating, maintaining, and operating facilities assisted under the ESG program, and in providing services for occupants of these facilities. See 24 CFR 576.405(c)and 42 USC 11375(d). F. Independent Contractor Nothing contained in this AGREEMENT is intended to, or shall be construed in any manner, as creating or establishing the relationship of employer/employee between the parties. The SUBRECIPIENT and its subcontractors shall at all times remain independent contractors with respect to the services to be performed under this AGREEMENT.The CITY shall be exempt from payment of any Unemployment Compensation, FICA, retirement, life and/or medical insurance and Workers' Compensation Insurance as the SUBRECIPIENT is an independent contractor. G. Subcontracts (1) Content Requirements. The SUBRECIPIENT will include all relevant provisions of this AGREEMENT in all subcontracts entered into as part of the activities undertaken in furtherance of this AGREEMENT and will take appropriate action pursuant to any subcontract upon a finding that the subcontractor is in violation of regulations issued by Page 6 of 23 any federal agency. The SUBRECIPIENT will not subcontract with any entity where it has notice or knowledge that the latter has been found in violation of regulations under 24 CFR Part 75 (Economic Opportunities for Low-and Very Low-Income Persons) and will not allow any subcontract unless the entity has first provided it with a preliminary statement of ability to comply with the requirements of these regulations. (2) Submission to the CITY. The SUBRECIPIENT must submit all subcontracts and other agreements that relate to this AGREEMENT to the CITY. H. Licensing The SUBRECIPIENT agrees to obtain and maintain all required licenses, registrations, accreditation, and inspections from all agencies governing its operations. The SUBRECIPIENT shall ensure that its staff and subcontractors shall also obtain and maintain all required licenses, registrations, accreditation and inspections from all agencies governing the SUBRECIPIENT's operations hereunder. Such licensing requirements include obtaining a City business license, as applicable. I. Responsibilities Toward Employees The SUBRECIPIENT accepts full responsibility for payment of any and all unemployment compensation, insurance premiums, workers' compensation premiums, income tax withholdings,social security withholdings, and any and all other taxes or payroll withholdings required for all employees engaged in the performance of the work and activities authorized by the AGREEMENT. The SUBRECIPIENT accepts full responsibility for providing workers with proper safety equipment and taking any and all necessary precautions to guarantee the safety of workers or persons otherwise affected. J. Insurance and Bonding SUBRECIPIENT shall procure and maintain for the duration of the Agreement and shall require any subcontractors to obtain and maintain the following insurance coverages: (1) MINIMUM SCOPE AND LIMIT OF INSURANCE a. SUBRECIPIENT shall maintain limits of insurance coverage in the following minimum amounts and shall be at least as broad as: i. 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 $2,000,000 per occurrence and $4,000,000 aggregate. ii. Automobile Liability(AL): Insurance Services Office Form Number CA 00 01 covering Code 1 (any auto),with combined single limits of$1,000,000. iii. Workers' Compensation (W/C) insurance as required by the State of California, with Statutory Limits, and Employer's Liability Insurance with Page 7 of 23 limit of no less than $1,000,000 per accident, per employee, per policy for bodily injury or disease. This requirement can be waived if SUBRECIPIENT has no employees. iv. Sexual Abuse or Molestation Liability (SAML): If the CGL policy referenced above is not endorsed to include affirmative coverage for sexual abuse or molestation, SUBRECIPIENT shall obtain and maintain a policy covering Sexual Abuse and Molestation with a limit no less than $1,000,000 per occurrence or claim. b. If the SUBRECIPIENT maintains broader coverage and/or higher limits than the minimums shown above,the CITY requires and shall be entitled to the broader coverage and/or the higher limits maintained by the SUBRECIPIENT. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the CITY. (2) Other Insurance Provisions The general liability policy is to contain, or be endorsed to contain, the following provisions: a. CGL, AL, LL and SAML policies shall name as additional insureds: City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers, with respect to liability arising out of work or operations performed by or on behalf of the SUBRECIPIENT including materials, parts, equipment, and personnel furnished in connection with such work or operations. b. SUBRECIPIENT shall require its insurance company(ies) to waive all rights of subrogation against City of Santa Ana, its City Council, its officers, officials, employees, agents and volunteers for losses paid under the terms of any policy which arise from the event for which any permit is issued. c. For any claims related to this Agreement, SUBRECIPIENT's insurance coverage shall be primary and any insurance maintained by City of Santa Ana, its City Council, its officers, officials, employees, agents, or volunteers shall not contribute with it. d. A severability of interest provision must apply for all the additional insured, ensuring that SUBRECPIENT's insurance shall apply separately to each insured against whom a claim is made or suit is brought, except with respect to the insurer's limits of liability. e. Each insurance policy required herein shall provide that coverage shall not be canceled, suspended, voided, reduced in coverage or in limits, non-renewed by the carrier, or materially changed except after thirty (30) days prior written notice has been given to the CITY. Ten (10) days prior written shall be provided to CITY for policy cancellation or non-renewal due to non-payment. f. Certificate Holder on each Evidence of Insurance certificate shall be: City of Santa Ana, Attention: Executive Director, Community Development Agency, 20 Civic Center Plaza, M-25, P.O. Box 1988, Santa Ana, CA 92702-1988. The name Page 8 of 23 and location of event or services should be included in the Description of Operations section of each certificate. (3) Acceptability of Insurers Insurance is to be placed with insurers authorized to conduct business in the State of California with a current A.M. Best rating of no less than A: VII, unless otherwise acceptable to the CITY. (4) Verification of Coverage SUBRECIPIENT shall furnish the CITY with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to CITY before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive SUBRECIPIENT's obligation to provide them. The CITY reserves the right to require complete, certified copies of all required insurance policies, including endorsements affecting the coverage required by these specifications, at any time. (5) Special Events Coverage for Instructors Special events coverage is available and can be purchased by SUBRECPIENT. Use this link to learn more:https://2sparta.com/index.php?p=selip (6) Special Risks or Circumstances CITY reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience,insurer, coverage, or other special circumstances. K. Zoning. The SUBRECIPIENT agrees that any facility/property used in furtherance of said program shall be specifically zoned and permitted for such use(s) and activity(ies). Should the SUBRECIPIENT fail to have the required land entitlement and/or permits, thus violating any local, state, or federal rules and regulations relating thereto, the SUBRECIPIENT shall immediately make good-faith efforts to gain compliance with local, state, or federal rules and regulations following written notification of said violation(s) from the CITY or other authorized citing agency. The SUBRECIPIENT shall notify the CITY immediately of any pending violations. Failure to notify the CITY of pending violations, or to remedy such known violation(s), shall result in termination of grant funding hereunder. The SUBRECIPIENT must make all corrections required to bring the facility/property into compliance with the law within sixty (60) days of notification of the violation(s); failure to gain compliance within such time shall result in termination of grant funding hereunder. L. Displacement and Relocation. The SUBRECIPIENT must assure that it has taken all reasonable steps to minimize displacement of persons. Relocation must be consistent with requirements as set forth in 24 CFR § 576.408. Page 9 of 23 M. Provisions Required by Law Deemed Inserted. Each and every provision of law and clause required by law to be inserted in this contract shall be deemed to be inserted herein and the AGREEMENT shall be read and enforced as though it were included herein, and if through mistake or otherwise any such provision is not inserted or correctly inserted, then upon the application of either party the contract shall forthwith be physically amended to make such insertion or correction. VI. ASSURANCES AND CERTIFICATIONS A. Non-Profit Status The SUBRECIPIENT certifies that: (1) The SUBRECIPIENT is a duly organized and existing non-profit corporation in good standing and authorized to do business under the laws of the State of California and in possession of required non-profit status under the United States Internal Revenue Code [for example, 26 USC § 501(c)(3)]. The SUBRECIPIENT has full right, power, and lawful authority to accept the funding hereunder and to undertake all obligations as provided herein and the execution, performance, and delivery of this AGREEMENT by the SUBRECIPIENT has been fully authorized by all requisite actions on the part of the SUBRECIPIENT. (2) If the SUBRECIPIENT's non-profit status changes at anytime during this AGREEMENT, it will advise the CITY within 15 days. (3) If the SUBRECIPIENT is a private non-profit, it hereby agrees that the members of its Board of Directors will receive no compensation, directly or indirectly, other than reimbursement for expenses, from any funds generated from or because of the ESG program,for their services. (4) As a non-profit, the SUBRECIPIENT acknowledges that administration of its operation and services are subject to the requirements as established in 2 CFR Part 200. B. Adherence to Federal, State,and Local Laws and Regulations (1) General. The SUBRECIPIENT agrees to comply with all requirements of the ESG program and applicable cross-cutting Federal, State, and Local requirements. (2) Economic Opportunities for Low- and Very Low-income Persons. The SUBRECIPIENT shall ensure that employment and other economic opportunities generated by the Program shall, to the greatest extent feasible, be directed to low- and very low-income persons, particularly those who are recipients of government assistance for housing. Section 3 of the Housing and Urban Development Act of 1968, 12 U.S.C. 1701u, and regulations at 24 CFR Part 75 apply, except that homeless individuals have priority over other Section 3 residents in accordance with 24 CFR§ 576.405(c). (3) Civil Rights. The SUBRECIPIENT agrees to comply with Title VI of the Civil Rights Act of 1964, as amended, Title VIII of the Civil Rights Act of 1968, as amended, Section 109 of the Title I of the Housing and Community Development Act of 1974, Page 10 of 23 Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990,the Age Discrimination Act of 1975,and 41 CFR, Subtitle B,Chapter 60. (4) Nondiscrimination and Equal Employment Opportunity. During the performance under this AGREEMENT, the SUBRECIPIENT shall not discriminate against any employee or applicant for employment based on race, color, religion, sex, age, disability, ancestry, national origin, marital status, familial status, sexual orientation, or any other basis prohibited by applicable law. The SUBRECIPIENT shall take affirmative action to ensure that all applicants and employees are treated without regard to race, color, religion, sex, gender, gender identity, gender expression, medical conditions, genetic information, military or veteran status, age, disability, ancestry, national origin, marital status, familial status, and sexual orientation, or any other basis prohibited by applicable law. The SUBRECIPIENT shall comply with all provisions of Executive Order 11246, Equal Employment Opportunity, as amended by Executive Orders 11375 and 12086. (5) Nondiscrimination and Equal Opportunity in Participation. The requirements in 24 CFR, Subtitle A Part 5, subpart A are applicable, including the nondiscrimination and equal opportunity requirements at 24 CFR 5.105(a). The SUBRECIPIENT shall not discriminate against any participant on the ground of race, color, religion, sex, age, disability, ancestry, national origin, marital status, familial status, sexual orientation, or any other basis prohibited by applicable law. The SUBRECIPIENT shall, through affirmative outreach, make known that use of the facilities, assistance, and services are available to all on a nondiscriminatory basis. The SUBRECIPIENT must take appropriate steps to ensure effective communication with persons with disabilities. (6) Americans with Disabilities Act. The SUBRECIPIENT agrees to comply with any federal regulations issued pursuant to compliance with the Americans with Disabilities Act which prohibits discrimination and ensures equal opportunity for persons with disabilities in employment, State and Local government services, and public accommodations. (7) Fair Housing. Under section 808(e)(5) of the Fair Housing Act [42 USC §3608], HUD has a statutory duty to affirmatively further fair housing. HUD requires the same of its funded sub-recipients. The SUBRECIPIENT has a duty to affirmatively further fair housing opportunities for classes protected under the Fair Housing Act. C. Falsification of Information The SUBRECIPIENT represents and warrants that it has made no false statements to the CITY in the process of obtaining this award of the ESG Funds. D. Drug Free Workplace The SUBRECIPIENT represents and warrants that it has established the following drug- free workplace policy: Page 11 of 23 (1) The unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace for any employee involved in a federally funded program. (2) As an employee working in conjunction with a federally funded program, the employees of the SUBRECIPIENT will be required to: a. Abide by the terms above in statement(1),and b. Notify the appropriate SUBRECIPIENT authorities and CITY officials of any criminal drug statute conviction for a violation occurring in the workplace. Such notification shall be made no later than five(5)days after conviction. (3) The CITY and the United States Department of Housing and Urban Development will be notified within ten days after receiving notice of any such violation. (4) Within thirty (30) days of receiving such notice, appropriate personnel action will be taken against such employee,up to and including termination. (5) Each such employee shall be required to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State or Local health, law enforcement, or other appropriate agency. E. Religious Organization The SUBRECIPIENT may not engage in inherently religious activities, such as worship, religious instruction, or proselytization as part of said program or services. If the SUBRECIPIENT conducts such activities, the activities must be offered separately, in time or location, from said programs or services, and participation must be voluntary for the program participants. The SUBRECIPIENT shall not, in providing program assistance, discriminate against a program participant or prospective program participant on the basis of religion or religious belief. If the SUBRECIPIENT is a religious organization, it retains its independence from Federal, State, and Local governments, and may continue to carry out its mission, including the definition,practice, and expression of its religious beliefs,provided that the religious organization does not use direct ESG funds to support any inherently religious activities. The SUBRECIPIENT agrees that rehabilitation of structures by the religious organization in connection with said program must be in sound accord with the provisions under 24 CFR § 576.406. F. Additional Terms between the CITY and HUD The SUBRECIPIENT agrees further that it shall be bound by the standard terms and conditions used in the Grant Agreement between HUD and the CITY and such other rules, regulations, or requirements as HUD may reasonably impose in addition to the aforementioned assurances at or subsequent to the execution of this AGREEMENT by the parties hereto. G. OSHA Page 12 of 23 Where employees are engaged in activities not covered under the Occupational Safety and Health Act of 1970, they shall not be required or permitted to work, be trained, or receive services in buildings or surroundings or under working conditions which are unsanitary, hazardous,or dangerous to the participants' health or safety. H. Hatch Act The SUBRECIPIENT agrees that no funds provided, nor personnel employed under this AGREEMENT, shall be in any way or to any extent engaged in the conduct of political activities in violation of the Hatch Act, 5 U.S.C. Section 1501 et seq. I. Davis-Bacon Act All laborers and mechanics employed by contractors or subcontractors in the performance of construction work, including alterations and repairs, in excess of $2,000.00, financed in whole or in part with federal funds shall be paid wages at rates not less than those prevailing on similar construction in the locality as determined in accordance with the Davis- Bacon Act, as amended, 40 U.S.C. 3142. Any such construction contract shall include and comply with the required contract provisions and rules set forth in 29 C.F.R. §5.5. Further, the payroll reports (along with the "Statement of Compliance") and basic records are required to be maintained and submitted, or made available, pursuant to 29 C.F.R. §5.5(a)(3). No payment, advance, grant, loan or guarantee of funds shall be approved by the federal agency unless there is on file with the agency a certification by the contractor that the contractor and its subcontractors have complied with the provisions of 29 C.F.R. §5.5. A breach of the contract clauses in 29 C.F.R. §5.5 may be grounds for termination of the contract, and for debarment as a contractor/subcontractor, as provided in 29 C.F.R. §5.12. Labor standards interviews/investigations shall be made as necessary to assure compliance. See 29 C.F.R. §5.6(a)(3). VII. ADMINISTRATIVE REQUIREMENTS A. Generally The following requirements and standards must be complied with: 2 CFR Part 200, et al. SUBRECIPIENT shall procure all materials, property, or services in accordance with the requirements of 2 CFR 200.318-326. B. Procurement (1) Compliance. The SUBRECIPIENT shall comply with current HUD and CITY policies concerning the procurement of equipment, goods, and services, and shall maintain inventory records of all non-expendable personal property as defined by such policy as may be procured with funds provided herein. The SUBRECIPIENT shall report to the CITY all program assets (unexpended program income, property, equipment, etc.), and upon the CITY'S request, such assets shall revert to the CITY upon termination of this AGREEMENT. (2) Pursuant to 2 CFR 200.331 (a) (4), the Indirect Cost Rate for the SUBRECIPIENT's award shall be an approved federally recognized cost rate negotiated Page 13 of 23 between the SUBRECIPIENT and the Federal government, or, if no cost rate exists, the de minims indirect cost rate as defined in 2 CFR 200.414(b) Indirect(F &A) costs shall be used.For this agreement,the de minims indirect cost of 10%will apply. (3) Use and Reversion of Assets. The use and disposition of equipment under this AGREEMENT shall be in compliance with the requirements of 2 CFR Part 200. C. Reporting Reporting requirements must conform to the policies and procedures as established by the CITY and 24 CFR § 576.500. The SUBRECIPIENT shall submit to the CITY, on or before the 15t'day of October,January,April,and July,as part of the Quarterly Report: (1) Payment Request. An original request for reimbursement and true copies of invoices, receipts, agreements, or other documentation supporting and evidencing how the ESG Funds have been expended during the applicable quarter. (2) Quarterly Activities and written cumulative (year-to-date) reports of activities, program accomplishments, new program information, and up-to-date program statistics on expenditures, caseload and activities. Failure to provide any of the required documentation and reporting will cause the CITY to withhold all or a portion of a request for reimbursement until such documentation and reporting has been received and approved by the CITY. (3) Matching. Quarterly certification of match,plus documentation of match source. (4) Any other such reports as the CITY (or HUD) shall reasonably require and/or request, including but not limited to the following information: monthly records of all ethnic and racial statistics of persons and families benefited by the SUBRECIPIENT in the performance of its obligations under this AGREEMENT. D. Record Keeping Sufficient records must be established and maintained to enable the CITY and HUD to determine whether the ESG requirements are being met. Record keeping requirements must conform to the policies and procedures as established by the CITY. All accounting records, reports, all evidence pertaining to costs, expenses, and ESG Funds of the SUBRECIPIENT, and all documents related to this AGREEMENT shall be maintained and kept available at the SUBRECIPIENT'S office or place of business for the duration of the AGREEMENT and thereafter for five (5)years post-completion of an audit in conformity with the ESG requirements, except as hereinafter provided relating to retention of any records or documentation existing, created, or maintained in compliance with Lead-based Paint regulations, which likely require longer retention as outlined below. Records which relate to (a) complaints, claims,administrative proceedings or litigation arising out of the performance of this AGREEMENT, or (b) costs and expenses of this AGREEMENT to which the CITY or any other governmental agency takes exception, shall be retained beyond the five (5) years until complete resolution or disposition of such appeals, litigation claims, or exceptions. All said records must be retained for the greater of the aforementioned duration or the periods specified in 24 CFR 576.500(y). All records relating to, or created or maintained in compliance with, the Lead-Based Paint regulations shall be retained and maintained by the SUBRECIPIENT indefinitely, including without limitation, all inspection report(s), disclosure statement(s), and clearance report(s). Copies made by Page 14 of 23 microfilming, photocopying, or similar methods may be substituted for the original records. The CITY, HUD and auditors shall have the right to access all the SUBRECIPIENT records for as long as the records are retained by the SUBRECIPIENT. In the event the SUBRECIPIENT does not make the above-referenced documents available within the City of Santa Ana, California, the SUBRECIPIENT agrees to pay all necessary and reasonable expenses incurred by the CITY in conducting any audit at the location where said records and books of account are maintained. The SUBRECIPIENT agrees to meet the requirements set forth in 24 CFR§ 576.500. E. Homeless Management Information Systems(HMIS) (1) Generally. The SUBRECIPIENT must ensure that data on all persons served and all activities assisted under ESG are entered into the applicable community-wide HMIS in the area in which those persons and activities are located, or with the express knowledge and written consent of the CITY, a comparable database, in accordance with HUD's standards on participation,data collection, and reporting under a local HMIS. (2) HIMIIS Agency Agreement. The SUBRECIPIENT shall have an agreement in place with the HMIS lead agency to participate in the regionally HMIS system. A copy of the SUBRECIPIENTS agreement with the HMIS lead agency shall be attached to this agreement as Exhibit F. In the case of Domestic Violence service providers or other agencies prohibited from entering data into HMIS, documentation from the HMIS lead agency certifying that the SUBRECIPIENT is using a comparable database shall be attached to this agreement as Exhibit E. (3) HMIS Interagency Data Sharing Agreement. The SUBRECIPIENT shall enter into an Interagency Data Sharing Agreement with the HMIS Lead Agency where the SUBRECIPIENT agrees to share HMIS data with other ESG funded agencies regarding clients that are served in ESG funded programs, unless prohibited by law. A copy of such agreement shall be attached as Exhibit F-1. (A.) The SUBRECIPIENT agrees to provide 2110C with all required data needed to complete data analysis regarding project performance, data timeliness,or data quality. F. Audit Report Requirements The SUBRECIPIENT agrees that if the SUBRECIPIENT expends Seven Hundred Fifty Thousand Dollars ($750,000.00) or more in federal funds, the SUBRECIPIENT shall have an annual audit conducted by a certified public accountant in accordance with the standards as set forth and published by the United States Office of Management and Budget(2 CFR 200.501(a)). The SUBRECIPIENT shall provide the CITY with a copy of said audit by April 1 of the year following the program year in which this AGREEMENT is executed. Further, the SUBRECIPIENT shall comply and/or cause compliance with audit report(s) required by applicable provisions of the Lead-Based Paint Regulations as further detailed below. VIII. EVALUATION AND MONITORING A. Generally Page 15 of 23 The CITY will monitor the performance of the SUBRECIPIENT against goals and performance standards as required herein. The SUBRECIPIENT shall provide the CITY all necessary reporting information as required by the CITY in the administration and review of the Program. Substandard performance as determined by the CITY will constitute noncompliance with this AGREEMENT. If action to correct such substandard performance is not taken by the SUBRECIPIENT within a reasonable period of time after being notified by the CITY, contract suspension or termination procedures will be initiated. B. Access to Records The SUBRECIPIENT gives the CITY and HUD, including their authorized representative, access to and the right to examine all records, books, papers, items, emails, and documents,both physical and electronic,relating to the program. C. Audit The CITY shall have the right to audit and monitor any program income as a result of an ESG activity. Upon request by the CITY and for audit purposes, the SUBRECIPIENT further agrees to provide all files, records, and documents pertaining to related activities and clientele demographic data. IX. LIABILITY A. Generally Each party to this AGREEMENT acknowledges that it will be liable for its own negligent acts or negligent omissions by or through itself, its employees, agents, and subcontractors. Each party further agrees to defend itself and themselves, and to pay any judgments and costs arising out of such negligent acts or omissions, and nothing in this AGREEMENT shall impute or transfer any such liability from one to the other. In other words,the SUBRECIPIENT agrees to be fully responsible for its negligent acts or omissions, or any intentional tortuous acts which result in claims or suits against the CITY, and agrees to be liable for any damages proximately caused by said acts or omissions. Nothing herein shall be construed as consent by a State or CITY agency or subdivision to be sued by third parties in any matter arising out of any contract, and nothing herein is intended to serve as a waiver of sovereign immunity where sovereign immunity applies. B. CITY not Liable for Funds The SUBRECIPIENT further acknowledges that the source of the ESG Funds is a federal pass-through grant to the SUBRECIPIENT. The CITY shall have no obligation to advance or pay the SUBRECIPIENT with any funds other than the ESG Funds the CITY receives from HUD. C. Hold Harmless The SUBRECIPIENT shall defend, indemnify and save harmless the CITY, its City Council, officers, agents, employees, representatives, volunteers, and student externs from and against any and all damages to property or injuries to or death of any person or persons, including property and employees or agents of the CITY, and shall defend, indemnify and save harmless the CITY, its City Council, officers, agents, employees, representatives, volunteers, and student externs from and against any and all claims,demands, suits,actions or proceedings of any kind or Page 16 of23 nature, including, but not by way of limitation, workers compensation claims and attorney fees/expenses for litigation or settlement, resulting from or arising out of the negligent or wrongful acts, errors or omissions of the SUBRECIPIENT, its officers, directors, employees, agents, subcontractors, and suppliers arising out of the SUBRECIPIENT's performance of this AGREEMENT. X. ENVIRONMENTAL CONDITIONS A. Generally ESG activities are subject to environmental review by HUD under the environmental regulations in 24 CFR Part 50. The SUBRECIPIENT, or any contractor of the SUBRECIPIENT, may not acquire, rehabilitate, convert, lease, repair, dispose of, demolish, or construct property for a project under this part, or commit or expend HUD or local funds for eligible activities under this part, until HUD has performed an environmental review under 24 CFR part 50 and the recipient has received HUD approval of the property. The SUBRECIPIENT agrees to comply with all applicable environmental requirements insofar as they apply to the performance of this AGREEMENT, including but not limited to the Clean Air Act,the Federal Water Pollution Control Act and the Flood Disaster Protection Act. If applicable,the SUBRECIPIENT also shall comply with the Historic Preservation requirements of National Historic Preservation Act of 1966. B. Lead-based paint remediation and disclosure The Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4821-4846), the Residential Lead-Based Paint Hazard Reduction Act of 1992 (42 U.S.C. 4851-4856), and implementing regulations in 24 CFR part 35, subparts A, B, H, J, K, M, and R apply to all shelters assisted under ESG program and all housing occupied by program participants that were built before 1978. C. Assignment of Responsibilities By this AGREEMENT, the SUBRECIPIENT will accept assignment from the CITY of all responsibilities set forth in Subpart K of 24 CFR 35. D. Compliance with Subpart K The purpose of Subpart K is to establish procedures to eliminate as far as practicable lead-based paint ("LBP") hazards in a residential property that receives Federal assistance under certain HUD programs for acquisition, leasing, support services, or operation. In connection with the grant funds under this AGREEMENT, the CITY requires that the SUBRECIPIENT comply and show evidence of compliance with all applicable subparts of 24 CFR Part 35, and especially, Subpart K("LBP Regs"). The SUBRECIPIENT shall conduct the following activities for the dwelling unit, common areas servicing the dwelling unit, and the exterior surfaces of the building in which the dwelling unit is located: (I) A visual assessment of all painted surfaces in order to identify deteriorated paint; Page 17 of 23 (2) Paint stabilization of each deteriorated paint surface, and clearance, in accordance with 24 CFR §§ 35.1330(a) and (b), before occupancy of a vacant dwelling unit or,where a unit is occupied, immediately after receipt of Federal assistance; and (3) Ongoing lead-based paint maintenance activities into regular building operations, in accordance with 24 CFR § 35.1355(a), if the dwelling unit has a continuing, active financial relationship with a Federal housing assistance program, except that mortgage insurance or loan guarantees are not considered to constitute an active programmatic relationship for the purposes of this part. (4) And, notice to occupants in accordance with 24 CFR §§ 35.125(b)(1) and (c), describing the results of the clearance examination. E. Notification of LBP Hazard The SUBRECIPIENT shall provide to all occupants of housing: (1) In accordance with Section 35.130 of the LBP Regs - the LBP hazard information pamphlet. The pamphlet shall be the EPA/HUD/Consumer Product Safety Commission lead hazard information pamphlet or an EPA-approved equivalent. The current form and version of the pamphlet can be found at: https://www.epa.gov/sites/default/fi les/2020-04/documents/lead-in-yo ur-home-portrait- color-2020-508.pdf (2) In accordance with 24 CFR Part 35, Subpart A, all available information and knowledge regarding the presence of LBP and LBP hazards prior to leasing a housing unit. (3) In accordance with 24 CFR Part 35, Subpart A, notification in writing of the results of the presumption of LBP and/or LBP hazards, results of any lead hazard evaluation,and any lead hazard reduction work. F. LBP Information Summary For purposes of information only and in no respect intended to be a representation or warranty of the provisions of the LBP Regulations, the CITY has caused to be prepared an information summary relating to the LBP Regs and application to dwelling units that may be occupied by recipients of services and/or funding from the SUBRECIPIENT under this AGREEMENT. CITY staff will cooperate with and be available to the SUBRECIPIENT to assist in implementation of compliance with the LBP Regs as to residential dwelling units to be assisted by the SUBRECIPIENT. The parties acknowledge and agree the CITY shall not be liable or responsible for the accuracy of such summary, and the SUBRECIPENT is directed to the LBP Regulations and implementing guidance published and provided by HUD relating to compliance with such LBP Regs. G. Exemptions Page 18 of 23 Section 35.115(a) provides exemptions from Subparts B through R. For example, lead- based paint requirements do not apply to housing assistance if the assistance lasts less than one hundred(100)days. XI. CONFLICTS OF INTEREST The SUBRECIPIENT shall comply with 2 CFR 200.112 with respect to the use of program funds to procure services, equipment, supplies, or other property. With respect to all other decisions involving the use of program funds, the following restriction shall apply: No person who is an employee, agent, consultant, officer, or elected or appointed official of the SUBRECIPIENT and who exercises or has exercised any functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision making process or gain inside information with regard to such activities,may obtain a personal or financial interest or benefit from the activity, or have an interest in any contract, subcontract, or agreement with respect thereto, or the proceeds there under, either for himself or herself, or for those with who he or she has family or business ties,during his or her tenure or for one(1)year thereafter. The SUBRECIPIENT agrees to abide by the ESG Program's Conflict of Interest provisions as expressly detailed in 24 CFR § 576.404 regarding Organizational Conflicts of Interest and Personal Conflicts of Interest. All contractors of the SUBRECIPIENT must comply with the same requirements that apply to the SUBRECIPIENT under this section. XII. ASSIGNABILITY None of the duties of, or work to be performed by, the SUBRECIPIENT under this AGREEMENT shall be subcontracted or assigned to any agency, consultant, or person without the prior written consent of the CITY. The SUBRECIPIENT must submit all subcontracts and other agreements that relate to this AGREEMENT to the CITY. No subcontract or assignment shall terminate or alter the legal obligations of the SUBRECIPIENT pursuant to this AGREEMENT. XIII. EXCLUSIVITY OF AGREEMENT This AGREEMENT supersedes any and all other agreements, either oral or in writing, between the parties hereto with respect to the use of the CITY's ESG Funds by the SUBRECIPIENT and contains all the covenants and agreements between the parties with respect to such ESG Funds in any manner whatsoever. Each party to this AGREEMENT acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party,which are not embodied herein, and that no other agreement or amendment hereto shall be effective unless executed in writing and signed by both the CITY and the SUBRECIPIENT. XIV. AMENDMENTS OR MODIFICATIONS The SUBRECIPIENT shall not obligate, encumber, spend, or otherwise utilize program funds for any activity or purpose not included or not in conformance with the budget as apportioned and as submitted to the CITY unless: (1) The SUBRECIPIENT has received explicit written approval from the CITY to undertake such actions, or Page 19 of 23 (2) Budget changes may be made among approved program activities and among approved budget categories so long as the specific project activity has been approved, there is no change to the total grant amount, and the changes to the budget are documented. Any program modification request by the SUBRECIPIENT must be requested at least forty-five (45) days prior to the end of the term of this AGREEMENT. No modification to this AGREEMENT shall be binding by either party unless in writing and signed by both parties. In the event that the CITY approves any amendment to the funding allocation, the SUBRECIPIENT shall be notified in writing and such notification shall constitute an official amendment. The CITY may, at its discretion and upon provision of proper notice to the SUBRECIPIENT, amend this AGREEMENT to conform with changes in Federal, State, and/or the CITY laws, regulations, guidelines, directives, and objectives. Such amendments shall be incorporated by written amendment as a part of this AGREEMENT. XV. VIOLATION OF TERMS AND CONDITIONS A. Termination If, due to any cause, the SUBRECIPIENT fails to comply with the terms, conditions or requirements of this AGREEMENT, or any prior AGREEMENT whereby ESG funds were received by the SUBRECIPIENT, whether stated in a Federal statute or regulation, an assurance, a State plan or application, a notice of award, or elsewhere, the CITY may terminate or suspend this AGREEMENT in accordance with 2 CFR 200.339 and in accordance with 2 CFR 200.340 by giving written notice, and the CITY may request in writing that all or some of the grant funds be returned even if the SUBRECIPIENT has expended the funds. If the SUBRECIPIENT reports inaccurately, or if on audit there is a disallowance of certain expenditures, the SUBRECIPIENT agrees to remedy the acts or omissions causing the disallowance and repay the CITY all amounts spent in violation thereof. If the SUBRECIPIENT engaged in fraudulent activity to obtain and/or justify expenditure of the ESG funds granted hereunder,the SUBRECIPIENT shall be required to reimburse the CITY of all such funds that were obtained and/or spent under fraudulent circumstances, and the CITY reserves the right to take other remedies that may be legally available. The SUBRECIPIENT agrees to return all funds as requested by the CITY under this section within thirty(30) days of receipt of the written request. Any objections regarding terminations or suspensions shall be made by the SUBRECIPIENT in writing and mailed to the CITY pursuant to the above NOTICES section. XVI. CLOSE-OUT The SUBRECIPIENT agrees to comply with the closeout procedures detailed in 2 CFR 200.343, including the following: Page 20 of 23 1. SUBRECIPIENT must submit, no later than ninety (90) calendar days after the end date of the period of performance, all financial, performance, and other reports as required by the terms and conditions of the Federal award; 2. Unless the CITY authorizes an extension, SUBRECIPIENT must liquidate all obligations incurred under the Federal award not later than ninety(90)calendar days after the end date of the period of performance as specified in the terms and conditions of the Federal award; 3. SUBRECIPIENT must promptly refund any balances of unobligated cash that the CITY paid in advance or paid and that is not authorized to be retained by SUBRECIPIENT for use in other projects(See OMG Circular A-129 and 2 CFR 200.345); 4. SUBRECIPIENT must account for any real and personal property acquired with Federal funds or received from the Federal government in accordance with 2 CFR 200.310-200.316 and 200.329;and, 5. The CITY should complete all closeout actions for the Federal award no later than one year after receipt and acceptance of all required final reports. XVII. VALIDITY AND SEVERABILITY The invalidity in whole or in part of any provision of this ARGREEMENT shall not void or affect the validity of any other provision of this AGREEMENT. Whenever possible, each provision of this AGREEMENT shall be interpreted in such manner as to be effective and valid under applicable law, but if any provision of this AGREEMENT is held to be prohibited by or invalid under applicable law, such provision shall be ineffective only to the extent of such prohibition or invalidity,without invalidating the remainder of such provisions of this AGREEMENT. XVIII. LAWS GOVERNING THIS AGREEMENT This AGREEMENT shall be governed by and construed in accordance with the laws of the State of California, and all applicable federal laws and regulations. XIX. WAIVER No delay or omission by the CITY hereto to exercise any right or power accruing upon any noncompliance or default by the SUBRECIPIENT with respect to any of the terms of this AGREEMENT shall impair any such right or power or be construed to be a waiver thereof. A waiver by either of the parties hereto of any of the covenants, conditions, or agreements to be performed by the other shall not be construed to be a waiver of any succeeding breach thereof or of any other covenant,condition, or agreement herein contained. XX. AGREEMENT DOCUMENT,EXHIBITS,AND ATTACHMENTS All of the attachments and exhibits attached to this AGREEMENT are deemed incorporated by reference. This document may be executed in three (3) counterparts, each of which shall be deemed to be an original. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this AGREEMENT, and shall indemnify the Page 21 of 23 CITY fully, including reasonable costs and attorney's fees,for any injuries or damages to the CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. [signature page to follow] Page 22 of 23 IN WITNESS WHEREOF, the parties hereto have executed this AGREEMENT on the date and year first above written. ATTEST: CITY OF SANTA ANA a municipal corporatio II L Q, „„, AlLIILA d • ;E i. Je r .�I ! Alvarado Nunez Ci t lerk Acting City Manager APPROVED AS TO FORM: SONIA CARVALHO UBRECIPIENT: City Attorney • Ely: A drea Garcia- Interval House Assistant City Attorney Carol Williams Tax ID:95-33 89 1 1 3 Unique Entity ID#: HYGCLPGSCSM8 RECOMMENDED FOR APPROVAL: 4;i/1, Michael Garcia Executive Director, Community Development Agency Page 23 of 23 City of Santa Ana Scope of Work Name of Organization Interval House Name of Funded Program Domestic Violence Shelter Services Annual Accomplishment Goal I. Total number of unduplicated clients (Santa Ana and Non-Santa Ana Residents)anticipated to be served by the funded program, named above, during the 12-month contract period. 250 Persons II. Number of unduplicated Santa Ana residents expected to be served by the funded program during the 12-month contract period. 85'Persons Program and Funding Description III. Description of Work- In the space below, describe the program to be funded during the 12-month contract period. What specific activities will be undertaken during the contract period. Please be concise in your response. Only the viewable space will print. Interval House will continue to provide life-saving shelter and comprehensive supportive services to a minimum of 85 individuals (homeless victims of domestic violence and their children)from the City of Santa Ana. Services will include: EMERGENCY SHELTER: Interval House shelter programs offer a safe, caring, and homelike environment for adults, adolescents, and children in life-threatening situations who are left homeless as a result of domestic violence ADDITONAL SPECIALIZED SUPPORT SERVICES: Comprehensive counseling; legal; health and wellness;financial management; employment counseling; permanent housing; and other services as needed, provided by skilled counselors in over 70 languages. Schedule of Performance Estimate the number of unduplicated Santa Ana residents to be served by the funded program during the 12-month contract period per quarter. (Enter number of new Santa Ana clients served each quarter. If they were served in quarter 1 do not count them again in quarter 2) Quarter 1: July 1 -September 30 22 Persons Quarter 2: October 1 -December 31 21 Persons Quarter 3: January 1 -March 31 21 Persons Quarter 4: April 1 -June 30 21 Persons 85 Total unduplicated Santa Ana Residents to be served. Schedule of Invoicing Estimate the amount of grant funds to be requested during the 12-month contract period on a quarterly basis. Quarter 1: July 1 -September 30 $19,049.25 Quarter 2: October 1 -December 31 $19,049.25 Quarter 3: January 1 -March 31 $19,049.25 Quarter 4: April 1 -June 30 $19,049.25 $ 76,197.00 Total Grant Exhibit A Page 1 of 1 ESG Final Budget Organization Name Interval House Program Name Domestic Violence Shelter Services Expenditures Expenses Funded Expenses Funded Total Program Total Organizational Category by Santa Ana by Other Sources Budget Budget Essential Services - DV Advocate $ 56,770 $ 55,455 $ 112,225 $ 112,225 $ - $ - $ - $ $ - $ - $ - $ Shelter Operations - $ - $ - $ - $ - $ - $ - $ - $ Other -Shelter Repair& Maint. $ 12,500 $ 12,500 $ 12,500 - $ Indirect Cost $ 6,927 $ 5,545 $ 12,472 $ 12,472 - $ Total S 76,197 $ 61,000 $ 137,197 $ 137,197 LIST ALL OTHER PROGRAM FUNDS THAT HAVE BEEN SECURED (Total Funds for Program must equal Total Program Budget above) Source Amount Santa Ana $ 76,197 City of Anaheim $ 25,000 City of Garden Grove $ 21,000 City of Fountain Valley $ 15,000 Total Funds for the Program $ 137,197 Exhibit B Page 1 of 1 ESG Funded Personnel Name of Organization: Interval House Name of Program Domestic Violence Shelter Services Program Staff Position Title Budget Annual Hourly Rate Approximate Total Amount (only list funded positions) Category Salary #of Hours per Requested month serving Santa Ana DV Advocate Essential $ 65,000 $ 31.25 151.00 $ 56,770.00 Services Total ESG Requested $ 56,770.00 Certification Regarding Debarment,Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions This certification is required by the regulations implementing Executive Order 12549, as amended, Nonprocurement Debarment and Suspension,29 CFR Part 2998, Subpart C,Responsibilities of Participants Regarding Transactions. The regulations were published as Part VII of the May 26, 1988 Federal Register (pages 19160-19211), and subsequently amended in 81 Federal Register 25585. (BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS FOR CERTIFICATION - Attached) 1. The prospective recipient of federal assistance certifies to the best of its knowledge and belief,that it and its principals: a. Are not presently excluded or disqualified; b. Have not been convicted within the preceding three years of any of the offenses listed in 2 CFR 180.800(a) convicted or had a civil judgment rendered against them for one of those offenses within that time period. c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(Federal, State or local)with commission of any of the offenses listed in 2 CFR 180.800(a);and d. Have not had one or more public transactions (Federal, State or local)terminated within the preceding three years for cause or default. 2. Where the prospective recipient of federal assistance is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Carol Williams, Executive Director ilaine and Title of Authorized Representative L0a,te , Signature Date EXHIBIT C Page 1 of 2 INSTRUCTIONS FOR CERTIFICATION L By signing and submitting this proposal, the prospective recipient of federal assistance funds is providing the certification as set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective recipient of federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the Department of Labor (DOL) may pursue available remedies,including suspension and/or debarment. 3. The prospective recipient of federal assistance funds shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective recipient of federal assistance funds learns that its certification was erroneous 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," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective recipient of federal assistance funds agrees by submitting this proposal that, should the proposed covered transaction he entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the DOL. 6. The prospective recipient of federal assistance funds further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary exclusion - Lower Tier Covered Transactions," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 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 eligibility of its principals. Each participant may, but is not required to check the List of Parties Excluded from Procurement or Non- Procurement Programs. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the DOL may pursue available remedies, including suspension and/or debarment. EXHIBIT C Page 2 of 2 Certification Regarding Lobbying Certification for Contracts, Grants. Loans. and Cooperative Agreements The undersigned certifies,to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, 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 cooperative agreement, and the extension, continuation, renewal,amendment, or modification of any Federal contact,grant, loan or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," 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 subcontract, 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 into this transaction imposed by Section 1352,Title 31, U. S.Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than$100,000 for each such failure. Interval House Domestic Violence Shelter Services Grantee/Contactor Orga ' tion Program Title ti Carol Williams ILGI yC.�� 0112-1 --1-( Name of Certifying Officer Signature Date EXHIBIT D Page 1 of 2 SUBRECIPIENT warrants the following: 1. SUBRECIPIENT will comply with Public Law 88-352, Title VI of the Civil Rights Act of 1964(42 U. S. C. Sections 2000d et seq.) and implementing regulation in 24 CFR Part 1. 2, No person in the United States shall on the ground of race, color, religion, national origin, or sex, be excluded from participation in, or be denied the benefits of, or be subjected to discrimination under any program or activity funded in whole or in part with community development funds made available pursuant to the ACT. 3. All laborers and mechanics,employed by contractors or subcontractors in the performance of construction work financed in whole or in part with community development funds shall be paid wages at rates not less than those prevailing on similar construction in the locality as determined in accordance with the Davis-Bacon Act, as amended,40 U. S. C. Sections 3141 -3147, except for individuals who perform services for which they volunteered; do not receive compensation for such services; or are paid expenses, reasonable benefits, or a nominal fee for such services; and are not otherwise employed at any time in construction work. 4. SUBRECIPIENT will comply with all Federal statutes applicable to projects funded with community development funds, except that(a) SUBRECIPIENT does not assume CITY'S environmental responsibilities described at 24 CFR 570.604; and(b) SUBRECIPIENT does not assume CITY'S responsibility for initiating the review process under Executive Order 12372. EXHIBIT D Page 2 of 2 OC HMIS Participating Agency Agreement Purpose The HMIS (Homeless Management Information System) is a HUD-mandated information technology system that is designed to capture client-level information over time, on the characteristics and service needs of homeless persons. Client data is maintained on a central server, which will contain all client information in an encrypted state. HMIS integrates data from all homeless service providers and organizations in the community and captures basic descriptive information on every person served. Participation in the OC HMIS allows organizations to share information with other participating organizations to create a more coordinated and effective service delivery system.The OC HMIS is the secured electronic database for Orange County and is a valuable resource for local communities. Agreement and Understanding This Agreement authorizes this Participating Agency(Agency)to designate HMIS Users (User). A User is a staff person entrusted to enter Protected Personal Information (PPI) into the OC HMIS, on behalf of this Agency. In order to allow a User to access the OC HMIS, a User Agreement must be signed by the User and stored electronically in the HMIS. Confidentiality and Informed Consent Confidentiality:This Agency must require all Users to abide by its organization's policies and procedures; uphold all privacy protection standards established by the OC HMIS Policies and Procedures; and comply with all relevant federal and State of California confidentiality laws and regulations that protect client records. Except where otherwise provided for by law,this Agency shall ensure that confidential client records are released with the client's written consent. Written Consent: To obtain written consent, prior to each client's assessment, each client must be informed that the client's information will be entered into an electronic database called HMIS.The terms of the Consent to Share Protected Personal Information form must also be explained to each client. Clients who agree to have their PPI entered into the OC HMIS must sign the Consent to Share Protected Personal Information form. Verbal Consent:Verbal consent to enter PPI into the OC HMIS may be obtained during circumstances such as phone screenings, street outreach, or community access center sign-ins. Each client must be informed that their information will be entered into the HMIS database.The terms of the Consent to Share Protected Personal Information form must also be explained to each client. The client's written consent must be obtained once the client appears for their initial assessment. EXHIBIT E 1 Updated 8f24/18 Client's Rights The client has a right to receive a copy of this Agency Agreement at the time of request. Each client has the right to receive the following, no later than five (5) business days of a written request: • A correction of inaccurate or incomplete PPI • A copy of their consent form • A copy of their HMIS records • A current list of participating agencies that have access to HMIS data Data Use This Agency must protect HMIS data by ensuring that: • A link to the Privacy Notice is accessed from the Organization's website. • OC HMIS is not accessible to unauthorized users • OC HMIS is only accessed by computers approved by the Organization • HMIS Users are trained regarding user responsibilities and conduct • HMIS Users sign and comply with the OC HMIS User Agreement • HMIS Users forward a copy of a client's Revocation of Consent to the HMIS System Administrator, 2-1- 1 Orange County (2110C),within 24 hours of receipt Responsibilities This Agency is responsible to ensure that: • The Notice Regarding Collection of Personal Information is posted at each intake desk or comparable location • HMIS Users do not misuse the system • Clients are notified if a breach of their PPI is discovered • Any HMIS User who finds a possible security lapse on the system is obligated to immediately report it to 2110C • A signed copy of the Consent to Share Protected Personal Information is retained for a period of seven (7) years after the PPI was created or last changed. Rights and Privileges OC HMIS data is stored in one central database and is managed by 2110C. While each agency owns their own data within the database, the Orange County Continuum of Care (CoC) may release aggregate data about its own continuum at the program, sub-regional, and regional level. Aggregate data may be released without organization permission at the discretion of the Continuum. Use of the OC HMIS is a privilege and is assigned and managed by 2110C. EXHIBIT E 2 Copyright The OC HMIS and other CoC-provided software are protected by copyright and are not to be copied, except as permitted by law or by contract with the owner of the copyright. The number and distribution of copies of any CoC provided software are at the sole discretion of 2110C. Violations Any violations or suspected violations of any of the terms and conditions of this agreement,the HMIS User Agreement, and/or the HMIS Policies and Procedures, must be immediately and confidentially reported to 2110C and the Executive Director or other authorized representative of this Agency. Term This Participating Agency Agreement becomes effective on the date of final execution and shall remain in effect unless terminated pursuant to paragraph Xl. Termination, below. Amendment and Termination • The OC CoC reserves the right to amend this agreement by providing a 3-day notice to this Agency. • Either party has the right to terminate this agreement, with or without cause, by providing a 3-day written notice to the other party. • If this agreement is terminated,this Agency shall no longer have access to HMIS or any information therein.The CoC shall retain the right to use all client data previously entered by this Agency, subject to any restrictions requested by the client. All agencies that sign this agreement and are granted access to the OC HMIS agree to abide by OC HMIS' Policies and Procedures.The signature of the Executive Director or other authorized representative of this Agency indicates acceptance of all terms and conditions set forth in this agreement. This Agreement is executed between the CoC and the Participating Organization. Upon final execution,this Agency will be given access to the OC HMIS. Agency Name DO NOT WRITE IN THIS SECTION—2110C USE ONLY Interval House HMIS System Administrator Name (Print) Executive Director/Authorized Representative Name (Print) HMIS System Administrator Signature(Wet signature Carol Williams, Executive Director only) E. 'cutive Director/Authorized Representative Signature pet si ature only) - gg k6C6 LC �I� C� Date Date (v/1,2- /2 L-1 EXHIBIT E 3 Updated 8/24/la 41121A -- Ili 174- C Orange County CoC Inter-Agency Data Sharing Memorandum of Agreement The Interval House agency agrees to share client data among participating agencies via the OC HMIS (Orange County Homeless Management Information System) for the purposes outlined below. Each participating agency must complete and comply with the Agency Agreement. Each individual HMIS user must complete and comply with the HMIS User Agreement.This document is available on the OCHMIS website. Uses of HMIS Data: • Coordinate housing services for families and individuals experiencing homelessness or facing a housing crisis in Orange County • Understand the extent and the nature of homelessness in Orange County • Evaluate performance and progress toward community benchmarks • Improve the programs and services available to Orange County residents experiencing homelessness or a housing crisis • Improve access to services for all Orange County homeless and at-risk populations • Reduce inefficiencies and duplication of services within our community • Ensure that services are targeted to those most in need, including"hard to serve" populations • Ensure that clients receive the amount and type of services that "best fits"their needs and preferences • Pursue additional resources for ending homelessness • Advocate for policies and legislation that will support efforts to end homelessness in Orange County Client Protection: • Informed consent must be given by clients in order for their identifying information to be shared among agencies in the OC HMIS (see Orange County HMIS participating agencies on OCHMIS.org). If the client does not give consent, their identifying information can still be entered into HMIS, but the record should only be visible to the agency entering the data. • All agencies participating in HMIS must sign this agreement. The client has the right to see a current list of the OC HMIS participating agencies. As part of the informed consent process, clients must be informed that additional agencies may join the OC HMIS at any time and will have access to their information. • HMIS Users will maintain HMIS data in such a way as to protect against revealing the identity of clients to unauthorized agencies, individuals, or entities. Last Updated: 8/28/2018 EXHIBIT F • Clients may not be denied services based on their choice to withhold their consent. Each party to this memorandum of agreement shall defend, indemnify, and hold all other parties harmless from any and all claims arising out of that party's negligent performance of this agreement. Any loss or liability to third parties resulting from negligent acts, errors, or omissions of an OC HMIS user while acting within the scope of their authority under this Agreement shall be borne by that user exclusively. Agreed to and signed by the following agency representative (Executive Director or equivalent only): Printed Name : Carol Williams, Executive Director Agency Name Interval Hou,e Signature: WC/ /Date: CR f/�-1?-t-/ Last Updated: 8/28/2018 EXHIBIT F ACoRE® CERTIFICATE OF LIABILITY INSURANCE DAr1/292DTt'YYY) 024 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 NAME: Maureen(MoMo)McDonald Arthur J. Gallagher Risk Management Services, LLC PHONE Extl:818.539.8625 FAX 500 N Brand Boulevard, Suite 100 (Arc No):818.539.8725 EMAIL @ Ig corn Glendale CA 91203 ADDRESS: aureen_mcdonald Digitally' �� rI JIt ERAGE NAIL It Angie Licensedi:'D69293 INSURER A:Berkley Regional Insurance ompany 29580 INSURED )N SH 0 ) • Interval House A hnie:�rOemnity Company 39152 P.O. Box 3356 I RERC:Underwriters at Lloyd's,London 32727 Seal Beach, CA 9074 Date72O2Q•O5.23 COVERAGES CERTIFICATE NUf,BO 1034270190 3•O —O�IoOREVISION 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR !NSW—WVD (MM/DDIYYYY) (MMIDD/YYYY), A X COMMERCIAL GENERAL LIABILITY Y HHS 8525626-17 10/1/2023 10/1/2024 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $500,000 MED EXP(Any one person) $20,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 X POLICY n PRO- JECT LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: $ A AUTOMOBILE LIABILITY HHS 8525626-17 10/1/2023 10/1/2024 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) $ A UMBRELLA LIAB X OCCUR HHS 8525626-17 10/1/2023 10/1/2024 EACH OCCURRENCE $2,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED X RETENTION$n $ g WORKERS COMPENSATION Y SATISO405003 2/1/2024 2/1/2025 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Cyber Liability RPS-P-50252618M 10/1/2023 10/1/2024 Limit $1,000,000 Claims-Made form Aggregate $1,000,000 Retro Date:Full Prior Acts Retention $2,500 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Policy:Crime Coverage Policy Term: 10/1/2022 To 10/1/2025 Policy#:107707393 Carrier:Travelers Casualty and Surety Company of America Employee theft:Limit:$2,000,000/Deductible:$15,000 ERISA: Limit:$2,000,000 Forgery&Alteration:Limit$2,000,000/Deductible:$15,000 Theft Money and Securities:Limit:$2,000,000/Deductible:$15,000 See Attached... 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 ACCORDANCE WITH THE POLICY PRC\ Attn: Risk Management Division o°R,�9s Risk Managem ent Division 20 Civic Center Plaza, 4th Floor AUTHORIZED REP ESENTATIVE ','� L c,y R�EW@&APPRQI/mBY: Santa Ana, CA 92701 R .... f I A4 e;,e Ac v4 Jarman I Risk Management Specialist ©1988-2015 ACORD / ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: INTEHOU-03 _ LOC#: A ® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Arthur J.Gallagher Risk Management Services,LLC Interval House P.O.Box 3356 POLICY NUMBER Seal Beach,CA 90740 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 Computer Fraud: Limit:$2,000,000/Deductible:$15,000 Fund transfer fraud:Limit:$2,000,000 I Deductible:$15,000 Money Orders and counterfeit paper currency:Limit: :$2,000,000/Deductible:$15,000 Policy:Abuse or Molestation Liability Policy#:HHS 8525626-17 Carrier:Berkley Regional Insurance Company Policy Term: 10/1/2023 To 10/1/2024 Per Claim:$1,000,000/Aggregate:$3,000,000 Policy:Professional Liability Policy#:HHS 8525626-17 Carrier:Berkley Regional Insurance Company Policy Term:10/1/2023 To 10/1/2024 Per Claim:$1,000,000/Aggregate:$3,000,000 Policy:Commercial Property Policy#:HHS 8525626-17 Carrier:Berkley Regional Insurance Company Policy Term:10/1/2023 To 10/1/2024 Blanket Building:Limit:$6,465,315/Deductible$1,000 Blanket Business Personal Property:Limit:$931,540/Deductible$1,000 Policy:Directors&Officers Liability Policy#:PHSD1828308 Carrier:Philadelphia Indemnity Insurance Company Policy Term:10/1/2023 To 10/1/2024 Per Claim:$1,000,000/Aggregate:$1,000,000/Retention:$5,000 Re:Contract#A-2023-083-02 City of Santa Ana,its officers,agents,employees and volunteers are named additional insured with respect to the General Liability policy of the named insured.The insurance provided in the General Liability and Network Security and Privacy Liability policy is primary and any other insurance shall be excess only,and not contributing. Waiver of Subrogation for Workers Compensation policy applies in favor of Additional insured. Such insurance is Primary and Non-Contributory.Written notice shall be provided at least ten(10)days in advance of cancellation for non-payment of premium and thirty(30)days in advance for any other cancellation or policy change. / g o�.w f Risk MsnsgementDtvisian a;�� REVIEWED&APPROVED 8Y: � 111a)" A..,�,,e�d,:,�z Aaevul. ®. Risk Management Specialist ACORD 101 (2008/01) ©2008 ACORD i/ The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT— CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you per- form work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be See Below% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization City of Santa Ana Attn: Risk Managment Division Job Description 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92701 DOO: Re Specific Waiver is $200 Flat Charge 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 Date:0 2/01/2 0 2 4 Policy No. SAT I S 0 4 0 5 0 0 3 Endorsement No. Policy Effective Date: 02/01/2024 to 02/01/2025 Premium $ Insured: Interval House DBA: Carrier Name/Code: Service American Indemnity Company Risk Management D[viston REVIEWED&APPROVED By: Countersigned by ,u ram! A Acaueda Risk Management Specialist WC 04 03 06 (Ed. 4-84) Page 1 of 1 POLICY NUMBER: HHS 8525626-17 COMMERCIAL GENERAL LIABILITY CG20100413 Berkley Regional Insurance Company 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 City of Santa Ana, its officers, agents, employees and volunteers 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 B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury' "property damage"occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. 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. r Risk Management Division REVIEWED&APPROVED BY: FFF( 11,4,414 mamma Risk Management Specialist CG 20 10 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Risk Management Division REVIEWED&APPROVED BY: F1ill�11_I?:_Li /� Arc>Qceverlu ® Risk Management Specialist / \ Page 2 of 2 ©Insurance Services Office, Inc., 2012 CG 20 10 0413 COMMERCIAL GENERAL LIABILITY CG 83 91 05 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ CAREFULLY. GENERAL LIABILITY BROADENING ENDORSEMENT This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Throughout this endorsement,the words "you" and "your"refer to the Named Insured shown in the Declarations. The word "we,""us,"and"our" refer to the company providing this insurance. The following is only a summary of the additional coverages provided by this endorsement and is provided only for your reference and convenience. For the Limits of Insurance and the additional coverages provided by this endorsement, read the provisions on the following pages and the Coverage Form,which this endorsement modifies. SUBJECTS OF INSURANCE Broadened Bodily Injury Broadened Personal and Advertising Injury Broadened Property Damage Broadened Fire, Lightning, Explosion, and Sprinkler Leakage-$500,000 Broadened Medical Payments-$10,000 Broadened Supplementary Benefits a. Bail Bonds-$1,000 b. Expenses Incurred to Assist in Defense-$500 per Day Broadened Newly Acquired or Formed Organization Broadened Non-Owned or Chartered Watercraft or Aircraft Broadened Commercial General Liability Conditions a. Duties in the Event of Occurrence, Offense, Claim,or Suit b. Liberalization—Automatic Coverage If We Adopt Broader Coverages c. Notice to Company Automatic Coverage for"Special Events" Automatic Additional Insureds a. Athletic Activity Participants b. Contractual Obligations c. Funding Sources d. Manager or Lessor of Premises e. Owner, Manager, Operator, or Lessor of"Special Event"Premises f. Supervisors or Higher in Rank—Co-Employee Exclusion Removed g. Limitations Blanket Waiver of Subrogation Priority of Application for Multiple Insureds The coverages listed in this endorsement are provided as extensions or additions to your insurance program. \ l_ Riak Mazaganatt Division 3 REVIEWED&APPROVED BY: I■�',A„ri1'� /4 (7GEV�i�u coma Risk Management Specialist CG 83 91 05 15 Includes copyrighted material of Insurance Services ✓ _ \ Office, Inc. used with its permission. A. BROADENED BODILY INJURY b. Material Published with Knowledge of Paragraph 3.of Section V— Definitions is Falsity deleted and replaced with the following: "Personal and advertising injury"arising 3. "Bodily injury" means physical injury, sickness, out of oral,written,televised, videotaped, or disease sustained by a person, including or electronic publication of material, if death resulting from any of these. "Bodily done by or at the direction of the insured injury"also means mental injury, mental with knowledge of its falsity; anguish, humiliation, or shock sustained by a c. Material Published Prior to Policy person, if directly resulting from physical Period injury, sickness, or disease sustained by that "Personal and advertising injury" arising person. out of oral,written,televised, videotaped, B. BROADENED PERSONAL AND ADVERTISING or electronic publication of material whose INJURY first publication took place before the 1. Paragraph 14. of Section V—Definitions is beginning of the policy period; deleted and replaced with the following: C. BROADENED PROPERTY DAMAGE 14. "Personal and Advertising Injury" means Exclusion 2.a. under Coverage A Bodily Injury injury, including consequential "bodily and Property Damage Liability is deleted and injury" arising out of one or more of the replaced with the following: following offenses during the policy period. a. Expected Or Intended Injury a. False arrest, detention,or "Bodily injury"or"property damage"expected imprisonment; or intended from the standpoint of the insured. b. Malicious prosecution or abuse of This exclusion does not apply to"bodily injury" process; or"property damage" resulting from the use of c. The wrongful eviction from,wrongful reasonable force to protect persons or entry into, or invasion of the right of property. private occupancy of a room, dwelling, D. BROADENED FIRE, LIGHTNING, EXPLOSION or premises that a person occupies by AND SPRINKLER LEAKAGE or on behalf of its owner, landlord, or 1. Paragraph 6. under Section III—Limits Of lessor; Insurance is deleted and replaced with the d. Oral,written,televised,videotaped, or following: electronic publication of material that 6. Subject to 5. above,the Damage to slanders or libels a person or Premises Rented to You Limit is the most organization or disparages a person's we will pay under Coverage A for or organization's goods, products, or damages because of"property damage" services; to: e. Oral, written, televised,videotaped or a. Any one premises while rented to you, electronic publication of material that or in the case of damage by fire, while violates a person's right of privacy; or rented to you or temporarily occupied f. Misappropriation of advertising ideas by you with permission of the owner; or style of doing business; or and g. Infringement of copyright, title, or b. Personal property of others in your slogan. care, custody,or control,while at h. Mental injury, mental anguish, premises rented to you or in the case humiliation, or shock, if directly of damage by fire,while rented to you resulting from Items 14.a. through or temporarily occupied by you with 14.g. above. permission of the owner, arising out of 2. Exclusions 2.b. and 2.c. under Coverage B any one fire, lightning, explosion or sprinkler leakage occurrence. Personal and Advertising Injury Liability are deleted and replaced with the following: e!. Risk Msmagement Division int. REVIEWED&APPROVED By: tpn f�.:7 A Aa4,46 IROZZIEL Risk Management Specialist Page 2 of 8 Includes copyrighted material of Insurance Services ✓ \ Office, Inc. used with its permission. The Damage to Premises Rented to You 2. This Medical Expense Limit is subject to all the Limit is the greater of: terms of Section III—Limits Of Insurance. c. $500,000; or 3. This above Medical Expense Limit does not d. The amount shown in the Declarations apply if Coverage C Medical Payments is for Damage to Premises Rented to excluded either by the Declaration to this You Limit. Coverage Part or by an endorsement to this 2. Paragraph 2. Exclusions of Coverage A Coverage Part. Bodily Injury and Property Damage F. BROADENED SUPPLEMENTARY PAYMENTS Liability is amended as follows: Paragraphs 1.b. and 1.d.under Supplementary Paragraphs c.through n.,do not apply to Payments—Coverages A and B are deleted and damage by fire, lightning, explosion,or replaced with the following: sprinkler leakage to premises while rented to b. Up to $1,000 for cost of bail bonds required you or temporarily occupied by you with because of accidents or traffic law violations permission of the owner. A separate limit of arising out of the use of any vehicle to which insurance applies to this coverage as the Bodily Injury Liability Coverage applies. described in Section III —Limits Of We do not have to furnish these bonds. Insurance. d. All reasonable expenses incurred by the 3. Paragraph 4. Other Insurance of Section IV insured at our request to assist us in the —Commercial General Liability Conditions investigation or defense of the claim or"suit," is amended as follows: including actual loss of earnings up to$500 a Paragraph b. (1) (a)(ii) is deleted and day because of time off from work. replaced with the following: G. BROADENED NEWLY ACQUIRED OR FORMED (ii) That is Fire, Lightning, Explosion, or ORGANIZATION Sprinkler Leakage insurance for premises Paragraph 3.a under Section II—Who Is An rented to you or temporarily occupied by Insured is deleted and replaced by the following: you with permission of the owner; or a. Coverage under this provision is afforded only 4. Paragraph 9.a. under Section V—Definitions until the 120th day after you acquire or form is deleted and replaced with the following: the organization or the end of the policy a. A contract for a lease of premises. period,whichever is earlier. However,that portion of the contract for a H. BROADENED NON-OWNED OR CHARTERED lease of premises that indemnifies any WATERCRAFT OR AIRCRAFT person or organization for damage by fire, Exclusion 2.g. under Coverage A Bodily Injury lightning, explosion or sprinkler leakage to and Property Damage Liability is deleted and premises while rented to you or replaced by the following: temporarily occupied by you with "Bodilyinjury" "property damage"arisingout permission of the owner is not an"insured g. or contract"; of the ownership, maintenance, use, or entrustment to others of any aircraft,"auto," or 5. This Broadened Coverage is subject to all the watercraft owned by or operated by, or rented terms of Section III—Limits Of Insurance. or loaned to, any insured. Use includes 6. This Broadened Coverage does not apply if operation and"loading or unloading". Fire Damage Liability of COVERAGE A This exclusion does not apply to: (SECTION I)is excluded either by the (1) A watercraft while ashore on premises you Declaration to this Coverage Part or by an endorsement to this Coverage Part. own or rent; E. BROADENED MEDICAL PAYMENTS (2) A watercraft you do not own that is: 1. The following provision is added to Paragraph (a) Less than 51 feet long; and 7. of Section III—Limits Of Insurance: (b) Not being used to carry persons or The Medical Expense Limit shall be the property for a charge; greater of: (3) Parking an "auto"on, or on the ways next a. $10,000; or to premises you own or rent, provided the to b. The amount shown in the Declarations for you is theht ins' 1,,,^r�onro.� ^� ^�^o� / Medical Expense Limit. to or ns Risk MaragementDtvision n�` @ REVIEWED&APPROVED BY: DEEM Risk Management Specialist CG 83 91 05 15 Includes copyrighted material of Insurance Services / Office, Inc. used with its permission. (4) Liability assumed under any"insured 11. Notice To Company contract"for the ownership, maintenance, If you report an "occurrence"or offense to or use of aircraft, watercraft, or"autos"; or your Workers'Compensation insurer (5) "Bodily injury"or"property damage" which later becomes a claim under this arising out of the operation of any of the Coverage Part,failure to report such equipment listed in Paragraph f. (2)or f. "occurrence"or offense to us at the time of (3)of Section V—Definitions, Paragraph the"occurrence"or offense will not be 12., "Mobile Equipment"; or considered a violation of the Duties In (6) An aircraft you do not own that is: The Event Of Occurrence, Offense, (a) Hired, chartered, or loaned with a Claim Or Suit Condition, if you notify us crew; and as soon as practicable when you become aware that the"occurrence"or offense has (b) Not owned in whole or in part by any become a liability claim. insured. J. AUTOMATIC COVERAGE FOR SPECIAL (7) This insurance does not apply, under EVENTS Paragraph g.(1) and g.(2)above, if the 1. You are automatically covered for all "special insured has any other insurance for"bodily events"which you organize, promote, injury"or"property damage"which would administer, sponsor, or conduct during the also apply to loss covered under this term of this policy. provision,whether the other insurance is primary, excess, contingent, or on any 2. Section V—Definitions is amended to add other basis. the following paragraph: (8) This insurance is excess, under 23. "Special Event" means any event: Paragraph g. (6) above, over any other a. The purpose of which is to raise funds insurance,whether the other insurance is for you; or primary, excess, contingent or on any b. To recognize the accomplishments of other basis. your organization, your"employees," I. BROADENED COMMERCIAL GENERAL or your volunteer workers; or LIABILITY CONDITIONS c. Which you, or an individual or 1. Paragraph 2. Duties in The Event Of organization with whom you have Occurrence, Offense, Claims Or Suit under entered into a contract or agreement, Section IV—Commercial General Liability organize, promote, administer, Conditions is amended to add the following sponsor,or conduct for the purposes provision: described in Paragraphs a. or b. e. Your obligation to notify us as soon as above; and practicable of an "occurrence,"or offense d. Which takes place on premises owned under Paragraph 2.a. above, or a claim or by you,or on premises while rented or "suit" or offense under Paragraphs 2.a., leased to you or to that organization 2.b.,and 2.c above, is satisfied if you described in Paragraph c. above. send us written notice as soon as K. AUTOMATIC ADDITIONAL INSURED(S) practicable after any of your"executive The following provisions are added to Section II— officers,"directors, partners, insurance Who Is An Insured: managers, or legal representatives becomes aware of, or should have 4. Automatic Additional Insured(s) become aware of, such "occurrence," a. Additional Insureds—Athletic Activity offense, claim or"suit." Participants 2. The following provisions are added to Section (1) This policy is amended to include as IV—Commercial General Liability an insured any person(s)[hereinafter Conditions: called Additional Insured(s)] 10. Liberalization representing you while participating in If we adopt any revision that would amateur athletic activities that you broaden the coverage under this coverage sponsor. However, no such person is part without additional premium within 30 an insured for: days prior to or during the policy period, (a) "Medical expenses" under the broadened coverage will immediately Coveranp r: Mpriir_aI Paun,pntc apply to this coverage part. (b) "Bodily I\ =g oa. Risk MainetnattDiviairnt _ REVIEWED&APPROVED BY: '!. ltf Id'c 3; A /lceva gazmatvl Risk Management Specialist Page 4 of 8 Includes copyrighted material of Insurance Services Office, Inc. used with its permission. (i) A co-participant, your (ii) Which takes place after you volunteer worker or your cease to be a tenant in that "employee"while participating premises. in amateur athletic activities (c) With respect to architects, that you sponsor; or engineers, or surveyors, coverage (ii) You, or any partner or does not apply to"Bodily Injury," member, (if you are a "Property Damage,""Personal partnership or joint venture), Injury,"or"Advertising Injury" or any member(if you are a arising out of the rendering or the limited liability company); or failure to render any professional (c) "Property damage"to property services by or for you including: owned by, occupied or used by, (i) The preparing, approving, or rented to , in the care, custody, or failing to approve or prepare control of, or over which physical maps,drawings, opinions, control is being exercised for any reports, surveys, change purpose by: orders, designs or (I) A co-participant, your specifications; and volunteer worker, or your (ii) Supervisory, inspection, or "employee"; or engineering services. (ii) You, or any partner or (d) Coverage provided herein shall be member, (if you are a considered excess over any other partnership or joint venture), valid and collectible insurance or any member(if you are a available to the Additional Insured limited liability company). whether that other insurance is b. Additional Insured—Contractual primary, excess, contingent, or on Obligations any other basis unless a written (1) This policy is amended to include as contractual arrangement an insured any person or organization specifically requires this insurance (hereinafter called Additional Insured) to be primary. that you are required by a written (e) In the event that you are engaged "insured contract"; to include as an in the manufacture or assembly of insured, subject to all of the following any goods or products for the provisions: benefit or at the direction of (a) Coverage is limited to liability another party, pursuant to a arising out of: contract or agreement with that party, this paragraph (e). does (i) Your ongoing operations not extend coverage to that party performed for such Additional as an Additional Insured. Insured; or Coverage for such a party will be (ii) Such Additional Insured's extended only by a specific financial control of you; or endorsement issued by us and (iii) The maintenance, operation naming such party. or use by you of equipment c. Additional Insured—Funding Sources leased to you by such (1) This policy is amended to include as Additional Insured; or an insured any Funding Source (iv)A permit issued to you by a (hereinafter called Additional Insured) state or political subdivision. which requires you in a written (b) Coverage does not apply to any contract to name such Additional "occurrence"or offense: Insured but only with respect to (i) Which took place before the liability arising out of your premises or "your work"for such Additional execution of, or subsequent to Insured, and only to the extent set the completion or expiration forth as folio\ of, the written "insured Risk MnnagemenLD[vislon contract"; or ,�_.- , REVIEWED&APPROVED BY: ,® Risk Management Specialist CG 83 91 05 15 Includes copyrighted material of Insurance Services / Office, Inc. used with its permission. (a) The Limits of Insurance applicable (2) With respect to the insurance afforded to the Additional Insured are the the Additional Insured identified in lesser of those specified in the Paragraph d. (1) immediately above, written contract or agreement or in the following additional provisions the Declarations for this policy and apply: subject to all the terms, conditions (a) This insurance applies only to and exclusions for this policy. The liability arising out of the Limits of Insurance applicable to ownership, maintenance, or use of the Additional Insured are that portion of the premises inclusive of, and not in addition to, leased to you; the Limits of Insurance shown in the Declarations. (b) The Limits of Insurance applicable to the Additional Insured are the (b) The coverage provided to the lesser of those specified in the Additional Insured is not greater written contract or agreement or in than that customarily provided by the Declarations for this policy and the policy forms specified in and subject to all this policy's terms, required by the contract. conditions, and exclusions. The (c) In no event shall the coverages or Limits of Insurance applicable to Limits of Insurance in this the Additional Insured are Coverage Form be increased by inclusive of, not in addition to, the such contract. Limits of Insurance shown in the (d) Coverage provided herein shall be Declarations. considered excess over any other (c) In no event shall the coverages or valid and collectible insurance Limits of Insurance in this available to the Additional Insured Coverage Part be increased by whether that other insurance is such contract or agreement. primary, excess, contingent, or on (d) Coverage provided herein shall be any other basis unless a written considered excess over any other contractual arrangement valid and collectible insurance specifically requires this insurance available to the Additional Insured to be primary. whether that other insurance is d. Additional Insured—Manager or Lessor primary, excess, contingent, or on of Premises any other basis unless a written (1) This policy is amended to include as contractual arrangement an insured any person or organization specifically requires this insurance (hereinafter called Additional Insured) to be primary. from whom you lease or rent your (3) This insurance does not apply to: premises and which requires you to (a) Any"occurrence"or offense which add such person or organization as an takes place after you cease to be Additional Insured in this policy under: a tenant in the premises covered (a) A written contract; or by this endorsement; or (b) An oral agreement or contract (b) Structural alterations, new where a Certificate of Insurance construction, or demolition has been issued showing that operations performed by or on person or organization as an behalf of the Additional Insured. Additional Insured; e. Additional Insured—Owner, Manager, but only if the written or oral Operator or Lessor of"Special Events" agreement is an "insured Premises contract"; (1) This policy is amended to include as (i) Currently in effect or to an insured any person or organization become effective during the (hereinafter called Additional Insured) term of this policy; and from whom you lease, rent or occupy (ii) Executed prior to the"bodily the premises upon which a "special injury," "property damage," event" is held, sponsored or "personal injury", or conducted b\ "advertising injury." under: „e�,N,a Risk Management llvision REVIEWED&APPROVED BY: Auva x, Risk Management Specialist Page 6 of 8 Includes copyrighted material of Insurance Services Office, Inc. used with its permission. (a) A written contract; or (3) This insurance does not apply to: (b) An oral agreement or contract (a) Any"occurrence"or offense which where a Certificate of Insurance takes place after you cease to be has been issued showing that a tenant, licensee or occupant in person or organization as an the premises covered by this Additional Insured; but only if the endorsement; or written or oral agreement is an (b) Any acts or"occurrences"caused "insured contract," by or attributable to the owner, (i) Currently in effect or to manager, operator, or lessor of become effective during the the premises upon which the term of this policy; and "special event" is held. (ii) Executed prior to the"bodily f. Additional Insured—Supervisors or injury,""property damage," Higher in Rank "personal injury,"or (1) This policy is amended to include as "advertising injury." insured any"employees" (hereinafter (2) With respect to the insurance afforded called Additional Insured), designated the Additional Insured identified in as supervisor or higher in rank, who Paragraph e. (1)of this endorsement, are authorized by you to exercise the following additional provisions direct or indirect supervision and apply: control over"employees"and the (a) This insurance applies only to manner in which work is performed, liability arising out of the use of but only for acts within the scope of that portion of the premises while their employment by you or while leased or rented to you for the performing duties related to the specific"special event"; conduct of your business. However, (b) The Limits of Insurance applicable none of these "employees"designated to the Additional Insured are the as supervisor or higher in rank, is an lesser of those specified in the insured for: contract or agreement pertaining (a) "Bodily injury"or"personal injury": to the use of the premises or in (i) To you,to your partners or the Declarations for this policy and members(if you are a subject to all of this policy's terms, partnership or joint venture), conditions,and exclusions. The or to your members(if you are Limits of Insurance applicable to a limited liability company); the Additional Insured are (ii) For which there is any inclusive of, not in addition to, the obligation to share damages Limits of Insurance shown in the with or repay someone else Declarations. who must pay damages (c) In no event shall the coverage or because of the injury Limits of Insurance in this described in paragraph (a)(i) Coverage Form be increased by above; or such contract or agreement. (iii)Arising out of his or her (d) Coverage provided herein shall be providing or failing to provide considered excess over any other professional health care valid and collectible insurance services. available to the Additional Insured (b) "Personal Injury": whether that other insurance is primary, excess, contingent, or on (i) To a co-"employee"while in any other basis unless a written the course of his or her contractual arrangement employment,or specifically requires this insurance (ii) To the spouse, child, parent, to be primary. brother or sister of that co- "em\ / of P ,�,.a�.,„ Risk ManaganeritDivisinn �. REVIEWED&APPROVED By: o ' ;�, A A,4-, �- Risk Management Specialist CG 83 91 05 15 Includes copyrighted material of Insurance Services / \ Office, Inc. used with its permission. (iii) For which there is any restitution, penalties, and formula obligation to share damages damages added to"actual with or repay someone else damages"and any other who must pay damages enhanced damages. because of the injury (4) All other terms and conditions of this described in Paragraph (b) (i) Coverage Part which are not or(b) (ii) above. inconsistent with this Paragraph h. (c) "Property damage" to property: apply to coverage extended to the (i) Owned, occupied or used by; above referenced Additional Insureds or REGARDLESS OF WHETHER OR NOT A COPY OF THIS COVERAGE (ii) Rented to, in the care, PART AND/OR ITS custody, or control of, or over ENDORSEMENTS ARE DELIVERED which physical control is being TO AN ADDITIONAL INSURED. exercised for any purpose by you, any of your"employees," L. BLANKET WAIVER OF SUBROGATION any partner, or member(if you Paragraph 8. under Section IV—Commercial are a partnership or joint General Liability Conditions is deleted and venture), or any member(if replaced with the following: you are a limited liability 8. Transfer of Rights Of Recovery Against company). Others To Us And Blanket Waiver Of g. Additional Insured—LIMITATIONS Subrogation (1) The persons, entities, or organizations a. If an insured has rights to recover all or to which coverage is extended under part of any payment we have made under Paragraphs a. (Athletic Activity this Coverage Part, those rights are Participants), b. (Contractual transferred to us. The insured must do Obligations), c. (Funding Sources), d. nothing after loss to impair them. At our (Managers or Lessors of Premises), request,the insured will bring "suit"or and e. (Owner, Manager, Operator, or transfer those rights to us and help us Lessor of"Special Events" Premises) enforce them. are Additional Insureds, but only: b. If required by written "insured contract," (a) With respect to each Additional we waive any right of recovery we may Insured's vicarious liability for have against any person or organization "actual damages"solely caused because of payments we make for injury by you or by"your work"that is or damage arising out of your ongoing ongoing for such Additional operations or"your work"done under a Insured's supervision of"your contract for that person or organization work"; and and included in the"products-completed (b) If the Additional Insured did not operations hazard." cause or contribute to the M. PRIORITY OF APPLICATION FOR MULTIPLE "occurrence"or act resulting in INSUREDS liability. Section III—Limits Of Insurance is amended to (2) If an endorsement is attached to this add the following paragraph: policy and specifically names a person 8. In the event a claim or"suit" is brought against or organization as an Additional more than one insured, due to"bodily injury" Insured, then the coverage extended or"property damage"from the same under this paragraph 4. AUTOMATIC "occurrence,"or"personal injury,"or ADDITIONAL INSURED(S)does not "advertising injury,"from the same offense,we apply to that person, entity, or will apply the Limits of Insurance in the organization. following order: (3) The following is added to Section V— a. You; Definitions: b. Your"executive officers,"directors, 24. "Actual Damages" is to have its "employees,"and usual and customary legal c. Any other insureds in any order that we meaning and excludes without choose. limitation, punitive damages, Riak Management Division EWED ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. ;1 Ran &APPROVED By: aces= Risk Management Specialist Page 8 of 8 Includes copyrighted material of Insurance Services / Office, Inc. used with its permission. ACCORD® DATE(MMIDD/YYYY) ACCORD CERTIFICATE OF LIABILITY INSURANCE 1/29/2024 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 NAME: Maureen(MoMo)McDonald Arthur J. Gallagher Risk Management Services, LLC PHONE FAX 500 N Brand Boulevard, Suite 100 (Arc.No.Exe:818.539.8625 [Arc,No):818.539.8725 Glendale CA 91203 ADDRESS: maureen_mcdonald@ajg.com INSURER(S)AFFORDING COVERAGE NAIC# License#:0D69293 INSURER A:Service American Indemnity Company 39152 INSURED INTEHOU-03 INSURER B:Berkley Regional Insurance Company 29580 Interval House P.O. Box 3356 INSURER C: Seal Beach, CA 90740 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1254379073 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTRINSnrQ POLICY NUMBER (MM/DD/YYYYL(MM/DD/YYYYL LIMITS B X COMMERCIAL GENERAL LIABILITY Y HHS 8525626-17 10/1/2023 10/1/2024 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $500,000 MED EXP(Any one person) $20,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 PRO X POLICY JECT LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) B UMBRELLA LIAB X OCCUR HHS 8525626-17 10/1/2023 10/1/2024 EACH OCCURRENCE $2,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED X RETENTION$f1 $ A WORKERS COMPENSATION Y SATISO405003 2/1/2024 2/1/2025 X PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE NrA E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED'? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Commercial Property HHS 8525626-17 10/1/2023 10/1/2024 BLKT Building Limit $6,465,315 BLKT BPP Limit $931,540 Deductible $1,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Policy:Crime Coverage Policy Term: 10/1/2022 To 10/1/2025 Policy#: 107707393 Carrier:Travelers Casualty and Surety Company of America Employee theft:Limit:$2,000,000/Deductible:$15,000 ERISA:Limit:$2,000,000 Forgery&Alteration:Limit$2,000,000/Deductible:$15,000 Theft Money and Securities:Limit:$2,000,000/Deductible:$15,000 See Attached... 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 ACCORDANCE WITH THE POLICY PRC\ Attn: Risk Management Division , Risk MRnagementDivision 20 Civic Center Plaza, 4th Floor AUTHORIZED REP ESENTATIVE 4, REVIEWED(Si.APPROVED BY: Santa Ana, CA 92701 • A"�`e Acu ul° ®• Risk Management Specialist I ©1988-2015 ACORD / ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: INTEHOU-03 _ LOC#: ® AR ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Arthur J.Gallagher Risk Management Services,LLC Interval House P.O.Box 3356 POLICY NUMBER Seal Beach,CA 90740 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 Computer Fraud:Limit:$2,000,000/Deductible:$15,000 Fund transfer fraud:Limit:$2,000,000/Deductible:$15,000 Money Orders and counterfeit paper currency:Limit: :$2,000,000/Deductible:$15,000 Policy:Abuse or Molestation Liability Policy#:HHS 8525626-17 Carrier:Berkley Regional Insurance Company Policy Term:10/1/2023 To 10/1/2024 Per Claim:$1,000,000/Aggregate:$3,000,000 Policy:Professional Liability Policy#:HHS 8525626-17 Carrier:Berkley Regional Insurance Company Policy Term:10/1/2023 To 10/1/2024 Per Claim:$1,000,000/Aggregate:$3,000,000 Policy:Cyber Liability Policy#:RPS-P-50252618M Carrier:Underwriters at Lloyd's,London Policy Term: 10/1/2023 To 10/1/2024 Per Claim:$1,000,000/Aggregate:$1,000,000/Retention:$2,500 Re:Contract#A-2023-083-02 City of Santa Ana,its officers,agents,employees and volunteers are named additional insured with respect to the General Liability policy of the named insured.The insurance provided in the General Liability and Network Security and Privacy Liability policy is primary and any other insurance shall be excess only,and not contributing. Waiver of Subrogation for Workers Compensation policy applies in favor of Additional insured. Such insurance is Primary and Non-Contributory.Written notice shall be provided at least ten(10)days in advance of cancellation for non-payment of premium and thirty(30)days in advance for any other cancellation or policy change. / Risk Management Dtvis[on . A ' REVIEWED&APPROVED By: A.ei�,,e?lava, Risk Management Specialist ACORD 101 (2008/01) ©2008 ACORD 1/ The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT— CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you per- form work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be See Below% of the California workers'compensation premium otherwise due on such remuneration. Schedule Person or Organization City of Santa Ana Attn: Risk Managment Division Job Description 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92701 DOO: Re Specific Waiver is $200 Flat Charge 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 Date:0 2/O 1/2 024 Policy No. SAT I S 0 4 05003 Endorsement No. Policy Effective Date: 02/01/2024 to 02/01/2025 Premium $ Insured: Interval House DBA: Carrier Name/Code: Service American Indemnity Company Risk MimslgematEDiviston REVIEWED&APPROVED 8Y: Countersigned by `,1+io' Acevedo ® Risk Management Specialist WC 04 03 06 (Ed. 4-84) Page 1 of 1 POLICY NUMBER: HHS 8525626-17 COMMERCIAL GENERAL LIABILITY CG20100413 Berkley Regional Insurance Company 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 City of Santa Ana, its officers, agents, employees and volunteers 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 B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for"bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" "property damage"occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. 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. \ - aRisk ManagementDEvision I 'i' REVIEWED&APPRVED BY: R_ ,._ / Risk Management Specialist / \ CG 20 10 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Risk Management Division REVIEWED&APPROVED By: g �a :,� A Aav€ ram, Risk Management Specialist Page 2 of 2 ©Insurance Services Office, Inc., 2012 CG 20 10 04 13 COMMERCIAL GENERAL LIABILITY CG 83 91 05 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ CAREFULLY. GENERAL LIABILITY BROADENING ENDORSEMENT This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Throughout this endorsement, the words"you"and "your"refer to the Named Insured shown in the Declarations. The word "we,""us,"and"our" refer to the company providing this insurance. The following is only a summary of the additional coverages provided by this endorsement and is provided only for your reference and convenience. For the Limits of Insurance and the additional coverages provided by this endorsement, read the provisions on the following pages and the Coverage Form,which this endorsement modifies. SUBJECTS OF INSURANCE Broadened Bodily Injury Broadened Personal and Advertising Injury Broadened Property Damage Broadened Fire, Lightning, Explosion, and Sprinkler Leakage-$500,000 Broadened Medical Payments -$10,000 Broadened Supplementary Benefits a. Bail Bonds-$1,000 b. Expenses Incurred to Assist in Defense-$500 per Day Broadened Newly Acquired or Formed Organization Broadened Non-Owned or Chartered Watercraft or Aircraft Broadened Commercial General Liability Conditions a. Duties in the Event of Occurrence, Offense, Claim, or Suit b. Liberalization—Automatic Coverage If We Adopt Broader Coverages c. Notice to Company Automatic Coverage for"Special Events" Automatic Additional Insureds a. Athletic Activity Participants b. Contractual Obligations c. Funding Sources d. Manager or Lessor of Premises e. Owner, Manager, Operator, or Lessor of"Special Event" Premises f. Supervisors or Higher in Rank—Co-Employee Exclusion Removed g. Limitations Blanket Waiver of Subrogation Priority of Application for Multiple Insureds The coverages listed in this endorsement are provided as extensions or additions to your insurance program. / Risk Management Division ° tiroREVIEWED&APPROVED BY: " A+I :ismatesi, Risk Management Specialist CG 83 91 05 15 Includes copyrighted material of Insurance Services / Office, Inc. used with its permission. A. BROADENED BODILY INJURY b. Material Published with Knowledge of Paragraph 3. of Section V—Definitions is Falsity deleted and replaced with the following: "Personal and advertising injury" arising 3. "Bodily injury" means physical injury, sickness, out of oral,written,televised,videotaped, or disease sustained by a person, including or electronic publication of material, if death resulting from any of these. "Bodily done by or at the direction of the insured injury"also means mental injury, mental with knowledge of its falsity; anguish, humiliation, or shock sustained by a c. Material Published Prior to Policy person, if directly resulting from physical Period injury, sickness, or disease sustained by that "Personal and advertising injury"arising person. out of oral,written,televised,videotaped, B. BROADENED PERSONAL AND ADVERTISING or electronic publication of material whose INJURY first publication took place before the 1. Paragraph 14.of Section V—Definitions is beginning of the policy period; deleted and replaced with the following: C. BROADENED PROPERTY DAMAGE 14. "Personal and Advertising Injury" means Exclusion 2.a. under Coverage A Bodily Injury injury, including consequential "bodily and Property Damage Liability is deleted and injury"arising out of one or more of the replaced with the following: following offenses during the policy period. a. Expected Or Intended Injury a. False arrest, detention,or "Bodily injury"or"property damage"expected imprisonment; or intended from the standpoint of the insured. b. Malicious prosecution or abuse of This exclusion does not apply to"bodily injury" process; or"property damage" resulting from the use of c. The wrongful eviction from,wrongful reasonable force to protect persons or entry into, or invasion of the right of property. private occupancy of a room, dwelling, D. BROADENED FIRE, LIGHTNING, EXPLOSION or premises that a person occupies by AND SPRINKLER LEAKAGE or on behalf of its owner, landlord, or 1. Paragraph 6. under Section III—Limits Of lessor; Insurance is deleted and replaced with the d. Oral,written,televised,videotaped, or following: electronic publication of material that 6. Subject to 5. above, the Damage to slanders or libels a person or Premises Rented to You Limit is the most organization or disparages a person's we will pay under Coverage A for or organization's goods, products, or damages because of"property damage" services; to: e. Oral,written, televised, videotaped or a. Any one premises while rented to you, electronic publication of material that or in the case of damage by fire, while violates a person's right of privacy; or rented to you or temporarily occupied f. Misappropriation of advertising ideas by you with permission of the owner; or style of doing business; or and g. Infringement of copyright, title, or b. Personal property of others in your slogan. care, custody, or control,while at h. Mental injury, mental anguish, premises rented to you or in the case humiliation, or shock, if directly of damage by fire,while rented to you resulting from Items 14.a. through or temporarily occupied by you with 14.g. above. permission of the owner, arising out of 2. Exclusions 2.b. and 2.c. under Coverage B any one fire, lightning, explosion or Personal and Advertising Injury Liability sprinkler leakage occurrence. are deleted and replaced with the following: \ / II !.e Risk MRnagematEDtvision °' REVIEWED&APPROVED BY: _clitii issomsi Risk Management Specialist Page 2 of 8 Includes copyrighted material of Insurance Services / Office, Inc. used with its permission. The Damage to Premises Rented to You 2. This Medical Expense Limit is subject to all the Limit is the greater of: terms of Section III—Limits Of Insurance. c. $500,000; or 3. This above Medical Expense Limit does not d. The amount shown in the Declarations apply if Coverage C Medical Payments is for Damage to Premises Rented to excluded either by the Declaration to this You Limit. Coverage Part or by an endorsement to this 2. Paragraph 2. Exclusions of Coverage A Coverage Part. Bodily Injury and Property Damage F. BROADENED SUPPLEMENTARY PAYMENTS Liability is amended as follows: Paragraphs 1.b. and 1.d. under Supplementary Paragraphs c.through n., do not apply to Payments—Coverages A and B are deleted and damage by fire, lightning, explosion, or replaced with the following: sprinkler leakage to premises while rented to b. Up to$1,000 for cost of bail bonds required you or temporarily occupied by you with because of accidents or traffic law violations permission of the owner. A separate limit of arising out of the use of any vehicle to which insurance applies to this coverage as the Bodily Injury Liability Coverage applies. described in Section III—Limits Of We do not have to furnish these bonds. Insurance. d. All reasonable expenses incurred by the 3. Paragraph 4. Other Insurance of Section IV insured at our request to assist us in the —Commercial General Liability Conditions investigation or defense of the claim or"suit," is amended as follows: including actual loss of earnings up to$500 a Paragraph b. (1) (a)(ii) is deleted and day because of time off from work. replaced with the following: G. BROADENED NEWLY ACQUIRED OR FORMED (ii) That is Fire, Lightning, Explosion, or ORGANIZATION Sprinkler Leakage insurance for premises Paragraph 3.a under Section II—Who Is An rented to you or temporarily occupied by Insured is deleted and replaced by the following: you with permission of the owner; or a. Coverage under this provision is afforded only 4. Paragraph 9.a. under Section V—Definitions until the 120th day after you acquire or form is deleted and replaced with the following: the organization or the end of the policy a. A contract for a lease of premises. period,whichever is earlier. However, that portion of the contract for a H. BROADENED NON-OWNED OR CHARTERED lease of premises that indemnifies any WATERCRAFT OR AIRCRAFT person or organization for damage by fire, Exclusion 2.g. under Coverage A Bodily Injury lightning, explosion or sprinkler leakage to and Property Damage Liability is deleted and premises while rented to you or replaced by the following: temporarily occupied by you with "Bodilyinjury"or"property dama a arisingout permission of the owner is not an"insured g' t ryn g of the ownership, maintenance, use, or contract"; entrustment to others of any aircraft,"auto,"or 5. This Broadened Coverage is subject to all the watercraft owned by or operated by, or rented terms of Section III—Limits Of Insurance. or loaned to, any insured. Use includes 6. This Broadened Coverage does not apply if operation and"loading or unloading". Fire Damage Liability of COVERAGE A This exclusion does not apply to: (SECTION I)is excluded either by the (1) A watercraft while ashore on premises you Declaration to this Coverage Part or by an own or rent; endorsement to this Coverage Part. E. BROADENED MEDICAL PAYMENTS (2) A watercraft you do not own that is: 1. The following provision is added to Paragraph (a) Less than 51 feet long; and 7. of Section III—Limits Of Insurance: (b) Not being used to carry persons or The Medical Expense Limit shall be the property for a charge; greater of: (3) Parking an "auto"on, or on the ways next a. $10,000; or to premises you own or rent, provided the b. The amount shown in the Declarations for "auto" is not owr� "��^r ron+o,+ ^r I^n.,o� Medical Expense Limit. to you or the ins - o�y�c Risk Management Division 3,.�~. '•?_ REVIEWED&APPROVED BY: zoom Risk Management Specialist CG 83 91 05 15 Includes copyrighted material of Insurance Services / • Office, Inc. used with its permission. (4) Liability assumed under any"insured 11. Notice To Company contract"for the ownership, maintenance, If you report an "occurrence"or offense to or use of aircraft, watercraft, or"autos"; or your Workers' Compensation insurer (5) "Bodily injury"or"property damage" which later becomes a claim under this arising out of the operation of any of the Coverage Part, failure to report such equipment listed in Paragraph f. (2)or f. "occurrence"or offense to us at the time of (3)of Section V—Definitions, Paragraph the"occurrence"or offense will not be 12., "Mobile Equipment"; or considered a violation of the Duties In (6) An aircraft you do not own that is: The Event Of Occurrence, Offense, (a) Hired, chartered, or loaned with a Claim Or Suit Condition, if you notify us crew; and as soon as practicable when you become aware that the"occurrence" or offense has (b) Not owned in whole or in part by any become a liability claim. insured. J. AUTOMATIC COVERAGE FOR SPECIAL (7) This insurance does not apply, under EVENTS Paragraph g.(1)and g.(2)above, if the 1. You are automatically covered for all "special insured has any other insurance for"bodily events"which you organize, promote, injury"or"property damage"which would administer, sponsor,or conduct during the also apply to loss covered under this term of this policy. provision,whether the other insurance is primary, excess, contingent, or on any 2. Section V—Definitions is amended to add other basis. the following paragraph: (8) This insurance is excess, under 23. "Special Event" means any event: Paragraph g.(6) above, over any other a. The purpose of which is to raise funds insurance, whether the other insurance is for you; or primary, excess, contingent or on any b. To recognize the accomplishments of other basis. your organization, your"employees," I. BROADENED COMMERCIAL GENERAL or your volunteer workers;or LIABILITY CONDITIONS c. Which you, or an individual or 1. Paragraph 2. Duties in The Event Of organization with whom you have Occurrence, Offense, Claims Or Suit under entered into a contract or agreement, Section IV—Commercial General Liability organize, promote, administer, Conditions is amended to add the following sponsor,or conduct for the purposes provision: described in Paragraphs a. or b. e. Your obligation to notify us as soon as above; and practicable of an "occurrence,"or offense d. Which takes place on premises owned under Paragraph 2.a. above, or a claim or by you, or on premises while rented or "suit" or offense under Paragraphs 2.a., leased to you or to that organization 2.b., and 2.c above, is satisfied if you described in Paragraph c. above. send us written notice as soon as K. AUTOMATIC ADDITIONAL INSURED(S) practicable after any of your"executive The following provisions are added to Section II— officers,"directors, partners, insurance Who Is An Insured: managers, or legal representatives becomes aware of, or should have 4. Automatic Additional Insured(s) become aware of, such "occurrence," a. Additional Insureds—Athletic Activity offense, claim or"suit." Participants 2. The following provisions are added to Section (1) This policy is amended to include as IV—Commercial General Liability an insured any person(s) [hereinafter Conditions: called Additional Insured(s)] 10. Liberalization representing you while participating in If we adopt any revision that would amateur athletic activities that you broaden the coverage under this coverage sponsor. However, no such person is part without additional premium within 30 an insured for: days prior to or during the policy period, (a) "Medical expenses" under the broadened coverage will immediately Coverac<r. M:dit- Pavmrantc apply to this coverage part. (b) "Bodily I\ Risk ,tat Division EVI s R EWE ®D&APPROV8Y: z� c- �—�—r zwersa Risk Management Specialist Page 4 of 8 Includes copyrighted material of Insurance Services Office, Inc. used with its permission. (i) A co-participant, your (ii) Which takes place after you volunteer worker or your cease to be a tenant in that "employee"while participating premises. in amateur athletic activities (c) With respect to architects, that you sponsor; or engineers, or surveyors, coverage (ii) You, or any partner or does not apply to"Bodily Injury," member, (if you are a "Property Damage,""Personal partnership or joint venture), Injury,"or"Advertising Injury" or any member(if you are a arising out of the rendering or the limited liability company); or failure to render any professional (c) "Property damage"to property services by or for you including: owned by, occupied or used by, (i) The preparing, approving, or rented to , in the care, custody, or failing to approve or prepare control of, or over which physical maps,drawings, opinions, control is being exercised for any reports,surveys, change purpose by: orders, designs or (i) A co-participant, your specifications; and volunteer worker, or your (ii) Supervisory, inspection,or "employee"; or engineering services. (ii) You, or any partner or (d) Coverage provided herein shall be member, (if you are a considered excess over any other partnership or joint venture), valid and collectible insurance or any member(if you are a available to the Additional Insured limited liability company). whether that other insurance is b. Additional Insured—Contractual primary, excess, contingent, or on Obligations any other basis unless a written (1) This policy is amended to include as contractual arrangement an insured any person or organization specifically requires this insurance (hereinafter called Additional Insured) to be primary. that you are required by a written (e) In the event that you are engaged "insured contract";to include as an in the manufacture or assembly of insured, subject to all of the following any goods or products for the provisions: benefit or at the direction of (a) Coverage is limited to liability another party, pursuant to a arising out of: contract or agreement with that party, this paragraph (e). does (i) Your ongoing operations not extend coverage to that party performed for such Additional as an Additional Insured. Insured; or Coverage for such a party will be (ii) Such Additional Insured's extended only by a specific financial control of you; or endorsement issued by us and (iii) The maintenance, operation naming such party. or use by you of equipment c. Additional Insured—Funding Sources leased to you by such (1) This policy is amended to include as Additional Insured; or an insured any Funding Source (iv)A permit issued to you by a (hereinafter called Additional Insured) state or political subdivision. which requires you in a written (b) Coverage does not apply to any contract to name such Additional "occurrence"or offense: Insured but only with respect to (i) Which took place before the liability arising out of your premises or "your work"for such Additional execution of, or subsequent to Insured, and only to the extent set the completion or expiration forth as follo\ of, the written "insured contract"; or REVIEWED al..ltt�•�'a` IEWt D&APPROVED 8Y: Risk Management Specialist CG 83 91 05 15 Includes copyrighted material of Insurance Services f Office, Inc. used with its permission. (a) The Limits of Insurance applicable (2) With respect to the insurance afforded to the Additional Insured are the the Additional Insured identified in lesser of those specified in the Paragraph d. (1)immediately above, written contract or agreement or in the following additional provisions the Declarations for this policy and apply: subject to all the terms,conditions (a) This insurance applies only to and exclusions for this policy. The liability arising out of the Limits of Insurance applicable to ownership, maintenance, or use of the Additional Insured are that portion of the premises inclusive of, and not in addition to, leased to you; the Limits of Insurance shown in the Declarations. (b) The Limits of Insurance applicable to the Additional Insured are the (b) The coverage provided to the lesser of those specified in the Additional Insured is not greater written contract or agreement or in than that customarily provided by the Declarations for this policy and the policy forms specified in and subject to all this policy's terms, required by the contract. conditions, and exclusions. The (c) In no event shall the coverages or Limits of Insurance applicable to Limits of Insurance in this the Additional Insured are Coverage Form be increased by inclusive of, not in addition to, the such contract. Limits of Insurance shown in the (d) Coverage provided herein shall be Declarations. considered excess over any other (c) In no event shall the coverages or valid and collectible insurance Limits of Insurance in this available to the Additional Insured Coverage Part be increased by whether that other insurance is such contract or agreement. primary, excess, contingent, or on (d) Coverage provided herein shall be any other basis unless a written considered excess over any other contractual arrangement valid and collectible insurance specifically requires this insurance available to the Additional Insured to be primary. whether that other insurance is d. Additional Insured—Manager or Lessor primary, excess, contingent, or on of Premises any other basis unless a written (1) This policy is amended to include as contractual arrangement an insured any person or organization specifically requires this insurance (hereinafter called Additional Insured) to be primary. from whom you lease or rent your (3) This insurance does not apply to: premises and which requires you to (a) Any"occurrence"or offense which add such person or organization as an takes place after you cease to be Additional Insured in this policy under: a tenant in the premises covered (a) A written contract; or by this endorsement; or (b) An oral agreement or contract (b) Structural alterations, new where a Certificate of Insurance construction, or demolition has been issued showing that operations performed by or on person or organization as an behalf of the Additional Insured. Additional Insured; e. Additional Insured—Owner, Manager, but only if the written or oral Operator or Lessor of"Special Events" agreement is an"insured Premises contract"; (1) This policy is amended to include as (i) Currently in effect or to an insured any person or organization become effective during the (hereinafter called Additional Insured) term of this policy; and from whom you lease, rent or occupy (ii) Executed prior to the"bodily the premises upon which a "special injury,""property damage," event"is held, sponsored or "personal injury", or conducted b\ "advertising injury." under: ,,,.P�,,,,< Risk Management DvtsEon eo' REVIEWED&APPROVED BY: yi��fru__ A A v o iffaMS Risk ManagementSpedalist Page 6 of 8 Includes copyrighted material of Insurance Services / \ Office, Inc. used with its permission. (a) A written contract; or (3) This insurance does not apply to: (b) An oral agreement or contract (a) Any"occurrence"or offense which where a Certificate of Insurance takes place after you cease to be has been issued showing that a tenant, licensee or occupant in person or organization as an the premises covered by this Additional Insured; but only if the endorsement; or written or oral agreement is an (b) Any acts or"occurrences"caused "insured contract," by or attributable to the owner, (i) Currently in effect or to manager,operator, or lessor of become effective during the the premises upon which the term of this policy; and "special event" is held. (ii) Executed prior to the"bodily f. Additional Insured—Supervisors or injury,""property damage," Higher in Rank "personal injury,"or (1) This policy is amended to include as "advertising injury." insured any"employees" (hereinafter (2) With respect to the insurance afforded called Additional Insured), designated the Additional Insured identified in as supervisor or higher in rank,who Paragraph e. (1)of this endorsement, are authorized by you to exercise the following additional provisions direct or indirect supervision and apply: control over"employees"and the (a) This insurance applies only to manner in which work is performed, liability arising out of the use of but only for acts within the scope of that portion of the premises while their employment by you or while leased or rented to you for the performing duties related to the specific"special event"; conduct of your business. However, (b) The Limits of Insurance applicable none of these"employees"designated to the Additional Insured are the as supervisor or higher in rank, is an lesser of those specified in the insured for: contract or agreement pertaining (a) "Bodily injury"or"personal injury": to the use of the premises or in (i) To you,to your partners or the Declarations for this policy and members(if you are a subject to all of this policy's terms, partnership or joint venture), conditions,and exclusions. The or to your members (if you are Limits of Insurance applicable to a limited liability company); the Additional Insured are (ii) For which there is any inclusive of, not in addition to, the obligation to share damages Limits of Insurance shown in the with or repay someone else Declarations. who must pay damages (c) In no event shall the coverage or because of the injury Limits of Insurance in this described in paragraph (a)(i) Coverage Form be increased by above; or such contract or agreement. (iii) Arising out of his or her (d) Coverage provided herein shall be providing or failing to provide considered excess over any other professional health care valid and collectible insurance services. available to the Additional Insured (b) "Personal Injury": whether that other insurance is (i) To a co-"employee"while in primary, excess, contingent, or on the course of his or her any other basis unless a written employment, or contractual arrangement specifically requires this insurance (ii) To the spouse, child, parent, to be primary. brother or sister of that co- "em\ of P „r a.��e Risk Management Di sk n REVIEWED&APPROVED BY: ®' '-,�lr' Risk Management Specialist CG 83 91 05 15 Includes copyrighted material of Insurance Services / Office, Inc. used with its permission. (iii) For which there is any restitution, penalties, and formula obligation to share damages damages added to "actual with or repay someone else damages"and any other who must pay damages enhanced damages. because of the injury (4) All other terms and conditions of this described in Paragraph (b) (i) Coverage Part which are not or(b) (ii) above. inconsistent with this Paragraph h. (c) "Property damage"to property: apply to coverage extended to the (i) Owned, occupied or used by; above referenced Additional Insureds or REGARDLESS OF WHETHER OR NOT A COPY OF THIS COVERAGE (ii) Rented to, in the care, PART AND/OR ITS custody, or control of, or over ENDORSEMENTS ARE DELIVERED which physical control is being TO AN ADDITIONAL INSURED. exercised for any purpose by you, any of your"employees," L. BLANKET WAIVER OF SUBROGATION any partner, or member(if you Paragraph 8. under Section IV—Commercial are a partnership or joint General Liability Conditions is deleted and venture), or any member(if replaced with the following: you are a limited liability 8. Transfer of Rights Of Recovery Against company). Others To Us And Blanket Waiver Of g. Additional Insured—LIMITATIONS Subrogation (1) The persons, entities, or organizations a. If an insured has rights to recover all or to which coverage is extended under part of any payment we have made under Paragraphs a. (Athletic Activity this Coverage Part,those rights are Participants), b. (Contractual transferred to us. The insured must do Obligations), c. (Funding Sources), d. nothing after loss to impair them. At our (Managers or Lessors of Premises), request,the insured will bring"suit"or and e. (Owner, Manager, Operator, or transfer those rights to us and help us Lessor of"Special Events" Premises) enforce them. are Additional Insureds, but only: b. If required by written "insured contract," (a) With respect to each Additional we waive any right of recovery we may Insured's vicarious liability for have against any person or organization "actual damages"solely caused because of payments we make for injury by you or by"your work"that is or damage arising out of your ongoing ongoing for such Additional operations or"your work"done under a Insured's supervision of"your contract for that person or organization work"; and and included in the"products-completed (b) If the Additional Insured did not operations hazard." cause or contribute to the M. PRIORITY OF APPLICATION FOR MULTIPLE "occurrence"or act resulting in INSUREDS liability. Section III—Limits Of Insurance is amended to (2) If an endorsement is attached to this add the following paragraph: policy and specifically names a person 8. In the event a claim or"suit" is brought against or organization as an Additional more than one insured, due to"bodily injury" Insured, then the coverage extended or"property damage"from the same under this paragraph 4.AUTOMATIC "occurrence,"or"personal injury,"or ADDITIONAL INSURED(S) does not "advertising injury,"from the same offense, we apply to that person, entity, or will apply the Limits of Insurance in the organization. following order: (3) The following is added to Section V— a. You; Definitions: b. Your"executive officers,"directors, 24. "Actual Damages" is to have its "employees,"and usual and customary legal c. Any other insureds in any order that we meaning and excludes without choose. limitation, punitive damages, " Risk Management' Mka ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. z REI D&APPRaveDBr. `1u3�1� Aai ® Risic Management Specialist Page 8 of 8 Includes copyrighted material of Insurance Services / Office, Inc. used with its permission. 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