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HomeMy WebLinkAboutThomas House 1s AGREEMENT TERDIINATION Please complete this form when the attached agreement is no longer in effect. Return form to the Deputy Clerk of the Council (1\4-30). Call 647 -6520 if you have any questions. M^[MLS ��&g , A- a6U3 —Di4® YP The agreement with was completed on \t LQ v _ 3 _ a O 0 f and final payment has been made. Date: g /-1/ b City of Santa Ana Revised 4 -16 -87 Clerk of the Council A- 2003 -074-46 INSURANCE NOT ON FILE WORK MAY NOT PROCEED CLERK OF COUNCIL DATE: a -t5 -a3 AGREEMENT BETWEEN THE CITY OF SANTA ANA AND C p THOMAS HOUSE TEMPORARY SHELTER FOR USE OF Lc.rhafiksj COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS (With Provisions Relating to Compliance with Title X and 24 CFR Part 35 Relating to Lead Based Paint) This Agreement, made and entered into this 1st day of July, 2003, by and between the City of S anta Ana, a charter city and municipal corporation o f the State o f C alifomia ( "CITY ") and THOMAS HOUSE TEMPORARY SHELTER; a California nonprofit corporation ( "SUBRECIPIENT "), WITNESSETH Recitals: A. The CITY, as an entitlement recipient and grantee of the United States Department of Housing and Urban Development ( "HUD ") Community Development Block Grant ( "CDBG ") Program, desires to enter this Agreement with the SUBRECIPIENT for the expenditure of CDBG funds in accordance with Title 24, Part 570 of Code of Federal Regulations 24 CFR 570.000, et seq. ( "CDBG REGS "); and B. CITY has applied for and received CDBG funds from HUD pursuant to Title I of the Housing and Community Development Act of 1974, Public Law 93 -383, as amended ( "ACT "); and C. The SUBRECIPIENT is a private nonprofit agency that has been selected by the CITY to receive CDBG funds and administer such financial assistance; and to provide the services described in "Exhibit A," in accordance with the schedule of performance included therein, hereinafter referred to as "said program" and SUBRECIPIENT represents that it is qualified and willing to operate said program. D. Title X of the 1992 Housing and Community Development Act (Title X) established requirements relating to lead based paint ( "LBP ") in housing receiving federal assistance, in particular requirements relating to (i) notification (including pamphlet distribution, disclosure to purchasers and lessees, notice of lead hazard presumption or results of evaluation, and/or lead hazard reduction), (ii) lead hazard evaluation (including visual assessment, paint testing, and/or risk assessment), (iii) lead hazard reduction (including paint stabilization, interim controls, standard treatments, or abatement depending on the requirements for housing activity type), (iv) ongoing maintenance, if required, and (v) response to children with environmental intervention blood lead levels, as required; and E. On September 15, 1999 HUD adopted implementing regulations to Title X that became effective September 15, 2000 as set forth in 24 CFR Part 35, et seq. ( "LBP Regs. "), which establish specific rules regarding notification to owners and occupants about the existence of LBP hazards, identification of LBP hazards, and control of LBP hazards; and F. Residential structures built after January 1, 1978 are exempt from lead -based paint requirements a s the u se of 1 ead -based p aint w as b anned f or u se i n residences a fter t his d ate b y Congress (24 CFR Part 35.115). Therefore, the Title X requirements set forth herein shall not be applicable if the structures involved were built after January 1, 1978. G. Subpart K - Acquisition, Leasing, Support Services, and Operation of the LBP Regs, sets forth specific requirements relating to housing providers, such as SUBRECIPIENT, who administer local programs that provide supportive housing for special needs populations and are funded by HUD Office of Community Planning and Development ( "CPD ") programs, including CDBG funds, as provided to SUBRECIPIENT under this Agreement; and H. In connection with the grant of funds under this Agreement, CITY requires that SUBRECIPIENT comply and evidence of compliance with all applicable requirements of Title X and the LBP Regs, in particular Subpart K relating to acquisition, leasing, support services, or operations, and Subpart J relating to rehabilitation, as and when applicable; and I. In connection with the grant of funds under this Agreement, CITY requires that SUBRECIPIENT c omply a nd s how e vidence o f c ompliance w ith a 11 applicable r equirements o f Title X and the LBP Regs, in particular Subpart M relating to tenant based rental assistance, as and when applicable; and J. Attached and hereby fully incorporated to this Agreement are the following notification attachments: Attachment No. 1 entitled "Protect Your Family From Lead In Your Home ", EPA747 -K -99 -001, Attachment No. 2 entitled "Sample Disclosure Format for Target Housing Sales, Disclosure of Information on Lead -Based Paint and Lead -Based Paint Hazards ", and Attachment No. 3 entitled Sample Summary Risk Assessment Notice Format'; provided however, that such attachments are not intended to modify or limit SUBRECIPIENT'S obligation to fully comply with all applicable provisions of Title X and the implementing regulations in the LBP Regs; and K. By this Agreement SUBRECIPIENT will accept assignment from the CITY of all responsibilities set forth in Subpart K of the LBP Regs; and L. The CITY and SUBRECIPIENT have duly executed this Agreement for the expenditure of such funds; and WHEREFORE, 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 SUBRECIPIENT: 2 L SUBRECIPIENT'S OBLIGATIONS A. Non -Profit Status - Representations and Warranties. (1) SUBRECIPIENT acknowledges that its operations and the services it provides to the community are subject to Subpart K (and, in some instance(s) Subpart J and/or Subpart M) of the LBP Regs. (2) SUBRECIPIENT acknowledges that its operations and the services it provides includes: (a) acquisition, leasing, or ownership of residential property for the purpose of providing affordable housing for persons with special needs, such as transitional housing, or (b) housing for persons with special needs, such as the disabled, or (c) financial assistance to assist transitional housing participants to move to permanent housing by paying for the first month's rent or security deposit, or (d) tenant -based rental assistance to program participants who choose their own housing units, and by provision of such services such housing is subject to the requirements of the LBP Regs. (3) Representations: (a) Authority. 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. 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 SUBRECIPIENT has been fully authorized by all requisite actions on the part of SUBRECIPIENT. (b) Experience. SUBRECIPIENT is a qualified provider of the services to be provided hereunder. (c) Familiarity With Services Required. By executing this Agreement, SUBRECIPIENT warrants that (i) it has thoroughly investigated and considered the services to be performed and provided hereunder, (ii) it has carefully considered how the services should be performed, and (iii) it fully understands the facilities, difficulties and restrictions attending performance of the services under this Agreement, inclusive of compliance with the LBP BEGS. Should SUBRECIPIENT discover any latent or unknown conditions materially differing from those inherent in the work or as represented by CITY, it shall immediately inform CITY of such fact and shall not proceed except at SUBRECIPIENT'S risk until written instructions are received from CITY'S representative. (d) No Conflict. To the best of SUBRECIPIENT'S knowledge, SUBRECIPIENT'S execution, delivery and performance of its obligations under this Agreement will not constitute a default or a breach under any contract, agreement or order to which SUBRECIPIENT is a party or by which it is bound. (e) No Bankruptcy. SUBRECIPIENT is not the subject of any current or threatened bankruptcy proceeding. (f) No Pending Legal Proceedings. SUBRECIPIENT is not the subject of a current or threatened litigation that would or may materially affect SUBRECIPIENT'S performance under this Agreement. (g) Application Veracity. All provisions of and information provided in SUBRECIPIENT'S application for funding submitted to CITY including any exhibits are true and correct in all material respects. (h) No Pending Investigation. SUBRECIPIENT is not aware that it is the subject of any current or threatened criminal or civil action investigation by any public agency, including without limitation a police agency or prosecuting authority, that would relate to affect performance of the Agreement or provision of services hereunder. (4) Compliance with Subpart K of LBP Refs. Subpart K — Acquisition, Leasing, Support Services, or Operation (a) SUBRECIPIENT acknowledges and agrees that it shall comply with and implement the requirements set forth in Title X and the LBP Regs to eliminate, as far as practicable, LBP hazards in all residential property that is under its ownership, possession, or control and/or residential property occupied by persons or families that receive financial or other assistance from SUBRECIPIENT. (b) SUBRECIPIENT shall provide a notice to all residents /occupants of residential property that is under its ownership, possession, or control and/or residential property occupied by persons or families that receive financial or other assistance from SUBRECIPIENT in accordance with Section 35.125 of the LBP Regs. (i) SUBRECIPIENT acknowledges that in connection therewith a visual assessment is not considered an evaluation for purposes of the LBP Regs. (c) Notification (24 CFR 35.130). SUBRECIPIENT shall provide the LBP hazard information pamphlet in accordance with Section 35.130 of the LBP Regs to all occupants, owners, and purchasers of housing. (i) 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 is attached as Attachment No. 1 to this Agreement. (ii) SUBRECIPIENT shall cause to be disclosed to all purchasers and lessees available information and knowledge regarding the presence of LBP El and LBP hazards prior to selling or leasing a housing unit in accordance with 24 CFR 35, Subpart A. The current form and version of such notice is attached as Attachment No. 2 to this Agreement. (iii) SUBRECIPIENT shall ensure that all occupants, owners, and purchasers of housing be notified in writing of the results of the presumption of LBP and/or LBP hazards, and results of any lead hazard evaluation, and any lead hazard reduction work in accordance with 24 CFR 35, Subpart A. The current form and version of such notice is attached as Attachment No. 3 to this Agreement. (d) Lead Hazard Evaluation (24 CFR 35.125). SUBRECIPIENT shall conduct all activities described in Section 35.1015 relating to visual assessment, paint stabilization, risk assessment, and maintenance with regard to all residential property that is under its ownership, possession, or control and/or residential property occupied by persons or families that receive financial or other assistance from SUBRECIPIENT, except for the exemptions described below in section 4 (d)(i)(1). (i) SUBRECIPIENT shall cause a visual assessment to identify deteriorated paint in all residential property that is under its ownership, possession, or control and/or residential property occupied by persons or families that receive financial or other assistance from SUBRECIPIENT. (1)Section 35.115(a) provides exemptions from Subparts B through R of the LBP Regs. including without limitation, (a) short term emergency assistance lasting less than 100 days cumulatively is exempted from compliance with Subpart K as to such short term rental assistance units, and (b) exemption for zero - bedroom units, including SRO units, for which occupancy by a recipient of SUBRECIPIENT'S services is for less than 100 days, and (c) exemption for residential housing units constructed after January 1, 1978. (ii) To the extent that the assistance provided by SUBRECIPIENT to persons or households meets one or more of the exemptions set forth in the LBP Regs, then compliance with the notification, evaluation, reduction, clearance and other requirements of the LBP Regs is not required related to the subject housing unit due to such exemption. (iii) SUBRECIPIENT shall comply with the applicable provisions of both Subpart K and Subpart M (Tenant Based Rental Assistance) of the LBP Regs. as to all tenant -based long term housing assistance, i.e., assistance to persons/households residing in housing units cumulatively for more than 100 days. If SUBRECIPIENT has knowledge that an assisted family or household will occupy a dwelling unit for more than 100 days, the LBP Regs require evidence of compliance prior to occupancy. Funding to be provided hereunder is conditioned upon evidence of compliance. (1) Subpart M applies to all dwelling units occupied to be occupied by families or households that have one or more children of less than 6 years of age, as well as the common areas servicing such dwelling units, and exterior painted surfaces associated with such dwelling units or common areas. LBP compliance requirements relating to such dwelling units includes, without limitation: notification, evaluation by visual assessment, paint stabilization utilizing safe work practices, and clearance. (2) CITY advises SUBRECIPIENT that in the event the services provided hereunder include rental assistance payments, such as first and last month's rent and/or security deposit, and the assisted tenant executes a lease for long term occupancy, including occupancy in the same dwelling unit for more than 100 days, then the provisions of Subpart M (Tenant Based Rental Assistance), will apply (unless otherwise informed and directed by HUD). In this regard, CITY advises SUBRECIPIENT that Subpart M requires HQS inspection of each dwelling unit prior to occupancy and prior to compliance with applicable notification, evaluation by visual assessment, reduction through paint stabilization utilizing safe work practices, and clearance requirements of the LBP REGS. (e) Lead Hazard Reduction Work. SUBRECIPIENT shall cause LBP hazard reduction, such as paint stabilization, interim controls, standard treatments, or abatement of all residential property that is under its ownership, possession, or control and/or residential property occupied by persons or families that receive financial or other assistance from SUBRECIPIENT, except as exempted as described in subsection 4(d)(i)(1) above. (1) If paint stabilization occurs, SUBRECIPIENT shall cause paint stabilization of each deteriorated surface and clearance of residential units pursuant to Section 35.1330(a) and (b) shall occur before occupancy of a vacant dwelling unit, or where a unit is occupied, immediately after receipt of the CDBG FUNDS hereunder. (2) Safe Work Practices shall be used in all LBP hazard reduction work. (3) Clearance shall be conducted to confirm that no LBP hazards remain when LBP hazard reduction work is complete. Confirmation of clearance by written certification of a qualified inspector is required on an annual basis in connection with submittal of the April 15 quarterly report. (f) Ongoing Maintenance. SUBRECIPIENT shall incorporate ongoing LBP maintenance activities into regular building operations in accordance with Section 35.1355(a) for all residential property that is under its ownership, possession, or control and/or residential property occupied by persons or families that receive financial or other assistance from SUBRECIPIENT, except as exempted as described in subsection 4(d)(i)(1) above. (1) Ongoing maintenance includes confirmation of clearance which shall be conducted to confirm that no LBP hazards remain when LBP hazard reduction work is complete. 0 (2) Ongoing maintenance also includes confirmation of clearance by written certification of a qualified inspector on an annual basis in connection with submittal of the April 15 quarterly report. (3) A part of such ongoing maintenance obligation includes notification of the results of clearance confirmation and annual confirmation of clearance. a. SUBRECIPIENT shall cause to be provided a notice to all occupants of all residential property that is under its ownership, possession, or control and/or residential property occupied by persons or families that receive financial or other assistance from SUBRECIPIENT in accordance with Sections 35.125(b)(1) and (c), describing the results of the clearance examination and the results of annual certification. (g) Units Cleared Prior to Date of Agreement; Confirmation of Clearance. In the event the requirements of the LBP REGS relating to lead hazard evaluation, lead hazard reduction, and lead hazard clearance have been completed on the subject dwelling units prior to the Date of Agreement, then the SUBRECIPIENT shall provide to the CITY with the April 15 quarterly report a certificate from a qualified inspector evidencing a recent inspection and confirmation of clearance of LBP and LBP hazards from the subject dwelling unit(s). 5. LBP Informational Summary. For purposes of information only and in no respect intended to be a representation or warranty of the provisions of the LBP REGS, 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 SUBRECIPIENT under this Agreement. Attachment No. 4 to this Agreement, attached and hereby fully incorporated by this reference, is such information summary. CITY staff will cooperate with and make themselves available to SUBRECIPIENT to assist in implementation of compliance with the LBP REGS as to residential dwelling units to be assisted by SUBRECIPIENT. The parties acknowledge and agree the CITY is and shall not be liable or responsible for the accuracy of such summary, and the SUBRECIPENT is directed to the LBP REGS and implementing guidance published and provided by HUD relating to compliance with such LBP REGS. B. Amount of Grant and Quarterly Disbursement. The amount granted to SUBRECIPIENT is $19,000 ( "CDBG FUNDS "), and such funds shall be expended by SUBRECIPIENT on or before June 30, 2004. The CDBG FUNDS shall be disbursed by CITY to SUBRECIPIENT on a quarterly basis, subject to and upon receipt and approval of a complete SUBRECIPIENT'S quarterly activity report, with the final payment subject to the satisfaction of the condition precedent of submittal of complete reporting information due on or before July 15th of the applicable funding year, as hereinafter more fully set forth. SUBRECIPIENT shall be obligated to perform such duties as would normally extend beyond the term, including but not limited to obligations with respect to indemnification, audits, reporting, data retention/reporting, and accounting. C. Use of Funds. SUBRECIPIENT agrees to use all federal funds provided by CITY to SUBRECIPIENT pursuant to this Agreement to operate said program, as set forth in "Exhibit B ", attached hereto and by this reference incorporated herein. 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 CITY is otherwise obligated to pay to SUBRECIPIENT under Paragraph II hereof. D. Allowable Costs. SUBRECIPIENT agrees to complete said program on or before June 30, 2004 and to use said funds to pay for necessary and reasonable costs allowable under the federal law and regulations to operate said program. Said amounts shall include, but not be limited to, wages, administrative costs, and employee benefits comparable to other similarly situated employees. Other allowable program costs are detailed in the Budget, as set forth in "Exhibit B ", attached hereto and by this reference incorporated herein. 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. E. Licensing. SUBRECIPIENT agrees to obtain and maintain all required licenses, registrations, accreditation and inspections from all agencies governing its operations. SUBRECIPIENT shall ensure that its staff shall also obtain and maintain all required licenses, registrations, accreditation and inspections from all agencies governing SUBRECIPIENT's operations hereunder. F. Zoning. 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 SUBRECIPIENT fail to have the required land entitlement and/or permits, thus violating any local, state or federal rules and regulations relating thereto, 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. SUBRECIPIENT shall notify CITY immediately of any pending violations. Failure to notify CITY of p ending v iolations, o r t o r emedy s uch k nown v iolation(s) s hall r esult in t ermination o f g rant funding hereunder. 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. G. Separation of Accounts. All funds received by SUBRECIPIENT from CITY pursuant to this Agreement shall b e maintained in an account in a federally insured b anking or savings and loan institution with record keeping of such accounts maintained pursuant to applicable OMB Circular A -110 requirements. SUBRECIPIENT is not required to maintain separate depository accounts for CDBG FUNDS; provided however, the SUBRECIPIENT must be able to account for receipt, obligation and expenditure of CDBG FUNDS pursuant to applicable OMB Circular A -110 requirements. 0 H. Audit Report Requirements. SUBRECIPIENT agrees that if SUBRECIPIENT receives Three Hundred Thousand Dollars ($300,000.00) or more in federal funds, 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. SUBRECIPIENT shall provide CITY with a copy of said audit by October 1 of the year following the program year in which this Agreement is executed. Further, SUBRECIPIENT shall comply and/or cause compliance with audit report(s) required by applicable provisions of Title X and the LBP Regs. I. Record Keeping/Reporting. SUBRECIPIENT shall keep and maintain complete and adequate records and reports to assist CITY in meeting and maintaining its record keeping responsibilities under the CDBG BEGS, Title X, and the LBP Regs, including the following: (1) Records a. Documentation evidencing program income requirements in conformity with 24 CFR 570.504(b((2)(i), (ii) and 24 CFR 570.503(b)(3) and 24 CFR 570.208(a)(2)(B) of the income level of persons and/or families participating in or benefiting by the SUBRECIPIENT program. b. Documentation of the number of persons and/or families participating in or benefiting by the SUBRECIPIENT program. c. Household information shall include number of persons, identification of head of household, race /ethnicity, and income verification. d. Documentation of all CDBG FUNDS received from CITY. e. Documentation of expenses as identified in the Budget Proposal, including evidence of incurring the expense, invoices for goods or services, copies of any and all contracts or documentation pertaining to costs for subcontractors, plus all other invoices for which CDBG FUNDS were expended, and any payments therefor. f. Any such other related records as CITY shall reasonably require or as required to be maintained pursuant to the CDBG REGS. g. Documentation evidencing compliance with all applicable provisions of Title X and the LBP Regs, in particular Subpart K and, as applicable Subpart J and/or Subpart M. (i) Specific documentation, as required, evidencing compliance with all applicable provisions of such LBP Regs including: (i) notification, including distribution of the lead hazard information pamphlet (Attachment No. 1), disclosure and notices of hazard evaluation and reduction (Attachments 9 No. 2 and 3); (ii) evaluation of lead hazard(s), including paint testing and risk assessment; (iii) reduction of lead hazard(s), including safe work practices and clearance, and confirmation of clearance; and (iv) ongoing maintenance, as and if applicable for multifamily properties. (ii) In this regard SUBRECIPIENT shall track information on all persons/households assisted and the housing units assisted with the CDBG FUNDS. Attachment No. 5 hereto is a sample form for tracking persons/households and housing units assisted with the CDBG FUNDS. All categories of information set forth in such tracking form shall be prepared and submitted to the CITY with the April 15 quarterly report. (iii) In the event that such information and reports are not complete and reasonably satisfactory information submitted in order for CITY staff to review and evaluate compliance with applicable CDBG REGS and LBP Regs., then the final quarterly disbursement payment shall be withheld from the SUBRECIPIENT. (iv) Documentation of clearance confirmation as provided in Section L(1)(g) hereinabove. (2) Reports (i) Payment Request. Concurrently with the submittal of each quarterly report, on or before the 15th day of October, January, April and July, SUBRECIPIENT shall submit both: an original invoice and true copies of invoices, receipts, agreements or other documentation supporting and evidencing how the CDBG FUNDS have been expended during the applicable quarter. (ii) Quarterly Activity Report: Including in such reports evidence of compliance with all applicable provisions of Title X and t he LBP R egs, i n p articular S ubpart K and, a s applicable Subpart J, as further described in subsection (d) hereinafter, and Subpart M, if SUBRECIPIENT provides long term tenant -based rental assistance. SUBRECIPIENT agrees to provide CITY with written cumulative (year -to -date) reports of its activities on or before the 15th day of October, January, April and July for the period beginning July 1, 2003 and through and including the previous three -month reporting period setting forth the activities, program accomplishments, new program information and year -to- 10 date program statistics on expenditures, caseload and activities. When appropriate, pictures should be included. (iii) Any such other reports as CITY (or HUD) shall reasonably require and/or request, including but not limited to the following information: the receipt of program income [as defined at 24 CFR 570.500(a)] by SUBRECIPIENT in the operation of said program shall be recorded by SUBRECIPIENT and reported to CITY; monthly records of all ethnic and racial statistics of persons and families benefited by SUBRECIPIENT in the performance of its obligations under this Agreement, including, but not limited to, the number of low and moderate income persons and households assisted in accordance with federal income limits and the number of female heads of households. (3) Recordkeepin of f Ongoing Maintenance under the LBP Regs. If the services and program activities provided by SUBRECIPIENT hereunder establish an ongoing relationship with a property (such as long term tenant based rental assistance program [Subpart M] or transitional or permanent housing operated or administered by the SUBRECIPIENT), then the SUBRECIPIENT shall provide a report to the CITY evidencing that SUBRECIPIENT and/or the property owner(s), as applicable, has performed ongoing maintenance of the subject property. Ongoing maintenance shall include evidence of an annual clearance certification of the subject residential property conducted by a DHS certified technician to ensure that LBP hazard reduction measures are maintained. All maintenance activities shall be conducted to ensure the threat of LBP hazards is minimized. (4) Recordkegping under the LBP Regs. The SUBRECIPIENT shall keep records of distribution of notifications, all visual assessment, evaluations, inspections, repairs, and any other lead hazard evaluation, reduction, safe work practices, and clearance activities. (a) The SUBRECIPIENT shall keep records evidencing distribution of all lead hazard information pamphlet(s). (b) The SUBRECIPIENT shall keep records evidencing each LBP evaluation report, LBP hazard reduction documentations, (such as job specifications), and all clearance or abatement report(s). (c) The SUBRECIPIENT shall keep ongoing maintenance records and records of relevant building operations for use during reevaluations of subject property for LBP and/or LBP hazards. 1. Such records shall be maintained for not less than longer of (A) three (3) years after the activities cease or (B) the period 11 required by applicable program regulations. Under the CDBG REGS records shall be retained for not less than four (4) years after the activities cease. 2. The SUBRECIPIENT shall provide a copy of any of the above records to the CITY or to HUD upon request of either or both. (d) Tracking Report. If the SUBRECIPIENT has provided, or is providing, rental assistance payments directed to a housing unit or housing units for more than 100 days, or it is anticipated that during the last quarter of funding that such rental assistance payment will be for more than 100 days, then the April 15 quarterly report shall contain information and evidence of compliance with the requirements herein relating to tracking of housing units, cumulative days of rental assistance, proper notifications to occupants and owners, HQS inspection, visual assessment, work write -up, stabilization and clearance of LBP and LBP hazards, if any. The proposed form of such tracking information is attached hereto as Attachment No. 5 and fully incorporated by this reference. In the event such April 15 quarterly report does not fully satisfy the reporting requirements set forth herein and in the LBP Regs, then the final installment payment of the CDBG FUNDS shall be withheld from disbursement to SUBRECIPIENT. J. Access to Records. CITY and the United State Government and/or their representatives shall have access for purposes of monitoring, auditing, and examining SUBRECIPIENT's activities and performance, to books, documents and papers, and the right to examine records of SUBRECIPIENT's subcontractors, bookkeepers and accountants, employees and participants in regard to said program. CITY and the United States Government and/or their representatives shall also schedule on -site monitoring at their discretion. Monitoring activities may also include, but are not limited to, questioning employees and participants in said program and entering any premises or any site in which any of the services or activities funded hereunder are conducted or in which any of the records of SUBRECIPIENT are kept. Nothing herein shall be construed to require access to any privileged or confidential information as set forth in federal or state law. K. Location of Records/Required Length of Record Keepin¢. All accounting records, reports, and evidence pertaining to all costs, expenses and the CDBG FUNDS of SUBRECIPIENT and all documents related to this Agreement shall be maintained and kept available at SUBRECIPIENT'S office or place of business for the duration of the Agreement and thereafter for five (5) years after completion of an audit in conformity with the CDBG REGS, except as hereinafter provided relating to retention of any records or documentation existing, created, or maintained in compliance with Title X or the LBP Regs. Records which relate to (a) complaints, claims, administrative proceedings or litigation arising out of the performance of this Agreement, or (b) costs and expenses of this Agreement to which CITY or any other 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 records relating to, or created or maintained in compliance with, Title X and/or the LBP Regs shall be retained and maintained by SUBRECIPIENT indefinitely, including without limitation, all inspection 12 report(s), disclosure statement(s), and clearance report(s). hi the event SUBRECIPIENT does not make the above - referenced documents available within the city of Santa Ana, California, SUBRECIPIENT agrees to pay all necessary and reasonable expenses incurred by CITY in conducting any audit at the location where said records and books of account are maintained. L. Compliance with Law/Program Income. SUBRECIPIENT acknowledges that the funds being provided by CITY for said program are received by CITY pursuant to the ACT as amended and that expenditures of these funds shall be in accordance with the ACT and all pertinent regulations issued by agencies of the federal government, including, but not limited to, all regulations found at Title 24 of the Code of Federal Regulations. Program income received by SUBRECIPIENT shall be returned to CITY unless otherwise provided for in this Agreement. SUBRECIPIENT agrees to comply fully with all federal, state and local laws and court orders applicable to its operation whether or not referred to in this Agreement. M. Standing. SUBRECIPIENT shall be in good standing, without suspension by the California Secretary of State, Franchise Tax Board and Internal Revenue Service. Any change in the corporate status or suspension of SUBRECIPIENT shall be reported immediately to CITY. N. Confidentiality. Without prejudice to any other provisions of this Agreement, SUBRECIPIENT shall, where applicable, maintain the confidential nature of information provided to it concerning participants in accordance with the requirements of federal and state law. However, SUBRECIPIENT shall submit to CITY and or HUD or its representatives, all records requested, including audit, examinations, monitoring and verifications of reports submitted by SUBRECIPIENT, costs incurred and services rendered hereunder. O. Independent Contractor. SUBRECIPIENT agrees that the performance of obligations hereunder are rendered in its capacity as an independent contractor and that it is in no way an agency of CITY. P. Violation of Terms and Conditions. SUBRECIPIENT agrees that if SUBRECIPIENT violates any of the terms and conditions of this Agreement or any prior Agreement whereby CDBG funds were received by SUBRECIPIENT, or if SUBRECIPIENT reports inaccurately, or if on audit there is a disallowance of certain expenditures, SUBRECIPIENT agrees to remedy the acts or omissions causing the disallowance and repay CITY all amounts spent in violation thereof. If SUBRECIPIENT engaged in fraudulent activity to obtain and/or j ustify expenditure of the CDBG funds granted hereunder, SUBRECIPIENT shall be required to reimburse the CITY of all such funds that were obtained/spent under fraudulent circumstances. Q. Equivin . S UBRECIPIENT a grees t o in aintain a r ecord for a ach i tem of n on- expendable personal property acquired under the terms of this Agreement. Said record shall be made available to CITY upon request. The term 'non- expendable personal property" shall include leased and purchased equipment. 13 R. Prohibited Use. SUBRECIPIENT hereby certifies and agrees that it will not use funds provided through this Agreement to pay for entertainment, meals or gifts. S. Lobbyine. SUBRECIPIENT certifies 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. 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. SUBRECIPIENT shall submit said signed certification to CITY prior to performing any of its obligations under this Agreement and prior to any obligation arising on the part of CITY to pay any sums to 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 C -1). T. Financial Interest. SUBRECIPIENT agrees that except for the use of CDBG funds to pay salaries and other related administrative or personnel costs, no persons who exercise or have exercised any function with respect to CDBG activities assisted under the terms of this Agreement, or who are in a position to participate in a decision - making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a CDBG - assisted activity of SUBRECIPIENT, either for themselves or those with whom they have family or business ties, during their tenure or for one year thereafter. This prohibition applies to any person who is an employee, agent, consultant, officer, or elected or appointed official of CITY, or of any designated public agencies, or the SUBRECIPIENT. U. 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. sections 276a - 276a -5. 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 c omplied w ith t he p rovisions o f 2 9 C.F.R. §5.5.. A breach o f t he c ontract 14 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 [29 C.F.R. §5.6(a)(3)]. V. Drug Free Workplace. SUBRECIPIENT certifies that it has established the following drug -free workplace policy: 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 SUBRECIPIENT will be required to: a) Abide by the terms above in statement 1. b) Notify appropriate officials of SUBRECIPIENT and CITY officials of any criminal drug statute conviction for a violation occurring in the workplace not later than five days after such conviction. 3. The United State Department of Housing and Urban Development will be notified within ten days after receiving notice of any such violation. 4. Within 30 days of receiving such notice, appropriate personnel action will be taken against such employee, up to and including termination. 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. II. CITY'S OBLIGATIONS A. Payment of Funds. Upon execution of this Agreement by SUBRECIPIENT, CITY shall pay to SUBRECIPIENT from CDBG funds, when, if and to the extent received from HUD, for CITY's 2003 -2004 CDBG program year amounts expended by SUBRECIPIENT in carrying out said program for fiscal year 2003 -2004 pursuant to this Agreement up to a maximum aggregate payment of Nineteen Thousand Dollars ($19,000) in installments detemlined by CITY. Payments shall be made to SUBRECIPIENT through the submission of invoices on a quarterly basis (October, January, April and July) in a form prescribed by CITY, detailing such expenses. CITY shall pay such invoices within thirty (30) days after receipt thereof provided CITY is satisfied that such expenses have been incurred and documented within the scope and provisions of this Agreement and that SUBRECIPIENT is in compliance with the terms and conditions of this Agreement, and in compliance with Title X and the LBP Regs. 15 B. Audit of Account. CITY shall include an audit of the account maintained by SUBRECIPIENT in CITY's annual audit of all CDBG FUNDS in accordance with Title 24 of the Code of Federal Regulations and other applicable federal laws and regulations. C. Common Rule: Pursuant to CFR 85.40(a), the CITY manages the day -to -day operations of each grant and subgrant supported activities. CITY staff has detailed knowledge of the grant program requirements and monitors grants and subgrant supported activities to assure compliance with Federal requirements. Such monitoring covers each program, function and activity and performance goals are reviewed periodically. D. Environmental Review: In accordance with 24 SFR 58, the CITY is responsible for undertaking environmental review and maintaining environmental review records for each applicable project. III. SUBRECIPIENT agrees that no person on the ground of race, age, color, national origin, religion or sex will be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity funded in whole or in part with CDBG funds. IV. CONFLICT OF INTEREST SUBRECIPIENT agrees that no officer, employee, agent or assignee of CITY having direct or indirect control of any CDBG monies granted to the CITY, inclusive of the subject CDBG FUNDS, shall serve as an officer of SUBRECIPIENT. Further, any conflict or potential conflict of interest of any officer of SUBRECIPIENT shall be fully disclosed in writing prior to the execution of this Agreement and said writing shall be attached and deemed fully incorporated as a part hereof. Notice shall be sent by SUBRECIPIENT to CITY regarding any changes or modifications to its board of directors and list of officers. V. SPECIAL CERTIFICATION FOR RELIGIOUS ENTITIES If SUBRECIPIENT is a religious entity, SUBRECIPIENT hereby agrees that in connection with the provision of the services SUBRECIPIENT shall provide with CDBG funds: A. SUBRECIPIENT shall not discriminate against any employee or applicant for employment on the basis of religion and shall not limit employment or give preference in employment to persons on the basis of religion. B. SUBRECIPIENT shall not discriminate against any person applying for the services SUBRECIPIENT agrees to provide under the terms of this Agreement on the basis of religion and shall not limit such services or give preference to applicants for such services on the basis of religion. 16 C. SUBRECIPIENT shall NOT provide religious instruction or counseling, conduct any religious worship or services, or engage in any religious proselytizing, or exert any religious influence in the provision of the services in said program. The parties agree that this covenant is intended to and shall be construed for the limited purpose of assuring compliance with respect to the use of CITY funds by SUBRECIPIENT with applicable constitutional limitations respecting the establishment of religion as set forth in the establishment clause under the First Amendment of the United States Constitution and Article I, Section 4 of the California Constitution, and is not in any manner intended to restrict other activities of SUBRECIPIENT. D. Where the services to be provided under said program are rendered on property owned by the primarily religious entity SUBRECIPIENT, CDBG funds may also be used for minor repairs to such property which are directly related to the cost of rendering the services under said program, where the cost constitutes in dollar terms only an incidental portion of the CDBG expenditure for rendering the services under said program. VI. PROHIBITION OF NEPOTISM SUBRECIPIENT a grees not t o h ire o r p ermit t he h iring o f a ny p erson t o fill a p osition funded through this Agreement if a member of that person's immediate family is employed in an administrative capacity by SUBRECIPIENT. For the purposes of this section, the term "immediate family" means spouse, child, mother, father, brother, sister, brother -in -law, sister -in -law, father -in- law, mother -in -law, son -in -law, daughter -in -law, aunt, uncle, niece, nephew, stepparent and stepchild. The term "administrative capacity" means having selection, hiring, supervisor or management responsibilities. VII. NOTICES Notices to the parties shall, unless otherwise requested in writing, be sent by U.S. Mail, postage prepaid, and addressed as follows: TO CITY: City of Santa Ana Community Development Agency (M -25) 20 Civic Center Plaza P.O. Box 1988 Santa Ana, California 92702 -1988 TO SUBRECIPIENT: Thomas House Temporary Shelter P.O. Box 2737 Garden Grove, CA 92843 -2737 17 VIII. ASSIGNABILITY None of the duties of, or work to be performed by, SUBRECIPIENT under this Agreement shall be subcontracted or assigned to any agency, consultant, or person without the prior written consent of CITY. SUBRECIPIENT must submit all subcontracts and other agreements that relate to this Agreement to CITY. No subcontract or assignment shall terminate or alter the legal obligations of SUBRECIPIENT pursuant to this Agreement. IX. HOLD HARMLESS SUBRECIPIENT shall indemnify and save harmless CITY, its officers, employees, agents, representatives and volunteers from and against any and all damages to or for loss of use of property and for injuries to or death of any person or persons, including property and employees or agents of CITY, and shall defend, indemnify and save harmless CITY, its officers, employees, agents, representatives and volunteers from and against any and all claims, demands, suits, actions or proceedings of any kind or nature, including, but not by way of limitation, workers compensation claims and including attorney fees and reasonable expenses for litigation or settlement, resulting from or arising out of the negligent or wrongful acts, errors or omissions of SUBRECIPIENT, its officers, directors, employees, agents, subcontractors and suppliers arising out of SUBRECIPIENT's performance of this Agreement. X. INSURANCE A. In accordance with the provisions of Section 3300 of the Labor Code, if SUBRECIPIENT has a ny employees i t i s r equired t o b e i nsured a gainst 1 iability for w orker's compensation or to undertake self - insurance. Prior to commencing performance of this Agreement, SUBRECIPIENT agrees to obtain and maintain employer's liability insurance with limits not less than $1,000,000 per accident. If SUBRECIPIENT has no employees, nor workers' compensation coverage, it must execute a Declaration available from the CITY, and update as is necessary. B. SUBRECIPIENT shall obtain, at its sole cost, a policy or policies of commercial general liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall: (1) name the City of Santa Ana, its officers, agents, representatives, employees and volunteers as additional insureds; (2) be primary with respect to insurance or self - insurance programs maintained by the CITY; (3) contain standard separation of insureds provisions; and (4) give to CITY prompt and timely notice of claim made or suit instituted arising out of SUBRECIPIENT's operations hereunder. SUBRECIPIENT shall: (a) prior to exercising any right under this Agreement, furnish properly executed certificates of insurance and additional insured endorsement to the 18 CITY which shall clearly evidence all coverages required above; (b) provide that such insurance shall not be materially changed or terminated except on 30 days prior written notice to the CITY; (c) maintain such insurance for the period covered by this Agreement; and (d) replace such certificates for policies expiring prior to the expiration of this Agreement. M. REVERSION OF ASSETS A. Upon the expiration of this Agreement, SUBRECIPIENT shall transfer to CITY any CDBG funds on hand at the time of the expiration of this Agreement as well as any accounts receivable attributable to the use of CDBG funds. [24 CFR 570.503(b)(8).] B. Any real property under SUBRECIPIENT's control that was acquired or improved in whole or in part with CDBG funds in excess of $25,000.00 must either be: 1. Used, where CITY has given written approval, to meet one of the national objectives stated in 24 CFR 570.208 until five (5) years after expiration of this Agreement, or for such longer period of time as determined to be appropriate by CITY; or 2. If not used in accordance with subparagraph A above, SUBRECIPIENT shall pay to CITY an amount equal to the current fair market value of the property less any portion of the value attributable to the expenditure of non -CDBG funds for acquisition of, or improvement to, the property. Such payment is program income to CITY. C. Subject to the obligations set forth herein, title to equipment acquired under the terms o f this A greement w ill vest upon a cquisition i n SUBRECIPIENT. W hen said a quipment which has been acquired in accordance with this Agreement and all applicable regulations is no longer needed for said program, disposition of said equipment will be made as follows: 1. Items o f e quipment w ith a c urrent p er u nit f air market v alue o f t ess t han $5,000.00 may be retained, sold or otherwise disposed of with no further obligation to CITY. 2. Items of equipment with a current fair market per unit value of $5,000.00 or more may be retained or sold and CITY shall have the right to an amount calculated by multiplying the current market value or proceeds from the sale by CITY's share of federal funds used to acquire the equipment, in accordance with 24 CFR 85.32(e)(2). D. SUBRECIPIENT hereby agrees, upon the demand of CITY, to execute, acknowledge and deliver, or cause any person or entity who may have any claim to rights hereunder or under any document, instrument or agreement executed in furtherance of the services and activities to be performed hereunder, to execute, acknowledge and deliver, to CITY assignment(s), quit c laim d eed(s) o r s uch o ther a nd further i nstruments, d ocuments a nd agreements a s m ay b e necessary, in the sole and absolute discretion of CITY, to vest in CITY all of SUBRECIPIENT's right, title and interest (if any it may have) in and to CITY, CDBG or other federal, state and/or local accounts or program funds or allocation of funds to which CITY is or may be entitled, either 19 for its own account or as fiduciary or trustee for others, which were obtained for the purpose of the performance of this Agreement or any previous agreements relating to the same subject matter or activities as this Agreement, together with any instruments, loans, grants or advances by SUBRECIPIENT on behalf of CITY, in furtherance of the activities hereunder or thereof. SUBRECIPIENT's obligations and responsibilities set forth in this paragraph "XI. REVERSION OF ASSETS." and in paragraph "XII. TERMINATION" and other requirements pertaining to program income shall not be affected by the termination of this Agreement and shall survive the date of termination of this Agreement for such period of time as CITY and/or HUD deems necessary for the responsibilities, duties and obligations to be performed and completed to the satisfaction of CITY and HUD. X1I. TERMINATION A. This Agreement may be terminated on thirty (30) days' written notice by either party. In the event of such termination, SUBRECIPIENT shall only be entitled to reimbursement for approved expenses incurred to the effective date of termination. B. This Agreement may be suspended or terminated by CITY upon five (5) days' written notice for violation by SUBRECIPIENT of Federal Laws governing the use of Community Development Block Grant Funds. In the event of such suspension or termination, SUBRECIPIENT shall only be entitled to reimbursement for approved expenses incurred up to the effective date of suspension or termination. C. Pursuant to 24 CFR 85.43, in the event SUBRECIPIENT defaults by failing to fulfill all or any of its obligations hereunder, CITY may declare a default and termination of this Agreement by written notice to SUBRECIPIENT, which default and termination shall be effective on a date stated in the notice which is to be not less than ten (10) days after certified mailing or personal service of such notice, unless such default is cured before the effective date of termination stated in such notice. If terminated for cause, CITY shall be relieved of further liability or responsibility under this Agreement, or as a result of the termination thereof, including the payment of money, except for payment for approved expenses incurred for services satisfactorily and timely performed prior to the mailing or service of the notice of termination, and except for reimbursement of (1) any payments made for services not subsequently performed in a timely and satisfactory manner, and (2) costs incurred by CITY in obtaining substitute performance. D. The grant of funds under this Agreement may be terminated for convenience in accordance with 24 CFR 85.44. E. In the event this Agreement is terminated as set forth in subparagraphs XII.A. through XII.D., inclusive, SUBRECIPIENT agrees to immediately return to CITY upon CITY's demand and prior to any adjudication of SUBRECIPIENT's rights, any and all funds not used, and to comply with paragraph "XI. REVERSION OF ASSETS" of this Agreement. 20 XIII. LIMITATION OF FUNDS The United States of America, through HUD, may in the future place programmatic or fiscal limitations on the use of CDBG funds which limitations are not presently anticipated. Accordingly, CITY reserves the right to revise this Agreement in order to take account of actions affecting HUD program funding. In the event of funding reduction, CITY may, in its sole and absolute discretion, reduce the budget of this Agreement as a whole or as to costs category, may limit the rate of SUBRECIPIENT's authority to commit and spend funds, or may restrict SUBRECIPIENT's use of both its uncommitted and its unspent funds. Where HUD has directed or requested CITY to implement a reduction in funding, in whole or as to a cost category, with respect to funding for this Agreement, CITY's City Manager or delegate is authorized to act for CITY in implementing and effecting such a reduction and in revising, modifying, or amending the Agreement for such purposes. Where CITY has reasonable grounds to question SUBRECIPIENT's fiscal accountability, financial soundness, or c ompliance with this Agreement, CITY may suspend the operation of this Agreement for up to sixty (60) days upon five (5) days written notice to SUBRECIPIENT of its intention to so act, pending an audit or other resolution of such questions. In no event, however, shall any revisions made by CITY affect expenditures and legally binding commitments made by SUBRECIPIENT before it received notice of such revision, provided that such amounts have been committed in good faith and are otherwise allowable and that such commitments are consistent with HUD cash withdrawal guidelines. XIV. EXCLUSIVITY AND AMENDMENT 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 CITY's CDBG funds by SUBRECIPIENT and contains all the covenants and agreements between the parties with respect to such employment in any manner whatsoever. Each party to this Agreement acknowledges that 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 CITY and SUBRECIPIENT. XV. 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. XVI. VALIDITY The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any other provision of this Agreement. 21 XVII. MISCELLANEOUS PROVISIONS a. Each undersigned represents and wan-ants 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 CITY fully, including reasonable costs and attorney's fees, for any injuries or damages to CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits and Attachments referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. c. No delay or omission by either party hereto to exercise any right or power accruing upon any noncompliance or default by the other party with respect to any of the terns 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. 22 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the last date and year written below. Dk DATED: W02 11;. RE. City Manager ATTEST: Clerk of the Council DATE: APPROVED AS TO FORM: JOSEPH W.FLETCHER City Attorney SU13RECIPIENT: Thomas House Temporary Shelter r ame: Albert D1 ino Title: Vice Presi ent, Grants Tax ID: 33- 0204757 23 THOMAS HOUSE TEMPORARY SHELTER hXBM7 A. of work AlMftgf A�tiQ2 03/64 CDEG GRANT M. A 711,6/03 I. Number of uaftligoW Banta Ann reeide4ts to be savored with great Atnds Aff ttr the 12- rppwtlt srmttwct pasir+d — P r+1l5iNt M I1. Deecroft of Work - w wm bow% dw tx Afin prDtpsm w%e firodeA d�etng tte t2aaeeth so ng permed itnoiading, advisee tobe xvAML pt'6$ m ao&14 elior>rttr aotmreEieo, aE Now grant funds will t» utilised. i. Services to be provided Food Shelter & life skill serviced. 2. Goals To return Santa Ana homeless families to independence and w- sufficiency. 3. Client: Chararteristie$ Homeless families 4. Use of Funds Puled$ will be used' for:` a. Staff Salaries . and Benefits $5.000 a. Supplies. 5.000 C. Utilities 5,OOQ. d. Social service Costs 4,000 1 =001 A katvd 2U to Ana res &mb to he ?starved derma$ the 12 -wma th coatmA Pddod pargw1te - Qtrarter !:14 i — 90802bai' 30 7 pmm ¢leaner 2: October 1— Deoembet 31 pwom QMA"P 3: Jaa eona Pw Sl rtrr �. April t June I -2 pers m Total --- U....._.. PwVm Bstatmted the amount of gram fiuots tv be regtret W dwhi the i 7 -m v* cot�raat;xriod on a quwwrly teasio: awwor t: July 1— Septogdter 30 gm*ol2:,OctoberI— t3ecmtw3I $ _5.IJQU:. Qumlcr 3: Jauuw i — March 31 O"rf: Apra 1 --June 30 $ a o00 Total $11490 Exhibit A 2d wd9o:zo Woe 9I "1 n .0 ;)mod REVISED MAY 14, 2003 ATTACHMENT PROGRAM BUDGET PROPOSAL Organization Name: THOMAS HOUSE TEMPORARY SHELTER Program Name: HOMELESS FAMILY SHELTER EXPENOrrUREA CATEGORY SANTA ANA CDBG OTHER PROGRAM CORPORATE GRANTS GRANT REQUESTED RESOURCES TOTAL Administrative Staff $ NEWSLETTER /FUND RAISING 30,000 Salaries& Benefits 4,000 $ 43,250 $ 7 Program Staff Salaries &Benefits 127,750 127,750 supplies 1 5,000 40,000 45P000 DEBT SERVICE 1 Wc'@M 1 20.000 20,000 Communications I Utilities 15,000 0 0 0 Professional Services Specify: AUDIT /ETC. ! 10,000 10,000 FUND RAISING 15,000 15,000 Training/Travei Ex ensss Insurance 42.000 42 000 Other (Please Specify) SOCIAL SERVICES 5,000 98,000 103,000 ADMINISTRATION 12,000 12,000 MAINT. &REPAIR 25,000 25,000 FURNISHINGS 25,000 25,000 TOTALj$ 19,000 I$ 473,000 $ PROGRAM RESOURCES SOURCE AMOUNT GOVERNMENT GRANTS $ 250,000 CORPORATE GRANTS 45,000 CIVIC FOUNDATION GRANTS 110,000 INDTVIDUALSIRELIGIOUS GROUPS 60,000 NEWSLETTER /FUND RAISING 30,000 INTERESTIPROGRAM FEES /MISC. 15,000 TOTAL 5 510 000 Exhibit B t f 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 Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including 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. Grantee /Contactor Organization Program Title EXHIBIT C 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. section 2000 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 276 a 1 -5, 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 C Page 2 of 2 DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348 -0046 (See reverse for public burden disclosure.) 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: ❑a. contract �a. bid /offer /application a. initial filing b. grant b. initial award b. material change c. cooperative agreement c. post -award For Material Change Only: d. loan year ____ quarter e. loan guarantee date of last report f. loan insurance 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is a Subawardee, Enter Name ❑ Prime ❑ Subawardee and Address of Prime: Tier— if known: Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name /Description: CFDA Number, if applicable: 8. Federal Action Number, if known: 9. Award Amount, if known: 10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if (if individual, last name, first name, MI): different from No. 10a) (last name, first name, Ml): (attach Continuation Sheet(s) SF -LLLA, if necessary) 11. Amount of Payment (check all that apply): 13. Type of Payment (check all that apply): $ ❑ actual ❑ planned ❑ a. retainer ❑ b. one -time fee ❑ c. commission 12. Form of Payment (check all that apply): ❑ a. cash ❑ d. contingent fee ❑ b. in -kind; specify: nature ❑ e. deferred value ❑ f. other; specify: 14. Brief Description of Services Performed or to be Performed and Date(s) of Service, including officer(s), employee(s), or Member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheets) SF -LLLA, if necessary) 15. Continuation Sheets SF -LLLA attached: ❑ Yes ❑ No 16. Information requested through Mis form is authorized by title 31 U.S.C. section Signature: g 1352. This diadosure of bbbying adlVWW is a material representation of fact print Name: upon which reiiance was placed "a tier above when Mis sansadion waa made or entered Info. This disdosure is regWrd e pursuant b 31 U.S.C. 1352. This Title: information we be reposed b Me Congress samFamually and will be available fa public Inspection. My person who fails M file the required diedosun shall be Telephone No.: Date: subject to e civil penalty of not Was Mat $10,000 and not him Man 5100,000 fie each si dr ladies. Federal Use Daly: Authorized for Local Reproduction Standard Form LLL (Rev. 7 -97) SP �+.�.A CERTHOLDER COPY ' / i7 �I"!'�TE P.O. BOX 807, SAN FRANCISCO,CA 94142- 0807' A'�(�3 -04-`i COMPENSATION INSURANCg FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE J lfJi ISSUE DATE: 10-01 -2003 GROUP: - POLICY NUMBER: .1209851 -2003 CERTIFICATE 10: ,..22 CERTIFICATE EXPIRES: 10 -01 -2004 10-01'-- 2003/10 -01 -2004 CITY OF SANTA ANA SP JOB: ALL OPERATIONS COMMUNITY DEVELOPMENT AGENCY M -25 P.O. BOX -19$8 SANTA ANA CALIFORNIA 92702 -198$' This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California fileurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30days'. advance written notice to the employer. We will also give you,30 days" advance notice should this policy be cancelled prior to its normal expiratow. This certificate of insurance is not an insurance policy and does not amend extend"or' alter the coverage afforded by the policies listed herein. 'Notwithstanding any requirement, term, or condition of any contractor other document with respect to which this certificate of insurance 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. ; AUTHORIZED REPRESENTATNE PRESIDENT `EMPLOYER'S LIABILITY LIMIT INCLUDI€*.:DEFENSP (79S ?S• -. $1,006-000.00 PER 'OCCURRENCE. ENDORSEMENT #"ES ENTITLEED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-01-200$ IS ATTACHED TO AND FORMS A...PART 01'` " -*;S POLICY, ,. s�t"L3 AS TtiCDa`Li tL. i';• rx g uai. .::EMPLOYER .M LEGAL NAME d F " THOMAS HOUSE TEMPORARY,,SHELTER THOMAS ►aurE rEMPORAl3Y SHELTER PO. BOX' 273`7' (A NONtiP1ZItFIT i :. . GARRET GROVE CA 92842 ' ` • ��Ev.s•o31 _ „. aa`Htatttn 69- 17-2009 Orono..,'