HomeMy WebLinkAboutBOYS AND GIRLS CLUB 1 -2002INSURAHCE OH FILrC
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Contract No. A2002-097
AGREEMENT UNDER THE WORKFORCE INVESTMENT ACT
THIS AGREEMENT, made and entered into this 3rd .day of June ,20 02 , by
and between the City of Santa Aha, a charter city and municipal corporation duly organized and
existing under the Constitution and laws of the State of California ("CITY") and Boys & Girls Club of
Santa Ana ("CONTRACTOR").
W-I-T-N-E-S-S-E-T-H
Recitals:
A. CITY has been designated a Local Workforce Investment Area (LWIA) under
the Workforce Investment Act of 1998, Public Law 105-220 ("the Act").
B. The State of California has created the LWIA to administer the Act programs
operated by the State of California pursuant to the Act.
C. As a LWIA, CITY is entitled to receive federal funds to establish programs to
prepare economically disadvantaged youths for entry into the labor market and to provide job training
to those individuals who are economically disadvantaged or otherwise face serious barriers in obtaining
productive employment. One goal of Califomia's Workforce Investment System is to provide youth
with the opportunities to achieve career goals that will allow them to successfully compete in the labor
market and prepare them for higher education.
D. CONTRACTOR is experienced in operating education, training and
employment programs for economically disadvantaged youths for entry into the labor market ("said
program").
Califomia law.
CONTRACTOR is willing to operate said program pursuant to the Act and
WHEREFORE, for and in consideration of the respective and mutual covenants and
promises hereinafter contained and made, and subject to all the terms and conditions hereof, the parties
hereto do hereby agree as follows:
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CONTRACTOR'S OBLIGATIONS
A. CONTRACTOR agrees to provide the following services pursuant to said
program, as more specifically set forth in CONTRACTOR'S program narrative contained in "Exhibit
A" and in the Statement of Work (Exhibit B and Exhibit B-i), attached hereto and by this reference
incorporated herein:
Title I - Youth
In-School Youth Program
CONTRACTOR'S failure to provide said services may be grounds for CITY to readjust
the level of payment to CONTRACTOR otherwise provided for hereinafter.
B. CONTRACTOR agrees to provide benefits to individuals who participate in the
activities and services funded by this Agreement ("participants") in accordance with the standards and
requirements set forth in Workforce Investment Act of 1998, Public Law 105-220.
C. CONTRACTOR agrees to perform the services set forth herein in a professional,
timely and diligent manner.
D. CONTRACTOR shall provide wages and benefits to individuals who participate
if the activities and services funded by this Agreement ("participants") in accordance with the
standards and requirements of the Act, including Section 181 of the Act.
E. CONTRACTOR shall adhere to the Labor Standards described in the Act
including Section 181 of the Act.
F. CONTRACTOR agrees to comply with the "Complaint Handling Procedures under
the WlA", attached hereto as "Exhibit C" and incorporated herein as though fully set forth in 20 CFR
§667.200, Subpart F. CONTRACTOR shall advise participants of their rights to file complaints under
the Act and the procedures for resolution of any complaints. CITY's procedures for handling
complaints alleging a violation of the Act, regulations, grants, or other agreements under the Act shall
be followed and any decision of CITY, the State or the federal government relating to the complaint
shall be binding and followed by CONTRACTOR. CONTRACTORS who are employers shall operate
a grievance system that incorporates CITY's procedures for resolution of complaints relating to the
terms and conditions of employment; these procedures shall be approved in writing by CITY.
G. As a condition of this award of financial assistance under the Act to
CONTRACTOR from CITY, CONTRACTOR assures, with respect to operation of all programs or
activities funded with funds provided pursuant to the Act, and all agreements or arrangements to carry
out such programs or activities, that it will comply fully with the nondiscrimination and equal
opportunity provisions of the Act (Section 188); the Nontraditional Employment for Women Act of
1991; Title VI of the Civil Rights Act of 1964, as amended; section 504 of the Rehabilitation Act of
1973, as amended; the Age Discrimination Act of 1975, as amended; the Americans with Disabilities
Act of 1990; and with all applicable requirements imposed by or pursuant to regulations implementing
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those laws, including, but not limited to, 29 CFR part 37. The United States, the State of California
and CITY have the right to seek judicial enforcement of this assurance.
H. CONTRACTOR agrees that no participant(s) shall commence training prior to the
approval of funding pursuant to Section 123 of the Act.
I. CONTRACTOR agrees to maintain such records and submit such reports, data and
information, on the form and containing such information, at such times as CITY may request or
require regarding the performance of CONTRACTOR'S services or activities, costs or other data,
including but not limited to, participants' attendance, payroll records and job duty statements.
CONTRACTOR agrees to forward to the WIB Administrative Office, 1000 East Santa
Aha Blvd., Suite 200, Santa Ana, California 92701 a completed Workforce Investment Act
Enrollment/Registration form (WlA EWIE) within 15 days of enrollment/registration; Workforce
Investment Act Goals (WlA EWlG) within 10 days of active enrollment of trainee; Workforce
Investment Act Exit (WIA EWlT) within 10 days of completion/termination of active enrollment of
trainee; and the Workforce Investment Act Follow-Up Information (WlA EWlF) within 10 days
following 30, 60, and 90 days of placement.
CITY, the State of California and the United States government and/or their
representatives shall have access for purposes of monitoring, auditing and examining of
CONTRACTOR'S activities, performance, books, documents, papers, and records of CONTRACTOR
subcontractors, bookkeepers and accountants, and employees and participants related to this
Agreement. Such agencies or representatives shall also schedule on-site monitoring in their discretion.
Monitoring activities may also include, but are not limited to, questioning employees and participants
and entering any premises or onto any site in which any of the services or activities funded hereunder
are conducted or in which any of the records of CONTRACTOR are kept. Nothing herein shall be
construed to require access to any privileged or confidential information as set forth in federal or state
law.
In the event CONTRACTOR does not make the above-referenced documents available
within the City of Santa Ana, California, CONTRACTOR 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.
Ail accounting records and evidence pertaining to all costs of CONTRACTOR and all
documents related to this Agreement shall be kept available at CONTRACTOR'S office or place of
business for the duration of this Agreement and thereafter for three (3) years after completion of an
audit. 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,
the State of California or the United States Government take exception, shall be retained beyond the
three (3) years until resolution of disposition of such appeals, litigation, claims, or exceptions.
J. Without prejudice to any other section of this Agreement, CONTRACTOR
shall, where applicable, maintain the confidential nature of information provided to it concerning
participants in accordance with the requirements of federal and state law. Notwithstanding the
foregoing, CONTRACTOR agrees to submit to CITY, the State of California and/or the United States
Government or their representatives, all records requested for administrative purposes, including
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audits, examinations, monitoring and verification of records submitted by CONTRACTOR, costs
incurred and services rendered hereunder.
K. CONTRACTOR agrees to complete in triplicate, a monthly Invoice/Voucher on
CITY's Invoice/Voucher form, showing in detail the amount of money expended by CONTRACTOR
hereunder. CONTRACTOR agrees to submit the above-stated document to the WlB Administrative
Office, 1000 East Santa Ana Blvd., Suite 200, Santa Ana, California, 92701, by the tenth (10th) day of
the month following the month in which CONTRACTOR'S services are performed. Should
CONTRACTOR fail to deliver said documents to CITY, CITY shall have the option to cancel this
Agreement by giving CONTRACTOR ten (10) days written notice thereof. CONTRACTOR shall
either return to the CITY excess revenues over costs or use such excess revenues as program income by
utilizing such program income for additional training activities authorized under the Act.
L. CONTRACTOR agrees to expend all funds in accordance with all applicable
federal, state and local laws and regulations. CONTRACTOR also agrees to provide at
CONTRACTOR'S own expense supplies and other costs of said PROGRAM.
M. CONTRACTOR shall arrange independently for an audit that includes WIA
funds received fi.om CITY, in accordance with the Act and 20 CFR Section 667.200. CONTRACTOR
shall submit one original of each required audit report to CITY within (30) days after the date received
by CONTRACTOR. Should CONTRACTOR fail to comply with these requirements, CITY may at its
option withhold payment of funds, or disallow funds or suspend additional grant funds.
N. CONTRACTOR shall not expend funds pursuant to this Agreement to provide
services to any participant where costs of training are paid for by any other person or entity.
O. CONTRACTOR shall comply with the provisions of Cimular A-102 of the U.S.
Office of Management and Budget (OMB) and the related "Common Rule" entitled "Uniform
Administrative Requirements for Grants and Cooperative Agreements to State and Local Government",
Subpart C, paragraphs 37 and 42, Cimular A-128, and all other applicable federal statutes and
executive orders and their implementing regulations, including regulations at 29 CFR Part 97.
P. CONTRACTOR shall comply with the requirements of federal regulations
found at 29 CFR 93 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. CONTRACTOR shall sign
a certification to that effect in a form as set forth in "Exhibit D," attached hereto and by this reference
incorporated herein. CONTRACTOR 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 CONTRACTOR under the terms and conditions of this Agreement.
Q. CONTRACTOR agrees to provide a drug-free work place and to execute a
certification as set forth in "Exhibit E" attached hereto and incorporated herein by this reference.
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R. CONTRACTOR, in accordance with the Child Support Compliance Act,
recognizes and acknowledges the importance of child and family support obligations and shall fully
comply with all state and federal laws relating to child and family support enfomement, including, but
not limited to: disclosure of information and compliance with earnings assignment orders, as provided
in Chapter 8 (commencing with Section 5200) of Part 5 of Division 9 of the state Family Code; and, to
the best of its knowledge is fully complying with the earnings assignment orders of all employees and
is providing the names of all new employees to the New Employee Registry maintained by the
California Employment Development Department (EDD).
S. CONTRACTOR agrees to comply with all applicable provisions of the ACT and
the federal regulations, including but not limited to the regulations found at 20 CFR part 629.
II.
CITY'S OBLIGATIONS
A. CITY agrees to pay to CONTRACTOR when, if and to the extent federal funds
are received under the provisions of the Act a sum not to exceed One Hundred Sixteen Thousand Five
Hundred Seventy Seven and no/100 Dollars ($116,577.00) for CONTRACTOR'S performance in
accordance with the payment schedule attached hereto as "Exhibit F" during the period of this
Agreement. Said sum shall be paid after CITY receives invoices submitted by CONTRACTOR as
provided hereinabove.
B. CITY agrees to provide for on-site monitoring reviews of said program
operation at least twice annually. In addition, monthly desk-top reviews of pertinent information will
be conducted.
III.
TIME PERIOD OF AGREEMENT
This Agreement shall commence on May 7, 2002 and all duties arising under this
Agreement shall have been performed by June 30, 2003 . The term of this Agreement may be
extended by a writing executed by the Executive Director of the Community Development Agency and
the City Attorney.
IV.
INDEPENDENT CONTRACTOR
Consultant shall, during the entire term of this Agreement, be construed to be an
independent contractor and not an employee of the City. This Agreement is not intended nor shall it be
construed to create an employer-employee relationship, a joint venture relationship, or to allow the City
to exercise discretion or control over the professional manner in which Consultant performs the
services which are the subject matter of this Agreement; however, the services to be provided by
Consultant shall be provided in a manner consistent with all applicable standards and regulations
governing such services. Consultant shall pay all salaries and wages, employer's social security taxes,
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unemployment insurance and similar taxes relating to employees and shall be responsible for all
applicable withholding taxes.
WORKER'S COMPENSATION AND EMPLOYER'S RIGHTS
A. CONTRACTOR shall use appropriate funds received from CITY to provide
workers' compensation to all those hired by CONTRACTOR under this Agreement.
B. CONTRACTOR shall have the right to hire, dismiss, or promote its employees
or contract personnel hired under this Agreement so long as its hiring or dismissal policy or standard
does not violate Title VII of the Civil Rights Act of 1964, Fair Labor Standards Act of 1938, or any
other applicable law, and CONTRACTOR maintains itself as an Equal Opportunity employer.
VI.
APPLICABLE GUIDELINES
A. The parties hereto agree that CONTRACTOR shall comply with all applicable
federal and state laws and regulations, including, but not limited to the Performance Standards (Exhibit
G) and general program requirements described in Sections 106 and 141 of the Act (29 USC Sections
1516 and 1551) and applicable regulations, and the U.S. Department of Labor guidelines and
regulations, including amendments or revisions made during the terms of this Agreement. Said
applicable laws are hereby incorporated by reference and made as part of this Agreement as though
fully set forth herein.
B. CONTRACTOR also assures and certifies that:
1. CONTRACTOR shall comply with Title VII of the Civil Rights Act of
1964 (P.L. 83-354) and in accordance with Title VII of the Act, no person shall, on the grounds of race,
color, religion, sex, age, handicap or national origin be excluded from participation in, be denied the
benefits of, or be otherwise subjected to discrimination under this Agreement.
2. CONTRACTOR shall comply with any and all federal laws limiting the
political activity of employees hired under this Agreement.
3. CONTRACTOR shall comply with thc requirements that no program
under the Act shall involve political activities.
4. RECORD INSPECTION. CONTRACTOR shall provide the U.S.
Department of Labor and the Controller General, by and through any authorized representative, as well
as the WIB Administrative Office, access to and the right to examine all records, books, papers or
documents relating to the accounting and use of funds under this Agreement for a three-year period
from and after the effective date of this Agreement.
5. No person with responsibilities in the operation of any program under the
Act shall discriminate with respect to any program participant or any application for participation in
such program because of race, creed, color, national origin, sex, political affiliation or beliefs.
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6. CONTRACTOR shall maintain appropriate standards for health and
safety in work and training situations.
7. CONTRACTOR shall comply with general provisions, assurances, and
certifications attached hereto as "Exhibit H" and incorporated herein.
8. EQUAL OPPORTUNITY. Any literature distributed by CONTRACTOR
for the propose of apprising businesses, participants, or the general public of its programs under this
Agreement shall state that its programs are supported by the City of Santa Ana and the Santa Ana
Workforce Investment Board, and shall state that the program is an "equal opportunity
employer/program" and that "auxiliary aids and services are available upon request to individuals with
disabilities."
9. CONTRACTOR certifies that all property, finished or unfinished
documents, data, studies and reports prepared or purchased under this Agreement, will be disposed of
in accordance with the direction of the CITY. In addition, any tools and/or equipment furnished to the
CONTRACTOR by the CITY and/or purchased by the CONTRACTOR with funds pursuant to this
Agreement, will be limited to use within the activities outlined in this agreement and will remain the
property of the United States Government and/or CITY. Upon termination of this Agreement,
CONTRACTOR will immediately return such tools and/or equipment to the CITY or dispose of them
in accordance with the direction of the CITY.
10. CONTRACTOR certifies that this Agreement does not provide
for the advancement or aid to any religious sect, church or creed, or sectarian purpose nor does it help
to support or sustain any school, college, university, hospital or other institution controlled by any
religious creed, church, or sectarian denomination, as specified by Article XVI, Section 5, of the
Constitution of the State of California, regarding separation of church and state.
11. PATENT, COPYRIGHTS AND RIGHTS IN DATA. The
CONTRACTOR will disclose to the CITY any invention, written product, computer program
developed or data assembled as a result of performance of work under this Agreement within seventy
four (74) days of invention, development or assembly. The CITY, State of California, and U.S.
Department of Labor will have the right to patent any invention and copyright any written product or
computer program or data generated by CONTRACTOR. Upon written request, CONTRACTOR will
transfer all pertinent information, specifications and right, title and interest to the designated agency.
12. INVENTIONS, PATENTS AND COPYRIGHTS.
A. Reporting Procedure If any project produces patentable items, patent rights, processes, or
inventions in the course of work under a U.S. Department of Labor (DOL) grant or agreement, the
CONTRACTOR shall report the fact promptly and fully to the CITY. The CITY shall report
the fact to the Grant Officer, at the DOL. Unless there is a prior agreement between the CITY and the
DOL and its representative on these matters, the DOL shall determine whether to seek protection on
the invention or discovery. The DOL and its representative shall determine how the rights
in the invention or discovery, including rights under any patent issued thereon, will be allocated and
administered in order to protect the public interest consistent with the "Governmental Patent Policy"
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(President's Memorandum for Heads of Executive Departments and Agencies, August 23, 1971,
and Statement of Government Patent Policy as printed in 36 FR 16889).
B. Copyright Policy
1. Unless otherwise provided in the terms of the grant or agreement, when copyright-able
material is developed in the course of or under a DOL Grant or agreement, the author and the CITY
which developed the work is free to copyright material or to permit others to do so. The
CONTRACTOR and the Workforce Investment Board (WlB) shall have a royalty-free, nonexclusive
and irrevocable license to reproduce, publish, use and to authorize others to use all copyrighted
material.
2. The DOL reserves a royalty-free, nonexclusive, and irrevocable license to reproduce,
publish or otherwise use, and to authorize others to use, for Federal Government purposes: (a) The
copyright in any work developed under any grant, sub-grant, or contract under a grant or subgrant; (b)
Any right of copyright to which a grantee, subgrantee or a CONTRACTOR purchases ownership with
grant support; and (c) CONTRACTOR shall comply with the requirements of 29 CFR Part 97.34.
C. Rights to Data
The DOL and the CITY shall have unlimited rights to any data first procured or delivered
under this Agreement.
13. CLEAN AIR / CLEAN WATER ACT. If the grant hereunder exceeds
$100,000, CONTRACTOR must comply with Section 306 of the Clean Air Act [(42 USC 1875(h)];
Section 508 of the Clean Water Act (33 USC 1368); Executive Order 11738 and Environmental
Protection Agency ("EPA") regulations (40 CFR Part 15) as any may now exist or be hereafter
amended. Under these laws and regulations, the CONTRACTOR assures that:
(a) No facility to be utilized in the performance of the proposed grant has been listed
on the EPA List of Violating Facilities;
(b) It will notify CITY prior to award of the receipt of any communication from the
Director, Office of Federal Activities, U.S. EPA, indicating that a facility to be
utilized for the grant is under consideration to be listed on the EPA List of
Violating Facilities;
(c) It will notify the CITY and the EPA about any known violation of the above laws
and regulations.
C. CONTRACTOR agrees to adhere to the following STANDARDS OF CONDUCT:
1. General Assurance. Every reasonable course of action will be taken by CONTRACTOR in
order to maintain the integrity of this expenditure of public funds and to avoid favoritism. This
Agreement will be administered in an impartial manner, free from errors to gain personal, financial
political gain. CONTRACTOR, its officers and employees, in administering this Agreement, will
avoid situations which give rise to a suggestion that any decision was influenced by prejudice, bias,
special interest or desire for personal gain.
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2. Employment of Former State or CITY Employees. CONTRACTOR will ensure that any of
its employees who were formerly employed by the State of California or CITY, in a position that could
have enabled such individuals to impact policy regarding or implementation of programs covered by
this Agreement, will not be assigned to any part or phase of the activities conducted pursuant to this
Agreement for a period of not less than two years following the termination of such employment.
3. Conducting Business Involving Relatives. No relative by blood, adoption or
marriage of any executive or employee of CONTRACTOR will receive favorable treatment when
considered for enrollment in programs provided by, or employment with, CONTRACTOR.
4. Conducting Business Involving Close personal Friends and Associates.
Executives and employees of CONTRACTOR will be particularly aware of the varying degrees of
influence that can be exerted by personal friends and associates and, in administering this Agreement,
will exercise due diligence to avoid situations which give rise to an assertion that favorable treatment is
being granted to friends and associates. When it is in the public interest for CONTRACTOR to
conduct business with a friend or associate of an executive or employee of CONTRACTOR, an elected
official in the area or a voting or non-voting member of the Workfome Investment Board (WIB), a
permanent record of the transaction will be retained.
5. Avoidance of Conflict of Economic Interest. No executive or employee of
CONTRACTOR elected official in the area, or voting or non-voting member ofa WlB, will solicit or
accept money or any other consideration from a third person, for the performance of an act reimbursed
in whole or part by CONTRACTOR or CITY. Supplies, materials, equipment or services purchased
with Agreement funds will be used solely for purposes asserted or allowed under this Agreement. No
voting member of the WIB will cast a vote on the provision of services or vote on any matter which
would provide direct financial benefit to that member or any business or organization which the
member directly represents.
VII.
HOLD HARMLESS
A. CONTRACTOR shall indemnify and save harmless CITY, its officers, agents
and employees, 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 CITY, and shall defend, indemnify and save
harmless CITY, its officers, agents and employees, from any and all claims, demands, suits, actions or
proceedings of any kind or nature, including, but not by way of limitation, workers' compensation
claims, resulting from or arising out of the negligent acts, errors or omission of CONTRACTOR, its
employees or subcontractors.
B. CONTRACTOR shall indemnify and save harmless CITY, its officers, agents
and employees, 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 CITY, and shall defend, indemnify and save
harmless CITY, its officers, agents and employees, from and against any and all claims, demands, suits,
actions or proceedings therefore, resulting from or arising out of the intentional or malicious acts of
CONTRACTOR, its employees or subcontractors.
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VIII.
INSURANCE
1. Commercial General Liability. CONTRACTOR agrees to obtain and keep in force
during the term of this Agreement a policy of comprehensive commercial public liability insurance
insuring the State of California, CITY, and CONTRACTOR against any liability for accident, injury or
death arising out of or in consequence of this Agreement. Such insurance shall be in an mount not
less than One Million Dollars ($1,000,000.00) for any injury to or death of any person or persons in
any single accident or occurrence. Said policy of comprehensive public liability insurance shall be
endorsed to provide to CITY and to the State of California, Employment Development Department, at
least thirty (30) days written notice prior to cancellation; name CITY, its officers, agents, employees,
and volunteers, and the State of California, its officers, employees, and volunteers as additional
insureds; and state that such coverage is primary to any other coverage or self-insurance of the State of
California and CITY. Governmental entities may substitute a certificate of self-insurance.
2. Automobile Liability Coverage. CONTRACTOR shall also obtain and maintain,
during the effective period of this Agreement, broad form automobile liability coverage with a
$1,000,000 limit unless reduced by CITY, which applies to both owned/leased and non-owned
automobiles used by CONTRACTOR employees or participants in performance of this Agreement, or,
in the event that CITY will not utilize such owned/leased automobiles but intends to require
employees, participants or other agents to utilize their own automobiles in the performance of this
Agreement, CONTRACTOR shall secure and maintain on file from all such employees, participants, or
agents as self-certification of automobile insurance coverage. Governmental entities may substitute a
certificate of self-insurance.
3. Workers' Compensation. If CONTRACTOR is an "employer", as set forth in
California Labor Code Section 3300 et seq., or utilizes participants as "employees," as set forth in
California Labor Code Section 3350 et seq., CONTRACTOR shall obtain and keep in force during the
term of this Agreement full Workers' Compensation insurance coverage for injuries suffered by
participants. Said insurance policy shall guarantee CITY at least thirty (30) days written notice of
cancellation or modification. CONTRACTOR shall can3, medical and accident insurance for those
participants not qualifying as "employees" for Worker's Compensation Coverage, pursuant to
California Labor Code Section 3350, et seq.
4. Equipment Coverage. CONTRACTOR shall purchase a policy or policies of
insurance covering loss or damage to any and all Equipment provided to or purchased by
CONTRACTOR in accordance with this Agreement. Said insurance shall be in the amount of the full
replacement value thereof, providing protection against the classification of fire, extended coverage,
vandalism, malicious mischief, theft, and special extended perils. Governmental entities may
substitute a certificate of self-insurance.
5. Proof of Insurance. Certificates and endorsements must be submitted and approved by
CITY prior to any work under this Agreement. CONTRACTOR understands that CITY will make no
payments under this Agreement until the required certificates and endorsements have been approved by
CITY.
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IX.
CORPORATE STATUS
All corporate CONTRACTORS shall be in good standing, without suspension by the
California Secretary of State, Franchise Tax Board and Internal Revenue Service. Any change in
corporate status or suspension shall be reported immediately to CITY.
X.
ASSIGNABILITY
None of the duties of, or work to be performed by, CONTRACTOR under this Agreement
shall be subcontracted or assigned to any agency, consultant, or person without the prior written
consent of CITY. CONTRACTOR 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
CONTRACTOR pursuant to this Agreement.
XI.
LAWS GOVERNING THIS AGREEMENT
In its performance under this Agreement, CONTRACTOR shall fully comply with the
requirements of the following, whether or not otherwise referred to in this Agreement:
1. The Act and all applicable federal statutes, regulations, policies, procedures and directives,
including but not limited to, 20 C.F.R. Parts 652 and 660 through 671.
2. All applicable State statutes, regulations, policies, procedures and directives;
3. All applicable CITY policies, procedures and directives;
4. All applicable local ordinances and requirements, including use permits and licensing;
5. Court orders applicable to its operation; and,
6. The terms and conditions of this Agreement.
If any of the foregoing is enacted, amended, or revised, CONTRACTOR will comply with
such or will notify CITY after enactment or modification that it cannot so comply. CITY may
thereupon terminate this Agreement, if necessary.
XII.
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 employment of CONTRACTOR by CITY, and contains
all the covenants and agreements between the parties with respect to such employment. 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
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embodied herein, and that no other agreement or amendment hereto shall be effective unless executed
in writing and signed by both CITY and CONTRACTOR.
XIII.
FRAUD
CONTRACTOR shall immediately report to CITY all instances and facts concerning
possible fraud, abuse or criminal activity relating to expenditure or receipt of funds under this
Agreement.
XIV.
CONTINGENCY OF FUNDS
CONTRACTOR acknowledges that approval of and funding for this Agreement is
contingent upon State approval, and funds received or obligated from the State of California to CITY.
If such approval of funds is not forthcoming, or is otherwise limited, CITY shall immediately notify
CONTRACTOR. Within twenty (20) days of receipt of such notice, CONTRACTOR shall modify or
cease operations as directed by CITY and negotiate necessary modification to this Agreement and/or
reimbursement of costs incurred hereunder.
XV.
TERMINATION
This Agreement may be terminated by either party at its sole discretion, upon thirty (30)
days written notice to the other party. Notice shall be deemed served on the date of mailing. However,
CONTRACTOR may not terminate this Agreement if undue hardship will result to any participant.
X~.
DISPUTES
Except as othenvise provided in this Agreement, any dispute concerning any question
arising under this Agreement shall be decided by CITY. In such a case CITY shall reduce its decision
to writing and mall or otherwise furnish a copy thereof to CONTRACTOR. The decision of the City
shall be final and conclusive unless within thirty (30) calendar days fi.om the mailing or delivery of
such copy, CITY receives from CONTRACTOR written request to appeal said decision.
Procedures governing the appeal shall be prescribed by CITY and/or the State of
California in accordance with the Act and all corresponding regulations and OMB circulars. Pending
final disposition of the appeal, CONTRACTOR shall act in accordance with CITY's decision unless
the dispute involves a change order.
XVII.
BREACH - SANCTIONS
If, through any cause, CONTRACTOR violates any of the terms and conditions of this
Agreement, and/or prior agreements whereby grant funds were received by CONTRACTOR pursuant
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to this Agreement, or if CONTRACTOR reports inaccurately or if any Audit Report makes
disallowances, CONTRACTOR shall promptly remedy its acts or omissions and/or repay CITY all
amounts due CITY as a result of CONTRACTOR's violation. For any such failures or violations,
CITY shall also have the fight at its sole discretion to either: (1) discontinue program support until
such time as CONTRACTOR fulfills its obligations or remedies all violations of this agreement or
prior agreements; and/or (2) collect outstanding amounts as determined by CITY due CITY by
offsetting or debiting from current claims or invoices, if after thirty (30) days' written notice
CONTRACTOR has failed to repay same or a repayment schedule has not been made; and/or (3)
terminate this Agreement by giving written notice to CONTRACTOR of such termination in
accordance the notice provision in Paragraph XVIII herein below.
XVIII.
NOTICES
All notices, reports and correspondence between the parties hereto respecting this
Agreement shall be in writing and deposited in the United States Mail, postage prepaid, addressed as
follows:
CITY:
City of Santa Ama
Manager, WlB Administrative Office
1000 Santa Ama Blvd., Suite 200
Santa Aha, CA 92701
telefacmilie (714) 565-2602
and,
CLERK:
Clerk of the City Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ama, CA 92702-1988
telefacsimile (714) 647-6956
CONTRACTOR:
Boys & Girls Club of Santa Ama
950 W. Highland
Santa Ama, CA 92703
(714) 543-7212
telefacsimile (714) 543 -4613
of the parties.
stated herein.
~X.
MERGER
This Agreement, together with the attachments hereto, expresses the total understanding
There are no oral understandings of the parties or terms and conditions other than as
Page 13 of 14
XX*
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.
MISCELLANEOUS PROVISIONS
a. 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 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 referenced herein and attached hereto shall be incorporated as if fully set forth in
the body of this Agreement.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first
above-written.
ATTEST:
Clerk of the Council
CITY OF SANTA ANA, a municipal
corporation of the State of California
"CITY"
By: ~~
David N Ream
City Manager
APPROVED AS TO FORM:
Joseph W. Fletcher
City Attorney
BY:
Lisa E. Storck
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
John P]Reekstin, Executive Director
Community Development Agency
Boys & Girls Club of Santa Ana
( JohnJF. Brewstel~
~Ex~utive Director
~Fed. Tax ID#: 95-1893417
Page 14 of 14
Exhibi~ A
Program Narrative
Prepared for the
Santa Ana Workforce Investment Board
Please answer each question as concisely as possible
About the Program
Executive Summary
Which WIA population will the program recruit and serve?
The Boys & Girls Club of Santa Ana (Club) will provide the Career Prep program
to in-school youth between the ages of 14-18. In addition, program participants
will be identified as legal U.S. Santa Ana City residents and from families with
Iow annual incomes.
Indicate how many participants to be served.
The program will serve a minimum of.~'youth.
Indicate which of the 10 WIA elements the program will address.
The Career Prep program will provide youth with three of the ten WIA elements.
These elements are: #3 (summer employment opportunities), #4 (paid and
unpaid work experiences), and #6 (leadership development opportunities.)
Indicate planned outcomes.
· ~/youth ages 14-18 will be tested in ascertaining Basic Skill Levels
using current TABE materials and standards,
· .~'youth will participate in summer employment for ten weeks.
· .~'youth will successfully complete unpaid work experience for five
weeks.
· ,20"youth will complete Office Smart training, resulting in participant
employability in an office environment.
· A minimum o,f,,~O'youth between the ages of 16-18 will successfully
complete Job Ready and Career Launch pre-employment training.
· At least 4~outh between the ages of 14-15 will complete the Career
Explorers Club program.
Describe the basic program approach. (workshop/classroom/in the
community)
Since we began providing this program four years ago, the basic program
approach of Career Prep has developed and chang(~d. It is designed to be
flexible to participant interest and needs. Program components of Career Prep
are both flexible in the locale and in the delivery of the service. Our Program
Managers have provided the program in classroom settings during designated
class time and in after-school programs at schools and at the Boys & Girls Club.
While most of the program workshops will take place in classroom-like settings,
many elements included in the training are not. Participants will engage in
special field trips, guest speakers, career and job fairs, computer based learning,
group presentations and role-playing.
Main Purpose of Program
What is the organization Mission Statement?
The mission of the Boys & Girls Club of Santa Aha is to promote the positive and
healthy development of youth, especially those from disadvantaged
circumstances by providing services that build the skills, civility, and self-
confidence necessary to succeed in a competitive wodd.
Indicate what the program will accomplish,
The Career Prep program is made up of several components, designed to
provide age-appropriate, needs-based employment and career training. The
program will accomplish the following:
· A minimum of..80"~outh ages 16-18 will successfully complete the Job
Ready pre-employment training. Youth will acquire skills and knowledge
for entry-level employment in 11 specific competency areas (please see
attachment F) identified by the Department o~ Labor as critical to
employment success. At the same time, they will develop appropriate job
attitudes and behaviors while establishing specific steps and actions
towards career goals. In addition, participants will be provided with Career
Launch, an added piece of the Job Ready program that promotes
computer-based lear.n, ing and exploration.
· A minimum of ~0/~outh ages 14-15 will successfully complete Career
Explorers Club, designed to help young teens explore key occupational
areas, assess their own interests and abilities, and develop tentative
occupational plans.
· ~OVyouth will be placed in subsidized summer employment for 20 hours a
week for 10 weeks.
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· ~d'youth will take part in non-paid work experience for 10 hours a week
for five weeks. Upon successful completion of the work experience,
participants will receive a stipend award.
· ?x0"youth, with an identified interest in Windows application learning will
participate in Office Smart. Participants will develop a basic set of
computer skills and knowledge that are applicable and transferable to a
wide range of work experiences and will also receive a stipend upon
successful completion.
What is the length of the program?
Each program component varies in length. Typicallyl '~he Job Ready component
concludes after six to eight weeks of training. The Career Explorers Club is an
eight-week program. Summer employment will continue for ten-weeks and
participants will perform in non-paid work experiences for five weeks. The Office
Smart component lasts approximately six weeks. With exception to summer
employment, each component will be continually provided to participants
throughout the year.
How often will the WIA participant need to attend the program?
How often a participant attends the program depends upon the Career Prep
component in which they are involved. Typically, Job Ready/Career Launch
participants take part in workshops two to three times each week, or at least
three hours a week for six to eight weeks. Participants are not graduated from
the program until they have successfully completed a post-assessment,
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employment applications and a r~sum~. For some youth, this process may take
more time, more instruction and assistance from staff.
The Career Explorers Club is made up of approximately 24 sessions, each
approximately 60-minutes long. Participants will attend three times each week.
Summer employment participants will work 20 hours a week for ten weeks. In
addition, participants will simultaneously attend Job Ready/Career Launch
training, resulting in an additional three hours of training for six to eight weeks.
Work experience participants will spend 10 hours a week for five weeks "on the
job." Participants will have already successfully completed Job Ready/Career
Launch or the Career Explorers Club training.
Office Smart participants will also have successfully completed either Job
Ready/Career Launch or the Career Explorers Club training. Office Smart
training will take place in two 60-minutes sessions a week for six weeks.
Program elements will be conducted during mornings, afternoons, evenings, and
on Saturday.
What is the ratio of adult interaction to WIA participant?
A maximum ratio of 12 youth to 1 staff will be observed throughout the duration
of each program component.
What is the frequency of adult interaction with WIA participant?
The frequency of adult interaction varies by program component and individual
participant needs. As mentioned previously, some youth need additional
instruction in order to positively complete programs. At a minimum, Job
Ready/Career Launch participants will spend approximately 18 hours interacting
with program staff. Career Explorers Club participants will spend a minimum of
24 hours in instruction. Summer employment and non-paid work experience
participants will receive daily feedback from their supervisors. Office Smart
participants will work closely with program staff for at least 12 hours. Staff
regularly make themselves available to participants in order to provide extra
assistance.
Goals/Objectives and Performance Levels
How many WIA youth will the program serve this year?
LOO
The Career Prep program will serve a total of,~'different WIA youth, ages 14-
18 years old throughout the year.
Which WIA program element will you offer?
The Boys & Girls Club of Santa Ana will offer three of the ten WIA elements.
These elements are: #3 - summer employment opportunities, fl4 - paid and
unpaid work experiences, and #6 - Leadership development opportunities. The
Career Prep training, including Job Ready/Career Launch, Career Explorers
Club, and Office Smart components are included in element #6.
How will service(s) be deemed necessary?
Services will be deemed necessary by following WIA eligibility youth profile
criteria. All youth recruited for the program will meet eligibility by being Iow
income, Santa Ana and U.S. residents, by meeting age requirements, and by
meeting one or more other criteria that according to WIA standards pose a
barrier to employment.
How will recruitment be coordinated with program activities?
Since the Club began providing Career Prep in 1998, effective recruitment has
been critical to success and has resulted in the participation of 375 youth.
Recruitment will continue to be critical to the success of both the Career Prep
program and the overall Youth Service Provider Network. Recruitment will be
continuous throughout the program. An Outreach Worker will be hired and
trained to work closely with the Program Managers of the Career Prep program. :
The Outreach Worker will regularly communicate to the Program Manager
relevant issues concerning outreach initiatives so that the program may eliminate
any barriers to youth participatio~...~, ~, ~f th'e Outreach Worker were to
gather ten high school students who qualify for the program from Valley High
School, efforts would begin to gain access to Valley in order to provide Career
Prep to the participants at their school, thus eliminating a potential tr. ansportation
barrier. Additionally, the Outreach Worker will communicate regularly with other
WIA service providers. If a youth is recruited to participate in the Career Prep
program and the next program cycle does not begin for a few weeks, the
Outreach Worker would work with other service providers in order to begin
delivering WIA services to that youth.
How will current services meet the needs of the WIA performance
standards?
The Career Prep program will help to meet the needs of the WIA performance
standards by providing career exploration, pre-employment training and paid and
unpaid work experiences that will directly reduce participants' barriers to
employment. In addition, all participants will be Basic Skills tested using TABE
materials.
Will the participant receive a certificate of completion or accomplishment
for participation?
Directly following the completion of a program component, participants will
receive a certificate of completion at a "graduation celebration" honoring their
achievements.
An additional incentive includes joining our existing ClubService, an
Americorps program that encourages Club members to earn educational
awards through volunteer service. '
How will continuous improvement be conducted?
Since the Boys & Girls Club began providing Career Prep in 1998, continuous
improvement has been critical our success. Participant feedback by 375
graduates over four years has resulted in a program that today is more
interactive and flexible. It delivers skills to the participants, provides fun social
interaction, and includes computer-based learning activities. In addition, staff are
continually monitored to ensure program success. The Assistant Executive
Director meets with Program Managers each week to discuss program
accomplishments, problems, new ideas and training. Weekly meetings bring
issues to light early on, so that problems are dealt with before they critically affect
positive program outcomes.
The Club has also been a regular employer in the Summer Youth Employment
Program (SYEP), averaging 30 youth each summer. The Club employs a full-
8
time manager of these youth in order to assure their safety, proper work habits
and regular supervision. The Club employs 10 additional high school students
on a year-round basis to assist with programs.
In addition, Boys & Girls Clubs of America provides our staff with regional and
national training and program curriculum development. Finally, program staff
will administer customer surveys in order to assess levels of participant
satisfaction and knowledge.
Program Description (please see attachment B for brief description)
Describe the overall services that will be made available to the WlA
participant?
In addition to the Career Prep program, WIA participants will have the
opportunity to engage in all other age appropriate services offered at the Club.
Participants will be made aware of employment and educational services
available at the Santa Ana W/O/R/K Center and other WlA providers.
Illustrate how the organization will interface with the Santa Ana W/O/R/K
Center and how the participant flow will occur and how parent involvement
will be incorporated.
The Boys and Girls Club of Santa Ana will continue its collaborative relationship
with the Santa Ana W/O/R/K Center. After Santa Aha W/O/R/K Center staff has
approved participant eligibility, the Career Prep staffwill begin providing services
to that youth. Within the second week of services, participants will be
transported to the Santa Ana W/O/PJK Center to receive a facility tour and to be
introduced to the W/O/PJK Center Case Manager assigned to them. Participants
will be encouraged to visit or call their Case Manager twice each month. In order
to insure that appropriate quality services are being provided to youth, Career
Prep staff will maintain regular communication with the Santa Ana W/O/PJK
Center Case Managers and refer all eligible WIA participants to the Santa Ana
W/O/PJK Center. In addition, the Boys & Girls Club of Santa Ana will continue to
attend monthly WIA Youth Council meetings.
The involvement of parents wilt be established by providing them with a written
invitation to the Career Prep orientation and graduation celebrations. Parents
will be required to sign a permission slip for their child to participate,
Implementation of above services will be coordinated in the following manner:
Outreach/Recruitment/Eligibility Determination
The Career Prep Outreach Worker will recruit..t20' Santa Ana in-school youth
ages 14 -18 from local traditional and alternative high schools and middle
schools, Outreach efforts will occur year-round and will include: program
presentations during school advisement periods, lunchtime recruitment, and
distribution of program flyers throughout the community. The Career Prep
program has an established rapport with school administrators and teachers -
from experience working with us in the past, teachers and school administrators
know the value of the Career Prep program for their students. The Outreach
Worker and Program Managers will collect initial eligibility documentation. This
documentation will be forwarded to the appropriate Santa Ana W/O/R/K Center
staff.
l0
Intake/Assessment
After the Outreach Worker has identified potential participants, eligibility will be
established. After eligibility is determined, staff will create a file for each
participant. The file will hold up-to-date and relevant participant information such
as the program enrollment form, TABE testing results (to determine Basic Skill
levels), eligibility documentation, and a copy of the students completed Career
Prep work (application, r~sum~, goal setting forms). In addition, pre-and post-
assessments (determining pre-employment skills) will be in all participant files.
The pre-employment skills test will help determine the youths need for job
readiness training. Program managers will inform santa Aha W/O/R/K Center
staff as to the assessment results for each participant.
Case Management
The Santa Ana W/O/PJK Center will have the responsibility of assigning youth to
a Case Manager. Career Prep Program Managers will provide appointment
reminders to participants on a needed basis. Career Prep Program Managers
will be available to assist case managers in determining appropriate program
goals for the participants and will conduct weekly phone contact with each
participant. All information acquired over the phone will be shared with the
participant's Case Manager. In addition, W/O/PJK Center Case Manager's will
be invited to meet with program participants at the Boys & Girls Club facility.
Case Managers will also be invited to attend participant graduation celebrations
and other appropriate program related events.
t!
Program Services/Parent Involvement
The Career Prep program will provide WIA element #3 (summer employment
opportunities), #~4 (paid and unpaid work experiences), and #6 (leadership
development oppor[unities) to l~in-school youth ages 14-18. The Career Prep
program managers will conduct a basic skill (TABE) and pre-employment (Pre-
Test) skills assessment test and a post-assessment after successful completion
of program. After the appropriate Santa Ana W/O/PJK Center staff has finalized
the eligibility process of each participant, Career Prep program services will be
implemented. Program services will include the following: ~ youth between the
ages of 16-18 will complete Job Ready and Career Launch pre-employment
training, at least ~l~"youth between the ages of 14-15 will complete the Career
Explorers Club program,.20'youth will participate in summer employment for ten
weeks,.,~'~outh will complete a five week unpaid work experience, and L~youth
will complete Office Smart training. In addition, all eligible program participants
will be encouraged to take part in the ClubService (Americorps) program that
awards youth money for college in exchange for volunteer service.
In order to ensure parent involvement in the program, parents of the participants
will be invited to attend the Career Prep orientation and will be required to sign a
program permission slip. Parents will also be invited to attend their child's
graduation celebration.
Placement in Jobs or Continuing Education
The Career Prep program will secure unpaid work experience for,~,~'in-school
youth ages 14-18. Their successful completion of this work experience will result
in a $250 stipend. ~ youth who successfully complete Office Smart will also
10
receive $250 stipend award. In addition, the program will provide ~'youth with
paid summer employment opportunities at the Boys & Girls Club of Santa Ana.
After youth have participated in the Career Prep program, they will have the
knowledge and the tools to be successful in an entry-level position. The Career
Prep program will educate WIA participants on the importance of setting short
term and long-term educational and occupational goals.
Follow-up
At the completion of program services, all ~youth will fill out a customer
satisfactory survey that will be provided to the Santa Aha W/O/PJK Center. The
survey will give appropriate feedback on how program services have positively
affected the participant or how services may need to improve.
Staff Plan
Staff needs for the program include (2) .9 FTE Program Managers to provide the
Job Ready/Career Launch and Career Explorers Club program elements.
These staff will also oversee the summer employment and unpaid work
experiences components. In addition, a .5 FTE will coordinate the program's
outreach efforts. A .25 FTE will facilitate elements of the Office Smart program
component and will assist with the Career Launch component. 1 FTE (for 14
weeks) will coordinate the efforts of the summer employment component. In
addition, a part-time van driver will coordinate the transportation needs of
participants. The Assistant Executive Director at .3 FTE will oversee and
coordinate the efforts of the overall WIA program and directly supervise program
staff.
Facilities
From where will program services be delivered?
Services will be delivered at the Boys & Girls Club of Santa Ana, area high
schools and middle schools, and alternative schools.
How has the organization assured that the location is a safe and youth
friendly environment?
In order to assure safety, the Boys & Girls Club requires that all youth who enter
the facility first tour the clubhouse and are oriented to' Club rules. It will be
necessary for all youth to join the club by filling out a membership application
(signed by a legal guardian) and carry a valid club membership card. This card
is used to keep accurate daily attendance records as well as ensure all youth
who enter belong in the facility. In addition club staff, parents of club members
and guests of the club are the only adults who may enter the club. All guests and
parents are required to sign in and wear a visitors tag identifying them.
The Club is well staffed to ensure safety. Currently eight full-time, professional
staff provide programs and security at the club. 10 additional part-time staff and
20 college-age volunteers from the University of California at Irvine assist them.
In addition, the Club will provide transportation to the facility so that participants
may avoid the dangers of walking in unfamiliar, potentially dangerous
neighborhoods.
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EXHIBIT B
STATEMENT OF WORK
Scope of Work. City hereby engages contractor as an independent contractor to
perform the following described work, and contractor hereby agrees to perform
said work upon the terms and conditions here-in-after set forth.
A. Specifically, contractor shall perform the following services:
Contractor shall assess each participant using a standardized
assessment tool within thirty (30) days of enrollment. If
assessment supports a Basic Skills deficiency, reading and math
must be the first service to be delivered to participant.
Contractor shall identify through prescribed assessment which of
the ten elements as noted below will be prescribed for each
participant. Chosen elements will be noted in each participant's
Individual Service Strategy (ISS). Services needed but not
provided by Contractor must be coordinated with the Service
Navigator and other youth partners.
The ten elements are:
Tutoring, study skills and instruction leading to completion of
secondary school, including dropout prevention strategies.
Alternative secondary school services, as appropriate.
Summer employment opportunities directly linked to
academic and occupational learning.
Paid and unpaid work experiences including OJT, job
shadowing and internships as appropriate.
Occupational skills training as appropriate.
Leadership development opportunities, which may include
community service and peer-centered activities encouraging
responsibility and other positive social behaviors during non-
school hours as appropriate.
Supportive services
Adult mentoring for the period of participation and
subsequent period, for a total of not less than 12 months.
Follow-up services for not less than 12 months after the
completion of participation.
Comprehensive guidance and counseling, which may
include pregnancy prevention, drug and alcohol abuse,
counseling and referrals, as appropriate.
Contractor shall establish at least one goal for each participant as
related to the elements identified in their ISS, If the participant is
deficient in basic reading and/or math skills, one primary goal must
be for basic skills and must be the first service provided. Goals are
to be based on appropriate age standards and entered in
participant's ISS.
Contractor shall provide an enrollment orientation for each
participant which at the minimum includes the following information:
Program goals and objectives
Length of program period
Complaint handling procedures
Available supportive services
Anticipated exit date
Hands-on orientation at the Santa Aha WORK Center
Participant orientation shall be documented and placed in
participant's file. An orientation of the Santa Aha W/O/R/K Center
will also be provided,
Contractor shall provide participant services in accordance with the
program schedule and curriculum attached hereto as the program
narrative (Exhibit A). Neither the program schedule nor curriculum
may be altered in any way during the term of this agreement,
without prior written approval given to contractor by the Santa Aha
Workforce Investment Board 0NIB).
Contractor shall maintain daily, weekly, and monthly classroom and
internship training time and attendance records for all participants.
Copies of attendance records shall be placed in participant's file
upon completion of program.
Contractor shall maintain individualized counseling records and
shall make these records available for review and inspection upon
request by City staff. All such records shall remain otherwise
confidential and shall be kept in a form approved by City.
Contractor shall maintain and share with other Youth partners the
Individual Service Strategy (ISS) for each participant from time of
enrollment through and including twelve (12) months after he/she is
exited from the program.
Full completion of the program and its elements shall be defined as
and determined by individual participant attainment of the learning
objectives and demonstrated achievement of the standards for
evaluation listed in the training curriculum verified and approved by
the Santa Ana WIB.
10.
Contractor shall provide each participant who attains full completion
of the program with a certificate of completion. Such certificate
shall serve as contractor's assurance to the City that the recipient
of said certificate has satisfied the conditions of full completion as
set forth in conditions identified in paragraph 5 above.
11.
Contractor shall, upon request by City or in accordance with
schedules and/or procedures stipulated by City staff at the outset of
the program, transmit to City reports and/or forms containing all
appropriate data and any other pertinent information available on
each participant and program operations in general.
12.
Contractor shall report on progress of program to Youth Council on
a regular basis as determined by contractor and City staff.
13.
Contractor shall follow and abide by the proposal submitted and
approved by the Santa Ana Workforce Investment Board. Any
changes to the proposal must be submitted in writing to the Santa
Ana WlB for consideration.
Exhibit C
COMPLAINT HANDLING
UNDER THE
WORKFORCE INVESTMENT ACT
SANTA ANA
WIA
Santa Ana Local Workforce Investment Area
July 1, 2001
Table of Contents
I. Information Regarding Complaints ............................................................................................ 2
A. Nondiscrimination and Equal Opportunity Complaints .......................................................... 2
1. Policy Statement ................................................................................................................ 2
2. Civil Rights ......................................................................................................................... 3
3. Nondiscrimination Laws underWlA ........................................................................ i .......... 4
4, Howto File Your Complaint ............................................................................................... 5
B. Criminal Complaints .............................................................................................................. 6
II. General Procedures for Handling Non-Criminal Violations of the Act ....................................... 6
III. Procedures for Handling Complaints at the SDA Level ............................................................. 8
IV. Procedures for Handling Complaints at the State Level .......................................................... 13
V. Procedures for Handling Discrimination Complaints by Participants ....................................... 15
VI. Procedures for Handling Handicap Complaints by Participants .............................................. 16
GLOSSARY OF WlA TERMS ........................................................................................................ 18
Information Regarding Complaints
A. Nondiscrimination and Equal Opportunity Complaints
1, Policy Statement
In carrying out the purpose of the Workforce Investment Act (WlA), the City of
Santa Aha Local Workforce Investment Area (LWIA) will establish programs to
prepare youth and unskilled adults for entry into the labor force and to afford
job training to those individuals facing serious barriers to employment. Every
effort will be made to provide services necessary for eligible individuals to
obtain productive employment,
In implementing WIA, all contractors in the Santa Ana LWIA will foster equal
opportunity and non-discrimination, as provided in State and Federal equal
opportunity and non-discrimination laws including, but not limited to:
· Title VI of the Civil Rights Act of 1964
· Title VII of the Civil Rights Act of 1964
· The Age Discrimination Act of 1975, as amended
· Section 503 of the Rehabilitation Act of 1973
· Section 504 of the Rehabilitation Act of 1973
· Title IX of the Education Amendments of 1972
· Section 186 of the Workforce Investment Act of 1998
In keeping with our commitment, no individual shall be excluded from
participation in, denied benefits of, subjected to discrimination under, or denied
employment, in the administration or of in connection with any WIA funded
program because of race, color, religion, sex, national origin, age, handicap, or
political affiliation or belief.
Participation in programs and activities financially assisted in whole or in part
under WIA shall be open to citizens and nationals of the United States, lawfully
admitted permanent resident aliens, lawfully admitted refugee, parolees, and
other individuals authorized by the Attorney General to work in the United
States.
No individual will be intimidated, threatened, coerced, or discriminated against
because of filing a complaint, furnishing information, or assisting or
participating in any manner in an investigation, compliance review, hearing, or
any other activity related to the administration of WIA.
2
Administration responsibility for this Equal Opportunity/Affirmative Action
(EO/AA) Program is delegated to the Equal Employment Opportunity (EEO)
Officer for the Santa Ana Local Workforce Investment Area. Equal opportunity
and non-discrimination, however, will only be achieved through leadership and
implementation of a viable Affirmative Action Equal Opportunity Program.
Patricia Nunn, Executive Director
Santa Ana Local Workforce investment Area
Civil Rights
No one applying for or enrolled in the Workforce investment Act (WIA).
Programs may be discriminated against because of race, color, creed,
handicap, national origin, sex, age, political affiliation, or beliefs.
This means that - for any of the characteristics listed above:
You may not be denied the opportunity to enroll in WIA.
No benefits or services may be denied you for diScriminatory
reasons.
You may not be segregated or treated any differently from other
applicants or participants, while you are being registered,
interviewed, counseled or tested; or while you are working or
attending classes as part of the program.
You must be provided an equal chance to use all facilities
available in the program.
Fair employment practices must be provided to all staff with
regard to recruiting, hiring, transferring, promotions, training,
compensation, benefits, layoff, and termination.
You have the right to make a complaint if you feel you have been denied any
of the above opportunities. You cannot in any way be penalized for filing a
complaint. Your WlA sponsor has established a mechanism for handling
complaints or grievances. Your complaint must be filed within 180 days. All
complaints will be handled confidentially.
3
o
Nondiscrimination Laws under WIA
Title VI of the Civil Riqhts Act of 1964
Prohibits discrimination on the basis of race, color, national origin, or
religion.
The Age Discrimination Act of 1975
Prohibits arbitrary discrimination against persons age 40-70.
The Rehabilitation Act of f 1973
Prohibits discrimination based on handicap.
Title IX of the Education Amendments of 1972
Prohibits discrimination in any education or training program or activity
receiving federal financial assistance.
OTHER CIVIL RIGHTS LAWS:
Title VII of the Civil Ri,qhts Act of 1964
Prohibits discrimination in employment based on race, color, religion,
sex, or national origin in all terms and conditions of employment and
establishes the Equal Employment Opportunity Commission as the
administrative agency.
White House Executive Order No. 11246 as Amended by Executive
Order No. 11375
Creates the office of Federal Contract Compliance and prohibits
discrimination based on race, color, sex, religion, or national origin.
Department of Labor Secretary's Order no. 4-73
Prohibits discrimination based on sex.
Equal Pay Act of 1963
Prohibits pay differential solely because of sex.
4
Emergency Employment Act of 1971
Prohibits discrimination based on race, creed, national origin, political
affiliation, or beliefs.
How to File Your Complaint
do
Put your complaint in wdting.
Have it sworn to before a notary public, if possible.
Provides details that tell what happened, where it happened, and when
it happened.
Give the name and addresses of all persons who were present or who
had anything to do with the matter.
...Complaints on the basis of race, color, or national origin, age, sex,
religion, political affiliation or belief, retaliation and citizenship, must be
filed within 180 days of the alleged occurrence directly with:
Director
Civil Rights Center
U.S. Department of Labor, Room N-4123
200 Constitution Ave., NW
Washington, D.C. 20210
Complaints on the basis of handicap must be filed within 180 days of
the alleged occurrence. These complaints must be filed directly with
the WlA administrative entity. The WlA administrative entity shall issue
a written decision within 30 days of the filing of the complaint. If the
complaint is still unresolved, an appeal may be made to the Chief of
State Workforce Investment Division Office.
The Department of Labor, the Civil Service Commission, the Equal
Employment Opportunity Commission, and many other offices and agencies
are committed to assuring equal employment opportunities for all persons.
They will protect you.
A case may be taken to court if the other processes do not yield satisfactory
results.
You may hire your own lawyer, or if you cannot afford one, the court may
appoint one for you.
5
It is unlawful for an employer, union, or employment agency to punish you or
any witness for attempting to present the facts in a case.
YOUR CIVIL RIGHTS UNDER THE
WORKFORCE INVESTMENT ACT
Santa Ana Local Workforce Investment Area
1000 E. Santa Ana Blvd., Suite 200
Santa Ana, CA 92701
(714) 565-2600
II.
B. Criminal Complaints
In accordance with the WIA (P.L. 105-200) and the implementing code of Federal
section 667.600 .... Federal handling of criminal complaints and report of fraud, abuse
and other criminal activity. "All information and complaints involving fraud, abuse or
other criminal activity shall be reported directly and immediately to the City of Santa
Ana and the Secretary of Labor."
General Procedures for Handling Non-Criminal Violations of the Act
The following procedure is promulgated to meet the requirements of Title 20, of the Code of
Federal Regulations, Section 667.600 through 667.640 of the WIA regulations, and Section
181(c) of the Act (Public Law 105.200:29 U.S. Code Sec. 2931 et seq.) at the State and
LWIA level for the receipt, investigation, hearing, and resolution of complaints by WIA
participants, subrecipients, applicants for participation, or financial assistance, labor unions,
community based organizations, or any other persons.
These procedures provide for resolution of non-criminal complaints arising from the
operation of the Santa Aha LWlA.
A complaint is defined here as a written expression by a party alleging a violation of the
Act, regulations promulgated under the Act, recipient grants, subagreements, or other
specific agreements under the Act, including terms and conditions of employment of such
participants in employment training programs. All complaints, amendments and
withdrawals shall be in writing. These procedures are intended to resolve matters which
concern policies, procedures or action(s) arising in connection with WIA programs operated
by each LWlA grant recipient and subrecipient under the Act.
These procedures shall not be construed as affecting any other available legal remedy
outside of the WlA complaint process (i.e., disputes regarding terms and conditions of
employment of any employee who is not a participant), either separately or simultaneously,
that a person may wish to pursue in the resolution of a non~WIA complaint. Also, these
procedures do not restrict the LWlA grant recipient staff in carrying out informal discussion
6
procedures do not restrict the LWIA grant recipient staff in carrying out informal discussion
and resolution of any problems outside of and without resort to the formal complaint
procedure,
The following principles and rules apply to all complaints at all steps of the complaint
procedures:
All complaints must be made in writing within 180 days of the alleged
occurrence, except complaints alleging fraud or criminal activity.
All persons filing a complaint shall be free from restraint, coercion, reprisal, or
discrimination. Good faith efforts shall be made to informally resolve the
complaint prior to the scheduled hearing. Complainants have the right to
withdraw their complaints (in writing) at any time prior to the hearing. A
complainant may amend his/her complaint to correct technical deficiencies but
not to add issues.
Complainants shall have the right to be represented at their own expense by
person(s) of their choosing at all levels of the complaint process.
Upon enrollment into employment or training, participants shall be provided
with a written description of these procedures, including notification of their
right to file complaints and instructions for filing.
An employer of participants, including private-for-profit employers of
participants, may use this or other complaint resolution procedures so long as
the participant is informed of the complaint resolution procedure they are to
follow and the time frames governing review of complaints are met.
A "participant", within the meaning of these procedures, is an individual who
receives employment-training services under a program funded by Santa Ana
LWIA. The Complaint Resolution Procedures contained herein (or the
alternative procedures which an employer may use) shall be available to
participants to resolve disputes regarding items and conditions of employment
of such participants in employment training programs. However, such
procedures shall not be used to resolve disputes regarding terms and
conditions of employment of any employee who is not a participant, as defined
herein.
If a complaint does not receive a decision at the LWIA grant recipient level
within 60 days of filing the complaint or receives an unsatisfactory decision,
the complainant then has a right to request a review of the complaint by the
Governor,
7
Complainants must initially file and exhaust LWIA grant recipient/hearing
procedures prior to appealing to the State except where the State determines
that the LWIA grant recipient's procedures are not in compliance with the
State's procedures.
III.
Procedures for Handling Complaints at the LWIA Level
A. Receipt of Complaints
Pursuant to the WIA regulations found at 20 CFR, Section 667.600, the LWIA
administrative entities have the responsibility to conduct hearings and resolve
complaints made by individuals about the administration of programs in the LWIA.
"LWIA level" encompasses LWIA administrative entity and employers to which the
administrative entity has delegated the complaint resolution process. The following
comprise the guidelines for resolving issues arising in connection with WIA programs
operated by the Santa Ana LWIA including resolutions of complaints arising from
actions, such as audit disallowances or the imposition of sanctions taken by the
Governor with respect to audit findings, investigations or monitoring reports.
1. Form and Filing of Complaint
Official filing date of the complaint is the date the written complaint is received.
The filing of the complaint with the Santa Ana LWIA Equal Employment
Opportunity Officer shall be considered as a request for hearing and a
decision must be issued within 60 days. The complaint must be in writing and
must be signed and dated. The complaint should also contain the following
information:
Full name, telephone number, if any, and mailing address of the
complainant;
Full name, telephone number, and mailing address of the agency
involved (respondent);
Clear and concise statement of facts including dates constituting
alleged violation;
What provisions under the Act, regulations, grant or other agreements
under the Act, are believed to have been violated;
Remedy sought by the complainant; and
If the complainant is a private or public entity or corporation, and not a
natural person, the filing of the complaint must be duly authorized by
the governing body of such entity or corporation.
8
o
The absence of any of the requested information shall not be a basis for
dismissing the complaint.
A copy of the complaint must be sent to the respondent and both parties
notified of the opportunity for an informal resolution. At each step of the
complaint process, the complainant must be notified in writing of the next
procedural step.
Informal Conference
Informal conferences will be utilized by the Santa Ana LWlA to resolve
complaints; however, such informal conferences shall not extend the time
within which a decision must be issued after receipt of a complaint. Attempts
at informal resolution will commence with two (2) weeks of the date of filing of
the complaint.
The EEO Officer will review the case and ascertain facts prior to the
conference so that appropriate resolution can take place at the time of
this meeting whenever possible.
bo
Although the compiaintant should be encouraged to attend this
conference, his/her failure to do so should not preclude his/her right to
request a hearing on the matter.
Co
If mutually satisfactory resolution results and the Santa Ana LWIA
concurs, the EEO Officer will write a brief report for the file stating the
issues and resolution. The matter shall then be considered closed.
do
If resolution does not result, the complainant shall be provided the
necessary information and assistance to request a hearing if he/she so
desires.
Request for Hearing
As in the case of the complaint, the request for a hearing should be put
in writing and be filed in person or by mail. A governing board
resolution of authorization to appeal should also be submitted when
appropriate. The request should be filed with:
Lydia H. Morgan
EEO Officer
Santa Ana Local Workforce investment Area
1000 E. Santa Ana Blvd., Suite 200
Santa Aha, CA 92701
9
A hearing will be scheduled by the EEO Officer within thirty (30) days of
the date of filing of the complaint.
4. Notice of Hearing
Upon receipt of the request for hearing, the complainant and the respondent
will be notified in writing of the hearing ten (10) calendar days prior to the date
of the hearing. The ten-day notice may be shortened with the written consent
of the parties. A decision will be issued by the Santa Ana LWlA within sixty
(60) days of the date of filing of the complaint.
The hearing notice shall be in writing and contain the following information:
The date of notice, name of the complainant, and the name of the party
against whom the complaint is filed.
The date, time, and place of hearing before an impartial hearing officer.
A statement(s) of the alleged violation(s)
Advise as to where information or assistance may be obtained, and the
name, address, and telephone number of the Santa Aha LWlA Equal
Employment Opportunities (EEO) Officer who can answer inquiries.
Conduct of Hearing
The headng shall be conducted in an informal manner with strict rules of evidence
not applicable. Unnecessary technicalities should be avoided. It should provide the
flexibility to enable adjustment to the circumstances presented.
The hearing officer shall have complete independence to obtain facts and
make decisions. The hearing officer shall be in a position to render impartial
decisions and thus should not be subordinate to the Santa Aha LWlA or its
subrecipients. The hearing officer will be selected from a list of names on file
with the EEO Officer.
Full regard must be given to the requirements of due process to insure a fair
and impartial hearing.
The hearing office designated by the EEO Officer to function in a quasi-judicial
capacity should begin the hearing by summarizing the record and the issue
and should explain the manner in which the hearing will be conducted, making
sure that everyone involved understands the proceedings. Such explanations
should be adapted to the needs of the specific situation. The hearing officer
might take testimony under oath or affirmation to give some assurance of
veracity to the hearing.
10
The burden of proof should be reasonable and flexible, dependent upon the
circumstances of the case involved. The hearing officer determines the order
of proof. Generally, the party making the complaint has the obligation of
establishing his or her case and should be examined first.
The party involved should have the right to be represented (at their own
expense) if he/he so desires. Other he/she is limited to his/her own abilities
and those of the hearing officer in obtaining testimony in the case.
It is important that the hearing officer obtain the fullest information for the
record. If the parties involved, or their representatives, do not know how to
ask the right or pertinent questions in pursuing their right to due process, it
shall be necessary for the hearing officer to step in to have all the materials
and relevant facts elicited.
The practice in informal hearings is generally not to apply strict rules of
evidence in obtaining facts. However, the quantity of evidence required to
support a decision on an issue should be sufficiently credible that the state (or
other appropriate agency), upon reviewing the decision, would conclude that
the decision is supported by substantial evidence.
The hearing officer should attempt to negotiate a resolution of the issue at any
time prior to the conclusion of the hearing.
Within ten (10) days of the conclusion of the hearing, the hearing officer will
issue a recommended decision to the LWlA for final determination. The
recommended decision shall be in writing and may be accepted, rejected or
modified by the Santa Ana Workfome Investment Board.
Issuance of Decision
Within sixty (60) calendar days of filing of the complaint, the Santa Ana LWIA shall
issue a written decision to all parties by first class mail. The final decision shall
contain the following information:
2.
3.
4.
5.
6.
The name of the parties involved.
A statement of the alleged violation and issues related to the alleged violation.
A statement of the facts.
The decision and the reasons for the decision.
A statement of corrective action, if any, to be taken.
Notice of the right to request, within ten (10) calendar days of receipt of the
decision, a review of the decision by the State Review Panel.
11
Record of Hearing
An administrative file containing support documents on the complaint resolution
process hearing conducted will be retained by the Santa Ana LWIA. The purpose of
a record is to serve as substantiation of the process followed by the Santa Aha LWIA
on the resolution of the issues and the results. This information would then be
available for subsequent review in the event the matter is raised with the State. Such
records must be retained for a three-year period after the grant has been officially
closed out.
The Santa Ana LWlA's written decision will be included in the record. Evidence
received at the hearing, notes by the hearing officer, stenographer's notes and tape
recordings may also be used.
EJ
Establishment of Complaint Procedures
in accordance with Section 667.600, each employing agency including private-for-
profit employers of participants under the Act is required to establish a complaint
procedure for resolving matters relating to the terms and conditions of employment.
Employers may operate their own grievance system or may utilize the Santa Ana
LWlA's established procedures under Section 667.600. At a minimum these
procedures must include:
Written notice, upon enrollment into employment training services, of the scope
and availability of such procedures. Employer's grievance procedures shall be
set forth in a written document and must meet the regulation mandate that a
complaint will be resolved with sixty (60) days from the date the complaint was
filed. A copy of employer's grievance procedure shall be provided to each
participant upon enrollment in employment training.
2. Written notice, at the time the grievance is filed, of the procedures under which
the grievance will be processed.
Written notification of the disposition of the grievance and a written decision shall
be issued within thirty (30) days of the filing of the grievance unless a present and
long established grievance specifically provides other limits; and
=
Written notification of the participant's right to request a review of the employer's
decision by the Santa Aha LWIA and the State Review Panel in accordance with
Section 667.600.
12
IV. Procedures for Handling Complaints at the State Level
Section 181(c) of the Act and the WIA regulations at 20 CFR, Section 667.600(d) requires
the Governor to establish a State Review process of complaints filed at the LWIA grant
recipient level and of complaints initially filed at the State level.
Appeals of decisions issued at the LWIA level including audit disallowances and sanctions
shall be reviewed by the State Review Panel. The State Review Panel shall review the
record established at the LWlA level and shall issue a decision based on the information
contained therein.
Complaints which may be initially filed at the State level will be heard by an independent
hearing officer designated by the State Workforce Investment Division (WiD). The hearing
officer shall conduct a hearing and issue a recommended decision to the State Panel. The
recommended decision shall be in writing and may be accepted, rejected or modified by the
State Review Panel.
Form and Filing of Complaint.
1. Request for State Review of LWIA Level Decisions
On receipt of a complainant's request for review because of an unsatisfactory
decision, the State shall provide for an independent state review.
Filing of Requests for State Review
The State Review Panel shall review all LWIA level decisions when a request
for review is filed within 10 days of receipt of the adverse decision. Such
requests must be filed in writing with the Chief of the WID Office. The request
for review should contain the following information:
a. Full name, address, telephone number of the party requesting the
review
b. Full name, address, telephone number of the other party
c. A copy of the decision
d. Brief statement of reasons for review or the section of the LWlA
decision to be reviewed including regulatory and statutory citations
e. A statement of the relief sought.
13
Complaintant Responsibility
It is the responsibility of the complainant to include in the request for review a
written statement setting forth the facts presented at the LWIA hearing which
support the requested relief.
The Chief, WID, shall mail a copy of the request for review to the other party
and to the LWIA. It shall be the responsibility of the LWIA to submit the
complete record including a typed record of the hearing to the Chief, WID,
within ten (10) days.
Conduct of Hearings.
1. Request for Hearing at the State Level
If no decision has been issued at the LWIA level or the State has determined
an audit disallowance or imposed sanctions, the complainant may request a
hearing. The hearing officer will then issue a recommended decision to the
State's Review Panel for final determination.
2. Filing for Request for Review
The request for a State hearing shall be filed within ten (10) days after LWIA
should have issued a decision or ten (10) days after the issuance of the audit
disallowance or sanction. The request shall be filed directly with the Chief of
the WID in writing and should include the following:
Full name, address, and telephone number of the party requesting the
review
Name, address, and telephone number of the LWIA
Copies of complaints made at LWIA level from which no decisions were
issued or sanctions imposed
A statement of basis for the request for hearing.
3. Evidentiary Hearing
Upon receipt of the request for a State level headng, a hearing before a
designated hearing officer will be scheduled.
14
The hearing will be recorded mechanically or by court reporter.
Both parties concerned will have the opportunity to present oral and written testimony
under oath, to call and question witnesses in support of his/her position, to present
oral and/or written arguments, to examine records and documents relevant to the
issue(s), and to be represented.
The hearing officer shall issue a written decision, which shall be forwarded to the
State Review Panel for final determination.
The State Review Panel may accept, reject or modify this recommendation. The
decision of the State Review Panel is final except for audit disallowances, which must
be approved by the Secretary of Labor.
C. State Review Panel
The State Review Panel will consist of a panel of three representatives from the
Employment Development Department: one from the Legal Offices, one from the
WID, and one from the Director's office. The panel will issue a written decision,
which will be sent to the appropriate parties within thirty (30) days of receipt of the
request for State review.
Decisions issued by this panel, under the authority of the Governor, are final.
D. Issuance of State Review Decision.
The State review will be limited to violations of the WIA, implementing WIA
regulations or the grant agreement. This review shall be limited to the record
established at the LWIA hearing.
V. Procedures for Handling Discrimination Complaints by Participants
Complaints on the basis of race, color, or national origin, age, sex, religion, political
affiliation or belief, retaliation, and citizenship, where appropriate, must be filed within
180 days of the alleged occurrence.
it is the responsibility of the Santa Ana LWlA's Equal Employment Opportunity
(EEO) Officer to determine jurisdiction and to make the complainant aware of
and provide assistance in filing a complaint in accordance with the Santa Ana
LWIA's procedure under Section II (A).
15
No later than 180
days of alleged __
discrimination
Within 10 days of
receipt of
unsatisfactory
decision or 10 days
from date L WIA
decision should have
been issued
Handling of complaints filed at LWIA level arising in
connection with WlA programs operated by LWlAs
Informal Resolution Process
Filing of Complaint / Request for Hearing
Notice of Hearing issued by LWIA
Heating Conducted
LWlA Decision within 60 days
Unsatisfactory Decision or LWIA Decision not
issued within 60 days
Request for State Review
Governor's Decision issued by State Review
Panel
If no decision issued by State Review Panel
Appeal to DOL
In cases where areas of authority overlap, it is the responsibility of the EEO
Officer to advise the complainant of the existence of State, Federal and other
proper action agencies, which may also have a bearing.
Complainants alleging discrimination under this part will be made aware of
their right to file directly with the Office of Civil Rights (OCR), U.S. Department
of Labor and applicable procedures.
Complainants must file their complaint directly with:
Lydia H. Morgan
EEO Officer
Santa Ana Local Workforce Investment Area
1000 E. Santa Ana Blvd., Suite 200
Santa Ana, Ca 92701
VI. Procedures for Handling Handicap Complaints by Participants
Complaints alleging discrimination on the basis of handicap will be filed and processed
under the Department of Labor regulations implementing Section 504 of the Rehabilitation
Act of 1973 at 29 Code of Federal Regulations Section 32.
Complaints must exhaust the Santa Ana LWIA's informal resolution
procedures before filing their complaint with OCR.
Complainants will be made aware of the 180 days requirement in which to file
his/her complaint.
A. Procedures at the LWIA Level
The complainant shall file his/her complaint directly with the Santa Ana LWIA.
Upon receipt of the complaint, the EEO Officer shall investigate and gather
information concerning the complaint.
An informal conference will be held with the parties concerned in an effort to
resolve the issue(s), The complainant has the right to be present and may be
represented during the conference.
The Santa Aha LWlA shall issue in writing its decision to the complainant no
later than thirty (30) days after the filing of the complaint.
16
Procedures at the State Level
The complainant may appeal to the State if he/she is not satisfied with the
decision of the Santa Ana LWIA.
The Complainant must file his/her appeal as a request for review directly with
the Chief WlD within ten (10) calendar days after the receipt of the Santa Ana
LWIA's decision.
The Chief-WiD, shall issue a decision no later than thirty (30) calendar days
after receipt of the request for review.
After the complainant has received a decision or no decision has been.
received from the Director of Employment Development Department (on
behalf of the Governor), the complainant has the right to appeal his/her
complaint within thirty (30) calendar days to the Office of Civil Rights (OCR)
with the Department of Labor.
No later than 180
days of alleged __
discrimination
Filing of complaint on the basis
Of Handicap with LWIA
[ Informal Resolution ]
If no resolution reached
Request for Heating ]
[ Notice of Hearing ]
[ Hearing Conducted ]
LWIA Decision
Unsatisfactory Decision or No Decision
State Review
Governor's Decision
Appeal to Assistant Secretary
Department of Labor
Day 1
Day/45 Day
Filed within 30
days of
L WfA/State
Decision or 90
days from date of
initial filing of
complaints
60 Days
GLOSSARY OF WIA TERMS
AGE DISCRIMINATION ACT - A law passed by Congress in 1975 which prohibits discrimination
on the basis of age by any program or activity receiving Federal funds.
APPLICANT - An individual who applies to a subrecipient or contract for services provided under
WIA and who has no yet transitioned to the status of participant.
ASSESSMENT - Services designed to determine each participant's employability, aptitudes,
abilities and interests and to develop a plan to achieve the participant's employment and related
goals; also to identify the available employment and training activities appropriate for the
participant. Testing and counseling may also be used during the assessment process.
CHARGING PARTY (CP), COMPLAINANT, GRIEVANT, OR AGGRIEVED PERSON - The
person who charges that he/she has been discriminated against under Department of Justice
nondiscrimination and civil rights regulations and/or guidelines.
DISCRIMINATION - In general, a failure to treat all equally, whether intentional or unintentional;
the effect of an action, policy or practice which selects an individual or class of persons to receive
unequal treatment.
ELIGIBLE NON-CITIZEN - Lawfully admitted permanent resident, aliens, lawfully admitted
refugees, and parolees and other individuals authorized by the Attorney General to work in the
United States.
EMPLOYER - An employer subject to the provisions of the Civil Rights Act of 1964, as amended,
including state and local governments and any Federal agency subject to the provisions of Section
717 of the Civil Rights Act, as amended; and any Federal contractor or subcontractor covered by
Executive Order 11246, as amended.
GRIEVANCE - An allegation that something imposes an illegal obligation or burden or denies
some equitable or legal right, or causes injustice.
HANDICAPPED INDIVIDUAL ~ Any individual who has a physical or mental disability that
constitutes or results in a substantial handicap to employment.
18
INTAKE - Includes screening to determine eligibility; to select from eligible applicants those
individuals who are most in need and can benefit from program services; to complete procedural
requirements necessary to enroll an individual into the program and to refer those not enrolled to
other programs.
JOINT COMPLAINT - A complaint of employment discrimination covered by Title VII or the Equal
Pay Act and by Title VI or Title IX. Individual "joint complaints" are normally investigated by EEOC
unless OCR has a compelling reason to investigate. "Joint complaints" alleging discrimination in
employment and other practices and pattern or practice "joint complaints" are normally investigated
by OCR.
JURISDICTION - Authority to investigate and resolve complaints against an institution subject to a
law or statute which has been assigned to OCR for enforcement, i.e., Title VI, Title I×, etc.
PARTICIPANT - Any applicant who has: (1) Been determined eligible for participation upon intake;
and (2) Who is receiving subsidized employment, training or services (except post-termination
services) funded under the Act, following intake, except for an individual who receives only
outreach and/or intake and assessment services.
19
EXHIBIT D
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 an agency, a Member of Congress, an pfficer or
employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any Federal contracts, the making of an~/
Federal grant, the making of any Federal loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal,
amendment or modification of any Federal contract, grant, loan or
cooperative agreement.
2)
If any funds other than Federal appropriated funds have been paid or will be
paid to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in connection with this
Federal contract, grant, loan or cooperative agreement, the undersigned shall
complete and submit Standard 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
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
31 U.S.C. 1352. 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 that $100,000 for
each such failure.
Boys & Girls Club of Santa Ana
Grantee/Contractor Organization
WIA Youth
'Na me ,9~rt~fyin~gn atu re
~hn~rewster, Executive Director
EXHIBIT E
Certification Reqardinq Drug-Free Workplace Requirements
The certification set out below is a material representation upon which reliance is placed by the
U.S. Department of Housing and Urban Development in awarding the grant. If it is later
determined that the contractor knowingly rendered a false certification, or otherwise violates the
requirements of the Drug-Free Workplace Act, the U.S. Department of Housing and Urban
Development, in addition to any other remedies available to the Federal Government, may take
action authorized under the Drug-Free Workplace Act.
CERTIFICATION
A. The contractor certifies that it will provide a drug-free workplace by:
(a)
Publishing a statement notifying employees that the unlawful manufacture,
distribution, dispensing, possession or use of a controlled substance is prohibited
in the contractor's workplace and specifying the actions that will be taken against
employees for violation of such prohibition;
(b) Establishing a drug-free awareness program to inform employees about -
(1)
(2)
(3)
(4)
The dangers of drug abuse in the workplace;
The contractor's policy of maintaining a drug-free workplace;
Any available drug counseling, rehabilitation, and employee assistance
program; and
the penalties that may be imposed upon employees for drug abuse
violations occurring in the workplace;
(c)
Making it a requirement that each employee who will be engaged in the
performance of the grant be given a copy of the statement required by paragraph
(a);
(d)
Notifying the employee in the statement required by paragraph (a) that, as a
condition of employment under the contract, the employee will -
(1)
(2)
Abide by the terms of the statement; and
Notify the employer of any criminal drug statute conviction for a violation
occurring in the workplace no later than five days after such conviction.
(e)
Notifying the U.S. Department of Housing and Urban Development within ten days
after receiving notice under subparagraph (d)(2) from an employee or otherwise
receiving actual notice of such conviction;
Pg. 2
(f)
Taking one of the following actions, within 30 days of receiving notice under
subparagraph (d)(2), with respect to any employee who is so convicted -
(1)
(2)
Taking appropriate personnel action against such an employee, up to and
including termination; or
Requiring such employee 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;
(g)
Making a good faith effort to continue to maintain a drug-free workplace through
implementation of paragraphs (a), (b)~ (c), (d), (e) and (f).
The contractor shall insert in the space provided on the attached "Place of Performance"
form the site(s) for the performance of work to be carried out with the grant funds
(including street address, city, county, state, and zip code), the contractor further
certifies that, if it is subsequently determined that additional sites will be used for the
performance of work under the contract, it shall notify the U.S. Department of Housing
and Urban Development immediately upon the decision to use such additional sites by
submitting a revised "Place of Performance" form.
Dated:
~'~Program C)perator
~ewster, Executive Director
DIVISION OF EMPLOYMENT SERVICES
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
Name:
Enedina Mejia
Boys & Girls Club of Santa Ana
Name of Contractor:
Contractor Number:
Date: June 3, 2002
A2002-097
The Contractor shall insert in the space provided below the site(s) expected
to be used for the performance of work under the contract convered by the
certification:
Place of Performance (include street address, city, county, state, zip code
for each site):
950 W. Highland
Santa Ana, CA 92703
(Revised 5/8/02)
Attachment C
Exhibit F
BUDGET FORM
Matchffn
Administrative Program Total WIA ]find
Personnel 67,169. 67,169 16,200
Salaries* 16,740 16,740 3,890 --
Benefits
Other (list)* I --
Total Personnel 83,909 1 83,909 ~0,090
Operating Expenses
Rent or user fee* 13,200 --
Utilities 1,000 1 ~000 . 10r000
Phones 1,100 1,100
Interact fees t 300
Parking fees
Security } 4,000
Maintenance . 4,400 t 4,400
Insurance 3,000 ] 3,000 10,000
Equipment*
Rental fees
Purchase
Vehicle lease charges
(vehicles may not be
purchased)
Office expenses
(consumables) 1,400 1,400
Accounting Services 1~000 I 1,000 1,000
Legal services [ _
Auditing services 2,400 i 2,400
Indirect costs
(attach indirect cost
rate plan**) 8,720 8,720 4,751
Staff traink~g 225 I 225 800
Staff travel/mileage 1,080 [ 1,080
Customer Training*
Suppoa services*
Profit (for profitsonl7) ~ ~tJ.~ iq } ~a~'~ 0
Other(list)*
Total Operatlng Expenses 33,825 [ 38~825 I 44~051
GP~h~D TOTAL ~ ~ 64,141
(Total Personnel + Total IIb, 5'W_ It6tS"lT,
Operating Expenses)
* attach a separate sheet detailing these costs
Exhibit
3of 3
Projected Match/In Kind Expenses
Personnel
The Boys & Girls Club of Santa Ana will match personnel expenses by $20,090
($16,200 - salaries, $3,890 - benefits) from general operating funds and Career
Prep funding provided by the Department of Labor and TANF funds.
Personnel match includes an additional 5% of the Assistant Executive Director.
The Boys & Girls Club will also cover 10% of the costs for the Employment
Program Manager and the Employment Program Coordinator. The Club will
match 50% of the Summer Employment Coordinator's position and 5% of our
Office Manager.
Operating Expenses
Rent or User Fee
The Career Prep program is provided at the Club in three separate rooms
totaling 1,100 sq. ft. The match represents this space at $1.00 per sq. ft. for 12
months ($13,200)
Indirect Costs
Indirect costs ($4,751) are calculated at 8% of the overall budgeted cost of the
program.
Exhibit F
2of3
Attachment C (cont.)
Revised 5/8/02
Budget Narrative
Projected WIA Administrative and Program Costs
Personnel
.8 FTE Employment Program Manager - $30,400 - (80% of $38,000) --This
professional management position is responsible for the Job Ready and Career
Launch program components. In addition, the Manager will coordinate elements
of the non-paid work experience component and the summer employment
component. This position will serve as a liaison to the Santa Ana W/O/R/K
Center. :
.3 FTE Employment Program Coordinator - $10,500 -- (30% of $35,000) -
This professional management position is responsible for the Career Explorers
Club component and will assist with the non-paid work experience component
and the summer employment component. This position will also serve as a
liaison to the Santa Aha W/O/PJK Center.
.15 FTE Assistant Executive Director - $8,269 - (15% of $55,125) -- This
executive management position is responsible for coordination of all Career Prep
program components, staff supervision and training, accurate and timely
reporting, and successful program outcomes.
Summer Paid Employment -- $13,500 - Employment costs for 10 youth to
earn $6.75 and hour for 20 hours each week for 10 weeks.
.5 FTE Summer Employment Coordinator - $4,500 - Cost {or coordinator for
20 hours aweek at $15.00 per hour.
Operating Expenses:
Indirect Costs - ($8,720) - Indirect Costs are calculated at 8% of the overall
budgeted cost for program.
Other Costs - ($9,500) - This reflects the costs for program promotional
material ($500), program supplies ($1,500) and participant stipends for the non-
paid work experiences and Office Suite completion ($250 each for 30
participants).
EXHIBIT G
PERFORMANCE STANDARDS
ix]
[]
YOUTH PROGRAMS
In-School Youth
Out-of-School Youth
Name of Organization:
Bny.~ & Qid.~ Club c)f ~nntn Ann
Contract #: A20(32-097
Program Year: May 17. 2002 - June 30. 2003
Contract Amount: ~116.577
# of Participants Enrolled:
§0 Cost per Participant: $1.943
Performance Standards for Youth ages 14-18:
Will serve a minimum of 60 youth.
· 60 youth ages 14-18 will be tested in ascertaining Basic Skill Levels using current TABE
materials and standards
· 10 youth will participate in summer employment for ten weeks
· 20 youth will successfully complete unpaid work experience for five weeks
· 10 youth will complete Office Smart training, resulting in participant employability in an office
environment
· A minimum of 40 youth between the ages of 16-18 will successfully complete job Ready and
Career Launch rep-employment training
· At least 20 youth between the ages of 14-15 will complete the Career Explorers Club program.
Exhibit H
Contractor agrees that in addition to those agreements and obligations specified in the
contract boiler plate, program narrative and statement of work, they will also adhere to
and obey the following provisions, assurances, and certifications.
ARTICLES
1)
2)
3)
4)
5)
Contractor assures and certifies that where applicable, classroom training
instructors are properly credentialed, and training curriculums comply with State
Education Codes.
Contractor assures and certifies that any requested modification to this agreement
must be submitted in writing, explaining requested changes and rationale.
Contractor further assures that no modification will be implemented without prior
written approval from the Santa Ana Local Workforce Investment Area's Board.
Contractor assures and certifies that they are in good standing with the California
Secretary of State Franchise Tax Board and Internal Revenue Service. Any
change in corporate status or suspension shall be reported immediately to the
CITY.
Contractor agrees to cooperate with any monitoring, inspection, audit, or
investigations of activities related to this agreement as may be scheduled and
conducted by the Santa Aha Local Workforce Investment Area's Board.
Contractor assures and certifies that it will maintain and abide by the Santa Ana
Local Workforce Investment Area's Grievance Complaint Procedures in its
entirety as included here in Exhibit C. All contractor's publications and
advertisements shall include the phrase "An Equal Employment and Training
Opportunity Organization".
Sent By: IBM INSURANCE; 714 6327197; Feb- 10:02AM;
ACORD_.. CERTIFIC,.,'E OF LIABILITY INSU._.ANCE'
Page 1/2
o~/25/o3
IBM INSURANCE BEOKERS
P.O. BOX 17939
ANAHEIM, CA 92817
LICENSE # 0532703
PHONE %(714) 688-1167
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON rile CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AliENS, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
BOYS AND GIRLS CLUB OF SANTA
ANA, A CALIFORNIA CORPORATION
950 WEST HIGHLAND
SA/~TA ANA, CA 92703
tOYERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO tHE INSUREO NA~ED ABOVE FOR THE POLICY PERIS0 INDICATED. ~DTWITItSTANSING
ARY 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 BYTHE POLICIES DESCRIBED HEREIN IS SUE]JECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OFSUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
'~'~: I 8502CY073003
-5
C
Xj NON.OWNeD AUTOS
1002CY073004-5
OTHER
460CY073010-5
APPR~ AS T(
ORIel'tHE LEE SF
Deputy City Affor
12/20/02 12/20/03
1000000
!12/20/02
kW
ey
12/2o/o3
50000
5OOO
1000000
3000000
1000000
1000000
~=.....OE !~ ~oooooo
^OOREaATE 4 0 0 0 0 0 0
E.L DtS;-a~E - EA EMPLOYE,; $
OE$C~P~ONOFOP~ATION$iLOOATIONS~HIC~$1~C~SIONSADDEO~RSEME~ISPECIALPROVI$1ONS
R~; THE CITY OF SANTA ANA, ITS OFFICERS, AOENTS AND EMPLOYEES AND
REPRESENTATI1~ES AR~ NAMED AS ADDITIONAL INSUREDS WITH ~EGARD TO LIAE~ILITY
AND DEFENSE A~ISING FROM THE OPERATIONS ia=ND USES PERFORMED BY OR ON BEHALF
OF THE NA~ED INSURED.
=ERTIFICATEHOLDER ix IADOITmo~ALINsuRE=;INsuRERLE!?~:-
T~ CITY OF SANTA ARA
20 CIVZC CENTER PL~A M-32
SANTA ANA, CA 92701
ATTN~ ALMA FLORES
~.CORD 25-S (7/a7)
CANCELLATION
...... ~ ~ ACORD CORPORATION 1988
S~nt By: IRM INSURANCE;
' 02/~5~20e3 00:51 ?145434~,~
714 6327197; Feb.2§
BOYS & GIRLS CLUR
IO:03AM;
Page 2/2
PAgE 04
~XHIBIT B
ADDITIONAL INSURED ENDORSEMENT
FOR COMMERCIAL OENEKAL LIAB1LI ,TY POLICY
Insurance Company
MARKEL INSURANCE COMPANY
This endorsement modifies such insurance as is afforded by the provisions of Policy
# 8502cY073003-5 relating to the following:
I. The City of Santa Ana, 20 Civ/c Center Plaza,. Santa gna, California 92701; it.~
officers, employee% agent% volunteers slid representatives are named as additional insu~eds
("additional insureds") with regard to liability and defense of suits arising from the operations
and uses performed by or on behalf of the named insured,
2. With respect to claims arising out of the operations ~nd uses performed by or on
behalf of the named insured, such i~suranee as is afforded by this policy is primary and is not
additional m or contributing with any other insurance carded by or for the benefit of the
additional insu~eds,
3. This insurance applies separately to each insured against whom claim is made or
suit is brought except with respect to the company's limlt~ of liability. The inclmion of any
person or organization as an insured shall not affect any right which such person ot organization
would have as a claimant if not so included.
4. With respect to the addiQonal insweds, this insurance ~hall not be cancelled, or
materially reduced in coverage or limits exce~ after thirty (30) days written notice has been
given to the City of Santa Aha, 20 Civic Center Plaza, Santa Ann, California 92701.
(Completion of the following, including countersignature, is required to make this endorsement
effective.)
Effective
Policy #
Issued to
12-20-02 ,' , this endorsement form as a part of
8502CYO7R~03-~
Countersigned by .~(Mx: J~- C'~ ~
Aufltorized Representative '
Deputy ..,t) Attorney
' A(~ORE~Ri~ CERTIFICATE OF INSURANCE I'BsuEDAfE MM'D°'Y'
12-23-2002
PRODUCER
Markel Insurance Company
P.O. Box 3870
Glen Allen, VA 23058-3870
CODE SUB-CODE
INSURED
Boys & Girls Club of Santa Ana,
A California Corporation
950 W Highland
SantaAna, CA 92703
COVERAGES
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY
A MARKEL INSURANCE COMPANY
LETTER
COMPANY
R
LETTER
COMPANY
C
LETTER
COMPANY
D
LETTER
COMP^,¥ E
LETTER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW
POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR ~
WITH RESPECT TO WHICH THIS CERTIFICATE MAY SE ISSUED OR MAY PERTAIh
HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH PO[
THE SNSURED NAMED ABOVE FOR THE
E AFFORDED BY THE POLICIES DESCRIBED
ITS SHOWN MAY HAVE BEEN REDUCED BY
LIMITS
GENERAL AGGREGATE 3~000,000
PRGDUCTS-COMP/OPS AGGREGATE 1,000,000
PERSONAL & ADVERTISING INJURY 1,000,000
TYPE OF INSURANCE
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
__ CLAIMS MADE F~ OCCUR,
OWNERS & CONTRACTOR'S PROT,
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSA¥10N
OTHER
AND
EMPLOYERS' LIABILITY
POLICY NUMBER
InSand Marine
Property 8502CY073003-5
DESCRIPTION OF OPERATIONS/LOOATIONBNEHICLES/SPECIAL ITEMS
12-20-2003
I 12-20-2002 12-20-2003
EACH OCCURRENCE 1,000, 000
FIRE DAMAGE (Any one firel 100,000
MEDICAL EXPENSE (Any one person}
COMBINED SINGLE
$
LIMIT
BODILY INJURY
{Per Person) $
BODILY INJURY
$
{Per accident)
PROPERTY DAMAGE $
BACH OCCURRENCE $
AGGREGATE
STATUTORY LIMITS
EACH ACCIDENT
DISEASE - POLICY LIMIT
DISEASE - EACH EMPLOYEE
Certificate holder is included as additional insured for operations conducted by the named insured.
CERTIFICATE HOLDER
Clerk of the City Council -City of Santa Aha
20 Civic Center Plaza
PO Gox 1988
Attn: Maria Yanez
Santa Aha, CA 92702
ACORD 25-S(7/90)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO
THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION
OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
REPRESENTATIVES.
Bruce A. Kay CPO
( D CORPORATION 1990
ADDITIONAL INSURED ENDORSEMENT
Insurance Company
This endorsement modifies such insurance as is afforded by the provisions of Policy
# relating to the following:
1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California
92701; its officers, employees, agents and volunteers are named as additional insureds
("additional insureds") with regard to liability and defense of suits arising from the
operations and uses performed by or on behalf of the named insured.
2. With respect to claims arising out of the operations and uses performed by
or on behalf of the named insured, such insurance as is afforded by this policy is
primary and is not additional to or contributing with any other insurance carried by or for
the benefit of the additional insureds.
3. This insurance applies separately to each insured against whom claim is
made or suit is brought except with respect to the company's limits of liability. The
inclusion of any person or organization as an insured shall not affect any right which
such person or organization would have as a claimant if not so included.
4. With respect to the additional insureds, this insurance shall not be
canceled, or materially reduced in coverage or limits except after thirty (30) days written
notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana,
California 92701.
(Completion of the following, including countersignature, is required to make this
endorsement effective.)
Effective
Policy #
, this endorsement form as a part of
Issued to
Named Insured
Countersigned by
Authorized Representative
C~[~OLDER COPY
STATE P.o. BOX 420807, SAN F~NOISCO, CA 94142-0807
FUN O CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 08-14-2003
CITY OF SANTA ANA
COMMUNITY DEVELOPMENT AGENCY
PO BOX 1988 M-25
SANTA ANA CA 92702
GROUP: 000723
POLICY NUMBER: 75-2003
CERTIFICATE iD: 2
CERTIFICATE EXPIRES: 06-01-2004
06-01-2003/06-01-2004
This ia to certify thet we h~v~ issued a valid W¢,r~.,',~ c,r, mpensation insurance policy in a form approved by the California
Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer.
We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration.
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 contract or 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.
AUTHORIZEO REPRESENTATIVE
PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $t,000,000 PER OCCURRENCE.
ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 08-14-2003 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL INSURED:
CITY OF SANTA ANA
APPROVED AS '10 tORM
·.,~y,, City Attorney
EMPLOYER
BOYS AND GIRLS CLDB OF SA/qTA ANA
CORPORATION)
950 ~IGHLAND ST
SANTA ANA CA 92703
(A NON PROFIT
$ClF I0262E
Accept this certificate only if ~ou see a faint watermar~ that reads "OFFICIAL STATE FUND DOCUMENT"