HomeMy WebLinkAboutCHILD SHUTTLE 1AGREEMENT TERMINATION
Please complete this form when the attached agreement is no longer in effect.
Return form to the Deputy Clerk of the Council (1\4-30). Call 647-6520 if you have any
questions.
----------------------------
The agreement with l_.N�-t�iL � , A -a,003 /172
was completed on ' W an4 fmal¢payment has been made.
Department: J
Signature:
Date:
City of Santa Ana
Revised 4-16-87 Clerk of the Council
INSURANCE ON FILE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
CLERK0 COUNCIL
DATE: �k f f;-Oj
A-2003-103
AGREEMENT WITH
C CHILD SHUTTLE
THIS AGREEMENT, made and entered into this 2nd day of June, 2003, by and between Child
Shuttle, hereinafter referred to as "CONTRACTOR", and the City of Santa Ana, a charter city and municipal
corporation duly organized and existing under the Constitution and laws of the State of California,
hereinafter referred to as "CITY".
TERMS AND CONDITIONS
TIME PERIOD OF AGREEMENT
This Agreement shall commence as of July 1, 2003 and all services to be performed pursuant to this
Agreement shall be completed on or before June 30, 2004. 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.
2. INDEPENDENT CONTRACTOR
CONTRACTOR agrees that CONTRACTOR is an independent contractor and not an employee of
CITY and all of CONTRACTOR'S personnel shall be employees of CONTRACTOR and not employees of
the CITY. CONTRACTOR shall pay all salaries and wages, employer's Social Security taxes,
unemployment insurance and wages, and similar taxes relating to employees and shall be responsible for all
applicable withholding taxes.
CONTRACTOR shall not subcontract any of the services required hereunder without prior written
approval of the CITY.
3. SCOPE OF SERVICES
For and in consideration of the hereinafter stated payment by CITY to CONTRACTOR,
CONTRACTOR agrees to perform, at its own cost and expense except for the compensation specified in this
Agreement, the services specified in Exhibit A attached hereto and incorporated herein as Exhibit A to this
Agreement.
4. CONTRACTOR OBLIGATIONS
A. 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.
B. 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.
All 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.
C. 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 audits, examinations, monitoring
and verification of records submitted by CONTRACTOR, costs incurred and services rendered hereunder.
D. 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.
E. CONTRACTOR shall comply with the provisions of 48 CFR, Chapter 1, Parts 1-31.2,
for commercial organizations and all other applicable federal statutes and executive orders and their
implementing regulations.
F. CONTRACTOR shall comply with the provisions of E.0 12549 and 12689, requiring
compliance with the debarment and suspension requirements contained in 29 CFR Part 98.
G. 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 B," 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.
H. CONTRACTOR agrees to provide a drug-free work place and to execute a
certification as set forth in "Exhibit C" attached hereto and incorporated herein by this reference.
L 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 enforcement, 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).
5. 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 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 any and all federal laws limiting the
political activity of employees hired under this Agreement.
2. CONTRACTOR shall provide the U.S. Department of Labor and the
Controller General, by and through any authorized representative, as well as the Santa Ana Local Workforce
Investment Area's Board, 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.
3. No person with responsibilities in the operation of any program under the
Welfare -to -Work grant 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.
4. CONTRACTOR shall maintain appropriate standards for health and safety in
work and transportation situations.
5. CONTRACTOR shall comply with general provisions, assurances, and
certifications attached hereto as "Exhibit D" and incorporated herein.
6. Any literature distributed by CONTRACTOR for the purpose 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."
7. CONTRACTOR certifies that all property, finished or unfinished documents,
data, studies and reports prepared or purchased by the CONTRACTOR 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.
8. 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.
9. If the compensation hereunder exceeds $100,000, CONTRACTOR shall be in
compliance 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.
10. CONTRACTOR may copyright any work that is subject to copyright and was
developed, or for which ownership was purchased, under an award. The Federal awarding agency(ies)
reserve a royalty -free, nonexclusive and irrevocable right to reproduce, publish, or otherwise use the work for
Federal purposes, and to authorize others to do so.
11. CONTRACTOR is subject to applicable regulations governing patents and
inventions, including government -wide regulations issued by the Department of Commerce at 37 CFR part
401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government
Grants, Contracts and Cooperative Agreements."
6. COMPENSATION
CITY agrees to pay, and CONTRACTOR agrees to accept for said services, total compensation in the
amount not to exceed One Hundred Thirteen Thousand Nine Hundred Sixty Four and no/100 Dollars
($113,964.00). CONTRACTOR will submit a detailed invoice evidencing services performed. Final
payment by the CITY shall be within 30 days following receipt of said invoice, subject to CITY accounting
procedures.
7. MISCELLANEOUS PROVISIONS
A. CONTRACTOR covenants that it presently has no interest, and shall not have any interest,
direct or indirect, which would conflict in any manner with the performance of services required hereunder.
B. CONTRACTOR certifies that it will not discriminate against any employee or applicant for
employment because of race, religious creed, color, national origin, ancestry, physical disability, mental
disability, medical condition, marital status, sex or age, in compliance with Title VII of the Civil Rights Act
of 1964 (P.L. 83-354) and Government Code 12900, et seq.
C. This Agreement may be terminated by either party upon thirty (30) days written notice of
termination.
HOLD HARMLESS CLAUSE
CONTRACTOR agrees to indemnify and hold harmless CITY, its officers, agents, employees, and
volunteers from and against any and all loss or damage, and from any and all suits, actions and claims filed or
brought by any person or persons arising out acts or omissions of CONTRACTOR or of its approved
subcontractor or of the officers, agents, employees of CONTRACTOR or of its subcontractors in the
performance of this Agreement.
8. INSURANCE
CONTRACTOR shall obtain and maintain for the entire term of this Agreement comprehensive
general public liability insurance, in companies acceptable to the City, authorized to issue such insurance in
the State of California. Said insurance shall consist of the following:
a. Liability Insurance. CONTRACTOR shall maintain in full force and effect, for the period covered
by this Agreement, comprehensive general liability insurance. This comprehensive general liability
insurance shall name the City, its officers, agents and employees as additional insured(s) and shall include,
but not be limited to protection against claims arising from bodily and personal injury, including death
resulting therefrom and damage to property, resulting from any act or occurrence arising out of
CONTRACTOR's operations in the performance of this Agreement, including, without limitation, acts
involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage
applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total
amount of $1,000,000 per occurrence.
b. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the
Labor Code, CONTRACTOR, if CONTRACTOR has any employees, is required to be insured against
liability for worker's compensation or to undertake self-insurance. CONTRACTOR agrees to comply with
such provisions before commencing the performance of the work under this Agreement.
c. Automobile Insurance. Contract shall provide the City with proof of valid automobile insurance
coverage for all vehicles in Contractor's fleet of shuttles, with coverage in the minimum amount of
$5,000,000.00.
d. The following requirements apply to the insurance to be provided by CONTRACTOR pursuant to
paragraph a., above:
A certificate of insurance, to be approved in form by the City Attorney, shall be furnished
to the City within 30 days of the execution of this Agreement.
2. Certificates and policies shall state that the policies shall not be canceled or reduced in
coverage or changed in any other material aspect without thirty (30) days prior written
notice to the City.
e. If CONTRACTOR fails or refuses to produce or maintain the insurance required by this section or
fails or refuses to furnish the City with required proof that insurance has been procured and is in force and
paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such
termination shall not effect CONTRACTOR's right to be paid for its time and materials expended prior to
notification of termination.
9. 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.
10. DISPUTES
Except as otherwise 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
mail or otherwise furnish a copy thereof to CONTRACTOR. The decision of the City shall be final and
conclusive unless within thirty (30) calendar days from 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.
11. 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 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 right 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.
12. 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:
To City: Clerk of the Council
City of Santa Ana
20 Civic Center Plaza (M-30)
P.O. Box 1988
Santa Ana, CA 92702-1988
Telefacsimile (714) 647-6956
With courtesy copy to:
Santa Ana Work Center
1000 E. Santa Ana Blvd., #200
Santa Ana, CA 92701
Telefascimile (714) 565-2602
To Contractor: Child Shuttle
420 S. Euclid Street, Suite 111
Anaheim, CA 92802
Telefascimile (714) 999-0226
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first
above written.
ATTEST:
atricia E. Healy
Clerk of the Council
APPROVED AS TO FORM:
Joseph W. Fletcher
City Attorney
Lisa E. Storck
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
X
Jo . Reekstin, Executive Director
Community Development Agency
CITY OF SANTA ANA, a municipal
corporation of the State of California
David N. Ream
City Manager
CHILD SHUTTLE
William Brown
CFO
33 -1966501
Tax ID#
EXHIBIT A
Program Services
Child Shuttle has successfully been working with the Santa Ana Work Program for two
years. With our route scheduling we are able to handle a large number of clients. We
have distinguished ourselves from other transportation programs in numerous ways.
First, employees are screened according to the standards required by the State of
California for licensed childcare providers. That includes the utilization of the "Live
Scan" program approved by the California Department of Social Services and California
Highway Patrol, to conduct a criminal background investigation when hiring new
employees. Prior to hiring, all new employees are required to pull a 10 -year DMV
printout, through the Department of Motor Vehicles; and submit to a drug test. All
drivers are required to be certified in CPR and First Aid. All employees and long-term
clients wear picture identification badges.
• Drug screening and DMV pulls are done throughout employment
• CPR renewal is every 2 years
• CERT training
• Car Seat safety training
All Child Shuttle vehicles are inspected daily, and are inspected by a certified mechanic
every 45 days, as required by the California Highway Patrol (CHP)
Child Shuttle has developed a unique tracking system, which allows us to know at any
time the number of clients being served during any given period from one day to one
year. Each driver and vehicle can be tracked individually by client count; time of day
client is on board and miles driven by the driver. We have installed a tracking system in
our vehicles, that tells us where the driver is, as well as the office can also monitor how
fast the driver is traveling, as well as how long the vehicle as been at a certain location.
In addition, all drivers are accessible by cell phone and two-way radio.
Child Shuttle's service works as follows for all Santa Ana Work Program Participants:
• Referrals from Santa Ana via fax or email
• Child Shuttle will contact clients when Santa Ana was unable to (personnel or
telephone contact )
• Child Shuttle staff to confirm all requests
• All scheduled clients will be given a toll free number to contact us direct for
cancellations or changes when necessary
• Child Shuttle will call 10 minutes prior to pick-up to let clients know we are on
the way
• We maintain pick-up and delivery spread sheets for tracking purposes, which
enables us to meet program needs (available upon request at any time)
• We will confirm with clients pick-up time for return trip
• All logs sheets will be reviewed and submitted on a monthly basis or as needed.
• Any unexpected needs will be dealt with (such as last minute drop off location) as
the need arises.
StafVOrganization
With several years of experience Child Shuttle is familiar with the needs of Santa Ana
Work Participants and their children. And with that experience we are able to adjust our
routing schedule to meet any unexpected changes. The following is a list of what we will
offer Santa Ana Work Program.
Child Shuttle has been in existence for a little over three years. But comes with over 25
years over experience working with families in need. Our company was founded to help
bridge the gap between employment opportunities, shelters, childcare facilities, schools
and other temporary living facilities, by providing transportation services to families who
are unable to afford transportation themselves, thus helping these families become self-
sufficient.
• Scheduled routes
• Toll free number for all clients
• Photo I.D. cards for all children being shuttled long term
• Daily run sheets available for Santa Ana Work Program
• After hour, weekend, and holiday drivers available (additional cost some "In
Kind" services)
• We offer Spanish and Vietnamese speaking drivers
• Vehicles that are clean and operational at all times
• Confirmation by phone with participants for evening pick-ups
• Tracking system in vehicles
• Unscheduled and emergency routes
Hours of operation are 6:00am to 6:00pm Monday thru Friday, as well as all other hours
on an as needed basis. With our flexible schedule we are able to meet all transportation
needs as they arise. Child Shuttle will offer one vehicle available at all times, with more
vehicles available with a minimum 1-1/2 lead time.
With our years of experience comes collaboratives with many other organizations, thus
providing a one-stop shop in helping families become self-sufficient. They include the
following:
• Blind Children's Learning Center
• Alex Center for children with brain injuries
• Aspen
• Several school districts they include: Anaheim, Centralia, Garden Grove, Los
Alamitos, Linden
• Boys & Girls Club in Garden Grove, and Anaheim
• O.C. Child Care & Development Planning Council
• O.C. Association for the Young Child Public Policy
• Olive Crest
• Homeless & Domestic Violence Shelter Meetings
• WIC
• YMCA & YWCA
• And many others
Some of the other services that Child Shuttle takes part in is helping participants through
the CaIWORKS program move from either motel to shelter, or shelter to their own
apartment. We have helped provide clothing; food, toys, furniture and appliances,
through our non-profit "Bring A Smile Foundation". We are actively involved in
providing Thanksgiving Dinners to the homeless through We Give Thanks. Our caring
does not only apply to the Holidays but throughout the year.
Child Shuttle's future plans include a resource center located at our Anaheim office, thus
enabling our clients to come to our office, and receive help in locating licensed childcare
facilities, transportation, housing, and schooling for children and adults and other
necessary resources.
Other future plans include changing our tracking system to a GPS system, which will
enable us to track our vehicles more effectively.
Also, new this year is a program called Work Experience Program, which has been set up
by Hao Tran and Bill Brown. Which offers career opportunities for Santa Ana Work
Participants. Child Shuttle will train them for 6 months to transport children and adults
and will also help them receive their Class B license along with their Youth
Endorsement. After training they may either remain with Child Shuttle or move on to
other endeavors.
Child Shuttle takes great pride in stating that we care about all our clients, we take a
personnel interest in all the children and adults that we shuttle. We take the time to
interact with them and their families, and offering support when needed. Child Shuttle is
not just a transportation company, but a family wanting to make life a little easier for the
clients we shuttle.
420 S. Euclid Street Suite 111
Anaheim, CA 92802
Phone: (877) 4child4
Fax: CIA)9994226
Thank you for considering Child Shuttle, as a transportation agency. We are confident
that we can meet your expectations. All terms are subject to negotiations. These prices
are for transportation within Orange County only.
Are regular daily rates are as follows:
Monday -Friday (6:00am to 6:00pm)
Monday -Friday (after hours)
$65 per hour two hour minimum
$75 per hour two hour minimum
This program would dedicate two drivers and one vehicle to be on call from 5 am to 8 pm
with a one-hour lead-time for spontaneous unscheduled rides. All other transportation
would be done on a scheduled demand -responsive ride within Orange County.
Salary $ 74,830
Fixed Costs $ 35,260
Administrative Costs $ 3,874
Total cost for one year $113,964
I YEAR PROPOSED PROGRAM BUDGET
Personel/Salaries/Benefits
Drivers $ 63,751.00
Routing/Relief Driver $ 6,438.00
Personnel Costs 5% $ 4,641.00
Fixed Costs
Vehicles (1 leased vehicle per year) $ 10,560.00
Auto Insurance $ 11,022.00
Fuel $ 8,438.00
Maintenoce (vehicles) $ 3,140.00
Communication $ 2,100.00
Administrative/Office Costs
Rent $ 2,040.00
Office Supplies $ 600.00
Permits, Operating License $ 250.00
Liability Insurance $ 984.00
$ 113,964.00
EXHIBIT B
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 oron 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 gfficer or
employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any Federal contracts, the making of any
Federal grant, the making of any Federal loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal,
amendment or modification of any Federal contract, grant, loan or
cooperative agreement.
2) If any funds other than Federal appropriated funds have been paid or will be
paid to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in connection with this
Federal contract, grant, loan or cooperative agreement, the undersigned shall
complete and submit Standard 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.
Child Shuttle
Grantee/Contractor Organization
William Brown, CFO
EXHIBIT G
Certification Regarding 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) The dangers of drug abuse in the workplace;
(2) The contractor's policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee assistance
program; and
(4) 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) Abide by the terms of the statement; and
(2) 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) Taking appropriate personnel action against such an employee, up to and
including termination; or
(2) 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).
B. '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: August 27, 2003
Program Operator
William Brown, CFO
DIVISION OF EMPLOYMENT SERVICES
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
Name: William Brown, CFO
Name of Contractor: Child Shuttle
Contractor Number:
Date: July 1, 2003
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):
Transportation throughout Orange County
Exhibit D
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) Contractor assures and certifies that where applicable, classroom training
instructors are properly credentialed, and training curriculums comply with State
Education Codes.
2) 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.
3) Contract assures and certifies that they are in good standing with the California
Secretary of State Franchise Tax Board and Internal Revenue Service.
4) Contract 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 Ana Local Workforce Investment Area's Board.
RDe CERTIFICAOF LIABILITY INSURANCE
ii0L
osojz0)
PRODUCER (949) 553-9700 FAX ( 553-9797
Westland Insurance Brokers '�11
2192 Martin Street, Suite 130 110
Irvine, CA 92612 n IgO�
THIS CERTIFICATEI LIED AS A MATTER OF INFORMATION
ONLY AND CONFER RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
INSURED Child Shuttle
420 South Euclid
Ste, 111
Anaheim, CA 92804
INSURERA: TRAVELERS INSURANCE COMPANY 0158
INSURERB: LANCER INSURANCE COMPANY 26077
INSURER C:
NSURER D:
NSURER E:
A/_CC
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN
ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
IU)DPL
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
GENERAL LIABILITY
I 660 793X1270 TCT 03
06/26/2003
06/26/2004
EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED $ 100,000
CLAIMS MADE O OCCUR
MED EXP (Any one person) $ S'000
A
PERSONAL&ADV INJURY S 1,000,00
GENERAL AGGREGATE $ 2,000,00
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG $ 2,000,000
POLICY PRO -
JECT OC
AUTOMOBILE
LIABILITY
BAIS4219
04/10/2003
04/10/2004
COMBINED SINGLE LIMIT
ANY AUTO
$
(Ea accident) 5'000,00
ALL OWNED AUTOS
BODILY INJURY $
B
X
SCHEDULED AUTOS
(Per Persm)
BODILY INJURY $
X
HIRED AUTOS
X
NON -OWNED AUTOS
(Par accident)
PROPERTY DAMAGE $
(Per=ideM)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT $
ANY AUTO
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE $
OCCUR CLAIMS MADE
APPROVED
AS
10 1~ORNI
AGGREGATE $
S
g
DEDUCTIBLE
RETENTION $
irj
WORKERSCOMPENSATIONAND
DeputyCity
Attorney
WC STATU- OTH-
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER/EXECUTNE
E.L. EACH ACCIDENT Is
E. L. DISEASE -EA EMPLOYE 5
OFFICERIMEMBER EXCLUDED?
U yes, desadbe under
E. L. DISEASE -POLICY LIMIT 1 $
SPECIAL PROVISIONS bebvi
OTHER
I 660 793X1270 TCT 02106/26/2003
06/26/2004
Property Limit: 11,025
property
A
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
E: The City of Santa Ana, Its Officers, Agents, and Employees are named as Additional Insureds
s respects the operations of the Named Insured as per attached CG2026 (11/8S) &GN0079 (01/90)
0 Days Notice of Cancellation for Non Payment of Premium
The City of Santana
Lydia Morgan M'1
1000 E. Santa Ana Blvd
Suite 200
Santa Ana, CA 92701
ACORD 26120011081 FAX:
SHOULD ANY OF
POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL X1 MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
AArnon rn00n0Ar,na, neo.
MAY-
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 26 (2001/08)
POLICY NUMBER:
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
Name of Person or Organization: The City of Santa Ana
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as
applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the
Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or
rented to you.
APPROVED AS TO FORM
L ra Sheedy
Deputy City Attorney
CG 20 26 1186 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 13
• C*ERCIAL GENERAL LIABILITY
POLICY NUMBER: I -660 -793X1270 -TCT -03 ISSUE DATE: 6/26/03
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY INSURANCE
WAIVER OF TRANSFER RIGHTS OF RECOVERY
AGAINST OTHERS
AMENDMENT -SEPARATION OF INSUREDS
This endorsement modifies Insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
NAME OF PERSON OR ORGANIZATION
THE CITY OF SANTA ANA
1. The following amend SECTION IV—COMMER-
CIAL GENERAL LIABILITY CONDITIONS:
a. This insurance is primary with respect to the
additional insured. Any other insurance avail-
able to that person or organization is excess
and non-contributing.
b. We waive any right of recovery we may have
against the person or organization shown in
the Schedule because of payments we make
for injury or damage arising out of "your
work" done under a Contract with that person
or organization. The waiver applies only to
the person or organization shown in the
Schedule.
c. Section IV, COMMERCIAL GENERAL
LIABILITY CONDITIONS, Part 7, Separation
of Insureds Is amended to Include paragraph
c:
(c) The Inclusion of any person or organiza-
tion as an insured will not affect any
rights that person or organization would
have as a claimant if not included as an
insured.
APPROVED AS TO FORM
La ra Sheedy
Deputy City Attorney
GN 00 79 01 90 Copyright, The Travelers Indemnity Company. Page 1 of 1
1ADDUTONAL INSURF_D ENDO?ZSEMENT
FOR CON(MERCIAL QENERAL LIABMITY POLICY
lasuranoe Company Travelers Insurance Company
This etdr,"r. ent rnnrGnes such insurance as is afforded by the provisions of Policy
9 660793X1270 relating to the following:
1. The City of Scuta. Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its
officers, employees, agents, vohmtccrs and representatives are named as additional insureds
("additional insureds') with regard to liability and defense of shits 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 pedbrmed 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 ins urt ce 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 insurcdT, this insurance shall not be cancelled, 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, Califomia 92701.
(Completion of the following, including countersignature, is required to make this endorsement
effective.)
Effective 6-- 2 6-- 02 this endorsement form as a part of
6
Policy 60793X1270
Issuedro CTS, LLC dba: Chi! u e
Named an;ed '
Countersigned b,
_nth .zed Represeatarivc
APPROVED AS l'O +ORNj
Laura Sheedy
Deputy City Attorney