HomeMy WebLinkAboutHUMAN RESOURCE MARKETING 1AGREEMENT TERMINATION
Please complete this form when the attached agreement is no longer in effect.
Return form to the Sr. Deputy Clerk of the Council (M-30). Call 647-5238 if you have any
questions.
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was completed on and final payment has been made.
Department:
Signature:
Date:
City of Santa Ana
Revised 8-7-03 Clerk of the Council
INSURANcr.
WORD Pr'!,;C.
LEEK ; CJitiVi;li.
DATL c
AGREEMENT WITH
HUMAN RESOURCE MARKETING SERVICES
UNDER THE WORKFORCE INVESTMENT ACT
A-2005-129
THIS AGREEMENT, made and entered into this 2nd day of May, 2005, by and between Human
Resource Marketing Services, Inc. dba HR Management Services, hereinafter referred to as
"CONSULTANT", 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".
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 adults, dislocated workers and youth 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 California's Workforce Investment System is to
provide individuals 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. CONSULTANT is experienced in operating education, training and employment
programs for economically disadvantaged adults, dislocated workers, and youth for entry into the labor
market ("said program").
E. CONSULTANT is willing to operate said program pursuant to the Act and California
law.
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:
1. TIME PERIOD OF AGREEMENT
This Agreement shall commence as of May 2, 2005 and all services to be performed pursuant to this
Agreement shall be completed on or before June 30, 2005. 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
CONSULTANT agrees that CONSULTANT is an independent contractor and not an employee of
CITY and all of CONSULTANT'S personnel shall be employees of CONSULTANT and not employees of
the CITY. CONSULTANT 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.
CONSULTANT shall not subcontract any of the services required hereunder without the prior written
approval of the CITY.
3. SCOPE OF SERVICES
For and in consideration of the hereinafter stated payment by CITY to CONSULTANT,
CONSULTANT agrees to perform, at its own cost and expense except for the compensation specified in this
Agreement, the services specified in the scope of work attached hereto and incorporated herein as Exhibit A
to this Agreement.
4. CONSULTANT OBLIGATIONS
A. CONSULTANT 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 CONSULTANT'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 CONSULTANT'S
activities, performance, books, documents, papers, and records of CONSULTANT, 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 CONSULTANT 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 CONSULTANT does not make the above -referenced documents available within
the City of Santa Ana, California, CONSULTANT 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 CONSULTANT and all
documents related to this Agreement shall be kept available at CONSULTANT'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
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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, CONSULTANT 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, CONSULTANT
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 CONSULTANT, costs incurred and services rendered hereunder.
D. CONSULTANT agrees to expend all funds in accordance with all applicable federal,
state and local laws and regulations. CONSULTANT also agrees to provide at CONSULTANT'S own
expense supplies and other costs of said PROGRAM.
E. CONSULTANT 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. CONSULTANT shall comply with the provisions of E.O. 12549 and 12689, requiring
compliance with the debarment and suspension requirements contained in 29 CFR Part 98.
G. CONSULTANT 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. CONSULTANT shall sign a certification to that effect in a form as set forth
in "Exhibit B," attached hereto and by this reference incorporated herein. CONSULTANT 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 CONSULTANT under the terms and conditions of
this Agreement.
H. CONSULTANT 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.
I. CONSULTANT, 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).
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5. APPLICABLE GUIDELINES
A. The parties hereto agree that CONSULTANT 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. CONSULTANT also assures and certifies that:
1. CONSULTANT shall comply with any and all federal laws limiting the
political activity of employees hired under this Agreement.
2. CONSULTANT 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
Workforce Investment Act 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. CONSULTANT shall maintain appropriate standards for health and safety in
work and transportation situations.
5. CONSULTANT shall comply with general provisions, assurances, and
certifications attached hereto as "Exhibit D" and incorporated herein.
6. Any literature distributed by CONSULTANT 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. CONSULTANT certifies that all property, finished or unfinished documents,
data, studies and reports prepared or purchased by the CONSULTANT 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 CONSULTANT by the CITY and/or purchased by the CONSULTANT 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, CONSULTANT will
immediately return such tools and/or equipment to the CITY or dispose of them in accordance with the
direction of the CITY.
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8. CONSULTANT 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 grant hereunder exceeds $100,000, CONSULTANT 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
CONSULTANT 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. CONSULTANT 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. CONSULTANT 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 CONSULTANT agrees to accept for said services, total compensation in the
amount not to exceed Twenty Thousand Dollars ($20,000.00). CONSULTANT 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.
CONSULTANT 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 CONSULTANT. 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.
MISCELLANEOUS PROVISIONS
A. CONSULTANT 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. CONSULTANT 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.
HOLD HARMLESS CLAUSE
CONSULTANT agrees to indemnify, defend 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 CONSULTANT or of
any approved subcontractor or of the officers, agents, employees of CONSULTANT or of its subcontractors
in the performance of this Agreement.
9. INSURANCE
CONSULTANT shall obtain and maintain for the entire term of this Agreement comprehensive
professional 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. Professional Liability Insurance. CONSULTANT agrees to obtain and keep in force during the
term of this Agreement a policy of professional public liability insurance insuring the CITY and
CONSULTANT against any liability for accident, injury or death arising out of or related to this Agreement.
Such insurance shall be in an amount 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 professional liability
insurance shall be endorsed to provide to CITY at least thirty (30) days written notice prior to cancellation.
b. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the
Labor Code, CONSULTANT, if CONSULTANT has any employees, is required to be insured against
liability for worker's compensation or to undertake self-insurance. CONSULTANT agrees to comply with
such provisions before commencing the performance of the work under this Agreement.
c. The following requirements apply to the insurance to be provided by CONSULTANT pursuant to
paragraph a., above:
1. 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.
d. If CONSULTANT 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 affect CONSULTANT's right to be paid for its time and materials expended prior to
notification of termination.
10. 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,
CONSULTANT may not terminate this Agreement if undue hardship will result to any participant.
11. 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 CONSULTANT. 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 CONSULTANT 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, CONSULTANT shall act in accordance with CITY's decision unless the dispute involves a
change order.
12. BREACH - SANCTIONS
If, through any cause, CONSULTANT violates any of the terms and conditions of this
Agreement, and/or prior agreements whereby grant funds were received by CONSULTANT pursuant to this
Agreement, or if CONSULTANT reports inaccurately or if any Audit Report makes disallowances,
CONSULTANT shall promptly remedy its acts or omissions and/or repay CITY all amounts due CITY as a
result of CONSULTANT'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 CONSULTANT 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 CONSULTANT has failed to repay same or a repayment schedule has not
been made; and/or (3) terminate this Agreement by giving written notice to CONSULTANT of such
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termination in accordance the notice provision contained below.
13. 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
Telefacsimile (714) 565-2602
To CONSULTANT: Richard Katz
Human Resource Marketing Services
8491 W. Sunset Blvd. #750
West Hollywood, CA 920069
Telefascimilie ((310) 854-1055
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first
above written.
ATTEST:
Patricia E. Healy
Clerk of the Council
APPROVED AS TO FORM:
Joseph W. Fletcher
City Attorney
By: Lisa E. Storck
Assistant City Attorney
RECO ENDED FOR APPROVAL:
f�, atricia C. Whitaker, Executive Director
Community Development Agency
CITY OF SANTA ANA
David N. Ream
City Manager
CONSULTANT:
Human Resources Mark
Richard Katz, President
Tax ID#/SS#: C f
Services, Inc
t/6f - 6fi-7
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Exhibit A
STATEMENT OF WORK
Description of Services and Products:
Task
Description
1
Initial consultation with client and start up. Review existing business services marketing
materials. Identify most sought after services from employers. Identify selling points
and value added propositions. Meet with and gain buy -in from staff and all stakeholders.
Establish an approval process. Fine-tune and agree to propose marketing plan. Establish
metrics for evaluating marketing program six months and one year after implementation.
2
Design four (4) unique sets of three (3) flash e-cards to employers with email in your
target marketing (marketing different aspects of your rapid response services to
businesses.). Flash e-cards can be distributed once per quarter, for a total of 12 e-cards
to be used over one year. Design of HTML email template for embedding flash e-cards
and the incorporation of stock photography in e-cards. Importation of Santa Ana
provided email addresses in Excel based upon HRMS formatspecifications.
3
Develop four versions of a one -page marketing letter (marketing different aspects of
Rapid Response services to businesses), for distribution by your staff on a quarterly basis
using a Santa Ana W/O/R/K Center database of employers.
4
Develop a Power Point presentation (maximum 14 slides, incorporating your logo and
graphics) summarizing Santa Ana WORK Center Rapid Response Services for
employers.
5
Design a customized Santa Ana WORK Center e-newsletter and static web site.
Newsletter (maximum of 10 articles per publication) will use existing NetAssets content
management and newsletter distribution technology. HRMS will register a unique Santa
Ana WORK Center domain name for the newsletter so that email contacts receiving
newsletter will have your domain name. The newsletter will be transparent, that is,
although HRMS distribute Santa Ana WORK Center's newsletter on a monthly basis
using HRMS's newsletter production staff. Santa Ana will designate one person to
aggregate articles and submit them in their final edited form in a single Word document
following our submission guidelines. A newsletter database will be created using email
contacts supplied by Santa Ana WORK Center, which can be updated once per month.
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 or'on behalf
of the undersigned, to any person for influencing or attempting to influence
an officer or employee of an agency, a Member of Congress, an officer or
employee of Congress, or an employee of a Member of Congress in
connection with the awarding'of any Federal 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.
Human Resources Marketing Services, Inc.
Grantee/Contractor Organization
hard Katz,
2, 2005
Exhibit c
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 paragrapF
(a);
(d) Notifying the employee in the statement required by paragraph (a) that, as r
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 violatio
occurring in the workplace no later than five days after such conviction
(a) Notifying the U.S. Department of Housing and Urban Development within ten day
after receiving notice under subparagraph (d)(2) from an employee or otherwis
receiving actual notice of such conviction;
!, A
(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.
esourc Marling Services, Inc,
Dated: May 02, 2005
,vrogram uperaiar/
Richard Katz, President
DIVISION OF EMPLOYMENT SERVICES
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG -FREE WORKPLACE REQUIREMENTS
Name: Rirhnrd Katz
Name of Contractor: uRMR
Contractor Number:
Date: May 02, 2005
The Contractor shall insert in the space provided below the site(s) expected
to be used for the performance of work under the contract convened by the
certification:
Place of Performance (include street address, city, county, state, zip code
for each site):
849 W. Sunset #750 West Hollywood cA 9nnAg
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.
08/22/2005 23:17 5652602 WORK CENTER PAGE 03
Lg5/17/2005 10:55 3109541055 FR MANAMMENT.SERVIC PAGE 02
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PAGE 02
154GE 03
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POLICYHOLDER COPY
TM P.0.80X807, SAN FRANCI$CO,CA- 94142.—QW7
1Nf/J AMG.� ,,. .• ,
F�a MS cwnFlICATR 0 woJ%KkRa ct 04ATn011%*AURANCE
ISSUE DATE 12-011-2004 ORGUP:
POLICY NUMIIIM; 1014IA0^I00a
.. CERTENCAIT IS, 27
,. ,C1314tikICAftil WKIPI Sr 12-01-2000
.i 14=01,2 /12-01-lOOs
CIT•Y'OF SANTA AMA SC'
ATTN MANAGER OF,WIB-ARMIN OFFICE
1000 SANTA ANA BLVD GTE 200'
SANTA ANA CA 927Q1
This is to oarilfy that we hove issued a valid Workers' Cbmpensetion insurarce Goliov In ■ Form approved by the
CaNfamis Insurance Csmmistlansr to the employer named below fbr the policy -period indicated
This Polley In not Subject to eg0111011idn by the Fund except upon so dayd advance written notice 10 the employer,
we will else give you 20 dsy"si 'WV*46 notice aho4td this pvtky be cantleFlad 'prier to Its irormd exPlrad0nl
This certiflosts Of ifleurancs in mat an insurance policy aril does Act r+t4nq„ exland or miter the covera0s afforded
by the palicibs listed harain, any reRvlrixirtAM , term, or cogdlllad of any contract or other' document
wRh na0ert to vvWloh tMs oertl bats at anaurartae may b/ L�aue4 ar nuy, peryte„'tga nWM10e sffMded by the
policies daceribod herein is subject to alb the 1147 ; ext:16 tl'tte 4 aanditiahs of such pollelell
A,� VXIL.'
AUTHDRIZED REPRE.5ENTAnve PRESIDENT
EWLG-fnR &,4IAIILIf1'Y'1,1<MIT, f*LUDIMO OCFFs46E,;iM>rllf; s,4,000,;Cs0.00 PLI!•OCCUIlIENCE.
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Eta)l*scvsmt 02040 INTITLEb CaTUPWAtt .HOLDERS' spret 1YYE �0-0.1-3004 �:6 ATTAt HRO 70 AND
F011115 A PtIRT OF --;His PaLrOy."'.
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APPROVED AS TA RojM
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'' ... di -trots. Stitt She y
ASSiStanf City Atlnrney
EMPLOYER "„ v:, .' „LLOAL "at
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