HomeMy WebLinkAboutORANGE COUNTY CRAZIES 5 - 2002
C-~
c~l\
~tJ
INSURANCE.NO! ON FILE
WORK MAY N.O.l PROCEED
CLERK OF COUNCIL
DATE. )6--ILf...oL
. AGREEMENT BETWEEN THE CITY OF SANTA ANA AND
ORANGE COUNTY CRAZIES FOR USE OF
COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS
\.i
~
A_2002-105-32
7/6/0ILS
This Agreement, made and entered into this \ ~-\;I:> day of ~ r ~ IL ,"2LV L ,
by and between the City of Santa Ana, a charter city and municipal corporation of the State of
California ("CITY") and ORANGE COUNTY CRAZIES, a California nonprofit corporation
("SUBRECIPIENT"),
WHN.ES.S.JHH
Recitals:
A. The CITY, as an entitlement recipient and grantee of the United States Department of
Housing and Urban Development ("HUD") Community Development Block Grant ("CDBG")
Program, desires to enter this Agreement with the SUBRECIPIENT for the expenditure of CDBG
funds in accordance with Title 24, Part 570 of Code of Federal Regulations 24 CFR 570.000, et seq.
("CDBG REGS"); and
B. CITY has applied for and received CDBG funds from HUD pursuant to Title I ofthe
Housing and Community Development Act of 1974, Public Law 93-383, as amended ("ACT"); and
C. The SUBRECIPIENT is a private nonprofit agency that has been selected by the CITY
to receive CDBG funds and administer such financial assistance; and to provide the services
described in "Exhibit A," hereinafter referred to as "said program" and SUBRECIPIENT represents
that it is qualified and willing to operate said program.
D. The CITY and SUBRECIPIENT have duly executed this Agreement for the expenditure of
such funds; and
WHEREFORE, it is agreed by and between the parties, that the foregoing Recitals are a
substantive part of this Agreement and the following terms and conditions are approved and
together with all exhibits and attachments hereto, shall constitute the entire Agreement between the
CITY and SUBRECIPIENT:
I. SUBRECIPIENT'S OBLIGATIONS
A. Non-Profit Status - Representations and Warranties.
(a) Authority. SUBRECIPIENT is a duly organized and existing non-profit corporation
in good standing and authorized to do business under the laws of the State of California.
SUBRECIPIENT has full right, power and lawful authority to accept the funding hereunder and
to undertake all obligations as provided herein and the execution, performance and delivery of
this Agreement by SUBRECIPIENT has been fully authorized by all requisite actions on the part
of SUBRECIPIENT.
1
'-'
"'"
716/0] LS
(b) Experience. SUBRECIPIENT is a qualified provider of the services to be provided
hereunder.
(c) Familiarity With Services Required. By executing this Agreement,
SUB RECIPIENT warrants that (i) it has thoroughly investigated and considered the services to
be performed and provided hereunder, (ii) it has carefully considered how the services should be
performed, and (iii) it fully understands the facilities, difficulties and restrictions attending
performance ofthe services under this Agreement.
(d) No Conflict. To the best of SUBRECIPIENT'S knowledge, SUBRECIPIENT'S
execution, delivery and performance of its obligations under this Agreement will not constitute a
default or a breach under any contract, agreement or order to which SUBRECIPIENT is a party
or by which it is bound.
(e) No Bankruptcy. SUBRECIPIENT is not the subject of any current or threatened
bankruptcy proceeding.
(f) No Pending Legal Proceedings. SUBRECIPIENT is not the subject of a current or
threatened litigation that would or may materially affect SUBRECIPIENT'S performance under
this Agreement.
(g) Application Veracity. All provIsIons of and information provided in
SUBRECIPIENT'S application for funding submitted to CITY including any exhibits are true
and correct in all material respects.
(h) No Pending Investigation. SUBRECIPIENT is not aware that it is the
subject of any current or threatened criminal or civil action investigation by any public agency,
including without limitation a police agency or prosecuting authority, that would relate to affect
performance of the Agreement or provision of services hereunder.
B. Amount of Grant and Quarterlv Disbursement. The amount granted to
SUBRECIPIENT is $ 15,000 ("CDBG FUNDS"), and such funds shall be expended by
SUBRECIPIENT within a time period not exceeding twelve (12) consecutive months following
the date of this Agreement. The CDBG FUNDS shall be disbursed by CITY to
SUBRECIPIENT on a quarterly basis (October, January, April and July) subject to and upon
receipt and approval of a complete SUBRECIPIENT'S quarterly activity report, with the final
payment subject to the satisfaction of the condition precedent of submittal of complete reporting
information due on or before July 15 of the applicable funding year, as hereinafter more fully set
forth. SUBRECIPIENT shall be obligated to perform such duties as would normally extend
beyond the term, including but not limited to obligations with respect to indemnification, audits,
reporting, data retention/reporting, and accounting.
C. Use of Funds. SUBRECIPIENT agrees to use all federal funds provided by CITY to
SUBRECIPIENT pursuant to this Agreement to operate said program, as set forth in "Exhibit A,"
attached hereto and by this reference incorporated herein. SUBRECIPIENT'S failure to perform as
2
'"'
'-I
7/6/0ILS
required may, in addition to other remedies set forth in this Agreement, result in readjustment ofthe
amount of funds CITY is otherwise obligated to pay to SUBRECIPIENT under Paragraph II hereof.
D. Allowable Costs. SUBRECIPIENT agrees to complete said program on or before
June 30, 2003 and to use said funds to pay for necessary and reasonable costs allowable under the
federal law and regulations to operate said program. Said amounts shall include, but not be limited
to, wages, administrative costs, and employee benefits comparable to other similarly situated
employees. Other allowable program costs are detailed in the Budget, as set forth in "Exhibit B,"
attached hereto and by this reference incorporated herein. SUBRECIPIENT shall use all income
received from said funds only for the same purposes for which said funds may be expended
pursuant to the terms and conditions ofthis Agreement.
E. Licensing. SUBRECIPIENT agrees to obtain and maintain all required licenses,
registrations, accreditation and inspections from all agencies governing its operations.
SUBRECIPIENT shall ensure that its staff shall also obtain and maintain all required licenses,
registrations, accreditation and inspections from all agencies governing SUBRECIPIENT's
operations hereunder.
F. Zoning. SUBRECIPIENT agrees that any facility/property used in furtherance of
said program shall be specifically zoned and permitted for such usee s) and activity(ies). Should
SUBRECIPIENT fail to have the required land entitlement and/or permits, thus violating any local,
state or federal rules and regulations relating thereto, SUBRECIPIENT shall immediately make
good-faith efforts to gain compliance with local, state or federal rules and regulations following
written notification of said violation(s) from the CITY or other authorized citing agency.
SUBRECIPIENT shall notify CITY immediately of any pending violations. Failure to notify CITY
of pending violations, or to remedy such known violation(s) shall result in termination of grant
funding hereunder. SUBRECIPIENT must make all corrections required to bring the
facility/property into compliance with the law within sixty (60) days of notification of the
violation(s); failure to gain compliance within such time shall result in termination of grant funding
hereunder.
G. Separation of Accounts. All funds received by SUBRECIPIENT from CITY
pursuant to this Agreement shall be maintained in an account in a federally insured banking or
savings and loan institution with record keeping of such accounts maintained pursuant to applicable
OMB Circular A-110 requirements. SUBRECIPIENT is not required to maintain separate
depository accounts for CDBG FUNDS; provided however, the SUBRECIPIENT must be able to
account for receipt, obligation and expenditure of CDBG FUNDS pursuant to applicable OMB
Circular A-II 0 requirements.
H. Audit Report Requirements. SUBRECIPIENT agrees that if SUBRECIPIENT
receives Three Hundred Thousand Dollars ($300,000.00) or more in federal funds,
SUBRECIPIENT shall have an annual audit conducted by a certified public accountant in
accordance with the standards as set forth and published by the United States Office of Management
and Budget. SUBRECIPIENT shall provide CITY with a copy of said audit by October I of the
year following the program year in which this Agreement is executed.
3
'-"
.....,/
7/6/01 LS
I. Record KeeuingfReuorting. SUBRECIPIENT shall keep and maintain complete and
adequate records and reports to assist CITY in meeting and maintaining its record keeping
responsibilities under the CDBG REGS, including the following:
(1) Records
a. Documentation evidencing program income requirements in
conformity with 24 CFR 570.504(b((2)(i), (ii) and 24 CFR 570.503(b)(3) and 24
CFR 570.208(a)(2)(B) of the income level of persons and/or families participating
in or benefiting by the SUBRECIPIENT program.
b. Documentation of the number of persons and/or families participating
in or benefiting by the SUBRECIPIENT program.
c. Household information shall include number of persons, identification
of head of household, race/ethnicity, and income verification.
d. Documentation of all CDBG FUNDS received from CITY.
e. Documentation of expenses as identified in the Budget Proposal,
including evidence of incurring the expense, invoices for goods or services, copies
of any and all contracts or documentation pertaining to costs for subcontractors,
plus all other invoices for which CDBG FUNDS were expended, and any payments
therefor.
f. Any such other related records as CITY shall reasonably require or as
required to be maintained pursuant to the CDBG REGS.
1. Reports
(i) Payment Request. Concurrently with the submittal of each
quarterly report, on or before the 15th day of October, January,
April and July, SUBRECIPIENT shall submit both: an original
invoice and true copies of invoices, receipts, agreements or
other documentation supporting and evidencing how the CDBG
FUNDS have been expended during the applicable quarter.
(ii) Quarterly Activity Report: SUBRECIPIENT agrees to keep monthly
records of all ethnic and racial statistics of persons and families benefited by
SUBRECIPIENT in the performance of its obligations under this Agreement,
including, but not limited to, the number of low and moderate income persons
and households assisted in accordance with federal income limits, the number
of female heads of households assisted, new program information and year-to-
date program statistics on expenditures, caseload and activities..
4
"-'
.....,
7/6/01LS
J. Access to Records. CITY and the United State Government and/or their representatives
shall have access for purposes of monitoring, auditing, and examining SUB RECIPIENT's activities
and performance, to books, documents and papers, and the right to examine records of
SUBRECIPIENT's subcontractors, bookkeepers and accountants, employees and participants in
regard to said program. CITY and the United States Government and/or their representatives shall
also schedule on-site monitoring at their discretion. Monitoring activities may also include, but are
not limited to, questioning employees and participants in said program and entering any premises or
any site in which any of the services or activities funded hereunder are conducted or in which any of
the records of SUB RECIPIENT are kept. Nothing herein shall be construed to require access to any
privileged or confidential information as set forth in federal or state law.
K. Location of RecordslRequired Length of Record Keeping. All accounting records,
reports, and evidence pertaining to all costs, expenses and the CDBG FUNDS of
SUBRECIPIENT and all documents related to this Agreement shall be maintained and kept
available at SUBRECIPIENT'S office or place of business for the duration of the Agreement and
thereafter for five (5) years after completion of an audit in conformity with the CDBG REGS., s.
Records which relate to (a) complaints, claims, administrative proceedings or litigation arising
out of the performance of this Agreement, or (b) costs and expenses of this Agreement to which
CITY or any other governmental agency takes exception, shall be retained beyond the five (5)
years until complete resolution or disposition of such appeals, litigation claims, or exceptions. In
the event SUBRECIPIENT does not make the above-referenced documents available within the city
of Santa Ana, California, SUBRECIPIENT agrees to pay all necessary and reasonable expenses
incurred by CITY in conducting any audit at the location where said records and books of account
are maintained.
1. Compliance with Law/Program Income. SUBRECIPIENT acknowledges that the funds
being provided by CITY for said program are received by CITY pursuant to the ACT as amended
and that expenditures of these funds shall be in accordance with the ACT and all pertinent
regulations issued by agencies of the federal government, including, but not limited to, all
regulations found at Title 24 of the Code of Federal Regulations. Program income received by
SUBRECIPIENT shall be returned to CITY unless otherwise provided for in this Agreement.
SUBRECIPIENT agrees to comply fully with all federal, state and local laws and court orders
applicable to its operation whether or not referred to in this Agreement.
M. Standing. SUBRECIPIENT shall be in good standing, without suspension by the
California Secretary of State, Franchise Tax Board and Internal Revenue Service. Any change in
the corporate status or suspension of SUB RECIPIENT shall be reported immediately to CITY.
N. Confidentiality. Without prejudice to any other provisions of this Agreement,
SUBRECIPIENT shall, where applicable, maintain the confidential nature of information provided
to it concerning participants in accordance with the requirements of federal and state law. However,
SUBRECIPIENT shall submit to CITY and or HUD or its representatives, all records requested,
'-'
.....;
J/61OILS
O. Independent Contractor. SUBRECIPIENT agrees that the performance of
obligations hereunder are rendered in its capacity as an independent contractor and that it is in no
way an agency of CITY.
P. Violation of Terms and Conditions. SUBRECIPIENT agrees that if
SUBRECIPIENT violates any of the terms and conditions of this Agreement or any prior
Agreement whereby CDBG funds were received by SUBRECIPIENT, or if SUBRECIPIENT
reports inaccurately, or if on audit there is a disallowance of certain expenditures, SUBRECIPIENT
agrees to remedy the acts or omissions causing the disallowance or repay CITY all amounts spent in
violation thereof.. If SUBRECIPIENT engaged in fraudulent activity to obtain and/or justify
expenditure ofthe CDBG funds granted hereunder, SUBRECIPIENT shall be required to reimburse
the CITY of all such funds that were obtained/spent under fraudulent circumstances.
Q. Eauipment. SUBRECIPIENT agrees to maintain a record for each item of non-
expendable personal property acquired under the terms of this Agreement. Said record shall be
made available to CITY upon request. The term "non-expendable personal property" shall include
leased and purchased equipment.
R. Prohibited Use. SUBRECIPIENT hereby certifies and agrees that it will not use
funds provided through this Agreement to pay for entertainment, meals or gifts.
S. Lobbving. SUBRECIPIENT certifies that it will comply with federal law (31
U.S.C. 1352) and regulations found at 24 CFR Part 87, which provide that no appropriated funds
may be expended by the recipient of a federal contract, grant, loan or cooperative agreement to pay
any person for influencing or attempting to influence an officer or employee of any agency,
Member of Congress, or an officer or employee of a Member of Congress in connection with
awarding of any federal contract, the making of any federal grant or loan, entering into any
cooperative agreement and the extension, renewal, amendment or modification of any federal
contract, grant, loan or cooperative agreement. SUBRECIPIENT shall sign a certification to that
effect in a form as set forth in "Exhibit C," attached hereto and by this reference incorporated herein.
SUBRECIPIENT shall submit said signed certification to CITY prior to performing any of its
obligations under this Agreement and prior to any obligation arising on the part of CITY to pay any
sums to SUBRECIPIENT under the terms and conditions of this Agreement.
If any funds other than Federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the
undersigned shall complete and submit a "Disclosure Form to Report Lobbying," in accordance
with its instructions (see C-l).
T. Financial Interest. SUBRECIPIENT agrees that except for the use ofCDBG funds
to pay salaries and other related administrative or personnel costs, no persons who exercise or have
exercised any function with respect to CDBG activities assisted under the terms of this Agreement,
6
'-"
...;
7/6/0lLS
or who are in a position to participate in a decision-making process or gain inside information with
regard to such activities, may obtain a financial interest or benefit from a CDBG-assisted activity of
SUBRECIPIENT, either for themselves or those with whom they have family or business ties,
during their tenure or for one year thereafter. This prohibition applies to any person who is an
employee, agent, consultant, officer, or elected or appointed official of CITY, or of
any designated public agencies, or the SUBRECIPIENT.
U. Davis-Bacon Act. All laborers and mechanics employed by contractors or
subcontractors in the performance of construction work, including alterations and repairs, in excess
of $2,000.00, financed in whole or in part with federal funds shall be paid wages at rates not less
than those prevailing on similar construction in the locality as determined in accordance with the
Davis-Bacon Act, as amended, 40 U.S.c. sections 276a - 276a-5. Any such construction contract
shall include and comply with the required contract provisions and rules set forth in 29 C.F.R. 95.5.
Further, the payroll reports (along with the "Statement of Compliance") and basic records are
required to be maintained and submitted, or made available, pursuant to 29 C.F.R. 95.5(a)(3). No
payment, advance, grant, loan or guarantee of funds shall be approved by the federal agency unless
there is on file with the agency a certification by the contractor that the contractor and its
subcontractors have complied with the provisions of 29 C.F.R. 95.5. . A breach of the contract
clauses in 29 C.F.R. 95.5 may be grounds for termination of the contract, and for debarment as a
contractor/subcontractor, as provided in 29 C.F.R. 95.12. Labor standards interviews/investigations
shall be made as necessary to assure compliance [29 C.F.R. 95.6(a)(3)].
V. Drug Free Workolace. SUBRECIPIENT certifies that it has established the following
drug-free workplace policy:
1. The unlawful manufacture, distribution, dispensing, possession or use of a
controlled substance is prohibited in the workplace for any employee involved in a federally funded
program.
2. As an employee working in conjunction with a federally funded program, the
employees of SUBRECIPIENT will be required to:
a) Abide by the terms above in statement 1.
b) Notify appropriate officials of SUBRECIPIENT and CITY officials of
any criminal drug statute conviction for a violation occurring in the workplace not
later than five days after such conviction.
3. The United State Department of Housing and Urban Development will be
notified within ten days after receiving notice of any such violation.
4. Within 30 days of receiving such notice, appropriate personnel action will be
taken against such employee, up to and including termination.
Each such employee shall be required to participate satisfactorily in a drug abuse
assistance or rehabilitation program approved for such purposes by a federal, state or local health,
7
'-'
>..ttI
J/61OILS
law enforcement, or other appropriate agency.
II. CITY'S OBLIGATIONS
A. Payment of Funds. Upon execution of this Agreement by SUBRECIPIENT, CITY shall
pay to SUBRECIPIENT from CDBG funds, when, if and to the extent received from HUD, for
CITY's 2002-2003 CDBG program year amounts expended by SUBRECIPIENT in carrying out
said program for fiscal year 2002.2003 pursuant to this Agreement up to a maximum aggregate
payment of FIFTEEN THOUSAND Dollars ($ 15,000) in installments determined by CITY.
Payments shall be made to SUBRECIPIENT through the submission of invoices on a quarterly
basis (October, January, April and July) in a form prescribed by CITY, detailing such expenses.
CITY shall pay such invoices within thirty (30) days after receipt thereof provided CITY is satisfied
that such expenses have been incurred and documented within the scope and provisions of this
Agreement and that SUBRECIPIENT is in compliance with the terms and conditions of this
Agreement.
B. Audit of Account. CITY shall include an audit of the account maintained by
SUBRECIPIENT in CITY's annual audit of all CDBG FUNDS in accordance with Title 24 of
the Code of Federal Regulations and other applicable federal laws and regulations.
III. NONDISCRIMINATION
SUBRECIPIENT agrees that no person on the ground of race, age, color, national origin,
religion or sex will be excluded from participation in, be denied the benefits of, or be subjected to
discrimination under any program or activity funded in whole or in part with CDBG funds.
IV. CONFLICT OF INTEREST
SUBRECIPIENT agrees that no officer, employee, agent or assignee of CITY having direct
or indirect control of any CDBG monies granted to the CITY, inclusive of the subject CDBG
FUNDS, shall serve as an officer of SUBRECIPIENT. Further, any conflict or potential conflict of
interest of any officer of SUBRECIPIENT shall be fully disclosed in writing prior to the execution
ofthis Agreement and said writing shall be attached and deemed fully incorporated as a part hereof.
Notice shall be sent by SUBRECIPIENT to CITY regarding any changes or modifications to its list
of officers.
V. SPECIAL CERTIFICATION FOR RELIGIOUS ENTITIES
If SUBRECIPIENT is a religious entity, SUBRECIPIENT hereby agrees that in connection
with the provision of the services SUBRECIPIENT shall provide with CDBG funds:
A. SUBRECIPIENT shall not discriminate against any employee or applicant for
employment on the basis of religion and shall not limit employment or give preference in
employment to persons on the basis of religion.
8
'-'
.,J
7/6/0ILS
B. SUBRECIPIENT shall not discriminate against any person applying for the services
SUBRECIPIENT agrees to provide Wlder the terms of this Agreement on the basis of religion and
shall not limit such services or give preference to applicants for such services on the basis of
religion.
C. SUBRECIPIENT shall NOT provide religious instruction or cOWlseling, conduct
any religious worship or services, or engage in any religious proselytizing, or exert any religious
influence in the provision of the services in said program. The parties agree that this covenant is
intended to and shall be construed for the limited purpose of assuring compliance with respect to the
use of CITY funds by SUBRECIPIENT with applicable constitutional limitations respecting the
establishment ofreligion as set forth in the establishment clause under the First Amendment of the
United States Constitution and Article I, Section 4 of the Califomia Constitution, and is not in any
manner intended to restrict other activities of SUB RECIPIENT.
D. Where the services to be provided Wlder said program are rendered on property
owned by the primarily religious entity SUBRECIPIENT, CDBG funds may also be used for minor
repairs to such property which are directly related to the cost of rendering the services Wlder said
program, where the cost constitutes in dollar terms only an incidental portion of the CDBG
expenditure for rendering the services under said program.
VI. PROHIBITION OF NEPOTISM.
SUBRECIPIENT agrees not to hire or permit the hiring of any person to fill a position
funded through this Agreement if a member of that person's immediate family is employed in an
administrative capacity by SUBRECIPIENT. For the purposes of this section, the term "innnediate
family" means spouse, child, mother, father, brother, sister, brother-in-law, sister-in-law, father-in-
law, mother-in-law, son-in-law, daughter-in-law, aWlt, Wlcle, niece, nephew, stepparent and
stepchild. The term "administrative capacity" means having selection, hiring, supervisor or
management responsibilities.
VII. NOTICES
Notices to the parties shall, unless otherwise requested in writing, be sent by U.S. Mail,
postage prepaid, and addressed as follows:
TO CITY:
City of Santa Ana
Community Development Agency (M-25)
20 Civic Center Plaza
P.O. Box 1988
Santa Ana, California 92702-1988
TO SUBRECIPIENT:
OC Crazies
809 N. Main Street
Santa Ana, CA 92701-4444
9
""'"
~
7/6/0 I LS
VIII. ASSIGNABILITY
None of the duties of, or work to be performed by, SUBRECIPIENT under this Agreement
shall be subcontracted or assigned to any agency, consultant, or person without the prior written
consent of CITY. SUBRECIPIENT must submit all subcontracts and other agreements that relate
to this Agreement to CITY. No subcontract or assignment shall terminate or alter the legal
obligations of SUB RECIPIENT pursuant to this Agreement.
IX. HOLD HARMLESS
SUBRECIPIENT shall indemnify, defend and save harmless CITY, its officers, employees,
agents, representatives and volunteers from and against any and all damages to or for loss of use of
property and for injuries to or death of any person or persons, including property and employees or
agents of CITY, and shall defend, indemnify and save harmless CITY, its officers, employees,
agents, representatives and volunteers from and against any and all claims, demands, suits, actions
or proceedings of any kind or nature, including, but not by way of limitation, workers compensation
claims and including attorney fees and reasonable expenses for litigation or settlement, resulting
from or arising out of the negligent or wrongful acts, errors or omissions of SUBRECIPIENT, its
officers, directors, employees, agents, subcontractors and suppliers arising out of
SUBRECIPIENT's performance of this Agreement.
X. INSURANCE
A. In accordance with the provisions of Section 3300 of the Labor Code, if
SUBRECIPIENT has any employees it is required to be insured against liability for worker's
compensation or to undertake self-insurance. Prior to commencing performance of this
Agreement, SUBRECIPIENT agrees to obtain and maintain employer's liability insurance with
limits not less than $1,000,000 per accident. If SUBRECIPIENT has no employees, nor
workers' compensation coverage, it must execute a Declaration available from the CITY, and
update as is necessary.
B. SUBRECIPIENT shall obtain, at its sole cost, a policy or policies of commercial
general liability insurance, or equivalent form, with a combined single limit of not less than
$1,000,000 per occurrence.
Such insurance shall: (1) name the City of Santa Ana, its officers, agents,
representatives, employees and volunteers as additional insureds; (2) be primary with respect to
insurance or self-insurance programs maintained by the CITY; (3) contain standard separation of
insureds provisions; and (4) give to CITY prompt and timely notice of claim made or suit
instituted arising out of SUB RECIPIENT's operations hereunder.
10
'-'
-'
7/6!OlLS
SUBRECIPIENT shall: (a) prior to exercising any right under this Agreement,
furnish properly executed certificates of insurance and additional insured endorsement to the
CITY which shall clearly evidence all coverages required above; (b) provide that such insurance
shall not be materially changed or terminated except on 30 days prior written notice to the CITY;
(c) maintain such insurance for the period covered by this Agreement; and (d) replace such
certificates for policies expiring prior to the expiration of this Agreement.
XI. REVERSION OF ASSETS
A. Upon the expiration ofthis Agreement, SUBRECIPIENT shall transfer to CITY any
CDBG funds on hand at the time of the expiration of this Agreement as well as any accounts
receivable attributable to the use ofCDBG funds. [24 CFR 570.503(b)(8).]
B. Any real property under SUBRECIPIENT's control that was acquired or improved
in whole or in part with CDBG funds in excess of$25,000.00 must either be:
1. Used, where CITY has given written approval, to meet one of the national
objectives stated in 24 CFR 570.208 until five (5) years after expiration of this Agreement, or for
such longer period oftime as determined to be appropriate by CITY; or
2. If not used in accordance with subparagraph A above, SUBRECIPIENT
shall pay to CITY an amount equal to the current fair market value of the property less any portion
of the value attributable to the expenditure ofnon-CDBG funds for acquisition of, or improvement
to, the property. Such payment is program income to CITY.
C. Subject to the obligations set forth herein, title to equipment acquired under the
terms of this Agreement will vest upon acquisition in SUBRECIPIENT. When said equipment
which has been acquired in accordance with this Agreement and all applicable regulations is no
longer needed for said program, disposition of said equipment will be made as follows:
1. Items of equipment with a current per unit fair market value of less than
$5,000.00 may be retained, sold or otherwise disposed of with no further obligation to CITY.
2. Items of equipment with a current fair market per unit value of $5,000.00 or
more may be retained or sold and CITY shall have the right to an amount calculated by multiplying
the current market value or proceeds from the sale by CITY's share of federal funds used to acquire
the equipment, in accordance with 24 CFR 85.32(e)(2).
D. SUBRECIPIENT hereby agrees, upon the demand of CITY, to execute,
acknowledge and deliver, or cause any person or entity who may have any claim to rights hereunder
or under any document, instrument or agreement executed in furtherance of the services and
activities to be performed hereunder, to execute, acknowledge and deliver, to CITY assigrunent(s),
quit claim deed(s) or such other and further instruments, documents and agreements as may be
necessary, in the sole and absolute discretion of CITY, to vest in CITY all of SUBRECIPIENT's
right, title and interest (if any it may have) in and to CITY, CDBG or other federal, state and/or
11
'-'
'-'
7/6/0] LS
local accounts or program funds or allocation of funds to which CITY is or may be entitled, either
for its own account or as fiduciary or trustee for others, which were obtained for the purpose of the
performance of this Agreement or any previous agreements relating to the same subj ect matter or
activities as this Agreement, together with any instruments, loans, grants or advances by
SUBRECIPIENT on behalf of CITY, in furtherance of the activities hereunder or thereof.
SUBRECIPIENT's obligations and responsibilities set forth in this paragraph "XL
REVERSION OF ASSETS," and in paragraph "XII. TERMINATION" and other requirements
pertaining to program income shall not be affected by the termination of this Agreement and shall
survive the date of termination of this Agreement for such period of time as CITY and/or mID
deems necessary for the responsibilities, duties and obligations to be performed and completed to
the satisfaction of CITY and mID.
XII. TERMINATION
A. This Agreement may be terminated on thirty (30) days' written notice by either
party. In the event of such termination, SUBRECIPIENT shall only be entitled to reimbursement
for approved expenses incurred to the effective date oftermination.
B. This Agreement may be suspended or terminated by CITY upon five (5) days'
written notice for violation by SUBRECIPIENT of Federal Laws governing the use of Community
Development Block Grant Funds. In the event of such suspension or termination, SUBRECIPIENT
shall only be entitled to reimbursement for approved expenses incurred up to the effective date of
suspension or termination.
C. Pursuant to 24 CFR 85.43, in the event SUBRECIPIENT defaults by failing to fulfill
all or any of its obligations hereunder, CITY may declare a default and termination of this
Agreement by written notice to SUBRECIPIENT, which default and termination shall be effective
on a date stated in the notice which is to be not less than ten (10) days after certified mailing or
personal service of such notice, unless such default is cured before the effective date of termination
stated in such notice. If terminated for cause, CITY shall be relieved of further liability or
responsibility under this Agreement, or as a result of the termination thereof, including the payment
of money, except for payment for approved expenses incurred for services satisfactorily and timely
performed prior to the mailing or service of the notice of termination, and except for reimbursement
of (I) any payments made for services not subsequently performed in a timely and satisfactory
manner, and (2) costs incurred by CITY in obtaining substitute performance.
D. The grant of funds under this Agreement may be terminated for convenience in
accordance with 24 CFR 85.44.
E. In the event this Agreement is terminated as set forth in subparagraphs XII.A.
through XII.D., inclusive, SUBRECIPIENT agrees to immediately return to CITY upon CITY's
demand and prior to any adjudication of SUBRECIPIENT's rights, any and all funds not used, and
to comply with paragraph "XI. REVERSION OF ASSETS" of this Agreement.
12
'-"
-'
7/6/01LS
XIII. LIMITATION OF FUNDS
The United States of America, through HUD, may in the future place programmatic or fiscal
limitations on the use ofCDBG funds which limitations are not presently anticipated. Accordingly,
CITY reserves the right to revise this Agreement in order to take account of actions affecting HUD
program funding. In the event of funding reduction, CITY may, in its sole and absolute discretion,
reduce the budget of this Agreement as a whole or as to costs category, may limit the rate of
SUBRECIPIENT's authority to commit and spend funds, or may restrict SUBRECIPIENT's use of
both its uncommitted and its unspent funds. Where HUD has directed or requested CITY to
implement a reduction in funding, in whole or as to a cost category, with respect to funding for this
Agreement, CITY's City Manager or delegate is authorized to act for CITY in implementing and
effecting such a reduction and in revising, modifying, or amending the Agreement for such
purposes. Where CITY has reasonable grounds to question SUBRECIPIENT's fiscal
accountability, financial soundness, or compliance with this Agreement, CITY may suspend the
operation of this Agreement for up to sixty (60) days upon five (5) days written notice to
SUBRECIPIENT of its intention to so act, pending an audit or other resolution of such questions.
In no event, however, shall any revisions made by CITY affect expenditures and legally binding
commitments made by SUBRECIPIENT before it received notice of such revision, provided that
such amounts have been committed in good faith and are otherwise allowable and that such
commitments are consistent with HUD cash withdrawal guidelines.
XIV. EXCLUSIVITY AND AMENDMENT OF AGREEMENT
This Agreement supersedes any and all other agreements, either oral or in writing, between
the parties hereto with respect to the use of CITY's CDBG funds by SUBRECIPIENT and contains
all the covenants and agreements between the parties with respect to such employment in any
manner whatsoever. Each party to this Agreement acknowledges that no representations,
inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone
acting on behalf of any party, which are not embodied herein, and that no other agreement or
amendment hereto shall be effective unless executed in writing and signed by both CITY and
SUBRECIPIENT.
XV. LAWS GOVERNING THIS AGREEMENT
This Agreement shall be governed by and construed in accordance with the laws of the State
of California, and all applicable federal laws and regulations.
XVI. V ALInITY
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.
13
'-'
'wi
7/6/01 LS
XVII. 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 ofthe terms of this Agreement, and shall
indemnify CITY fully, including reasonable costs and attorney's fees, for any injuries or damages to
CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn.
b. All Exhibits and Attachments referenced herein and attached hereto shall be incorporated
as if fully set forth in the body of this Agreement.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the last date and
year written below.
DATED:
\ (j... Iv\/OV
,
DAVID N.
City Manager
ATTEST:
APPROVED AS TO FORM:
PATRICIA E. HEALY
Clerk of the Council
~.
a....~
.F-10SEPH W. FLETCHER
City Attorney
c::2
DATE:
8/~1 /;~
{ /
SUBRECIPIENT:
QC~-
~~
N e~'
anae: , J
Title: . (~-
Tax ill:
C!~~~"-'
14
"".,. ._,~'~~;-'
'-'
-.J
VI.
"""
GOALS AND OBJECTIVES
Program Goal: To bring the OC Crazies School ofImprovisation Comedy on an on-site basis to
SAUSD schools between now and the end of the fiscal year 2000 or to Santa Ana Senior Citizen
Gj':nters or a combination of both with in the jurisdiction CDBG progral!l. In addition to the
comedy improvisational skills these students willleam how "improv" i:ait assist then in their
daily lives along with enhancing their self-<:onfidence and self-esteem.
OBJECTIVES: I.
METHODOLOGY
OBJECTIVES: 1.
"
Provide on-site training to these SAUSD schools and or to senior centers.
depending on funding received, we would like to increase the number of
student-hours from this past year of approximately 60 to over 90 student
hours. Expect to conduct sessions at 8 to 16 schools andlor senior
centers where between 400 and 600 people can be positively affected.
2.
Provide a performance venue for all active participants.
3.
A resource protocol for select performers to perform in a professional
environment setting revue (i.e. The Little Crazies or Generation Next) at
the O. C. Crazies theatre.
2.
Enroll over 400 school children in training program at their schools or
our theatre.
Task/Action
(A) Contact SAUSD schools via letters and personal calls.
(B) Follow-up with personal visits.
Provide on-site improvisational skills training that is tailored to specific
requirements as outlined by school personnel.
Task/Action
(A) Determine needs on-site meetings with the appropriate school
personnel - explain options available and specific goals that needs
to be reached.
(B) Develop curriculum as specified during this meeting.
Provide on-site training at each selected school for a minimum of
one hour per week for eight weeks. Ending with either an on-site
showcase or at the OC.. Crazies theatre.
Task/Action
(A) Design programs
(B) Provide instructors
(C) Outline - rehearse - produce and direct showcase
,
~.
--
fj.H1 S rr A-
--
'-'
.....
Fiscal Year 2002 - 2003 Proposed Budget
Orange County Crazies
This proposed budget is for a 9-month program coordinated by the Orange County
Crazies administrative staff. The program staff for whom funding is requested consists of
lItl Administrative Assistant, an Executive Director and three to fO\ll" .~ctors.
The following illustrates the amount of time each staff member will devote to the
proposed program with respect to the amount of time each staff member works at the
theater and/or school site.
I. The Administrative Assistant works 6 hours/wk at the theater of which a1l6 hours are
spent on the Kidprovisation Program (100% of salary form program).
2. The Executive Director works 4-5 hours/wk at the theater of which a1l4-5 hours are
spent on the Kidprovisation Program (100% salary from program).
3. The instructors work 140 hours/9month at the schools of which all 140 hours are
spent on the Kidprovisation Program and training hours for the instructors (100% of
salary from program).
Description of
Expenditures
Total
0;" Funded
bv CnBG
CnBG
Other
Salaries:
Ad. Assistant
Director
Instructors
$3500
$5000
$3500
100%
100%
100%
$3500
$5000
$3500
$0
$0
$0
Other:
RentlUtilities $2000 100% $2000 $0
Material & Supplies $1000 100% $1000 $0
Total: $15000 100% $15000 $0
Revenues:
Santa Ana CDBG $15000 100% $15000 $0
Other Cities $0
Donations $0
Total FY Revenues $15,000
[/It116/r ,g
'-'
..,
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:
(ll ,No Federal appropriated funds have been paid or will be paid, by oron be.halfofthe
undersigned, to any person for influencing or attempting to influence iui- officer or
employee of any agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with the awarding of any Federal
contract, the making of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal contact, grant, loan or cooperative
agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with this Federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure
Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the
award documents for all subawards at all tiers (including subcontract, subgrants, and
contracts under grants, loans, and cooperative agreements) and that all subrecipients shall
certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a
prerequisite for making or entering into this transaction imposed by Section 1352, Title
31, U. S. Code. Any person who fails to file the required certification shall be subject to
a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
Title
Grantee/Contactor Organization
~(~
Name of Certifying Officer
OhM/e ~
Signature
? /Ocl!;;l..)
Date f
EXHIBIT C
Page I of2
'-
'-'
SUBRECIPIENT warrants the following:
i. SUBRECIPIENT will comply with Public Law 88-352, Title VI of the Civil Rights
Act of 1964 (42 U. S. C. section 2000 et seq.) and implementing regulation in 24 CFR
Part 1.
~. 1'{o..person in the United States shall on the ground of race, color, religion, I}ational
ori~n, or sex, be excluded from participation in, or be denied the behe'fris of, or be
subjected to discrimination under any program or activity funded in whole or in part with
community development funds made available pursuant to the ACT.
3. All laborers and mechanics, employed by contractors or subcontractors in the
performance of construction work financed in whole or in part with community
development funds shall be paid wages at rates not less than those prevailing on similar
construction in the locality as determined in accordance with the Davis-Bacon Act, as
amended, 40 U. S. C. Sections 276 a 1-5, except for individuals who perform services for
which they volunteered; do not receive compensation for such services; or are paid
expenses, reasonable benefits, or a nominal fee for such services; and are not otherwise
employed at any time in construction work.
4. SUBRECIPIENT will comply with all Federal statutes applicable to projects funded
with community development funds, except that (a) SUBRECIPIENT does not assume
CITY'S environmental responsibilities described at 24 CFR 570.604; and (b)
SUBRECIPIENT does not assume CITY'S responsibility for initiating the review process
under Executive Order 12372.
".
EXHIBIT C
Page 2 of2
ACORD_ CERTIFICV OF LIABILITY INSUUNCI;~~l~ S9 DATE (MMIDDfYY)
01/27/03
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
PrideMark Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1820 E. First St. r Ste #500 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Santa Ana CA 92705
Phone: 714-569-2700 INSURERS AFFORDING COVERAGE
_.----- _._-~_..- - -
INSURED INSURER A First Financial Insurance Co.
,----- -------
~~RB
Orange County Crazies, Inc. ~-~-_..~-- ----- --- ---
Cher1e Kerr INSURER C .. _k-2()()~~jf)S ~3 {;j
809 N. Main St. i-INSURER 0------ -- -
Santa Ana CA 92701 I INSURER E:
,
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
LT: TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YV LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
., I.;l
, CLAlMS MADE L~ OCCUR
154F000103
12/02/02
12/02/03
EACH OCCURRENCE -e 9 ~Q-L9.9_0
FIRE DAMAGE (Anyone firel__+ $ 100 ,9Q~______
MED EXP (Anyone person) ~O 0
I PERSONAl & ADV INJURY i $ 1,000,000
. GENERAL AGGREGATE j_~_2, 0~Q.LQ9_9_
PRODUCTS - COMPIOP AGG $ INCLUDED
"-~~-,--~-
I
b
GEN'L AGGREGATE LIMIT APPLIES PER'
Xl POLICY r:;r2i LOC
AUTOMOBILE LIABILITY
~ ANY AUTO
, ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
i COMBINED SINGLE LIMIT
I (Eaaccident)
:-----'--~
I BODIL Y INJURY
(Perpersool
--------
BODILY INJURY
(Peraccldenl)
-- -----
PROPERTY DAMAGE
(Per accident)
$
--+--
$
$
tn---
, GARAGE UABllITY
r--I ANY AUTO
, AUTO ONLY - EA ACCIDENT $
---------
EAACC : $
OTHER THAN
AUTO ONLY
AGG $
~, -
EACH OCCURRENCE ,$
I AGGREGATE + I ~ -=-=--~
~~~j:m
--- --r--
I
EXCESS LIABILITY
OCCUR LJ CLAIMS MADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
J(!/~.
t:J~hec(\
De ut (~ity ('dll,;f'lC
, TORY L1MrrS I ~
E,L EACH ACCIDENT. ! $
l'::':.~___~________
! EL D:f;EASE - EA rMr-:..0VfE' $
1-----,-
EL DISEASE. POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESJEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Santa Ana, its officers, agents, employees' volunteers are named as
additional insured per form CG 2010 (11/85). Except 10 days for
non-payment. As respects cancellation by the company.
CITYSAN
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL~ MAIL -3.L DAYS WRITTEN
SHALL
CERTIFICATE HOLDER
Y ADDITIONAL INSURED; INSURER LETTER: A
City of Santa Ana
Community Development Agency
P. O. Box 1988
Santa Ana CA 92702-1988
IMPOSE NO OBLIGATION 0
REPRESENTATIVES.
AUTHORIZED REPRESENT
RER, ITS AGENTS OR
Jose Cazares
ACORD 25-S (7/97)
, ,
'-
""-'
ADDITIONAL INSURED ENDORSEMENT
Insurance Company First Financial Insurance Companv
This endorsement modifies such insurance as is afforded by the provisions of Policy
# 154F000103 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 12/2/02
Policy # 154F000103
Issued to Oranae Countv Crazies. Inc.
, this endorsement form as a part of
Named Insured
Countersigned by
APHWVED AS TO FORM
~~ d
/;1 .' tJ t7 __
(y.", , cody 1
DCPlllY City Attorney
. P,OLlCY NUMBER:
NAMED INSURED:
1541\...-103
Orange County Crazies, Inc.
COMME.",JIAL 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:
City of Santa Ana, its officers, agents, employees and volunteers are named as Additional Insured
as Respects their Interest in Connection with the Named Insured
Reference: Project # 7647
(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, but only with respect to liability arising out of "your work" for that insured by or for you.
It is further agreed that such insurance as is afforded by the policy for the benefit of the additional insureds shall
be primary insurance, but only as respects any claims, loss or liability arising out of the Named Insured's
operations and any insurance maintained by the additional insured shall be non-contributing.
A,'j'ROVED AS TO FORM
ifiAl
/:r-.t7.P r;;L
lpom , lcody 7-
l),':1uly Citv At10rlley f
CG20 10 1185
Copyright Insurance Services Office, Inc., 1984
'\
JAN-30-03 11:59AM
'-'
FROt.1-PR I DMARK . -~EF I TSl
714-55927~
11- c.OOC - IOS-- 3;;z.
H05 POllOI F 150
- CERTIFICA1~ OF LIABILITY INS -
ACORD. .....,Cl;uB!i~ 9~ .,.IIIl\"UIUWl,QII/ ,
01/29/03 i
'RQOU(::t:P THIS CERTIFICATE IS !SSLlED AS A MATTER OF INFORMATION
ON~Y AND CONFI'RS NO RIGHTS LlPON THE CERTIFICATE
~.~deMa.~ tnsuranee HOWI'R. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
~820 E. r~rst St., ste /1500 AI.. TER THE COVERAGE AFFORDED BY TIllE POLlCII'S 8l:~OW.
s....ta An" CA 92705 I
Phone: 714-569-2700 INSLlRER5 AFFORDING COVI!'RAGE !
.. ..~
,N$uRl!P INSUltER ~ r:i.rU Financ:i.<ll Insurance .l;?
Oranqe iounty C.az~es, INSU~R I I
lnc. .-
cser~e e~r IN~Uft=R c
8 9 N. Ka.~n S~270 ..---
J~SURfR C
santa Ana CA 1 ---
, INSuRER e: i
TI1E ~ICtl:S o~ INSUFWiCe L1STE]) BiLOW NAvE eeEN ISSl.lfD TO THE INS\lRI:P NMilEO ABove: FOIl Tnt: pOuCv PERlOO INOICATl:.P r.oTWITI"lSTAN01/"lC,
ANY ~UIREMfNT. TERliI OR CONDITION OF MY CotfMACT OR OTnfR DOCUMENT wIT" ftfSfECT TO W"ICI1 Tl1fS CeRTtFICAn. MAY Be Issueo OR
MAY PERTAlN. TNE INSuRMCf AfFORDI5P IJ't TMf POUCIES OE'9CRlaea rlSREIN IS SUBJECT TOAl-L Tt1E TERMS, ExCI.UStONS AND CONOITIONS OF SuCl'1
POIJCIES. AGGftt:G^Tt ..~~TS $"000 IN>.Y HAv~ BEj:N RSOUC~ lIly,AID CWIIIMS
'(1: n-I'I' Of' INlulW<Ce POuCV f<WIIIER
Gi~eRAa.l.JAaIU1'Y
A X COMMERC",-GENERAl..IAIII'-ITY 154i'000103
C....S MAllE [i] OCCUll
COVERAGES
12/02/02
12/02/03
Gi:N'1. "GGRi~n: I-lMIT APPI-I~S PER
X fJOt.lCY ~g: l.CC
AuTONOD.I.' l.IABlIolTY
MY AuTO
'U-L OWr..EO '-LlTOS
SCI'\eOULXO AuTOS
NlRliO AUTOS
NOfr4-O'Mo(W AuTOS
GARAGe 1-lAB1I.'T'r
/\NY AUTO
1>
a.cu~ LlAaluTY
occuR 0 CI.AIM$ MACE
I
OIiPUCT!fi...e
AETliNTION $
WOR~ERS CQMPetSAT1Of\I AfrtD
E~I'\.OYEfl:>_T\'
OTI'I~
uMITS
EACH OCC""","NCE , 1, 000 O.Q.~
F1RcPAMAGE(A,rl,Ol'ldTI/E1) .100,000__ _
MEPE.'lP(AtI!fOllOpor~) j55.000
PERSO~ IoAOv Irt.l\,lRv .s 1.000.000 '
GENEFW-AGaR"""E ,$b 000 000.-.1
PAOOr.lCTS" COMPJOP AGO ~_I!'iC"UDED
cOM8~....eo Slf\lGLj: LIMIT
tEil~IQo;!n!1
'.
!.__no
SOOIl- Y INJuRy
tPtrpof~)
"
,
aaou.. '( IN..IIJRy
tft8(lKCI<lOR)
$
PROPERty OAMAGe
(Pvr~Q8I\t)
,
-'UTO ONLY. EA ACCIDENT !.s
OTt'lSR T~ EA Ace, I'
AuTO ONl-Y AGO J
SAC" OCCURREfolce . t $;
~GATc i $
. ri
.
. .1
TOAY ..lMfTS I ERo
~,.L EACH ACCIOENl I $ _ .
e.. ~~SCAse.EAEM!-~_. ______
E I. DISeASe - POI-ICV LIMIT 5
OQiCRlPTION OJ" cpeRAll0~1lae.sNetuCl-ii~et.US'OMS ADN::D lilY ENDOfl$~EiI'CTI$Pt:.c.A1o PRO~ICt(S
C~ty 0; Santa Ana, ~ts otf~ce~s, aqents, employees & volunteers are n~Q as
add~uona1 ~ns="d pe~ ;0= CG 2010 (11/95). Except 10 clays for
nop-p"yuent. As respects caneel1at~on by the company.
CANCIi~LA110N
,"~I-P Al<4Y OF T"E::: AJSOve D~$CRiBSD POuctES pE eAAceu..E:O BEFOfiti: TI1E !XPIRA TIDr
OAn:Tt1IiFn~OF Tl1e 155\HNG INSURER WU-I-.... -----JI:"'" MAlL ..3..C- OAyS w~rn:/Il
NOncJ:: TO Tt1,'CEfll1FICATE HOI-DER IWAEO TOTtll~ ~~ I'''''' 'f 6Qtf~
~~ ( / ~ jIf,Qi_m
AUTItOlOZEO RE~RE>t:NT~TI
J'ose CA!:ares ,
CI'RTlfICAT~ HOWER
y ADOtTIO"A"IIfSU~D: IN5cJREf'. l-eT11!:R. A
CtTYSAN
C>-ty of Santa. Jlna
cOJIIJIlun~ty Pevelopllent Aqency
II. 0, pox +988
Sant" Ana CA 92102-1988
ACORD 25-S (7197)
,
,
JAN-28-0l 11 :2lA~
""'"
FROM-PR I D~RK .....? I TSI
714-5892749 ~
T-708 P.Ol/04 F-Ol8
ADDITIONAL INSURED ENDORSEMENT
Insurance Company First Financial Insurance Comaanv
This endorsement modifies such insurance as is afforded by the provisions of Policy
# 154F0001 03 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 pertormed 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 whol11 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 fight .....hich
such person or organization would have as a claimant if not so included
4. With respect to the additional insureds, this insurance shi:lll not be
canceled, or materially reduced in coverage or limits except after thirty (30) days wntten
notice has been given to the City of Santa Ana, 20 Civic Center Plaza, S,anta Ana,
California 92701.
(Completion of the following, including countersignature, is required to make this
endorsement effective)
Effective 12/2/02
Pohcy # 154F000103
Issued to OranQe Countv Crazies, Inc.
, thiS endorsement form as <l part of
S 1'0 FOlLi
A.PPROVED A
t; -.---
USA . SiORCK ,
. t CitY Attorne,
Ass,stan
(f- .0 +-;>j
Countersigned by
/
I
-,
/
"
, " '-"
JAN-28-03 11: 23AM FROM-PR I DUARK ' ,FITS)
POLICY NUMBER: 1S4F~103
NAMED INSURED: Orange CQllnfY CrUies, ll1e.
714-5692749, .j! T-706 P.04/04 F-038
COMMEM:IAL GENERAL liABILITY
THIS ENDORSEMENT CHANGES THE POLICY. -PI-EASE RI:AP IT CAREFUI-L Y.
ADDITIONAL INSUReD - DESIGNATeD peRSON or ORGANIZATION
Tn,s endorsement mOd.fies Insurance prOYld~ unllerlhe following'
CO~MERCIAL GENERAL LIABILITY CovERAGE PART
SCHEDULE
Name of Person or Organization:
City of Santa Ana, its officers, agents, employees and volunteers are named as Additional Insured
as Respects their Intere5t in Connection with the Named Insured
Referenc.: Projecrli 7647
(If no entry appears aDove, Information required to complete tnis endorsement Will De snown In me DeClarations
as applicable to tnis endorsement)
WHO IS AN INSURE:D (Sedion II) 1$ amended to include as an Insured tne person or orgaOlzaliOn snown In tne
Schedule. but only with respect to lIaDility arising Out of .your work" for lnat insured tly or for yOI,
It IS furtner agreed that suen insurance as is afforded tly tne policy for the benefit of tne addilion~1 inSureds snail
be pnmary msurance, bul only as respects any claims, lOSS or liatlility arising Out of Ihe Named Insured'S
operations and any insurance mamtained by tne aaditional insured snail be non-contritMing
'0-'\
S 'TO FO"l-
p,:PP1>.OVED h
w YiC;g.
~s10RCK
USA '. Attorney
Assistant Clt)'
(J p1-J)
-'
CO 20 10 II H5
Copynghllnsurance S~fYic.$ Office. Inc., 19S4