HomeMy WebLinkAboutMERCY HOUSE LIVING CENTERS (CDBG 2006) T
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AGREEMENT TERMINATION
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Please complete this form when the attached agreement is no longer In eTfecf.' . ..
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Return form to the Sr. Deputy Clerk of the Council (M-30). CI!.1tl\1713f3~l~~J1~~~e any
questIOns.
The agreement with ~ ~ , No.A-~oO(P-69~-o.).5
was completed on ~ .3 I ::l. 00-, , and final payment has been made.
Department: CFNlA ."... ~'..L ~~. <<~'" ~
Signature: C:<u~~(j ~
Date: 'is 1 ~ I D1
Revised 8-7-03
City of Santa Ana
Clerk of the Council
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V',uc\h, MAY h;(i~;[EL'
'iN IlL INSUR,'JICE EWIRES
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i;!.t.!1K OF COONCII 5/05
D~F AUG 0 9 2006
AGREEMENT BETWEEN THE CITY OF SANTA ANA AND
0: Co.4 C.;l.) MERCY HOUSE TRANSITIONAL LIVING CENTERS, INC. FOR USE OF
(I... Rot" es) COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS
(With Provisions Relating to Compliance with Title X
and 24 CFR Part 35 Relating to Lead Based Paint)
A-2006-092-025
This Agreement, made and entered into this 1st day of July, 2006, by and between the City
of~ant~.A.r1a?;<~ch~~~cil(al1dlTI~i~i.ll.al.coI]Jol"ation of the State of California ("CITY") and
M~~~ri:I!i!Wl~i'iri:i~~!_liiiii.j:,il!iglli;~~tmiiil"II~f; a California nonprofit corporation
("SUB RECIPIENT"),
WIINE.s..s..!HH
Recitals:
A. The CITY, as an entitlement recipient and grantee of the United States Department of
Housing and Urban Development ("HUD") Community Development Block Grant ("CDBG")
Program, desires to enter this Agreement with the SUBRECIPIENT for the expenditure of CDBG
funds in accordance with Title 24, Part 570 of Code of Federal Regulations 24 CFR 570,000, et seq.
("CDBG REGS"); and
B. CITY has applied for and received CDBG funds from HUD pursuant to Title I of the
Housing and Community Development Act of 1974, Public Law 93-383, as amended ("ACT"); and
C. The SUB RECIPIENT is a private nonprofit agency that has been selected by the CITY to
receive CDBG funds and administer such financial assistance; and to provide the services described
in Exhibit A, in accordance with the schedule of performance included therein, hereinafter referred
to as "said program". SUBRECIPIENT represents that it is qualified and willing to operate said
program and certifies that the activities carried out with funds provided under this Agreement will
meet one or more of the CDBG program's National Objectives (24 CFR Part 570.208),
D. SUB RECIPIENT agrees that it will adhere to the performance measurements and
outcomes as indicated on Exhibit A-I ("Outcome Tracking"). Failure to follow the
measurements and meet the stated outcomes may constitute breach of contract that could result
in termination of this Agreement or serve as reason for the City to recapture the grant funds
awarded to SUBRECIPIENT pursuant to this Agreement.
E. Title X of the 1992 Housing and Community Development Act (Title X) established
requirements relating to lead based paint ("LBP") in housing receiving federal assistance,
in particular requirements relating to (i) notification (including pamphlet distribution, disclosure to
purchasers and lessees, notice of lead hazard presumption or results of evaluation, and/or lead
hazard reduction), (ii) lead hazard evaluation (including visual assessment, paint testing, and/or risk
assessment), (iii) lead hazard reduction (including paint stabilization, interim controls, standard
treatments, or abatement depending on the requirements for housing activity type), (iv) ongoing
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maintenance, if required, and (v) response to children with environmental intervention blood lead
levels, as required; and
F. On September 15, 1999 HUD adopted implementing regulations to Title X that became
effective September 15,2000 as set forth in 24 CFR Part 35, et seq, ("LBP Regs"), which establish
specific rules regarding notification to owners and occupants about the existence of LBP hazards,
identification ofLBP hazards, and control ofLBP hazards; and
G. Residential structures built after January I, 1978 are exempt from lead-based paint
requirements as the use of lead-based paint was banned for use in residences after this date by
Congress (24 CFR Part 35.115). Therefore, the Title X requirements set forth herein shall not be
applicable if the structures involved were built after January I, 1978.
H. Subpart K - Acquisition, Leasing, Support Services, and Operation of the LBP Regs,
sets forth specific requirements relating to housing providers, such as SUBRECIPIENT, who
administer local programs that provide supportive housing for special needs populations and are
funded by HUD Office of Community Planning and Development ("CPD") programs, including
CDBG funds, as provided to SUBRECIPIENT under this Agreement; and
I. In connection with the grant of funds under this Agreement, CITY requires that
SUBRECIPIENT comply and evidence of compliance with all applicable requirements of Title X
and the LBP Regs, in particular Subpart K relating to acquisition, leasing, support services, or
operations, and Subpart J relating to rehabilitation, as and when applicable; and
J. In connection with the grant of funds under this Agreement, CITY requires that
SUB RECIPIENT comply and show evidence of compliance with all applicable requirements of
Title X and the LBP Regs, in particular Subpart M relating to tenant based rental assistance, as and
when applicable; and
K. Attached and hereby fully incorporated to this Agreement are the following notification
attachments: Attachment NO.1 entitled "Protect Your Family From Lead In Your Home",
EPA747-K-99-001, Attachment No.2 entitled "Sample Disclosure Format for Target Housing
Sales, Disclosure of Information on Lead-Based Paint and Lead-Based Paint Hazards", and
Attachment No.3 entitled Sample Summary Risk Assessment Notice Format"; provided however,
that such attachments are not intended to modify or limit SUBRECIPIENT'S obligation to fully
comply with all applicable provisions of Title X and the implementing regulations in the LBP Regs;
and
L. By this Agreement SUBRECIPIENT will accept assignment from the CITY of all
responsibilities set forth in Subpart K of the LBP Regs; and
M. The CITY and SUBRECIPIENT have duly executed this Agreement for the expenditure
of such funds; and
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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,
(I) SUBRECIPIENT acknowledges that its operations and the services it provides to the
community are subject to Subpart K (and, in some instance(s) Subpart J and/or Subpart M) of the
LBP Regs.
(2) SUBRECIPIENT acknowledges that its operations and the services it provides
includes: (a) acquisition, leasing, or ownership of residential property for the purpose of
providing affordable housing for persons with special needs, such as transitional housing, or
(b) housing for persons with special needs, such as the disabled, or (c) financial assistance to
assist transitional housing participants to move to permanent housing by paying for the first
month's rent or security deposit, or (d) tenant-based rental assistance to program participants
who choose their own housing units, and by provision of such services such housing is subject to
the requirements of the LBP Regs.
(3) Representations:
(a) Authority, SUBRECIPIENT is a duly organized and existing non-profit
corporation in good standing and authorized to do business under the laws of the State of
California. SUBRECIPIENT has full right, power and lawful authority to accept the funding
hereunder and to undertake all obligations as provided herein and the execution, performance
and delivery of this Agreement by SUBRECIPIENT has been fully authorized by all requisite
actions on the part of SUBRECIPIENT.
(b) Experience. SUB RECIPIENT is a qualified provider of the services to be
provided hereunder.
(c) Familiarity With Services Required. By executing this Agreement,
SUBRECIPIENT warrants that (i) it has thoroughly investigated and considered the services to
be performed and provided hereunder, (ii) it has carefully considered how the services should be
performed, and (iii) it fully understands the facilities, difficulties and restrictions attending
performance of the services under this Agreement, inclusive of compliance with the LBP REGS.
Should SUBRECIPIENT discover any latent or unknown conditions materially differing from
those inherent in the work or as represented by CITY, it shall immediately inform CITY of such
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fact and shall not proceed except at SUBRECIPIENT'S risk until written instructions are
received from CITY'S representative.
(d) No Conflict. To the best of SUBRECIPIENT'S knowledge,
SUBRECIPIENT'S execution, delivery and performance of its obligations under this Agreement
will not constitute a default or a breach under any contract, agreement or order to which
SUB RECIPIENT is a party or by which it is bound.
(e) No Bankruptcy, SUBRECIPIENT is not the subject of any current or
threatened bankruptcy proceeding.
(1) 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. SUB RECIPIENT is not aware that it is the
subject of any current or threatened criminal or civil action investigation by any public agency,
including without limitation a police agency or prosecuting authority, that would relate to affect
performance of the Agreement or provision of services hereunder.
(4) Compliance with Suboart K ofLBP Rees. Subpart K - Acquisition,
Leasing, Support Services, or Operation
(a) SUBRECIPIENT acknowledges and agrees that it shall comply with and
implement the requirements set forth in Title X and the LBP Regs to eliminate, as far as
practicable, LBP hazards in all residential property that is under its ownership, possession, or
control and/or residential property occupied by persons or families that receive financial or other
assistance from SUBRECIPIENT.
(b) SUB RECIPIENT shall provide a notice to all residentsloccupants of
residential property that is under its ownership, possession, or control and/or residential property
occupied by persons or families that receive financial or other assistance from SUBRECIPIENT
in accordance with Section 35.125 of the LBP Regs.
(i) SUBRECIPIENT acknowledges that in connection therewith a visual
assessment is not considered an evaluation for purposes of the LBP Regs.
(c) Notification (24 CFR 35.130). SUB RECIPIENT shall provide the LBP
hazard information pamphlet in accordance with Section 35.130 of the LBP Regs to all
occupants, owners, and purchasers of housing.
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(i) The pamphlet shall be the EPNHUD/Consumer Product
Safety Commission lead hazard information pamphlet or an EPA-approved
equivalent. The current form and version of the pamphlet is attached as
Attachment No. I to this Agreement.
(ii) SUBRECIPIENT shall cause to be disclosed to all purchasers
and lessees available information and knowledge regarding the presence of LBP
and LBP hazards prior to selling or leasing a housing unit in accordance with 24
CFR 35, Subpart A. The current form and version of such notice is attached as
Attachment No.2 to this Agreement.
(iii) SUBRECIPIENT shall ensure that all occupants, owners, and
purchasers of housing be notified in writing of the results of the presumption of
LBP and/or LBP hazards, and results of any lead hazard evaluation, and any lead
hazard reduction work in accordance with 24 CFR 35, Subpart A, The current
form and version of such notice is attached as Attachment No.3 to this
Agreement.
(d) Lead Hazard Evaluation (24 CFR 35.125). SUBRECIPIENT shall conduct
all activities described in Section 35.1015 relating to visual assessment, paint stabilization, risk
assessment, and maintenance with regard to all residential property that is under its ownership,
possession, or control and/or residential property occupied by persons or families that receive
financial or other assistance from SUB RECIPIENT, except for the exemptions described below
in section 4 (d)(i)(I).
(i) SUBRECIPIENT shall cause a visual assessment to identify
deteriorated paint in all residential property that is under its ownership, possession, or control
and/or residential property occupied by persons or families that receive financial or other
assistance from SUBRECIPIENT.
(I)Section 35.115(a) provides exemptions from Subparts B
through R of the LBP Regs including without limitation, (a) short term emergency assistance
lasting less than 100 days cumulatively is exempted from compliance with Subpart K as to such
short term rental assistance units, and (b) exemption for zero-bedroom units, including SRO
units, for which occupancy by a recipient of SUBRECIPIENT'S services is for less than 100
days, and (c) exemption for residential housing units constructed after January I, 1978.
(ii) To the extent that the assistance provided by SUB RECIPIENT
to persons or households meets one or more of the exemptions set forth in the LBP Regs, then
compliance with the notification, evaluation, reduction, clearance and other requirements of the
LBP Regs is not required related to the subject housing unit due to such exemption.
(iii) SUBRECIPIENT shall comply with the applicable provisions
of both Subpart K and Subpart M (Tenant Based Rental Assistance) of the LBP Regs as to all
tenant-based long term housing assistance, i.e., assistance to persons/households residing in
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housing units cumulatively for more than 100 days. If SUB RECIPIENT has knowledge that an
assisted family or household will occupy a dwelling unit for more than 100 days, the LBP Regs
require evidence of compliance prior to occupancy. Funding to be provided hereunder is
conditioned upon evidence of compliance.
(1) Subpart M applies to all dwelling units occupied to be
occupied by families or households that have one or more children of less than 6 years of age, as
well as the common areas servicing such dwelling units, and exterior painted surfaces associated
with such dwelling units or common areas. LBP compliance requirements relating to such
dwelling units includes, without limitation: notification, evaluation by visual assessment, paint
stabilization utilizing safe work practices, and clearance.
(2) CITY advises SUB RECIPIENT that in the event the
services provided hereunder include rental assistance payments, such as first and last month's
rent and/or security deposit, and the assisted tenant executes a lease for long term occupancy,
including occupancy in the same dwelling unit for more than 100 days, then the provisions of
Subpart M (Tenant Based Rental Assistance), will apply (unless otherwise informed and directed
by HUD), In this regard, CITY advises SUBRECIPIENT that Subpart M requires HQS
inspection of each dwelling unit prior to occupancy and prior to compliance with applicable
notification, evaluation by visual assessment, reduction through paint stabilization utilizing safe
work practices, and clearance requirements of the LBP REGS.
(e) Lead Hazard Reduction Work. SUB RECIPIENT shall cause LBP hazard
reduction, such as paint stabilization, interim controls, standard treatments, or abatement of all
residential property that is under its ownership, possession, or control and/or residential property
occupied by persons or families that receive financial or other assistance from SUBRECIPIENT,
except as exempted as described in subsection 4( d)(i)(I) above.
(I) Ifpaint stabilization occurs, SUBRECIPIENT shall cause paint
stabilization of each deteriorated surface and clearance of residential units pursuant to Section
35,1330(a) and (b) shall occur before occupancy of a vacant dwelling unit, or where a unit is
occupied, immediately after receipt of the CDBG FUNDS hereunder.
(2) Safe Work Practices shall be used in all LBP hazard reduction work.
(3) Clearance shall be conducted to confirm that no LBP hazards remain
when LBP hazard reduction work is complete. Confirmation of clearance by written certification
of a qualified inspector is required on an annual basis in connection with submittal of the April
15 quarterly report.
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(f) Onl!oinl! Maintenance. SUBRECIPIENT shall incorporate ongoing LBP
maintenance activities into regular building operations in accordance with Section 35.1355(a) for
all residential property that is under its ownership, possession, or control and/or residential
property occupied by persons or families that receive financial or other assistance from
SUBRECIPIENT, except as exempted as described in subsection 4(d)(i)(I) above.
(I) Ongoing maintenance includes confirmation of clearance which shall
be conducted to confirm that no LBP hazards remain when LBP hazard reduction work is
complete.
(2) Ongoing maintenance also includes confirmation of clearance by
written certification of a qualified inspector on an annual basis in connection with submittal of
the April 15 quarterly report.
(3) A part of such ongoing maintenance obligation includes notification of
the results of clearance confirmation and annual confirmation of clearance.
a. SUBRECIPIENT shall cause to be provided a notice to all
occupants of all residential property that is under its ownership, possession, or control and/or
residential property occupied by persons or families that receive financial or other assistance
from SUB RECIPIENT in accordance with Sections 35.125(b)(1) and (c), describing the results
of the clearance examination and the results of annual certification.
(g) Units Cleared Prior to Date of Al!reement: Confirmation of Clearance.
In the event the requirements of the LBP REGS relating to lead hazard evaluation, lead hazard
reduction, and lead hazard clearance have been completed on the subject dwelling units prior to
the Date of Agreement, then the SUBRECIPIENT shall provide to the CITY with the April 15
quarterly report a certificate from a qualified inspector evidencing a recent inspection and
confirmation of clearance ofLBP and LBP hazards from the subject dwelling unites),
5. LBP Informational Summary. For purposes of information only and in no
respect intended to be a representation or warranty of the provisions of the LBP REGS, the CITY
has caused to be prepared an information summary relating to the LBP REGS and application to
dwelling units that may be occupied by recipients of services and/or funding from
SUBRECIPIENT under this Agreement. Attachment No.4 to this Agreement, attached and
hereby fully incorporated by this reference, is such information summary. CITY staffwill
cooperate with and make themselves available to SUBRECIPIENT to assist in implementation of
compliance with the LBP REGS as to residential dwelling units to be assisted by
SUBRECIPIENT. The parties acknowledge and agree the CITY is and shall not be liable or
responsible for the accuracy of such summary, and the SUBRECIPENT is directed to the LBP
REGS and implementing guidance published and provided by HUD relating to compliance with
such LBP REGS.
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B. Amount of Grant and Ouarterlv Disbursement. The amount granted to
SUBRECIPIENT is $10.000 ("CDBG FUNDS"), and such funds shall be expended by
SUBRECIPIENT on or before June 30, 2007. The CDBG FUNDS shall be disbursed by CITY
to SUBRECIPIENT on a quarterly basis, subject to and upon receipt and approval of a complete
quarterly activity report from SUBRECIPIENT, with the final payment subject to the satisfaction
of the condition precedent of submittal of complete reporting information due on or before July
15th of the applicable funding year, as hereinafter more fully set forth. SUB RECIPIENT shall be
obligated to perform such duties as would normally extend beyond the term, including but not
limited to obligations with respect to indemnification, audits, reporting, data retention/reporting,
and accounting.
C. Use of Funds. SUBRECIPIENT agrees to use all federal funds provided by CITY to
SUBRECIPIENT pursuant to this Agreement to operate said program, as set forth in "Exhibit B",
attached hereto and by this reference incorporated herein. SUB RECIPIENT'S failure to perform as
required may, in addition to other remedies set forth in this Agreement, result in readjustment of the
amount of funds CITY is otherwise obligated to pay to SUB RECIPIENT under Paragraph II hereof.
D. Allowable Costs. SUBRECIPIENT agrees to complete said program on or before
June 30, 2007 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. SUB RECIPIENT shall use all income
received from said funds only for the same purposes for which said funds may be expended
pursuant to the terms and conditions of this Agreement.
E. Licensing. SUB RECIPIENT agrees to obtain and maintain all required licenses,
registrations, accreditation and inspections from all agencies governing its operations.
SUB RECIPIENT shall ensure that its staff shall also obtain and maintain all required licenses,
registrations, accreditation and inspections from all agencies governing SUB RECIPIENT's
operations hereunder. Such licensing requirements include obtaining a City business license, as
applicable.
F. Zoning. SUBRECIPIENT agrees that any facilitylproperty used in furtherance of
said program shall be specifically zoned and permitted for such use(s) and activity(ies). Should
SUBRECIPIENT fail to have the required land entitlement and/or permits, thus violating any local,
state or federal rules and regulations relating thereto, SUBRECIPIENT shall immediately make
good-faith efforts to gain compliance with local, state or federal rules and regulations following
written notification of said violation(s) from the CITY or other authorized citing agency.
SUB RECIPIENT 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. SUB RECIPIENT must make all corrections required to bring the
facilitylproperty 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
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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 SUSRECIPIENT must be able to
account for receipt, obligation and expenditure of CDSG FUNDS pursuant to applicable OMS
Circular A-IIO requirements.
H. Audit Report Requirements. SUB RECIPIENT agrees that if SUB RECIPIENT
receives Three Hundred Thousand Dollars ($300,000.00) or more in federal funds,
SUB RECIPIENT 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. SUB RECIPIENT 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. Further, SUB RECIPIENT
shall comply and/or cause compliance with audit report(s) required by applicable provisions of Title
X and the LBP Regs.
1. Record Keeping/Reporting. SUBRECIPIENT shall keep and maintain complete and
adequate records and reports to assist CITY in meeting and maintaining its record keeping
responsibilities under the CDBG REGS, Title X, and the LBP Regs, including the following:
(1) Records
a. Documentation evidencing program income requirements in
conformity with 24 CFR 570.504(b((2)(i), (ii) and 24 CFR 570.503(b)(3) and 24
CFR 570.208(a)(2)(B) of the income level of persons and/or families participating
in or benefiting by the SUBRECIPIENT program.
b. Documentation of the number of persons and/or families participating
in or benefiting by the SUB RECIPIENT program.
c. Household information shall include number of persons, identification
of head of household, racelethnicity, 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.
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f. Any such other related records as CITY shall reasonably require or as
required to be maintained pursuant to the CDBG REGS.
g. Documentation evidencing compliance with all applicable provisions
of Title X and the LBP Regs, in particular Subpart K and, as applicable Subpart J
and/or Subpart M.
(i) Specific documentation, as required, evidencing
compliance with all applicable provisions of such LBP Regs
including: (i) notification, including distribution of the lead
hazard information pamphlet (Attachment No. I), disclosure
and notices of hazard evaluation and reduction (Attachments
No.2 and 3); (ii) evaluation oflead hazard(s), including paint
testing and risk assessment; (iii) reduction oflead hazard(s),
including safe work practices and clearance, and
confirmation of clearance; and (iv) ongoing maintenance, as
and if applicable for multifamily properties.
(ii) In this regard SUB RECIPIENT shall track information on
all personslhouseholds assisted and the housing units assisted
with the CDSG FUNDS. Attachment No.5 hereto is a sample
form for tracking personslhouseholds and housing units
assisted with the CDBG FUNDS. All categories of
information set forth in such tracking form shall be prepared
and submitted to the CITY with the April 15 quarterly report.
(iii) In the event that such information and reports are not
complete and reasonably satisfactory information submitted in
order for CITY staff to review and evaluate compliance with
applicable CDBG REGS and LBP Regs, then the final quarterly
disbursement payment shall be withheld from the
SUB RECIPIENT.
(iv) Documentation of clearance confirmation as provided in
Section 1.(1 )(g) hereinabove.
(2) Reports
(i) Payment Request. Concurrently with the submittal of each
quarterly report, on or before the 15th day of October, January,
April and July, SUBRECIPIENT shall submit both: an original
invoice and true copies of invoices, receipts, agreements or
other documentation supporting and evidencing how the CDBG
FUNDS have been expended during the applicable quarter.
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(ii) Quarterly Activity Report: Including in such reports
evidence of compliance with all applicable provisions of Title X
and the LBP Regs, in particular Subpart K and, as applicable
Subpart J, as further described in subsection (d) hereinafter, and
Subpart M, if SUB RECIPIENT provides long term tenant-based
rental assistance. SUB RECIPIENT agrees to provide CITY with
written cumulative (year-to-date) reports of its activities on or
before the 15th day of October, January, April and July for the
period beginning July 1, 2003 and through and including the
previous three-month reporting period setting forth the activities,
program accomplishments, new program information and year-to-
date program statistics on expenditures, caseload and activities,
When appropriate, pictures should be included.
(iii) Any such other reports as CITY (or HUD) shall
reasonably require and/or request, including but not limited to
the following information: the receipt of program income [as
defined at 24 CFR 570.500(a)] by SUBRECIPIENT in the
operation of said program shall be recorded by SUB RECIPIENT
and reported to CITY; monthly records of all ethnic and racial
statistics of persons and families benefited by SUBRECIPIENT in
the performance of its obligations under this Agreement,
including, but not limited to, the number of low and moderate
income persons and households assisted in accordance with
federal income limits and the number of female heads of
households.
(3) Recordkeeping of Ongoing Maintenance under the LBP Regs. If the services and
program activities provided by SUBRECIPIENT hereunder establish an ongoing relationship
with a property (such as long term tenant based rental assistance program [Subpart M] or
transitional or permanent housing operated or administered by the SUBRECIPIENT), then the
SUBRECIPIENT shall provide a report to the CITY evidencing that SUBRECIPIENT and/or the
property owner(s), as applicable, has performed ongoing maintenance ofthe subject property.
Ongoing maintenance shall include evidence of an annual clearance certification of the subject
residential property conducted by a DHS certified technician to ensure that LBP hazard reduction
measures are maintained. All maintenance activities shall be conducted to ensure the threat of
LBP hazards is minimized.
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(4) Recordkeeping under the LBP Regs. The SUBRECIPIENT shall keep records of
distribution of notifications, all visual assessment, evaluations, inspections, repairs, and any other
lead hazard evaluation, reduction, safe work practices, and clearance activities.
(a) The SUBRECIPIENT shall keep records evidencing distribution of all lead
hazard information pamphlet(s).
(b) The SUBRECIPIENT shall keep records evidencing each LBP evaluation
report, LBP hazard reduction documentations, (such as job specifications), and all clearance or
abatement report(s).
(c) The SUB RECIPIENT shall keep ongoing maintenance records and records of
relevant building operations for use during reevaluations of subject property for LBP and/or LBP
hazards.
I. Such records shall be maintained for not less than longer of
(A) three (3) years after the activities cease or (8) the period
required by applicable program regulations. Under the CDBG
REGS records shall be retained for not less than four (4) years after
the activities cease.
2. The SUBRECIPIENT shall provide a copy of any of the
above records to the CITY or to HUD upon request of either or
both.
(d) Tracking Report. If the SUB RECIPIENT has provided, or is providing, rental
assistance payments directed to a housing unit or housing units for more than 100 days, or it is
anticipated that during the last quarter of funding that such rental assistance payment will be for
more than 100 days, then the April 15 quarterly report shall contain information and evidence of
compliance with the requirements herein relating to tracking of housing units, cumulative days of
rental assistance, proper notifications to occupants and owners, HQS inspection, visual
assessment, work write-up, stabilization and clearance of LBP and LBP hazards, if any. The
proposed form of such tracking information is attached hereto as Attachment No.5 and fully
incorporated by this reference, In the event such April 15 quarterly report does not fully satisfy
the reporting requirements set forth herein and in the LBP Regs, then the final installment
payment of the CDBG FUNDS shall be withheld from disbursement to SUBRECIPIENT.
J. Access to Records, CITY and the United State Government and/or their representatives
shall have access for purposes of monitoring, auditing, and examining SUBRECIPIENT's activities
and performance, to books, documents and papers, and the right to examine records of
SUB RECIPIENT'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
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any site in which any of the services or activities funded hereunder are conducted or in which any of
the records of SUBRECIPIENT are kept. Nothing herein shall be construed to require access to any
privileged or confidential information as set forth in federal or state law.
K. Location of RecordslRequired Length of Record Keeping. All accounting records,
reports, and evidence pertaining to all costs, expenses and the CDBG FUNDS of
SUB RECIPIENT and all documents related to this Agreement shall be maintained and kept
available at SUBRECIPIENT'S office or place of business for the duration of the Agreement and
thereafter for five (5) years after completion of an audit in conformity with the CDBG REGS,
except as hereinafter provided relating to retention of any records or documentation existing,
created, or maintained in compliance with Title X or the LBP Regs. Records which relate to (a)
complaints, claims, administrative proceedings or litigation arising out of the performance of this
Agreement, or (b) costs and expenses of this Agreement to which CITY or any other
governmental agency takes exception, shall be retained beyond the five (5) years until complete
resolution or disposition of such appeals, litigation claims, or exceptions. All records relating to,
or created or maintained in compliance with, Title X and/or the LBP Regs shall be retained and
maintained by SUBRECIPIENT indefinitely, including without limitation, all inspection
report(s), disclosure statement(s), and clearance report(s). In the event SUBRECIPIENT does not
make the above-referenced documents available within the city of Santa Ana, California,
SUB RECIPIENT agrees to pay all necessary and reasonable expenses incurred by CITY in
conducting any audit at the location where said records and books of account are maintained.
L. Compliance with Law/Program Income. SUB RECIPIENT 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
SUB RECIPIENT 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. SUB RECIPIENT 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. Confidentialitv. 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,
SUB RECIPIENT shall submit to CITY and or HUD or its representatives, all records requested,
including audit, examinations, monitoring and verifications of reports submitted by
SUBRECIPIENT, costs incurred and services rendered hereunder.
O. Independent Contractor. SUBRECIPIENT agrees that the performance of
obligations hereunder are rendered in its capacity as an independent contractor and that it is in no
13
5/05
way an agency of CITY.
P. Violation of Terms and Conditions. SUBRECIPIENT agrees that if
SUB RECIPIENT violates any of the terms and conditions of this Agreement or any prior
Agreement whereby CDBG funds were received by SUBRECIPIENT, or if SUBRECIPIENT
reports inaccurately, or if on audit there is a disallowance of certain expenditures, SUBRECIPIENT
agrees to remedy the acts or omissions causing the disallowance and repay CITY all amounts spent
in violation thereof. If SUB RECIPIENT engaged in fraudulent activity to obtain and/or justify
expenditure of the CDBG funds granted hereunder, SUBRECIPIENT shall be required to reimburse
the CITY of all such funds that were obtained/spent under fraudulent circumstances,
Q. Equipment. 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. SUB RECIPIENT 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 SUB RECIPIENT under the terms and conditions ofthis 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-I).
T. Financial Interest. SUBRECIPIENT agrees that except for the use of CDBG funds
to pay salaries and other related administrative or personnel costs, no persons who exercise or have
exercised any function with respect to CDBG activities assisted under the terms of this Agreement,
or who are in a position to participate in a decision-making process or gain inside information with
14
5/05
regard to such activities, may obtain a financial interest or benefit from a CDBG-assisted activity of
SUBRECIPIENT, either for themselves or those with whom they have family or business ties,
during their tenure or for one year thereafter. This prohibition applies to any person who is an
employee, agent, consultant, officer, or elected or appointed official of CITY, or of
any designated public agencies, or the SUBRECIPIENT.
U. Davis-Bacon Act. All laborers and mechanics employed by contractors or
subcontractors in the performance of construction work, including alterations and repairs, in excess
of $2,000.00, financed in whole or in part with federal funds shall be paid wages at rates not less
than those prevailing on similar construction in the locality as determined in accordance with the
Davis-Bacon Act, as amended, 40 U.S.C. sections 276a - 276a-5, Any such construction contract
shall include and comply with the required contract provisions and rules set forth in 29 C.F.R. ~5.5.
Further, the payroll reports (along with the "Statement of Compliance") and basic records are
required to be maintained and submitted, or made available, pursuant to 29 C.F.R. ~5.5(a)(3). No
payment, advance, grant, loan or guarantee of funds shall be approved by the federal agency unless
there is on file with the agency a certification by the contractor that the contractor and its
subcontractors have complied with the provisions of 29 C.F.R. ~5.5. . A breach of the contract
clauses in 29 C.F.R. ~5.5 may be grounds for termination of the contract, and for debarment as a
contractorlsubcontractor, as provided in 29 C.F.R. ~5.l2. Labor standards interviewslinvestigations
shall be made as necessary to assure compliance [29 C.F.R. ~5.6(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 SUB RECIPIENT and CITY officials of any
criminal drug statute conviction for a violation occurring in the workplace not later than five
days after such conviction.
3. The United State Department of Housing and Urban Development will be notified
within ten days after receiving notice of any such violation.
4. Within 30 days of receiving such notice, appropriate personnel action will be
taken against such employee, up to and including termination.
Each such employee shall be required to participate satisfactorily in a drug abuse assistance or
rehabilitation program approved for such purposes by a federal, state or local health, law
enforcement, or other appropriate agency.
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II. CITY'S OBLIGATIONS
A. Pavment 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 2006-07 CDBG program year amounts expended by SUB RECIPIENT in carrying out said
program for 2006-07 pursuant to this Agreement up to a maximum aggregate payment ofTen
Thousand Dollars ($10.000 ) in installments determined by CITY. Payments shall be made to
SUBRECIPIENT through the submission of invoices on a quarterly basis (October, Jaouary, April
and July) in a form prescribed by CITY, detailing such expenses. CITY shall pay such invoices
within thirty (30) days after receipt thereof provided CITY is satisfied that such expenses have been
incurred and documented within the scope and provisions of this Agreement and that
SUBRECIPIENT is in compliance with the terms and conditions of this Agreement, and in
compliance with Title X and the LBP Regs.
B. Audit of Account. CITY shall include an audit of the account maintained by
SUB RECIPIENT in CITY's annual audit of all CDBG FUNDS in accordance with Title 24 of
the Code of Federal Regulations and other applicable federal laws and regulations.
C. Common Rule: Pursuant to CFR 85.40(a), the CITY manages the day-to-day
operations of each grant and subgrant supported activities. CITY staff has detailed knowledge of
the grant program requirements and monitors grants and sub grant supported activities to assure
compliance with Federal requirements. Such monitoring covers each program, function and
activity and performance goals are reviewed periodically.
D. Environmental Review: In accordance with 24 SFR 58, the CITY is responsible
for undertaking environmental review and maintaining environmental review records for each
applicable project.
E. Performance Monitoring: CITY shall monitor the performance ofthe
SUBRECIPIENT against goals and performance standards required herein. Substandard
performance as determined by the CITY will constitute non-compliance with this Agreement. If
action to correct such substandard performance is not taken by the SUBRECIPIENT within a
reasonable period of time after being notified by the CITY, contract suspension or termination
procedures will be initiated.
III. NONDISCRIMINATION
SUB RECIPIENT 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
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Pursuant to the conflict of interest requirements set forth in 24 CFR 576.5 and OMB
Circulars 1-102 and A-I 107, 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 SUB RECIPIENT shall be fully disclosed in writing
prior to the execution of this Agreement and said writing shall be attached and deemed fully
incorporated as a part hereof. Notice shall be sent by SUBRECIPIENT to CITY regarding any
changes or modifications to its board of directors and list of officers.
V. SPECIAL CERTIFICATION FOR RELIGIOUS ENTITIES
If SUBRECIPIENT is a religious entity, SUBRECIPIENT hereby agrees that in connection
with the provision of the services SUBRECIPIENT shall provide with CDBG funds in accordance
with 24 CFR 570.200(j):
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. SUB RECIPIENT shall not discriminate against any person applying for the services
SUB RECIPIENT agrees to provide under the terms of this Agreement on the basis of religion and
shall not limit such services or give preference to applicants for such services on the basis of
religion.
C. SUBRECIPIENT shall NOT provide religious instruction or counseling, conduct
any religious worship or services, or engage in any religious proselytizing, or exert any religious
influence in the provision of the services in said program. The parties agree that this covenant is
intended to and shall be construed for the limited purpose of assuring compliance with respect to the
use of CITY funds by SUB RECIPIENT with applicable constitutional limitations respecting the
establishment of religion as set forth in the establishment clause under the First Amendment of the
United States Constitution and Article I, Section 4 of the California Constitution, and is not in any
manner intended to restrict other activities of SUBRECIPIENT.
D. Where the services to be provided under said program are rendered on property
owned by the primarily religious entity SUBRECIPIENT, CDBG funds may also be used for minor
repairs to such property which are directly related to the cost of rendering the services under said
program, where the cost constitutes in dollar terms only an incidental portion of the CDBG
expenditure for rendering the services under said program.
VI. PROHIBITION OF NEPOTISM
SUB RECIPIENT 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 "immediate
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family" means spouse, child, mother, father, brother, sister, brother-in-law, sister-in-law, father-in-
law, mother-in-law, son-in-law, daughter-in-law, aunt, uncle, niece, nephew, stepparent and
stepchild. The term "administrative capacity" means having selection, hiring, supervisor or
management responsibilities.
VII. NOTICES
Notices to the parties shall, unless otherwise requested in writing, be sent by U.S. Mail,
postage prepaid, and addressed as follows:
TO CITY:
City of Santa Ana
Community Development Agency (M-25)
20 Civic Center Plaza
P.O. Box 1988
Santa Ana, California 92702-1988
Robyn Greenstein
Grants Manager
Mercy House - Center
P.O. Box 1905
Santa Ana, CA 92702
TO SUBRECIPIENT:
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 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
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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 undertake self-insurance, or shall obtain, at its sole cost, a
policy or policies of commercial general liability insurance, or equivalent form, with a combined
single limit of not less than $1,000,000 per occurrence.
Such insurance shall: (1) name the City of Santa Ana, its officers, agents,
representatives, employees and volunteers as additional insureds; (2) be primary with respect to
insurance or self-insurance programs maintained by the CITY; (3) contain standard separation of
insureds provisions; and (4) give to CITY prompt and timely notice of claim made or suit
instituted arising out of SUBRECIPIENT's operations hereunder.
SUB RECIPIENT 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 of this Agreement, SUBRECIPIENT shall transfer to CITY any
CDBG funds on hand at the time of the expiration of this Agreement as well as any accounts
receivable attributable to the use 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 of time as determined to be appropriate by CITY; or
2, If not used in accordance with subparagraph A above, SUBRECIPIENT
shall pay to CITY an amount equal to the current fair market value of the property less any portion
of the value attributable to the expenditure of non-CDBG funds for acquisition of, or improvement
to, the property. Such payment is program income to CITY.
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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:
I. 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 assignment(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
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 subject matter or
activities as this Agreement, together with any instruments, loans, grants or advances by
SUBRECIPIENT on behalf of CITY, in furtherance of the activities hereunder or thereof.
SUBRECIPIENT's obligations and responsibilities set forth in this paragraph "XI.
REVERSION OF ASSETS." and in paragraph "XII. TERMINATION" and other requirements
pertaining to program income shall not be affected by the termination of this Agreement and shall
survive the date of termination of this Agreement for such period of time as CITY and/or HUD
deems necessary for the responsibilities, duties and obligations to be performed and completed to
the satisfaction of CITY and HUD.
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 of termination.
B, This Agreement may be suspended or terminated by CITY upon five (5) days'
written notice for violation by SUBRECIPIENT of Federal Laws governing the use of Community
Development Block Grant Funds. In the event of such suspension or termination, SUB RECIPIENT
shall only be entitled to reimbursement for approved expenses incurred up to the effective date of
suspension or termination.
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C. Pursuant to 24 CFR 85.43, in the event SUBRECIPIENT defaults by failing to fulfill
all or any of its obligations hereunder, CITY may declare a default and termination of this
Agreement by written notice to SUBRECIPIENT, which default and termination shall be effective
on a date stated in the notice which is to be not less than ten (10) days after certified mailing or
personal service of such notice, unless such default is cured before the effective date of termination
stated in such notice, If terminated for cause, CITY shall be relieved of further liability or
responsibility under this Agreement, or as a result of the termination thereof, including the payment
of money, except for payment for approved expenses incurred for services satisfactorily and timely
performed prior to the mailing or service of the notice of termination, and except for reimbursement
of (1) any payments made for services not subsequently performed in a timely and satisfactory
manner, and (2) costs incurred by CITY in obtaining substitute performance.
D. The grant of funds under this Agreement may be terminated for convenience in
accordance with 24 CFR 85.44.
E. The grant of funds under this Agreement may be terminated due to the non-
performance of SUBRECIPIENT and/or failure of SUBRECIPENT to perform the work described
in Exhibits A and B or failure to meet the performance standards and program goals set forth
therein.
F. In the event this Agreement is terminated as set forth in subparagraphs XILA.
through XILE., inclusive, SUBRECIPIENT agrees to immediately return to CITY upon CITY's
demand and prior to any adjudication of SUB RECIPIENT's rights, any and all funds not used, and
to comply with paragraph "XL REVERSION OF ASSETS" of this Agreement.
XIII. LIMITATIONOFFUNDS
The United States of America, through HUD, may in the future place programmatic or fiscal
limitations on the use of CDBG funds which limitations are not presently anticipated. Accordingly,
CITY reserves the right to revise this Agreement in order to take account of actions affecting HUD
program funding. In the event of funding reduction, CITY may, in its sole and absolute discretion,
reduce the budget of this Agreement as a whole or as to costs category, may limit the rate of
SUBRECIPIENT's authority to commit and spend funds, or may restrict SUBRECIPIENT's use of
both its uncommitted and its unspent funds. Where HUD has directed or requested CITY to
implement a reduction in funding, in whole or as to a cost category, with respect to funding for this
Agreement, CITY's City Manager or delegate is authorized to act for CITY in implementing and
effecting such a reduction and in revising, modifying, or amending the Agreement for such
purposes. If such a reduction in funding occurs, SUBRECIPIENT shall be permitted to de-scope
accordingly. Where CITY has reasonable grounds to question SUBRECIPIENT's fiscal
accountability, fmancial 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.
21
5105
In no event, however, shall any revisions made by CITY affect expenditures and legally binding
commitments made by SUB RECIPIENT before it received notice of such revision, provided that
such amounts have been committed in good faith and are otherwise allowable and that such
commitments are consistent with HUD cash withdrawal guidelines.
XIV. EXCLUSIVITY AND AMENDMENT OF AGREEMENT
This Agreement supersedes any and all other agreements, either oral or in writing, between
the parties hereto with respect to the use of CITY's CDBG funds by SUBRECIPIENT and contains
all the covenants and agreements between the parties with respect to such employment in any
manner whatsoever. Each party to this Agreement acknowledges that no representations,
inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone
acting on behalf of any party, which are not embodied herein, and that no other agreement or
amendment hereto shall be effective unless executed in writing and signed by both CITY and
SUBRECIPIENT.
XV. LAWS GOVERNING THIS AGREEMENT
This Agreement shall be governed by and construed in accordance with the laws of the State
of California, and all applicable federal laws and regulations.
XVI. VALIDITY
The invalidity in whole or in part of any provision of this Agreement shall not void or affect
the validity of any other provision of this Agreement.
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 of the terms of this Agreement, and shall
indemnify CITY fully, including reasonable costs and attorney's fees, for any injuries or damages to
CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn.
b. All Exhibits and Attachments referenced herein and attached hereto shall be incorporated
as if fully set forth in the body of this Agreement.
c. No delay or omission by either party hereto to exercise any right or power accruing
upon any noncompliance or default by the other party with respect to any of the terms of this
Agreement shall impair any such right or power or be construed to be a waiver thereof. A
waiver by either of the parties hereto of any of the covenants, conditions, or agreements to be
performed by the other shall not be construed to be a waiver of any succeeding breach thereof
or of any other covenant, condition or agreement herein contained.
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23
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the last date and
year written below.
ATTEST:
2
PATRICIA E, HEALY
Clerk ofthe Council
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
/~~ [ 2J;l~
By: LISA E. STORCK
Assistant City Attorney
DATE:
CITYaA~
DAVID N. REAM
City Manager
SUBRECIPIENT:
"'~ 1/
Nat2; Larry Haynes
Title: Executive Director
Tax ID: 33-0315864
----
24
City of Santa Ana
Community Development Block Grant
Scope of Work
Name of Organization- Mercv House Transitional Living Centers. Inc.
Name of Funded Program- Joseph HouselRegina House
Annual Accomplishment Goal
1. Total number ofunduplicated clients (Santa Ana and Non-Santa Ana Residents) anticipated to be served by
the funded program, named above, during the 12-month contract period.
91PERSONS
II. Number of only unduplicated Santa Ana residents to be served by the funded program, named above,
during the 12-month contract period.
lQPERSONS
Program and Funding Description
III. Description of Work - In the space below, describe the program to be funded during the 12-month
contract period.
Mercy House operates two transitional programs for the homeless. Joseph House is for homeless single men, including veterans and
emancipated youth, Regina House, our transitional program for single women with children, house seven mothers and their kids.
The transitional shelters offer supportive services, including individualized case management. The goal for the Mercy House clients-
is to end the homelessness of all who enter into our system of care. In order to achieve this goal the programs provide supportive
services through three programs. They are:
1. WeIlness Program - where the objective is to improve the client's mental and physical health conditions.
2. Planning for Success Program - where the objective is to improve the material and financial self-sufficiency of the clients.
3, Learning Matters Program - where the objective is to improve the client's quality of life because of increased knowledge and
modified behavior.
IV. Activities funded by this grant - How will CDBG funds be used for the funded program? Narratively
describe the budget for the funded program illustrated in Exhibit B and B-1.
CDBG funds will be used for rent, communications, utilities, insurance, and program expenses.
Exhibit A
Page 1 of2
Schedule of Performance
Estimate the number of only unduplicated Santa Ana residents to be served by the funded program during the
12-month contract period per quarter. (How many new Santa Ana clients will be served each quarter.)
Quarter I: Julyl - September 30
Quarter 2: October! - December 31
Quarter 3: January I - March 31
Quarter 4: April I - June 30
~Persons
~Persons
~Persons
~Persons
lQTotal number ofunduplicated Santa Ana residents to be served.
(Must equal the number for II above.)
Schedule ofInvoicing
Estimate the amount of grant funds to be requested during the 12-month contract period on a quarterly basis.
Quarter I: July I - September 30
Quarter 2: October! - December 31
Quarter 3: January 1 - March 31
Quarter 4: April I - June 30
$3000
$3000
$3000
$1000
$10000Total Grant (Must equal the Total Program Budget
indicated on Exhibit B.)
Exhibit A
Page 2 of2
CITY OF SANA ANA
Community Development Block Grant
Outcome Tracking
IMPO R T ANT: The City of Santa Ana is in the process of incorporating the new HUD Performance
Outcome Tracking guidelines, therefore this section is subject to change in order to be compliant with
HUD regulations. If the situation should occur that the current tracking system is not sufficient to meet
HUD regulations an amendment to this contract will be needed.
Instructions: From the list of activities below select the activity that best describes the purpose of the program that will be funded
in fiscal year 06-07 by these grant funds. Two activities have multiple outcomes, therefore if "Senior Services" or "Youth Services" is
selected, please select the one outcome that best describes the purpose of the funded program, ONLY if none of the activities listed
adequately describe the funded program, please select that last activity "Low- and Moderate Income Services".
Fulfillment
Tracking HUn Objective to be fulrdled HUn Outcome to be fulfiDed illustrated by
HUn Indicator
Suitable Creating Specific Outcome
Activity/Program Outcome Tracking Goal Living Decent Economic A vailabilityl Affordability SustainabilitJ Indicator #
Housing Iopportunitic Accessibility (Please see page 4
Environment of4 fordesc.)
nti-CrimeServices mck the reduction in educe response time to
sponse time and the erious crimes in the City's
umberofcrimina.l ow-and Moderate-Income
D apprchended as a result area by at least 3 minut.es
esultingin the apprehension 2
f 1,500 criminals that may X X
Iberwiseescape.
.US_year goal to be
chieved by FY 09/10
air Housing Services Provide fair housing scrvice I,Providefairhousing
and ongoing analysis of ounseling,educationand
impediments to fair housing, ~~~emlmt services to
D ,000 Santa Ana households. X X 2
U~5-yeargoaltobe
achieved by FY 09/10
2. Annllallyassessaction~~ 2
liminateimpcdimentstofai X X
ousing.
omelessnessPrevention Track assisted individuals 50"10 of assisted Individuals
ho retained theirhollsing or nd households will retain
lItilities for at lcast 6 months hcirhollsing orlltilities for 14
D fierassistancewas t least 6 months afier X X
lrovided, ssistance is provided.
merglmcyShelter Track individuals who 50"/nof
welvedsupportservices individuals/hollscholdslltat 12 or
that were linked to one or re providcd with emergency
D ore additional Sllpport helterwill transition to X X
service and/or appropriate nterim hOllsing (i.e" 13
jhollsing. ansitionalhOllsing).
ransitionalHousing rack homeless individllals 5% of homeless individuals
who participated in articipatinginb'ansitional 2
transitionalhousingprograrn ollsing prograrn will be X X
~ that were placed in laced in permanent hOllsing.
pennanenthousing
IIpportiveServices Track individuals who O%ofindividualsifamilies
/reccived Sllpport services lreceiving support services
~:twerehnkedtooneor ill be linked to one or more 2
D ore additional support dditional support service X X
service and/or appropriate and/or appropriate housing.
ousmg.
Exhibit A-I
Page 1 of4
Fulfillment
illustrated by
Trackinl! HUD Ob. ective to be fulfilled HUD Outcomes to be fulrdled HUD Indicator
Suitable Creating Specific Outcome
Activity/Program Outcome Tracking Goal Living Decent Economic Availability/ Affordability Sustainabilit) Indicator #
Housing Iopportunitic Accessibility (Please see pagc 4
Environment of 4 for dese.)
eniorServices 1. Track assisted senior 1. 80% ofassisted senior
itizcnsthatremained itizcns will remain
0 indepcodcnt for at least 1 independent for at least 1 X X 2
ear after services were jycar after services are
provided. rovided.
2. Track seniors receiving . 90% of seniors receiving
referrals lhat were linked to cferrals will be linked to the
0 thcservicessought services sought. X X 2
Owner-Occupied Numberofownersassisted Physical safety and comfort
ollsingRchabi1itation to rehabilitate thcirprimary ill be improved for Low
residence for the following md Moderate income
mcomecatcgories: ouseholdsbYlmproving
0 -Extremely Low Income omes to a level that meets 9
Very Low Income rexecedsHUDhousing X X
Moderate Tncome Ilalitystandards.
Special Needs Categories
-LargcFamilies
rail Elderly Services Track frail elderly 00% of frail elderly
individuals that were linked .ndividuals will be linked to 2
0 to the services soughl. he serviccssoughl. X X
isabledServiccs Track disables persons upport independcnt living
whose independent living for 90% ofdisabledpcrsons 2
0 was supported by City funds. assisted by City funds. X X
Scrviccs for Mentally III Track individuals assisted 100% of individuals assisted
ithCityresourcesil1atwere ith City resources will be
0 rovided an cntrypoint into rovided an cntrypoint into 2
thc rcgional mental health eregional mental health X X
care system and linked to at are system and linked to at
least one additional mental least onc additional mental
ealthsllPportiveservice. ealth supportive service.
ervicesforSubstancc rack how many individuals ovide entry into thc
ddicted ith substancc addiction in gional recovery system for
were provided an entry into 5 individuals with
the regional recovery systcm Ilbstance addiction and link
0 and linked to additional hcm to additional serviccs. 2
services. X X
.U5_year goal to be
achieved by FY 09/10
outhServices 1. Track improvement in I. Foreducation_based
lfe-tcst, posHest scores. ograms, improve pre-test 2
0 ost-test scores by 50% X X
0 2. Track number of . Provide opportunities for
individuals exposed to the xposuretothefinearts. X X 2
fine arts.
0 3. Trackchildrenlyollth 3.90%ofchildrenlyouth
seeking referrals that were seeking referrals will be X X 2
linked to the scrvices sought. linked to the services SOllght
~w-andModerale- rnck program participants ffl% of program participants
come Services that were linked to services ill be linked to services 2
sought. ought. X X
0
Exhibit A-I
Page 2 of 4
Description of Outcome Tracking System:
Please describe your organization's outcome tracking system that will enable you to fulfill the outcome selected above.
Mercy House is ready to fully implement its CMIS program (Client Management Information System). This is a database system
where Program Managers will input all relevant information about the clients into this system. As clients enter into the program. obtain
services, and leave the program, all information (including case notes) about their stay will be in the system. Fortunately, Mercy House
has a full-time Grant Manager/Program Evaluator who can then use this information to create reports which help the staff to determine
the success rates of the program, the amount of client services provided, etc. The staff can then assess the strengths and weaknesses of
the program and modifiy accordingly. All milestones and goals that we hope for our clients to achieve are tracked in the system in
order to ensure that Mercy House properly tracks the client's success and the program's outcomes.
Exhibit A-I
Page 3 of 4
Specific Outcome Indicators
2) Public service activities
Number of persons assisted:
. with new access to a service
· with improved access to a service
· where activity was used to meet a quality standard or measurably improved quality, report the number
that no longer only have access to substandard service
9) Owner occupied units rehabilitated or improved
Total number of units:
Number occupied by elderly
Number of units brought from substandard to standard condition (HQS or local code)
Number qualified as Energy Star
Number of units brought into compliance with lead safe housing rule (24 CFR part 35)
Number of units made accessible for persons with disabilities
12) Number of homeless persons given overnight shelter
13) Number of beds created in overnight shelter or other emergency housing
14) Homelessness Prevention
· Number of households that received emergency financial assistance to prevent
homelessness
· Number of households that received emergency legal assistance to prevent
homelessness
Exhibit A-I
Page 4 of 4
.
Program Year 2006-2007
Final Budget
Organization Name Mercy House Transitional Living Centers, Inc.
Program Name Joseoh House/Reoina House
Expenditures
Expenses Funded by Expenses Funded Total Program Total Organizational
Cate 0 Santa Ana COBG b Other Sources Bud et Bud et
Administrative Staff
Salaries & Benefits $ $ 41,572 $ 41,572 $ 297,927
Program Staff Salaries &
Benefits
Contractual/Professional
Services: List below
1 Audit $ $ 3,600 $ 3,600 $ 13,100
2 Computer Consultants $ $ 3,000 $ 3,000 $ 8,500
3 Other $ 1,200
Office Su lies 18,400 18,400 108,301
Rent 8,277 8,277 12,779
Communications 7,200 7,200 47,825
Utilities 28,100 28.100 108,300
Insurance 9,386 11,386 64,382
Other:List below
Facility Exp $ 1,500 $ 55,115 $ 56,615 $ 159,560
2 Client Services $ $ 40,280 $ 40,280 $ 250,553
3 Fundraising $ $ 137,500
4 $
5 $
Total $ 10,000 $ 360,968 $ 370,968 $ 1,751.392
LIST ALL OTHER PROGRAM FUNDS THAT HAVE BEEN SECURED FOR 06-07
(Total Funds for Program must equal Total Program Budget above)
Source Amount
Santa Ana CDBG $ 10,000
Santa Ana ESG $ 75,000
Anaheim ESG $ 10,000
CM CDBG $ 5,000
NOFA $ 124.712
Pro ram Fees $ 53,280
Donations & fundraisin $ 92,976
Total Funds for Pro ram
Exhibit B
Page 1 of 1
$
370,968
.
2006-2007 Funded Personnel
Name of Organization:
Name of Program
Mercy House Transitional Living Centers, Inc.
Joseph House/Regina House
ADMINISTRATIVE STAFF
Position Title Annual Annual Total CDBG Funds % of time Of this time % of Total
Salary Benefits Compensation Requested for spent on percent of Compensation
this position funded time serving Eligible
nro<rram Santa Ana
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
Total Amount Renuested $ -
Must equal amount indicated on Exhbit B
PROGRAM STAFF
Position Title Annual Annual Total CDBG Funds % of time Of this time % of Total
Salary Benefits Compensation Requested for spent on percent of Compensation
this position funded time serving Eligible
nrOQram Santa Ana
DC Program Director $ 38,500 $ 10.264 $ 48.764 $ 3,000 60% 30% 18%
JH Pro~am ManaQer $ 38500 $ 9179 $ 47679 $ 3.500 100% 30% 30%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
Total Amount Reauested $ 6500
Must equal amount indicated on Exhbit B
CONTRACTUAL/PROFESSIONAL SERVICES
Position Title Annual Annual Total CDBG Funds % of time Of this time % afTotal
Contract Benefits Compensation Requested for spent on percent of Compensation
Amount this position funded time serving Eligible
nrogram Santa Ana
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
$ - 0%
Total Amount ReCluested $ -
Must equal amount indicated on Exhbit B
***Please note for personnel whose time is not directly traced to serving Santa Ana and instead a percentage is used please
confirm the percentage is accurate prior to requesting reimbursement.
Exhibit B-1
Page 1 of I
Certification Regarding Lobbying
Certification for Contracts. Grants. Loans. and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of Congress, or
an employee ofa 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.
Mercy House Transitional Living Centers, Inc.
Grantee/Contactor Organization
Joseph House/Regina House
Program Title
Jerome T. Karcher
Name of Certifying Officer
~~.I ta
Signature
Date
EXHIBIT C
Page 1 of2
SUBRECIPIENT warrants the following:
1. SUB RECIPIENT will comply with Public Law 88-352, Title VI of the Civil Rights
Act of 1964 (42 U. S, C. section 2000 et seq.) and implementing regulation in 24 CFR
Part 1.
2. No person in the United States shall on the ground of race, color, religion, national
origin, or sex, be excluded from participation in, or be denied the benefits of, or be
subjected to discrimination under any program or activity funded in whole or in part with
community development funds made available pursuant to the ACT.
3, All laborers and mechanics, employed by contractors or subcontractors in the
performance of construction work financed in whole or in part with community
development funds shall be paid wages at rates not less than those prevailing on similar
construction in the locality as determined in accordance with the Davis-Bacon Act, as
amended, 40 U. S, C. Sections 276 a 1-5, except for individuals who perform services for
which they volunteered; do not receive compensation for such services; or are paid
expenses, reasonable benefits, or a nominal fee for such services; and are not otherwise
employed at any time in construction work.
4. SUBRECIPIENT will comply with all Federal statutes applicable to projects funded
with community development funds, except that (a) SUBRECIPIENT does not assume
CITY'S environmental responsibilities described at 24 CFR 570.604; and (b)
SUBRECIPIENT does not assume CITY'S responsibility for initiating the review process
under Executive Order 12372.
EXHIBIT C
Page 2 of2
If you think your home has high
levels of lead:
. Get your young children tested for lead, even if
they seem healthy.
. Wash children's hands. bottles, pacifiers, and toys
often.
. Make sure children eat healthy, low-fat foods.
. Get your home checked for lead hazards.
. Regularly clean floors, window sills, and other
surfaces.
. Wipe soil off shoes before entering house.
. Talk to your landlord about fixing surfaces with
peeling or chipping paint.
. Take precautions to avoid exposure to lead dust
when remodeling or renovating (call t -800-424-
LEAD for guidelines).
. Don't use a belt-sander, propane torch, high
temperature heat gun, scraper, or sandpaper on
painted surfaces that may contain lead,
. Don't try to remove lead-based paint yourself.
Are You Planning To Buy, Rent, or Renovate
a Home Built Before 19181
Many houses and apartments built before 1978 have
paint that contains high levels of lead (called lead-
based paint). Lead from paint. chips, and dust can
pose serious health hazards if not taken care of properly.
OWNERS, BUYERS, and RENTERS are
encouraged to check for lead (see page 6)
before renting. buying or renovating pre-
1978 housing,
F ederallaw requires that individuals receive certain
information before renting. buying, or renovating
pre- 1978 housing:
CTJ" FOR"
c" RI!N,.
'. ..,1..
, .
, , R
.,,'Au
. ~;" ,
/-
LANDLORDS have to disclose known infor-
mation on lead-based paint and lead-based
paint hazards before leases take effect.
Leases must include a disclosure about
lead-based paint.
SElLERS have to disclose known informa-
tion on lead-based paint and lead-based
paint hazards before selling a house. Sales
contracts must include a disclosure about
lead-based paint. Buyers have up to 10
days to check for lead.
RENOVATORS disturbing more than 2 square
feet of painted surfaces have to give you
this pamphlet before starting work.
IMPORTANT!
Lead from Paint, Dust, and
Soil Can Be Dangerous If Not
Managed Properly
fACT: Lead exposure can harm young
children and babies even before they
are born.
fACT: Even children who seem healthy can
have high levels of lead in their bodies.
fACT: People can get lead in their bodies by
breathing or swallowing lead dust, or by
eating soil or paint chips containing
lead.
fACT: People have many options for reducing
lead hazards, In most cases, lead-based
paint that is in good condition is not a
hazard.
fACT: Removing lead-based paint improperly
can increase the danger to your family.
If you think your horne might have lead
hazards. read this pamphlet to learn some
simple steps to protect your family.
Lead Gets in the Body in Many Ways
Childhood
lead
poisoning
remains a
major
environmen-
tal health
problem in
the U.S.
Even children
who appear
healthy can
have danger-
ous levels of
lead in their
bodies.
People can get lead In their body If they:
. Breathe in lead dust (especially during
renovations that disturb painted
surfaces).
. Put their hands or other objects
covered with lead dust in their mouths.
. Eat paint chips or soil that contains
lead.
Lead Is even more dangerous to children
under the age of 6:
. At this age children's brains and nervous
systems are more sensitive to the dam-
aging effects of lead.
. Children's growing bodies absorb more
lead.
. Babies and young children often put
their hands and other objects in their
mouths. These objects can have lead
dust on them.
Lead Is also dangerous to women of
childbearing age:
. Women with a high lead level in their
system prior to pregnancy would expose
a fetus to lead through the placenta
. ,,':' _ ,):4 -~:':.::'::'i',-, during fetal development.
~""" '0
~.)' '. ~
';-':'I";I~'.'::~ ~..':;.. ....
' . J , . ,~.~..,.,J
~ ,,'./
,.
2
Lead's Effects
It is important to know that even exposure
to low levels of lead can severely harm
children.
In children, lead can cause:
. NelVous system and kidney damage.
. Learning disabilities. attention deficit
disorder, and decreased intelligence.
. Speech, language, and behavior
problems.
. Poor muscle coordination.
. Decreased muscle and bone growth.
. Hearing damage.
While low-lead exposure is most
common, exposure to high levels of
lead can have devastating effects on
children, including seizures, uncon-
sciousness, and. in some cases, death.
Although children are especially
susceptible to lead exposure, lead
can be dangerous for adults too.
In adults, lead can cause:
. Increased chance of illness during
pregnancy.
. Harm to a fetus, including brain
damage or death.
. Fertility problems (in men and women).
. High blood pressure.
. Digestive problems.
. NelVe disorders.
. Memory and concentration problems.
. Muscle and joint pain.
Reproductive
Problems
(Adults)
lead affects
the body in
many ways,
3
Where lead-Based Paint Is Found
In general,
the older your
home, the
more likely it
has lead-
based paint.
Many homes built before 1978 have lead-
based paint. The federal government
banned lead-based paint from housing in
t 978. Some states stopped its use even
earlier. Lead can be found:
. In homes in the city, country. or suburbs.
. In apartments, single-family homes. and
both private and public housing.
. Inside and outside of the house.
. In soil around a home. (Soil can pick up
lead from exterior paint or other sources
such as past use of leaded gas in cars.)
Checking Your family for lead
Get your
children and
home tested
if you think
your home
has high lev-
els of lead.
4
To reduce your child's exposure to lead,
get your child checked, have your home
tested (especially If your home has paint
In poor condition and was built before
1978), and fix any hazards you may have.
Children's blood lead levels tend to increase
rapidly from 6 to t 2 months of age, and
tend to peak at t 8 to 24 months of age.
Consult your doctor for advice on testing
your children. A simple blood test can
detect high levels of lead. Blood tests are
usually recommended for:
. Children at ages t and 2.
. Children or other family members who
have been exposed to high levels of lead.
. Children who should be tested under
your state or local health screening plan.
Your doctor can explain what the test results
mean and if more testing will be needed.
Identifying lead Hazards
Lead-based paint is usually not a hazard if
it is in good condition. and it is not on an
impact or friction surface. like a window. It
is defined by the federal government as
paint with lead levels greater than or equal
to 1.0 milligram per square centimeter. or
more than 0.5% by weight.
Deteriorating lead-based paint (peeling,
chipping, chalking, cracking or damaged)
is a hazard and needs immediate attention.
It may also be a hazard when found on sur-
faces that children can chew or that get a
lot of wear-and-tear. such as:
. Windows and window sills.
. Doors and door frames.
. Stairs. railings. banisters. and porches.
Lead dust can form when lead-based paint is scraped. sanded. or
heated. Dust also forms when painted surfaces bump or rub togeth-
er. Lead chips and dust can get on surfaces and objects that people
touch. Settled lead dust can re-enter the air when people vacuum.
sweep. or walk through it. The following two federal standards have
been set for lead hazards in dust:
. 40 micrograms per square foot (J.1g1ft2) and higher for floors.
including carpeted floors.
. 250/lglft2 and higher for interior window sills,
Lead in soil can be a hazard when children play in bare soil or
when people bring soil into the house on their shoes. The following
two federal standards have been set for lead hazards in residential
soil:
lead from
paint chips,
which you
can see, and
lead dust,
which you
can't always
see, can both
be serious
hazards.
. 400 parts per million (ppm) and higher in play areas of bare soil.
. 1.200 ppm (average) and higher in bare soil in the remainder of
the yard.
The only way to find out if paint. dust and soil lead hazards exist is
to test for them. The next page describes the most common meth-
ods used.
5
Checking Your Home for lea.d
Just knowing
that a home
has lead-
based paint
may not teU
YOIJ if there
is a hazard.
6
You can get your home tested for lead in
several different ways:
. A paint Inspection tells you whether your
home has lead-based paint and where it
is located, It won't tell you whether or not
your home currently has lead hazards.
. A risk assessment tells you if your home
currently has any lead hazards from lead
in paint, dust, or soil. It also tells you what
actions to take to address any hazards.
. A combination risk assessment and
inspection tells you if your home has
any lead hazards and if your home has
any lead-based paint. and where the
lead-based paint is located.
Hire a trained and certified testing profes-
sional who will use a range of reliable
methods when testing your home.
. Visual inspection of paint condition
and location.
. A portable x-ray fluorescence (XRF)
machine.
. Lab tests of paint. dust. and soil
samples.
There are state and federal programs in
place to ensure that testing is done safely.
reliably, and effectively. Contact your state
or local agency (see bottom of page 11) for
more information. or call 1-800-424-LEAD
(5323) for a list of contacts in your area.
Home test klts for lead are available. but
may not always be accurate. Consumers
should not rely on these kits before doing
renovations or to assure safety.
.
What You Can Do Now To Proted
Your family
If you suspect that your house has lead
hazards, you can take some Immediate
steps to reduce your family's risk:
. If you rent, notify your landlord of
peeling or chipping paint.
. Clean up paint chips Immediately.
. Clean floors, window frames, window
sills, and other surfaces weekly. Use a
mop or sponge with warm water and a
general all-purpose cleaner or a cleaner
made specifically for lead. REMEMBER:
NEVER MIX AMMONIA AND BLEACH
PRODUCTS TOGETHER SINCE THEY
CAN FORM A DANGEROUS GAS.
. Thoroughly rinse sponges and mop
heads after cleaning dirty or dusty
areas.
. Wash children's hands often, especial-
ly before they eat and before nap time
and bed time.
. Keep play areas clean. Wash bottles,
pacifiers. toys. and stuffed animals
regularly.
. Keep children from chewing window
sills or other painted surfaces.
. Clean or remove shoes before
entering your home to avoid
tracking In lead from soli.
. Make sure children eat
nutritious, low-fat meals high
In Iron and calcium, such as
spinach and dairy products.
Children with good diets absorb
less lead.
.
., I
,~~ ~'"'4]~/
~
YOGURT
7
.
Reducing Lead Hazards In The Home
Removing
lead
improperly
can increase
the hazard to
your family
by spreading
even more
lead dust
around the
house.
Always use a
professional who
is trained to
remove lead
hazards safely.
8
In addition to day-to-day cleaning and good
nutrition:
. You can temporarily reduce lead hazards
by taking actions such as repairing dam-
aged painted surfaces and planting grass
to cover soil with high lead levels. These
actions (called "interim controls") are not
permanent solutions and will need ongo-
ing attention.
. To permanently remove lead hazards,
you should hire a certified lead "abate-
ment" contractor. Abatement (or perma-
nent hazard elimination) methods
include removing, sealing. or enclosing
lead-based paint with special materials.
Just painting over the hazard with regular
paint is not permanent removal.
Nways hire a person with special training
for correcting lead problems-someone
who knows how to do this work safely and
has the proper equipment to clean up
thoroughly. Certified contractors will employ
qualified workers and follow strict safety
rules as set by their state or by the federal
government.
Once the work is completed, dust cleanup
activities must be repeated until testing
indicates that lead dust levels are below the
following:
. 40 micrograms per square foot (j1gift2)
for floors. including carpeted floors;
. 250 /lgift2 for interior windows sills; and
. 400 /lgift2 for window troughs.
Call your state or local agency (see bottom
of page 11) for help in locating certified
professionals in your area and to see if
financial assistance is available.
.
Remodeling or Renovating a Home With
lead-Based Paint
Take precautions before your contractor or
you begin remodeling or renovating any-
thing that disturbs painted surfaces (such
as scraping off paint or tearing out walls):
. Have the area tested for lead-based
paint.
. Do not use a belt-sander, propane
torch, high temperature heat gun, dry
scraper, or dry sandpaper to remove
lead-based paint. These actions create
large amounts of lead dust and fumes.
Lead dust can remain in your home
long after the work is done.
. Temporarily move your family (espe-
cially children and pregnant women)
out of the apartment or house until
the work is done and the area is prop-
erly cleaned. If you can't move your
family, at least completely seal off the
work area.
. follow other safety measures to
reduce lead hazards. You can find out
about other safety measures by calling
t -800-424-LEAD. Ask for the brochure
"Reducing Lead Hazards When
Remodeling Your Home." This brochure
explains what to do before, during.
and after renovations.
If you have already completed renova-
tions or remodeling that could have
released lead-based paint or dust. get
your young children tested and follow
the steps outlined on page 7 of this
brochure.
.
If not
conducted
properly,
certain types
of renova.
tions can
release lead
from paint
and dust into
the air.
9
Other Sources of Lead
While paint, dust,
and soil are the
most common
sources of lead,
other lead
sources also exist.
10
. Drlnklng water. Your home might have
plumbing with lead or lead solder. Call
your local health department or water
supplier to find out about testing your
water. You cannot see, smell. or taste
lead. and boiling your water will not get
rid of lead. If you think your plumbing
might have lead in it:
. Use only cold water for drinking and
cooking.
. Run water for 15 to 30 seconds
before drinking it, especially if you
have not used your water for a few
hours.
. The job. If you work with lead. you
could bring it home on your hands or
clothes. Shower and change clothes
before coming home, Launder your work
clothes separately from the rest of your
family's clothes.
. Old painted toys and furniture.
. Food and liquids stored in lead crystal
or lead-glazed pottery or porcelain.
. Lead smelters or other industries that
release lead into the air.
. Hobbles that use lead, such as making
pottery or stained glass. or refinishing
furniture.
. folk remedies that contain lead. such as
"greta" and "azarcon" used to treat an
upset stomach.
for More Information
The National Lead Information Center
Call1-800-424-LEAD (424-5323) to learn
how to protect children from lead poisoning
and for other information on lead hazards.
To access lead information via the web, visit
www.epa.govlIead and
www.hud.gov/offlceslIeadl.
EPA's Safe Drinking Water Hotline
Call 1-800-426-4791 for information about
lead in drinking water.
Consumer Product Safety
Commission (CPSC) Hotline ____
To request information on lead in
consumer products, or to report an
unsafe consumer product or a prod-
uct-related injury call 1-800-638-
2772, or visit CPSC's Web site at:
www.cpsc.gov.
Health and Environmental Agencies
Some cities, states. and tribes have
their own rules for lead-based paint
activities. Check with your local agency to
see which laws apply to you. Most agencies
can also provide information on finding a
lead abatement firm in your area, and on
possible sources of financial aid for reducing
lead hazards. Receive up-to-date address
and phone information for your local con-
tacts on the Internet at www.epa.govlIead
or contact the National Lead Information
Center at 1-800-424-LEAD.
For the hearing impaired, call the federal Information
Relay Service at . -800-811-8339 to access any of
the phone numbers in this brochure.
11
ErA Regional Offices
Your Regional EPA Office can provide further information regard-
ing regulations and lead protection programs.
EPA Regional Offices
Region t (Connecticut, Massachusetts,
Maine. New Hampshire, Rhode Island.
Vermont)
Regional lead Contact
US. EPA Region I
Suite 1100 (Cpr)
One Congress Street
Boston, MA 02114-2023
I (888) 372-7341
Region Z (New Jersey. New York,
Puerto Rico, Virgin Islands)
Regional lead Contact
U,S. EPA Region 2
2890 \Noodbridge Avenue
Building 209. Mail Stop 225
Edison, NJ 08837-3679
(732) 321-6671
Region 3 (Delawate, Maryland,
Pennsylvania, Virginia. Washington DC.
West Virginia)
Regional Lead Contact
US, EPA Region 3 (3WC33)
1650 Arch Street
Philadelphia. PA 19103
(215) 814-5000
Region 4 (Alabama. Florida. Georgia,
Kentucky. Mississippi, North Carolina,
South Carolina, Tennessee)
Regional Lead Contact
US, EPA Region 4
61 Ii:lrsyth Street, SW
Atlanta, GA 30303
(404) 562-8998
Region 5 (illinois. Indiana. Michigan,
Minnesota, Ohio. Wisconsin)
Regional lead Contact
US, EPA Region 5 (DT-8))
77 West Jackson Boulevard
Chlcago,ll 60604-3666
(312) 886-6003
12.
Region 6 (Arkansas, loulslana. New
Mexico. Oklahoma, Texas)
Regional lead Contact
US. EPA Region 6
1445 Ross Avenue, 12th Floor
Dallas. rx 75202-2733
(214) 665-7577
Region 7 (Iowa, Kansas. Missouri,
Nebraska)
RegionaJ Lead Contact
US. EPA Region 7
(ARTD-RAlI)
90 I N. 5th Street
Kansas City. KS 66101
(913) 551-7020
Region 8 (Colorado, Montana. North
Dakota, South Dakota, Utah. Wyoming)
Regional Lead Contact
US. EPA Region 8
999 18th Street, Suite 500
Denver, CO 80202-2466
(303) 312-6021
Region 9 (Arizona, California. Hawaii,
Nevada)
Regional Lead Contact
US. Region 9
75 Hawthorne Street
San francisco. CA 94105
(415) 947-4164
Region to (Alaska, Idaho. Oregon,
Washington)
Regional Lead Contact
US, EPA Region 10
Toxics Section WCM-128
1200 Sixth Avenue
Seattle, WA 98101-1128
(206) 553-1985
CPSC Regional Offices
Your Regional CPSC Office can provide further information regard-
ing regulations and consumer product safety.
Eastern Regional Center
Consumer Product Safety Commission
101 Varick Street, Room 903
New York, NY 10014
(212) 620-4120
Western Regional Center
Consumer Product Safety Commission
1301 Clay Street. Suite 610-N
Oakland, CA 94612
(510) 637-4050
Central Regional Center
Consumer Product Safety Commission
230 South Dearborn Street, Room 2944
Chicago. IL 60604
(312) 353-8260
Hun Lead Office
Please contact HUD's Office of Healthy Homes and Lead Hazard
Control for information on lead regulations. outreach efforts. and
lead hazard control and research grant programs.
U.S. Department of Housing and Urban Development
Office of Healthy Homes and Lead Hazard Control
451 Seventh Street, SW. P-3206
Washington. DC 20410
(202) 755-1785
This document is in the public domain. It may be reproduced by an Individual or
organization without permission. Information provided In this booklet Is based
upon current scientific and technical understanding of the Issues presented and
is reflective of the jurisdictional boundaries established by the statutes governing
the co-authoring agencies. following the advice given will not necessarily pro-
vide complete protection in all situations or against all heaJth hazards that can
be caused by lead exposure.
U.S. EPA Washington OC 20460
U.S. CPSC Washington DC 20207
U.S. HUD Washington OC 20410
EPA747-K-99-001
June 2003
13
Disclosure of Infonnation on Lead-Based Paint and/or Lead-Based Paint Hazards
Lead Warning Statement
Housing built before 1978 may contain lead"based paint. Lead from paint paint chips, and dust can pose
health hawrds if not managed properly. Lead exposure is especial/y harmful to young children and pregnant
women. Bejore renting pre" 1978 housing, lessors must disclose the presence of known lead"based paint and/or
lead"based paint hazards in the dwelling. Lessees must also receive a federal/y approved pamphlet on lead
poisoning prevention.
Lessor's Disclosure
(a) Presence of lead-based paint and/or lead"based paint hazards (check (i) or (i1) below):
(I) Known lead-based paint and/or lead-based paint hazards are present in the housing
(explain).
(Ii) _ Lessor has no knowledge of lead"based paint and/or lead"based paint hazards in the
housing.
(b) Records and reports available to the lessor (check (i) or (i1) below):
(i) Lessor has provided the lessee with all available records and reports pertaining to
lead-based paint and/or lead-based paint hazards in the housing (list documents
below).
(i1) _ Lessor has no reports or records pertaining to lead"based paint and/or lead-based
paint hazards in the housing.
Lessee's Acknowledgment (Initial)
(c) Lessee has received copies of all information listed above.
(d) Lessee has received the pamphlet Proted Your Family from Lead in Your Home.
Agent's Acknowledgment (Initial)
(e) Agent has informed the lessor of the lessor's obligations under 42 U.S.c. 4852(d) and
is aware of his/her responsibility to ensure compliance.
Certification of Accuracy
The following parties have reviewed the information above and certify. to the best of their knowledge, that
the information they have provided is true and accurate.
Lessor
Date
Lessor
Date
Lessee
Date
Lessee
Date
Agent
Date
Agent
Date
Disclosure of Infonnation on Lead-Based Paint and/or Lead-Based Paint Hazards
Lead Warning Statement
Every purchaser of any interest in residential real property on which a residential dwelling was built prior to 1978 is
notified that such property may present exposure to lead from lead-based paint that may place young children at risk
of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage,
including learning disabilities, reduced intelligence quotient behavioral problems, and impaired memory. Lead
poisoning also poses a particular risk to pregnant women. The sel/er of any interest in resIdential real property is
required to provide the buyer with any information on lead-based paint hawrds from risk assessments or inspections
in the sel/ers possession and notifY the buyer of any known lead-based paint hazards. A risk assessment or inspedion
for possible lead-based paint hawrds is recommended prior to purchase.
Seller's Disclosure
(a) Presence of lead-based paint and/or lead-based paint hazards (check (i) or (i1) below):
(i) _ Known lead-based paint and/or lead-based paint hazards are present in the housing
(explain).
(Ii) _ Seller has no knowledge of lead-based paint and/or lead-based paint hazards in the housing.
(b) Records and reports available to the seller (check (i) or (i1) below):
(i) Seller has provided the purchaser with all available records and reports pertaining to lead-
based paint and/or lead-based paint hazards in the housing (list documents below).
(Ii) _ Seller has no reports or records pertaining to lead-based paint and/or lead-based paint
hazards in the housing.
Purchaser's Acknowledgment (Initial)
(c) Purchaser has received copies of all information listed above.
(d) Purchaser has received the pamphlet Proted Your Family from Lead in Your Home.
(e) Purchaser has (check (I) or (ii) below):
(i) _ received a lO-day opportunity (or mutually agreed upon period) to condud a risk assess-
ment or inspedion for the presence of lead-based paint and/or lead-based paint hazards; or
(Ii) _ waived the opportunity to condud a risk assessment or inspection for the presence of
lead-based paint and/or lead-based paint hazards.
Agent's Acknowledgment (Initial)
(f) Agent has informed the seller of the seller's obligations under 42 U.s.e. 4852(d) and is
aware of his/her responsibility to ensure compliance.
Certification of Accuracy
The following parties have reviewed the information above and certify. to the best of their knowledge. that the
information they have provided is true and accurate.
Seller
Date
Seller
Date
Purchaser
Date
Date
Purchaser
Agent
Date
Agent
Date
Appendix A--Sample Summary Inspection Notice Format
Note: The following appendix will not appear in the Code of
Federal Regulations
Summary Notice of Lead-Based Paint Inspection
Address/location of property or structure(s} this summary notice
applies to:
----------------------------------------------------------------------
l------------------------------________________________________________
~----------------------------------------------------------------------
Lead-based paint inspection description:
Date(s) of inspection:--------------------------_____________________
Summary of inspection results (check all that apply) :
(a) No lead-based paint was found.
(b) _ Lead-based paint was found.
(c) A brief summary of the findings of the inspection is
provided below (required if lead-based paint found).
Summary of where lead-based paint was found. List at least the
housing unit numbers and common areas (for multifamily housing), and
building components (including type of room or space, and the
material underneath the paint) :
J-----------------------------------------------------_________________
l----------------------------__________________________________________
]----------------------------------------------------------------------
L-----------------------------_________________________________________
L----------------------------__________________________________________
J---------------------------___________________________________________
l-------------------------_____________________________________________
C------------------------------________________________________________
L---------------------------___________________________________________
1------------------------______________________________________________
~----------------------------------------------------------------------
]----------------------------------------------------------------------
~----------------------------------------------------------------------
,
~----------------------------------------------------------------------
Contact person for more information about the inspection:
Printed name:----------------------__________________________________
Organization:------------------______________________________________
Street and city:-------------------__________________________________
[[Page 50231]]
State: ZIP:--------------------__________________________________
Phone number: (____)-------------------------------------------------
Person who prepared this summary notice:
Printed name:------------------------________________________________
Signature:------------------_________________________________________
Attachment 3
Page 1 of5
Date:-------------------------------------------------------_________
Organization:------------------------------------------------------__
Street and city:--------------------------------------------------___
State: ZIP: -----------------------------------------------___
Phone number: (____)-------------------------------------------------
Appendix B--Sample Summary Risk Assessment Notice Format
Note: This following appendix will not appear in the Code of
Federal Regulations
Summary Notice of Lead-Based Paint Risk Assessment
Address/location of property or structure(s) this summary notice
applies to:
L-----------------------------------------------------_________________
n-------------------------------------------------_____________________
n-----------------------------------------------------------___________
Lead-based paint risk assessment description:
Date(s) of risk assessment:------------------------------------------
Summary of risk assessment results (check all that apply) :
(a) No lead-based paint hazards were found.
(b) ____ Lead-based paint hazards were found.
(c) ____ A brief summary of the findings of the risk assessment
is provided below (required if any lead-based paint hazards were
found) .
Summary of types and locations of lead-based paint hazards. List at
least the housing unit numbers and common areas (for multifamily
housing), bare soil locations, dust-lead locations, and/or building
components (including type of room or space, and the material
underneath the paint), and types of lead-based paint hazards found:
J-----------------------------------------_____________________________
l-------------------------------------_________________________________
.J-------------------------------------------___________________________
n--------------------------------------------__________________________
]----------------------------------------------------------------------
L----------------------------------------______________________________
L--------------------------------------________________________________
n
'1----------------------------------------------------__________________
J----------------------------------------______________________________
D--------------------------------------________________________________
]----------------------------------------------------------------------
c-----------------------------------___________________________________
Contact person for more information about the risk assessment:
Printed name:---------------------------------_______________________
D----------------------------------____________________________________
Organization:--------------------------------________________________
c-------------------------------_______________________________________
Street and city:-------------------------------______________________
J-------------------------------_______________________________________
State: ZIP: Phone number: (____)---------------------------
Attachment 3
Page 2 of5
]----------------------------------------------------------------------
Person who prepared this summary notice:
Printed name:------------------------------------------______________
[----------------------------------------------------------------------
Signature:------------------------------------------_________________
L Date:----------------------------------------------__________________
[----------------------------------------------------------------------
Organization:-------------------------------------------_____________
----------------------------------------------------------------------
Street and city:-----------------------------------------____________
l---------------------------------------------_________________________
State: ZIP: Phone number: (____)---------------------------
J-----------------------------------------------_______________________
Appendix C--Sample Summary Presumption Notice Format
Note: The following appendix will not appear in the Code of
Federal Regulations
Notice That Lead-Based Paint or Lead-Based Paint Hazards Are Presumed
to be Present
Address/location of property or structure(s) this notice of
presumption applies to:
l-----------------------------------------_____________________________
-J------------------------------------------------______________________
]----------------------------------------------------------------------
Type of presumption (check all that apply) :
(a) Lead-based paint is presumed to be present.
(b) Lead-based paint hazard(s) is (are) presumed to be
present.
Summary of presumption. List at least the housing unit numbers and
common areas (for multifamily housing), bare soil locations, dust-
lead locations, and/or building components (including type of room
or space, and the material underneath the paint), and types of lead-
based paint hazards presumed to be present:
n------------------------------------------____________________________
[j----------------------------------------------------------------------
L---------------------------------------_______________________________
[----------------------------------------------------------------------
_1----------------------------------------------------__________________
~----------------------------------------------------------------------
]----------------------------------------------------------------------
[j----------------------------------------------------------------------
[----------------------------------------------------------------------
[----------------------------------------------------------------------
J-----------------------------------------------------_________________
,J--------------------------------------________________________________
D---------------------------------_____________________________________
L------------------------------------__________________________________
[----------------------------------------------------------------------
~----------------------------------------------------------------------
J-----------------------------_________________________________________
Contact person for more information about the presumption:
Attachment 3
Page 3 of 5
Printed name:--------------------------------------------------------
0----------------------------------------------------------------------
Organization:--------------------------------------------------------
0----------------------------------------------------------------------
Street and city:-----------------------------------------------------
l----------------------------------------------------------------------
State: ZIP: Phone number: (____)---------------------------
0----------------------------------------------------------------______
Person who prepared this notice of presumption:
Printed name:--------------------------------------------------------
0----------------------------------------------------------____________
Signature:---------------------------------------------------------__
L Date:-----------------------------------------------------------_____
[----------------------------------------------------------------------
Organization:-----------------------------------------------------___
~----------------------------------------------------------------------
Street and city:-----------------------------------------------------
~----------------------------------------------------------------------
State: ZIP: Phone number: (____)---------------------------
1-----------------------------------------------------_________________
Appendix D--Sample Hazard Reduction Completion Notice Format
Note: The following appendix will not appear in the Code of
Federal Regulations.
Summary Notice of Completion of Lead-Based Paint Hazard Reduction
Activity
Address/location of property or structure(s) this summary notice
applies to:
n-------------------------------------------___________________________
u------------------------------------------------______________________
L----------------------------------------------________________________
Summary of the hazard reduction activity:
Start and completion date(s) :----------------------------____________
Activity locations and types. List at least the housing unit numbers
and common areas (for multifamily housing), bare soil locations,
dust-lead locations, and/or building components (including type of
room or space, and the material underneath the paint), and types of
hazard reduction activities performed at the locations listed:
[----------------------------------------------------------------------
]----------------------------------------------------------------------
l------------------------------------__________________________________
, 1-----------------------------------------------------_________________
0---------------------------------------_______________________________
L---------------------------------------_______________________________
Date(s) of clearance testing and/or soil analyses: ____
Locations of building components with lead-based paint remaining in
the rooms, spaces or areas where activities were conducted:
J-----------------------------------___________________________________
Atmchrnent3
P.e4~5
]----------------------------------------------------------------------
n----------------------------------------------------------------------
n---------------------------------------------------------------_______
Summary
(a)
(b)
(c)
of results of clearance testing and soil analyses:
No clearance testing was performed.
Clearance testing showed clearance was achieved.
Clearance testing showed clearance was not achieved.
Contact person for more information about the hazard reduction:
Printed name:--------------------------------------------------------
Organization:--------------------------------------------------------
Street and city:-----------------------------------------------------
State: ZIP:-----------------------------------------------------
Phone number: (____)-------------------------------------------------
Person who prepared this summary notice:
Printed name:--------------------------------------------------------
Signature:-----------------------------------------------------------
Date:------------------------------------------------------------____
Organization:--------------------------------------------------------
Street and city:-----------------------------------------------------
State: ZIP:-----------------------------------------------------
Phone number: (____)-------------------------------------------------
[FR Doc. 99-23016 Filed 9-14-99; 8:45 am]
BILLING CODE 4210-32-P
Attachment 3
Page 5 of5
.
ATTACHMENT NO.4
LBP INFORMATION SUMMARY
1. ZEROlO BEDROOM < (LESS THAN) 100 DAYS IN UNIT; ASSISTANCE IN
HOMELESS SHELTER
. STATUS: EXEMPT TITLE X
2. ZERO/O BEDROOM> (MORE THAN) 100 DAYS IN UNIT
STATUS: OPEN ISSUE UNDER LBP REGS
ZERO/O BEDROOM> (MORE THAN) 100 DAYS ASSISTANCE IN
HOMELESS SHELTER
. STATUS: OPEN ISSUE UNDER LBP REGS
. SEE SUBPART K
. CLEARANCE OF UNITS) WILL BE REQUIRED BY CITY FOR ALL HOUSING UNITS
(EVEN ZERO BEDROOM). FOR WHICH OCCUPANCY OCCURS BY ASSISTED
HOUSEHOLD FOR MORE THAN 100 DAYS, PENDING FURTHER
INTERPRETATION/GUIDANCE FROM HUD
3. ONE OR MORE (1+) BEDROOMS OCCUPANCY < 100 DAYS IN
RESIDENTIAL UNIT AND/OR OCCUPANCY IN HOMELESS SHELTER
. EXEMPT TITLE X
4. 1+ BEDROOMS> 100 DAYS IN RESIDENTIAL UNIT
. STATUS: SAME AS #2 ABOVE; CLEARANCE REQUIRED
. SEE SUBPART K
5. EMERGENCY RENTAL ASSISTANCE < 100 DAYS
. EXEMPT TITLE X
6. EMERGENCY RENTAL ASSISTANCE> TO HOUSEHOLD TO BE
OCCUPANCY IN RESIDENTIAL UNIT FOR MORE THAN 100 DAYS (SUCH AS
LONG TERM LEASE SIGNED AT TIME OF EMERGENCY ASSISTANCE)
Attachment 4
Page 1 of2
. . CLEARANCE BEFORE ANY MONEY DISBURSED;
LBP COMPLIANCE: NOTIFICATION, EVALUATION, REDUCTION THROUGH
CLEARANCE REQUIRED BEFORE OCCUPANCY OF UNIT
. MAY BE CONSIDERED TENANT BASED RENTAL ASSISTANCE (TBRA); THUS
HQS INSPECTION AND SUBPART M MAY APPLY
. SEE SUBPARTS K AND M
. PENDING HUD GUIDANCE
7. TB RA < 100 DAYS
. EXEMPT TITLE X
8. TBRA> 100 DAYS OF HOME ASSISTANCE (SUCH AS WHEN TENANT
ENTERS INTO LONG TERM LEASE
. SEE SUBPART M
. CLEARANCE BEFORE ANY MONEY DISBURSED;
LBP COMPLIANCE: NOTIFICATION, EVALUATION, REDUCTION THROUGH
CLEARANCE REQUIRED BEFORE OCCUPANCY OF UNIT
. HQS INSPECTION REQUIRED BEFORE OCCUPANCY
. CLEARANCE BEFORE ANY MONEY DISBURSED
9. TBRA < 100 DAYS -TENANT ENTERS INTO LONG TERM LEASE, CITY
GIVES LESS THAN 100 DAYS OF ASSISTANCE.
. EXEMPT TITLE X
Attachment 4
Page 2 of2
.
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PRODUCER
Schweickert & Company
15 Peters Canyon Road
Irvine
OF LIABILITY INSU~CE
ACORD CERTIFIC
..
CA
92606-1402
DATE
04/27/2006
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED
Mercy House
P.O. Box 1905
Santa Ana
CA
92702
INSURER k. Great American Insurance Com an
INSURER B:
INSURER C:
INSURER 0:
INS RER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING
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.
rlr~: TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
A ~NERAL LIABILITY PAC5373885 05/02/2006 05/02/2007 EACH OCCURRENCE . 1,000,000
X COMMERCIAL GENERAl UABllITY Sex Abuse Aggregate Limit is FIRE DAMAGE fAll one fire) . 100,000
I CLAIMS MADE [KJ OCCUR $1,000,000 MED EXP (Anv one oersonl . 5,000
X Professional Liability PERSONAL & ADV INJURY . 1,000,000
ex Abuse & Molestation GENERAL AGGREGATE . 2,000,000
- 1,000,000
-_~'LAGG~n LIMIT APFlS PER: PRODUCTS - COMP/OP AGG .
X POUCY ~~,: LaC
A AUTOMOBilE LIABILITY PAC5373885 05/02/2006 05/02/2007 COMBINED SINGLE LIMIT 1,000,000
{Ea accident} . .
ANY AUTO
_ --J ALL OINNED AUTOS BODILY INJURY .
I SCHEDULED AUTOS {Per person)
I X] HIRED AUTOS BODILY INJURY .
i_2Li NON-QINNED AUTOS (Peraccidenl)
i----J PROPERTY DAMAGE .
I (Per accident)
LGARAGE LIABILITY AUTO ONLY - EA ACCIDENT .
~ ANY AUTO OTHER THAN EAACC .
, j AUTO ONLY: AGG .
r.E!~ESS LIABILITY /\PPR() EACH OCCURRENCE .
t~ OCCUR 0 CLAIMS MADE 1..8 TO pm M AGGREGATE .
------z51.~ tfy.~-~)- .
~~ DEDUCTIBLE .
, I RETENTION . "-.- .
i WORKERS COMPENSATION AND h'.'.'. Cj - I ~"'TATU-.I 10m-
~~"~~~<LH ; Y AUorney
i EMPLOYERS' LIABILITY E.L. EACH ACCIDENT .
,
I E_L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POliCY LIMIT .
i OTHElMisc. Equipment- PAC5373885 05/02/2006 05/02/2007 $100,000 special form
A : Rented & Property of othr $1,000 deductible
I
DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESJEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
The City of Santa Ana, its officials, employees, representatives, and volunteers are hereby named as Additional Insureds as
respects the operations of or on behalf on Mercy House Transitional Living Center, performed under contract with The City of
Santa Ana.
CERTIFICATE HOLDER I X I ADDlTlONAL INSURED- INSURER LETTER: A CANCELLATION
SHoutD AIfV OF THE ABOVE DESCRIBED POllCtES BE CANCELLED BEFORE THE EXPIRATION
City of Santa Ana DATe THEREOF, THE ISSUING INSURER WJLt:~~1'O MAIL ~ DAYS WRITTEN
Frank Hernandez Fx#647-6549 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEF1';"8tIT1"i!l:ILlj~'r&OC~-sHM..L
PO Box 1988 -lMlI08e"folO"'OBt.lC!AnmtOft'1:lAm:tr"l"-OF~KtNe ~'f'HE1N9t:tIII:~ rr!'~ OR
-~TmtY~
Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE ~ ~
I '1.VItL '
ACORD 25-S (7/97)
e..X,
@ACORD CORPORATION 1988
.
I
SPECIALTY-"UMAN_SERVICES
.
~003/003
U5/17/2UU5 13:49 FAX
CG 20 28
lEd. I I 85)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIOIIIAL INSUtED--DESICllATED PERSa'4 OR ORGANIZATION
Thia endorsement modifies insurance provided under the fol lowing:
COMMERCIAL GENERAL
POliCY #PAC5373885
Mercy House
LIABILITY COVERAGE PART
SCHEDULE
Neme of Pereon Dr Or.ani.atlon:
The City of Santa Ana, its officials, employees, representatives, and volunteer
are hereby named as Additional Insureds as respects the operations of or on
behalf of Mercy House Transitional Living Center, performed under contract
with the Ci~y of Santa Ana.
(If no entry appears above. information required to complete this endorsement
wi II be shown in the Declaratlona as appl icable to this endorsement.)
WHO ISAN INSURED (Section II) i. amended to include as an insured the pe.rson
or organization shown in the Schedule as an insured but only with respect to
I iabi I ity ar ising out of your operations or premi... owned by or rented to
you.
.,~
APPROVED "'.:; .
_f.~L)_~
--- i~_>i" ~
Assistanl Cil)_ t ~c,~..-
Copyright. Insurance Services Office. Inc., 1984
CG 2026 (Received TimeFMav.17. 11:42AMIPage 1 of 1)