HomeMy WebLinkAboutBOYS AND GIRLS CLUB 5 - 2007City of Santa
Clerk of the Cou ~I
AGREEMENT TERMINATION
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Please complete this form when the attached agreement is no longer , ~
in effect. Return form to the Clerk of the Council Office (M-30). ; j '' . '',;`'c ~
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Revised 07-23-07
A-2007-105-005 1/
INSURANCE ON FILE
"NORK MAY PROCEED
UNTIL INSURANCE EXPIRES
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CLERK OF COUNCIL
DATE'
AUG 2 2 2001
5/05
AGREEMENT BETWEEN THE CITY OF SANTA ANA AND
BOYS AND GIRLS CLUB OF SANTA ANA, INC FOR USE OF
COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS
This Agreement, is hereby made and entered into this 1st day of July, 2007, by and between
the City of Santa Ana, a charter city and municipal corporation of the State of Califomia ("CITY")
and BOYS AND GIRLS CLUB OF SANTA ANA, INe, a Califomia nonprofit corporation
("SUBRECIPIENT").
WIINg~~gIH
Recitals:
A. The CITY, as an entitlement recipient and grantee of the United States Department of
Housing and Urban Development ("HUD") COlmnunity Development Block Grant ("CDBG")
Program, desires to enter this Agreement with the SUB RECIPIENT 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 SUBRECIPIENT is a private nonprofit agency that has been selected by the CITY
to receive CDBG funds and administer such financial assistance; and to provide the services
described in Exhibit A, in accordance with the schedule of perfonnance 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. SUBRECIPIENT 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 tennination
of this Agreement or serve as reason for the City to recapture the grant funds awarded to
SUBRECIPIENT pursuant to this Agreement.
E. The CITY and SUB RECIPIENT have duly executed this Agreement for the expenditure of
such funds; and
WHEREFORE, it is agreed by and between the parties that the foregoing Recitals are a
substantive part of this Agreement and the following telms and conditions are approved and
together with all exhibits and attaclunents hereto, shall constitute the entire Agreement between the
CITY and SUB RECIPIENT:
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I. SUBRECIPIENT'S OBLIGATIONS
A. Non-Profit Status - Representations and Warranties.
(a) Authority. SUBRECIPIENT is a duly organized and existing non-profit corporation
in good standing and authorized to do business under the laws of the State of California.
SUB RECIPIENT has full right, power and lawful authority to accept the funding hereunder and
to undertake all obligations as provided herein and the execution, perfonnance and delivery of
this Agreement by SUBRECIPIENT has been fully authorized by all requisite actions on the part
of SUBRECIPIENT.
(b) Experience. SUBRECIPIENT 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 perfonned and provided hereunder, (ii) it has carefully considered how the services should be
perfom1ed, and (iii) it fully understands the facilities, difficulties and restrictions attending
perfonnance of the services under this Agreement.
(d) No Conflict. To the best of SUB RECIPIENT'S knowledge, SUBRECIPIENT'S
execution, delivery and perfonnance of its obligations under this Agreement will not constitute a
default or a breach under any contract, agreement or order to which SUBRECIPIENT is a party
or by which it is bound.
(e) No Bankruptcy. SUBRECIPIENT is not the subject of any current or threatened
bankruptcy proceeding.
(f) No Pending Legal Proceedings. SUBRECIPIENT is not the subject of a current or
threatened litigation that would or may materially affect SUBRECIPIENT'S perfonnance under
this Agreement.
(g) Application Veracity. All provisions of and infom1ation provided in
SUBRECIPIENT'S application for funding submitted to CITY including any exhibits are true
and con-ect in all material respects.
(h) No Pending Investigation. SUBRECIPIENT is not aware that it is the
subject of any current or threatened criminal or civil action investigation by any public agency,
including without limitation a police agency or prosecuting authority, that would relate to affect
perfonnance of the Agreement or provision of services hereunder.
B. Amount of Grant and Ouarterlv Disbursement. The amount granted to
SUB RECIPIENT is $ 40,000("CDBG FUNDS"), and such funds shall be expended by
SUBRECIPIENT on or before June 30, 2008. The CDBG FUNDS shall be disbursed by CITY
to SUBRECIPIENT on a quarterly basis (October, January, April and July) subject to and upon
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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
infonnation due on or before July 15 of the applicable funding year, as hereinafter more fully set
forth. SUBRECIPIENT shall be obligated to perfonn such duties as would n01111ally extend
beyond the term, including but not limited to obligations with respect to indemnification, audits,
rep0l1ing, 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 fOlth in "Exhibit A,"
attached hereto and by this reference incorporated herein. SUBRECIPIENT'S failure to perfonn 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 SUBRECIPIENT hereunder.
D. Allowable Costs. SUBRECIPIENT agrees to complete said program on or before
June 30, 2008 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 fi'om said funds only for the same purposes for which said funds may be expended
pursuant to the tenns and conditions ofthis Agreement.
E. Licensing. SUBRECIPIENT agrees to obtain and maintain all required licenses,
registrations, accreditation and inspections from all agencies governing its operations.
SUBRECIPIENT shall ensure that its staff shall also obtain and maintain all required licenses,
registrations, accreditation and inspections from all agencies goveming SUB RECIPIENT's
operations hereunder. Such licensing requirements include obtaining a City business license, as
applicable.
F. Zoning. SUBRECIPIENT agrees that any facility/property used in furtherance of
said program shall be specifically zoned and permitted for such use(s) and activity(ies). Should
SUB RECIPIENT fail to have the required land entitlement and/or pennits, thus violating any local,
state or federal rules and regulations relating thereto, SUBRECIPIENT shall immediately make
good-faith efforts to gain compliance with local, state or federal rules and regulations following
written notification of said violation(s) from the CITY or other authorized citing agency.
SUBRECIPIENT shall notity CITY immediately of any pending violations. Failure to notity CITY
of pending violations, or to remedy such known violation(s) shall result in tennination of grant
funding hereunder. SUBRECIPIENT must make all cOlTections required to bring the
facility/property into compliance with the law within sixty (60) days of notification of the
violation(s); failure to gain compliance within such time shall result in tennination of grant funding
hereunder.
G. Separation of Accounts. All funds received by SUBRECIPIENT from CITY
pursuant to this Agreement shall be maintained in an account in a federally insured banking or
savings and loan institution with record keeping of such accounts maintained pursuant to applicable
OMB Circular A-II 0 requirements. SUBRECIPIENT is not required to maintain separate
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depository accounts for CDBG FUNDS; provided however, the SUB RECIPIENT must be able to
account for receipt, obligation and expenditure of CDBG FUNDS pursuant to applicable OMB
Circular A-I 10 requirements.
H. Audit Report Requirements. SUBRECIPIENT agrees that if SUB RECIPIENT
receives Five Hundred Thousand Dollars ($500,000.00) or more in federal funds, SUBRECIPIENT
shall have an annual audit conducted by a celtified public accountant in accordance with the
standards as set fOlth and published by the United States Office of Management and Budget.
SUBRECIPIENT shall provide CITY with a copy of said audit by October I of the year following
the program year in which this Agreement is executed.
I. Record Keepimz/RepOlting. SUBRECIPIENT shall keep and maintain complete and
adequate records and reports to assist CITY in meeting and maintaining its record keeping
responsibilities under the CDBG REGS, including the following:
(I) 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 paIticipating
in or benefiting by the SUB RECIPIENT program.
b. Documentation of the number of persons and/or families palticipating
in or benefiting by the SUBRECIPIENT program.
c. Household infonnation shall include number of persons, identification
of head of household, race/ethnicity, and income verification.
d. Documentation of all CDBG FUNDS received from CITY.
e. Documentation of expenses as identified in the Budget Proposal,
including evidence of incurring the expense, invoices for goods or services, copies
of any and all contracts or documentation peltaining to costs for subcontractors,
plus all other invoices for which CDBG FUNDS were expended, and any payments
therefor.
f. Any such other related records as CITY shall reasonably require or as
required to be maintained pursuant to the CDBG REGS.
(2) RepOlts
(i) Payment Request. Concurrently with the submittal of each
qUaIterly 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, copies
of any and all contracts or documentation peltaining to costs for
subcontractors or other documentation supporting and
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evidencing how the CDBG FUNDS have been expended during
the applicable quarter.
(ii) Quarterly Activity Report: SUB RECIPIENT agrees to keep monthly
records of all ethnic and racial statistics of persons and families benefited by
SUBRECIPIENT in the perfonnance of its obligations under this Agreement,
including, but not limited to, the number of low and moderate income persons
and households assisted in accordance with federal income limits, the number
of female heads of households assisted, new program infom1ation and year-to-
date program statistics on expenditures, caseload and activities.
J. Access to Records. CITY and the United State Govemment and/or their representatives
shall have access for purposes of monitoring, auditing, and examining SUBRECIPIENT's activities
and perfonnance, to books, documents and papers, and the right to examine records of
SUBRECIPIENT's subcontractors, bookkeepers and accountants, employees and participants in
regard to said program. CITY and the United States Government and/or their representatives shall
also schedule on-site monitoring at their discretion. Monitoring activities may also include, but are
not limited to, questioning employees and participants in said program and entering any premises or
any site in which any of the services or activities funded hereunder is 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 infonnation as set forth in federal or state law.
K. Location of Records/Required Length of Record Keeping. All accounting records,
reports, and evidence pertaining to all costs, expenses and the CDBG FUNDS of
SUBRECIPIENT and all documents related to this Agreement shall be maintained and kept
available at SUBRECIPIENT'S office or place of business for the duration of the Agreement and
thereafter for five (5) years after completion of an audit in conformity with the CDBG REGS's.
Records which relate to (a) complaints, claims, administrative proceedings or litigation arising
out of the performance of this Agreement, or (b) costs and expenses of this Agreement to which
CITY or any other govemmental agency takes exception, shall be retained beyond the five (5)
years until complete resolution or disposition of such appeals, litigation claims, or exceptions. In
the event SUBRECIPIENT does not make the above-referenced documents available within the city
of Santa Ana, Califomia, SUB RECIPIENT agrees to pay all necessary and reasonable expenses
incUlTed by CITY in conducting any audit at the location where said records and books of account
are maintained.
L. Compliance with Law/ProlZram Income. SUBRECIPIENT acknowledges that the funds
being provided by CITY for said program are received by CITY pursuant to the ACT as amended
and that expenditures of these funds shall be in accordance with the ACT and all pertinent
regulations issued by agencies of the federal govemment, including, but not limited to, all
regulations found at Title 24 of the Code of Federal Regulations. Program income received by
SUBRECIPIENT shall be retumed to CITY unless othelwise 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 refelTed to in this Agreement.
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M. Standing. SUB RECIPIENT shall be in good standing, without suspension by the
Califomia Secretary of State, Franchise Tax Board and Intemal Revenue Service. Any change in
the corporate status or suspension of SUBRECIPIENT shall be reported immediately to CITY.
N. Confidentiality. Without prejudice to any other provisions of this Agreement,
SUBRECIPIENT shall, where applicable, maintain the confidential nature of infom1ation provided
to it conceming participants in accordance with the requirements offederal 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 incUlTed and services rendered hereunder.
O. Independent Contractor. SUB RECIPIENT agrees that the perfonnance of
obligations hereunder is rendered in its capacity as an independent contractor and that it is in no way
an agency of CITY.
P. Violation of Tern1s and Conditions. SUBRECIPIENT agrees that if
SUBRECIPIENT violates any of the tenns and conditions of this Agreement or any prior
Agreement whereby CDBG funds were received by SUBRECIPIENT, or if SUBRECIPIENT
repOlts 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 SUBRECIPIENT engaged in fraudulent activity to obtain and/or justity
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 ten11S of this Agreement. Said record shall be
made available to CITY upon request. The tenn "non-expendable personal property" shall include
leased and purchased equipment.
R. Prohibited Use. SUBRECIPIENT hereby celtifies and agrees that it will not use
funds provided through this Agreement to pay for enteltainment, meals or gifts.
S. Lobbying. SUBRECIPIENT certifies that it will comply with federal law (3 I
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 cOlmection with
awarding of any federal contract, the making of any federal grant or loan, entering into any
cooperative agreement and the extension, renewal, amendment or modification of any federal
contract, grant, loan or cooperative agreement. SUBRECIPIENT shall sign a certification to that
effect in a fonn as set forth in "Exhibit C," attached hereto and by this reference incorporated herein.
SUB RECIPIENT shall submit said signed certification to CITY prior to perfonning 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 ten11S and conditions of this Agreement.
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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 cOlmection with this Federal contract, grant, loan, or cooperative agreement, the
undersigned shall complete and submit a "Disclosure Pornl to Report Lobbying," in accordance
with its instructions (see C-l).
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 tenns of this Agreement,
or who are in a position to participate in a decision-making process or gain inside info1l11ation with
regard to such activities, may obtain a financial interest or benefit from a CDBG-assisted activity of
SUBRECIPIENT, either for themselves or those with whom they have family or business ties,
during their tenure or for one year thereafter. This prohibition applies to any person who is an
employee, agent, consultant, officer, or elected or appointed official of CITY, or of
any designated public agencies, or the SUB RECIPIENT.
U. Davis-Bacon Act. All laborers and mechanics employed by contractors or
subcontractors in the perfonnance 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 detelmined 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.P.R. ~5.5.
Further, the payroll repOlts (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. g5.5. A breach of the contract
clauses in 29 C.F.R. ~5.5 may be grounds for tennination of the contract, and for debannent as a
contractor/subcontractor, as provided in 29 C.F.R. gS.I2. Labor standards interviews/investigations
shall be made as necessary to assure compliance [29 C.P.R. g5.6(a)(3)].
V. Drug Pree Workplace. SUBRECIPIENT certifies that it has established the following
drug-free workplace policy:
I. 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 I.
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b) Notify appropriate officials of SUBRECIPIENT and CITY officials of
any criminal drug statute conviction for a violation occurring in the workplace not
later than five days after such conviction.
3. The CITY and the United State Depariment of Housing and Urban
Development wiII be notified within ten days after receiving notice of any such violation.
4. Within 30 days ofreceiving 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.
II. CITY'S OBLIGATIONS
A. Payment of Funds. Upon execution of this Agreement by SUBRECIPIENT, CITY shall
pay to SUBRECIPIENT fi'om CDBG funds, when, if and to the extent received from HUD, for
CITY's 2007-08 CDBG program year amounts expended by SUBRECIPIENT in canying out said
program for fiscal year 2007-08 pursuant to this Agreement up to a maximum aggregate payment
ofFOlty Thousand Dollars ($ 40,000) in installments determined by CITY. Payments shall be made
to SUBRECIPIENT through the submission of invoices on a quarterly basis (October, JanuaIY, April
and July) in a fonn 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
incUlTed and documented within the scope and provisions ofthis Agreement and that
SUBRECIPIENT is in compliance with the tenns and conditions of this Agreement.
B. Audit of Account. CITY shall include an audit of the account maintained by
SUBRECIPIENT in CITY's annual audit of all CDBG FUNDS in accordance with Title 24 of
the Code of Federal Regulations and other applicable federal laws and regulations.
C. Conunon Rule: Pursuant to CFR 85.40(a), the CITY manages the day-to-day
operations of each grant and subgrant suppOlied activities. CITY staffhas detailed knowledge of the
grant program requirements and monitors grant and subgrant supported activities to assure
compliance with Federal requirements. Such monitoring covers each program, function and activity
and perfonnance goals are reviewed periodically.
D. Environmental Review: In accordance with 24 CFR 58, the CITY is responsible for
undertaking environmental review and maintaining environmental review records for each
applicable project.
E. Perfonnance Monitoring: CITY shall monitor the perfol111ance of the
SUBRECIPIENT against goals and performance standards required herein. Substandard
perfol111ance 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
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reasonable period of time after being notified by the CITY, contract suspension or tennination
procedures will be initiated.
m. NONDISCRIMINATION
SUBRECIPIENT agrees that no person on the ground of race, age, color, national origin,
religion or sex wiII 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
Pursuant to the conflict of interest requirements set forth in 24 CFR 576.57 and OMB
Circulars I - 102 and A- 110, SUBRECIPIENT agrees that no officer, employee, agent or assignee of
CITY having direct or indirect control of any CDBG monies granted to the CITY, inclusive of the
subject CDBG FUNDS, shall serve as an officer of SUBRECIPIENT. Further, any conflict or
potential conflict of interest of any officer of SUBRECIPIENT shall be fully disclosed in writing
prior to the execution 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 SUB RECIPIENT is a religious entity, SUBRECIPIENT hereby agrees that in connection
with the provision of the services SUB RECIPIENT 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.
B. SUBRECIPlENT shall not discriminate against any person applying for the services
SUB RECIPIENT agrees to provide under the tenns 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. SUB RECIPIENT 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
establislunent of religion as set forth in the establislunent clause under the First Amendment of the
United States Constitution and Article I, Section 4 of the Califomia Constitution, and is not in any
manner intended to restrict other activities of SUBRECIPIENT.
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D. Where the services to be provided w1der 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 tenns only an incidental pOltion of the CDBG
expenditure for rendering the services under said program.
VI. PROIDBITION OF NEPOTISM
SUB RECIPIENT agrees not to hire or pennit 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 tenn "immediate
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 tenn "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
COlmnunity Development Agency (M-25)
20 Civic Center Plaza
P.O. Box 1988
Santa Ana, Califomia 92702- 1988
TO SUBRECIPIENT:
Derald Sidler
Executive Director
1615 E. 17th Street, Room 150
Santa Ana, CA 92703
VIII. ASSIGNABILITY
None of the duties of, or work to be perfonned 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 assigrunent shall tenninate or alter the legal
obligations of SUBRECIPIENT pursuant to this Agreement.
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IX. HOLD HARMLESS
SUBRECIPIENT shall indemnity, defend and save hannless 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, indemnity and save hallnless 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 attomey fees and reasonable expenses for litigation or settlement, resulting
from or arising out of the negligent or wrongful acts, en'ors or omissions of SUB RECIPIENT, its
officers, directors, employees, agents, subcontractors and suppliers arising out of
SUBRECIPIENT's perfom1ance of this Agreement.
X. INSURANCE
A. In accordance with the provisions of Section 3300 of the Labor Code, if
SUBRECIPIENT has any employees it is required to be insured against liability for worker's
compensation or to undertake self-insurance. Prior to commencing perfonnance 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: (I) name the City of Santa Ana, its officers, agents,
representatives, employees and volunteers as additional insured's; (2) be primary with respect to
insurance or self-insurance programs maintained by the CITY; (3) contain standard separation of
insured's provisions; and (4) give to CITY prompt and timely notice of claim made or suit
instituted arising out of SUBRECIPIENT's operations hereunder.
SUBRECIPIENT shall: (a) prior to exercising any right under this Agreement,
fumish 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 tenninated 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
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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 detennined 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 CUlTent 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.
C. Subject to the obligations set forth herein, title to equipment acquired under the
tenns of this Agreement will vest upon acquisition in SUB RECIPIENT. 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 CUlTent 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 cun"ent 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 cun"ent 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 perfol111ed 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 SUB RECIPIENT'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 fUltherance 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 tennination of this Agreement and shall
12
5/05
survive the date of tennination 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 tenninated on thirty (30) days' written notice by either
party. In the event of such tennination, SUBRECIPIENT shall only be entitled to reimbursement
for approved expenses incurred to the effective date oftennination.
B. This Agreement may be suspended or tenninated by CITY upon five (5) days'
written notice for violation by SUBRECIPIENT of Federal Laws govel11ing the use of Community
Development Block Grar1t Funds. In the event of such suspension or tennination, SUBRECIPIENT
shall only be entitled to reimbursement for approved expenses incurred up to the effective date of
suspension or tel111ination.
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 tennination of this
Agreement by written notice to SUB RECIPIENT, which default and termination shall be effective
on a date stated in the notice which is to be not less than ten (IO) days after certified mailing or
personal service of such notice, unless such default is cured before the effective date of tel111ination
stated in such notice. If tenninated for cause, CITY shall be relieved of fUlther liability or
responsibility under this Agreement, or as a result of the tennination thereof, including the payment
of money, except for payment for approved expenses incurred for services satisfactorily and timely
perfonned prior to the mailing or service of the notice oftennination, and except for reimbursement
of (I) any payments made for services not subsequently perfonned in a timely and satisfactory
manner, and (2) costs incun"ed by CITY in obtaining substitute perf0l111ance.
D. The grant of funds under this Agreement may be tenninated for convenience in
accordance with 24 CFR 85.44.
E. The grant of funds under this Agreement may be tenninated due to the non-
perfonnance of SUBRECIPIENT and/or failure of SUBRECIPENT to perfonn the work described
in Exhibits A and B or failure to meet the perfol1nance standards and program goals set forth
therein.
F. In the event this Agreement is tenninated as set forth in subparagraphs XII.A.
through XII.E., inclusive, SUBRECIPIENT agrees to immediately return to CITY upon CITY's
demand and prior to any adjudication of SUBRECIPIENT's rights, any and all funds not used, ar1d
to comply witl1 paragraph "XI. REVERSION OF ASSETS" of this Agreement.
XIII. LIMITATION OF FUNDS
13
5/05
The United States of America, tlu'ough HUD, may in the future place programmatic or fiscal
limitations on the use ofCDBG funds which limitations are not presently anticipated. Accordingly,
CITY reserves tile 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 categOlY, may limit the rate of
SUB RECIPIENT's authority to cOlmnit and spend funds, or may restrict SUBRECIPIENT's use of
botll 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, moditying, or amending the Agreement for such
purposes. If such a reduction in funding occurs, SUBRECIPIENT shall be pennitted to de-scope
accordingly. Where CITY has reasonable grounds to question SUB RECIPIENT's fiscal
accountability, financial soundness, or compliance with this Agreement, CITY may suspend the
operation of this Agreement for up to sixty (60) days upon five (5) days written notice to
SUBRECIPIENT of its intention to so act, pending an audit or other resolution of such questions.
In no event, however, shall any revisions made by CITY affect expenditures and legally binding
commitments made by SUBRECIPIENT before it received notice of such revision, provided that
such amounts have been committed in good faith and are othelwise 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 palties hereto with respect to the use of CITY's CDBG funds by SUBRECIPIENT and contains
all the covenants and agreements between the palties with respect to such employment in any
maimer 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
SUB RECIPIENT.
XV. LAWS GOVERNING TillS AGREEMENT
This Agreement shall be governed by aIld construed in accordance with the laws of tile 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 allY otller provision of this Agreement.
XVII. MISCELLANEOUS PROVISIONS
14
5/05
a. Each undersigned represents and warrants that its signature herein below has the power,
authority and right to bind their respective parties to each of the ten11S of this Agreement, and shall
indenmity CITY fully, including reasonable costs and attomey'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 telms 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
perfol111ed 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.
15
5/05
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as ofthe last date and
year written below.
/Al!~ '. i'..'
~I~72 'i
PATRICIA E HEALY
Clerk of the Council
CITY OF SANTA ANA
,b.UdCll1^ifttj,0f:t(
~t..-'. DAVID N. RE
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attomey
~~
~ .
. L NAC. E ALOZA
Assistant City Attomey
SUBRECIPIENT:
DATE: 3une. \L\. .~CD-'
\
16
Name of Organization
Name of Funded Program
Annual Accomplishment Goal
I. Total number of unduplicated clients (Santa Ana and Non-Santa Ana Residents) anticipated to be served by the
funded proram, named above, during the 12-month contract period.
I 550 Persons
II. Number of ONLY unduplicated Santa Ana residents to be served by the funded program, named above, during the
12-month contract period.
I 3401 Persons
Program and Funding Description
III. Description of Work - In the space below, describe the program to be funded during the 12-month contract period.
What specific activities will be undertaken during the contract period. Please be concise in your response. Only the
viewable space will print.
The Summer Youth Outreach Program will provide a day camp experience for youth out of school for the summer
break. They will have swimming lessons, tennis lessons, computer on-line safety classes, arts & crafts, life skills
activities that focus on prevention, health and safety, sports and recreational activities, weekly field trips, and even
overnight camping at accredited camps.
City of Santa Ana
Scope of Work
Boys & Girls Club of Santa Ana
Summer Youth Outreach Program
Schedule of Performace
Estimate the number of ONLY unduplicated Santa Ana residents to be served by the funded program during the 12-
month contract period per quarter. (Enter number of new Santa Ana clients served each quarter. If they were served
in quarter 1 do not count them again in quarter 2)
Quarter 1: July 1 - September 30
Quarter 2: October 1 - December 31
Quarter 3: January 1 - March 31
Quarter 4: April 1 -June 30
340 Persons
Persons
Persons
Persons
340 Total unduplicated Santa Ana Residents to be served.
Schedule of Invoicing
Estimate the amount of grant funds to be requested durin the 12-month contract period on a quarterly basis.
Quarter 1: July 1 - September 30 $ 35,000.00
Quarter 2: October 1 - December 31 $ 5,000.00
Quarter 3: January 1 - March 31
Quarter 4: April 1 -June 30
$ 40,000.00 Total Grant
Exhibit A
Page 1 of 1
City of Santa Ana
Performance Outcome Tracking
Please find the activity most c10sety associated to the service that will be provided and place an "X" next to it then answer
hid . h h'
the question below. Please note the tracking t at IS InVO ve Wit t IS activity.
Place an
"X" next to
one Activity/
Activity Program City Outcome Tracking Goal HUD Outcome Tracking HUD Goal
Anti-Crime Track the reduction in Reduce response time to Number of persons assisted: Sustainability for the
SeNices response time and the serious crimes in the City's -with new access to a seNice purpose of creating
number of criminal Low- and Moderate-Income -with improved access to a seNice Suitable Living
apprehended as a result. area by at least 3 minutes -where activity was used to meet a quality Environments
resulting in the standard or measurably improved quality,
apprehension of 1,500 report the number that no longer only
criminals that may have access to substandard seNice
otherwise escape.
,uS-year goal to be
achieved by FY 09/10
Fair Housing Provide fair housing seNice 1. Provide fair housing Number of persons assisted: Accessibility for the
SeNices and ongoing analysis of counseling, education and -with new access to a seNice purpose of providing
impediments to fair enforcement seNices to -with improved access to a seNice Decent Affordable
housing. 7,000 Santa Ana -where activity was used to meet a quality Housing
households. standard or measurably improved quality,
,uS-year goal to be report the number that no longer only
achieved by FY 09/10 have access to substandard seNice
2. Annually assess actions Number of persons assisted: Accessibility for the
to eliminate impediments to -with new access to a seNice purpose of providing
fair housing. -with improved access to a seNice Decent Affordable
-where activity was used to meet a quality Housing
standard or measurably improved quality,
report the number that no longer only
have access to substandard seNice
Homelessness Track assisted individuals 50% of assisted individuals -Number of households that RECEIVED Accessibility for the
Prevention who retained their housing and households will retain emergency financial assistance to purpose of creating
or utilities for at least 6 their housing or utilities for prevent homelessness Suitable Living
months after assistance at least 6 months after -Number of households that RECEIVED Environments
was provided. assistance is provided. emergency legal assistance to prevent
homelessness
Emergency Track individuals who 50% of Number of homeless persons given Accessibility for the
Shelter received support seNices individuals/households that overnight shelter purpose of creating
that were linked to one or are provided with Suitable Living
more additional support emergency shelter will OR Environments
seNice and/or appropriate transition to interim housing
housing. (i.e., transitional housing). Number of beds created in overnight
shelter or other emergency housing
Transitional Track homeless individuals 5% of homeless individuals Number of persons assisted: Accessibility for the
Housing who participated in participating in transitional -with new access to a seNice purpose of creating
transitional housing housing program will be -with improved access to a seNice Suitable Living
program that were placed in placed in permanent -where activity was used to meet a quality Environments
permanent housing. housing. standard or measurably improved quality,
report the number that no longer only
have access to substandard seNice
Supportive Track individuals who 50% of individuals/families Number of persons assisted: Accessibility for the
SeNices for received support seNices receiving support seNices -with new access to a seNice purpose of creating
ESG that were linked to one or will be linked to one or -with improved access to a seNice Suitable Living
more additional support more additional support -where activity was used to meet a quality Environments
seNice and/or appropriate seNice and/or appropriate standard or measurably improved quaiity,
housing. housing. report the number that no longer only
have access to substandard seNice
Exhibit A-1
Page 1 of 3
Place an
"X" next to
one Activity!
Activity Program City Outcome Tracking Goal HUD Outcome Tracking HUD Goal
Senior Services 1. Track assisted senior 1. 80% of assisted senior Number of persons assisted: Accessibility for the
citizens that remained citizens will remain -with new access to a service purpose of creating
independent for at least 1 independent for at least 1 -with improved access to a service Suitable Living
year after services were year after services are -where activity was used to meet a quality Environments
provided. provided. standard or measurably improved quality,
report the number that no longer only
have access to substandard service
2. Track seniors receiving 2. 90% of seniors Number of persons assisted: Accessibility for the
referrals that were linked to receiving referrals will be -with new access to a service purpose of creating
the services sought. linked to the services -with improved access to a service Suitable Living
sought. -where activity was used to meet a quality Environments
standard or measurably improved quality.
report the number that no longer only
have access to substandard service
Owner - Number of owners assisted Physical safety and Total number of units: Accessibility for the
Occupied to rehabilitate their primary comfort will be improved fOI -Number occupied by elderly purpose of providing
Housing residence for the following Low and Moderate income -Number of units brought from Decent Affordable
Rehabilitation income categories: households by improving substandard to standard condition (HQS Housing
-Extremely Low Income homes to a level that or local code)
-Very Low Income meets or exceeds HUD -Number qualified as Energy Star
-Moderate Income housing quality standards. -Number of units brought into compliance
Special Needs Categories with lead safe housing rule (24 CFR part
-Large Families 35)
-Number of units made accessible for
persons with disabilities
Frail Elderly Track frail elderly 90% of frail elderly Number of persons assisted: Accessibility for the
Services individuals that were linked individuals will be linked to -with new access to a service purpose of creating
to the services sought. the services sought. -with improved access to a service Suitable Living
-where activity was used to meet a quality Environments
standard or measurably improved quality,
report the number that no longer only
have access to substandard service
Disabled Track disables persons Support independent living Number of persons assisted: Accessibility for the
Services whose independent living for 90% of disabled -with new access to a service purpose of creating
was supported by City persons assisted by City -with improved access to a service Suitable Living
funds. funds. -where activity was used to meet a quality Environments
standard or measurably improved quality,
report the number that no longer only
have access to substandard service
Services for Track individuals assisted 100% of individuals Number of persons assisted: Accessibility for the
Mentally III with City resources that assisted with City -with new access to a service purpose of creating
were provided an entry resources will be provided -with improved access to a service Suitable Living
point into the regional an entry point into the -where activity was used to meet a quality Environments
mental health care system regional mental health care standard or measurably improved quality,
and linked to at least one system and linked to at report the number that no longer only
additional mental health least one additional mental have access to substandard service
supportive service. health supportive service.
Services for Track how many individuals Provide entry into the Number of persons assisted: Accessibility for the
Substance with substance addiction in regional recovery system -with new access to a service purpose of creating
Addicted were provided an entry into for 25 individuals with -with improved access to a service Suitable Living
the regional recovery substance addiction and -where activity was used to meet a quality Environments
system and linked to link them to additional standard or measurably improved quality,
additional services. services. report the number that no longer only
."5-year goal to be have access to substandard service
achieved by FY 09/10
Exhibit A-1
Page 2 of 3
Place an
"XU next to
one Activity/
Activity Program City Outcome Tracking Goal HUD Outcome Tracking HUD Goal
Youth Services 1. Track improvement in 1. For education-based Number of persons assisted: Accessibility for the
pre-test, post-test scores. programs, improve pre-test -with new access to a service purpose of creating
post-test scores by 50% -with improved access to a service Suitable Living
-where activity was used to meet a quality Environments
standard or measurably improved quality,
report the number that no longer only
have access to substandard service
2. Track number of 2. Provide opportunities fo Number of persons assisted: Accessibility for the
individuals exposed to the exposure to the fine arts. -with new access to a service purpose of creating
fine arts. -with improved access to a service Suitable Living
-where activity was used to meet a quality Environments
standard or measurably improved quality,
report the number that no longer only
have access to substandard service
3. Track children/youth 3. 90% of children/youth Number of persons assisted: Accessibility for the
seeking referrals that were seeking referrals will be -with new access to a service purpose of creating
X linked to the services linked to the services -with improved access to a service Suitable Living
sought. sought. -where activity was used to meet a quality Environments
standard or measurably improved quality,
report the number that no longer only
have access to substandard service
Low- and Track program participants 90% of program Number of persons assisted: Accessibility for the
Moderate- that were linked to services participants will be linked to -with new access to a service purpose of creating
Income sought. services sought. -with improved access to a service Suitable Living
Services -where activity was used to meet a quality Environments
standard or measurably improved quality,
report the number that no longer only
have access to substandard service
Describe how you will gather the tracking information, noted above, for that activity.
Attendance is tracked utilizing Kid Trax, an attendance program utilized by the Boys & Girls Clubs of America. As
participants enter the building they are entered into the Kid Trax system. Therefore, we will be able to track all youth who
became new members of BGCSA for the period of time from July 1, 2007 thru August 31,2007 when the summer
program ends. Additionally, we are able to ascertain the total number of youth served by the summer program (new
members and existing members who participate in the expanded program).
Exhibit A-1
Page 3 of 3
Program Year 2007-2008
Final Budget
Organization Name
Program Name
Boys & Girls Club of Santa Ana
Summer Youth Outreach Program
Expenses Funded by Expenses Funded Total Program Total Organizational
CateQorv Santa Ana CDBG bv Other Sources Budget Budget
Administrative Staff
Salaries & Benefits $ 13,766 $ 13,766 $ 128,122
Program Staff Salaries &
Benefits $ 24,612 $ 24,612 $ 672,638
Co ntractual/P rofessiona I
Services $ - $ - $ 44,500
Office Supplies $ 1,622 $ 1,622 $ 41,834
Rent $ - $ 39,210
Communications $ - $ 15,774
Utilities $ - $ 16,440
Insurance $ - $ 50,072
Other: List below
1 $ -
2 $ -
3 $ -
4 $ -
5 $ -
Total $ 40,000 $ - $ 40,000 $ 1,008,590
Expenditures
LIST ALL OTHER PROGRAM FUNDS THAT HAVE BEEN SECURED FOR 07-08
(Total Funds for Program must equal Total Program Budget above)
Source Amount
Santa Ana CDBG $ 40,000
Special Event Fundraising $ 106,229
Total Funds for the Program $ 146,229
Exhibit B
Page 1 of 1
2007-2008 Funded Personnel
Name of Organization: Boys & Girls Club of Santa Ana
Name of Program Summer Youth Outreach Progranl
NOTE: Please remember that this is only a budget and that reimbursement should be based on actual service.
ADMINISTRATIVE STAFF
Position Title Annual Annual Total CDBG Funds Of this time Maximum
Salary Benefits Compensation Requested for percent of Amount of
this position time serving eligible
Santa Ana Complensation
$ - $ -
Summer Coordinator $ 40.000 $ 7.200 $ 47.200 $ 7.866 100% $ 47.200.00
Camo & Field Trio Coordinator $ 30.000 $ 5.400 $ 35.400 $ 5.900 100% $ 35.400.00
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
Total Amount ReQuested $ 13.766
#DIV/O!
#DIV/O!
#DIV/O!
#DIV/O!
#DIV/O!
#DIV/O!
#DIV/O!
Must equal anlount indicated on Exhbit B
PROGRAM STAFF
Position Title Annual Annual Total CDBG Funds Of this time Maximum
Salary Benefits Compensation Requested for percent of Amount of
this position time serving eligible
Santa Ana Comolensation
Tennis instructors $ 3.000 $ 550 $ 3.550 $ 3.550 100% $ 3.550.00
Earlv Bird staff (4) $ 16.000 $ 2.880 $ 18.880 $ 17,286 100% $ 18.880.00
Front Desl Clerk $ 3.200 $ 576 $ 3.776 $ 3.776 100% $ 3.776.00
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
Total Amou.nt ReQuested $ 24.612
#DIV/O!
#DIV/O!
#DIV/O!
#DIV/O!
#DIV/O!
#DIV/O!
Must equal anlount indicated on Exhbit B
CONTRACTUALIPROFESSIONAL SERVICES
Type of Service Annual Contract Amount Total CDBG Funds Of this time Maximum
Compensation Requested for percent of Amount of
this position time serving eligible
Santa Ana ConmJensation
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
$ - $ -
Total Amount ReQuested $ -
#DIV/O!
#DIV/O!
#DIV 10!
#DIV 10!
#DIV/O!
#DIV/O!
#DIV/O!
#DIV/O!
#DIV/O!
Must equal amount indicated on Exhbit B
***Please note for personnel whose time is not directly traced to serving Santa Ana and i.nstead a percentage is used please
confinn the percentage is accurate prior to requesting reimbursement.
Exhibit B-1
Page I of I
Certification Regarding Lobbying
Certification for Contracts. Grants, Loans. and Cooperative A2:reements
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 cOlmection 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 Fonn-LLL, "Disclosure
Fonn 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 ce11ification shall be subject to
a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
be ~ G~,\ C
Gran ee/Contactor Organization
o ~ S~\-o... ~~
Sa tf\W\e(" \(ou-\~ 0 0 ""\\~Cl.C,",
Program Title
\0 . o..\J '... '5-\G..\..l ~~e
Name of Certifying Officer
.---.
o Ll ~e.. \ '4. 'l.007
Date
EXHIBIT C
Page I of2
SUBRECIPIENT warrants the following:
I. SUBRECIPIENT will comply with Public Law 88-352, Title VI of the Civil Rights
Act of 1964 (42 U. S. C. section 2000 et seq.) and implementing regulation in 24 CFR
Part I.
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
perfol1nance 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 detel1nined in accordance with the Davis-Bacon Act, as
amended, 40 U. S. C. Sections 276 a 1-5, except for individuals who perfol1n 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)
SUB RECIPIENT does not assume CITY'S responsibility for initiating the review process
under Executive Order 12372.
EXHIBIT C
Page 2 of2
ACORD,. CERTIFICA TE OF LIABILITY INSURANCE OA TE (MMIDOfYYYY)
- 6/11{2007
DUCER (949)215-5431 FAX: (949)215-550~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
..genQfitsouree Insuranoe CA:OE36358 HOLOER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
92 1u;-gonaut A-2007 -105-005 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 150
A1iso Viejo CA 92656 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER />; MoLrk91 Insurance Company
Boys And Girls Cl"Ub Of Santa lUla INSUREI't8: St.ate Comp Ins Fund
950 West:. Highland IHSUREI\ c: NiOl t . Union. J;".ire ins. Co.
-' IN$URER 0:
San.ta Ana. CA 92703 INSURER E:
'l'HE ?QUOtES OF INSURANCE U5TEO BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSiANDING ANY
REQUJREME:NT, TERM OR CONDlTlON OF ANY CONTRACT OR Oll1E:R DOCUMENT WITH Re:SPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,
THE INSURANCE AFFORDED 1;IY THE POLICIES DESCIl!IBED HEREIN IS SUSJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF' SUCH POLICIES.
AGGREGATE UMITS SHOI/"vN MAY HAVE g"'FN REDUCFD BY PAlrJ ClAIMS
,IN$R ~I!L TYPE OF INSURANCE POUCY NIJ!lBER P&~:~&-%E Pgk'fl(~'"t~ UMITS
GENERAL LIABlUlY ....r.... I'lr.CURRENCE $ :1.,000,000
r- DAMAGE T I RE/'oITIOD 100,000
r- 5MMERClAL GENQ<AL lIABiliTY PIlEM1!'>FIl E$ OOCU~1 I
A f- CUIlMS MADE 0 ocCuR 19502c:t283270 1/1/200? 1/1/2008 MED EXP IAnv cr'Ie O<nonl $ S,OOO
PERSoNAL 8. ArM IN.Jt.RV $ 1,000,000
, <'IF'''ERAl ACGREC'.ATE $ 3,000,000
Gfl'LAGr;~EnEUMIT nES p~: ?RODUCTS - COMPIOP ACr.: ~ 1,000,000
X POUCY ~fg: LOC
~TOMOBILE LlAlSlUlY COM~INEO SINI3LE LIMIT $ 1,000,000
(Ea 'IlCXXIeol)
- ^"" AuTO
A - ALL OVll'lEO AUTos 1002CY283271 1/1/2007 1/1{2008 BODILY INJURY
(P"'l*"'"'l $
- SCHEDULED AUTOS
- HIRED AUTOS OODILYINJtJRY $
...ON-QVl'NED AUTOS (Per ac:iIlenl)
'X COIIlP- 1,000' PROPERlYOAMAGE
X CoU- 1 000 (Per aoc:idefrt) $
GARA~ UABlUTY AUTO ONI Y - EA ACCIDENT $
R N~Y AVTO OTHER THAN EA ACC $
AUTO OrolL y, AM $
EXCESSIlJIIIBRELLA L.lAB/UlY FAl:H DCf'lIRRENCI" $ 5,000,000
~ ,OCCUR o CLAllhS IMOE A~GREGAT" $
$
A ~ DEDUCTIBLE 4602C~2a3273 1/1{2007 1/1/2008 $
RETENTlCiN' S $
B wo~s COMPEN6AnON AND I WCSTATV-: I O~
EMPl-OYERS' UABlLITY E.L EACH ACCIDENT 1,000,000
ANY PROI'RIETORlPARTNER/El<E!OLJTlVE $
OFFICERlM6MBER EXCLUDED? "/23-06 6/1/2006 6/1/2007 E.L DISEASE. EA EMPLOYEE $ 1,000,000
"yeo, d~iI>e Uf)der
SPECIAL PROVISIONS belcw E.L, DISEASE. POLICY lIMIT $ 1 000,0000
C 07>l1!~ Di:r:acto~s and 1-M151? 60 6/1/2006 6{1/2007 1,000,000
Officers ,. ~.- .... - . , -
01/01/2007 -. -, '.- '- .-" . -,. ""-'
A Bu~inQss Persoal p 8S0cr283270 01/01/2008 ~- 5S,000
DESCRIpTION OF oPERATIONSlLOCA nON$IVEHIC~Cl.USlONll ADDED BY I!HDO~ENTfSPECI.'oI. PIlOVllllON$ .~d~r6_
ce.ri;;i.f';'Qata Bo.ld,u: is Additional Insu&III:l:L
._- , , -- : . ,"
C~T'FICATe HOLD~R
e - WOlt.... Ki<.lW\;f Financll5l Sertic=
III! CANCaLED BEFORE TilE
The City of Santa Ana
The Santa Ana. R8de"o"Q~oplllent Aqency ClJ"9G
P.O. Box 1988
Santa Ana, CA 92702
ACORD 25 (2001108)
INS025 (0108).08 AMS
EG/~0 39~d
TION 1988
P~il'" 1 012
~~nSNI 38~nOS1I~3N3a
6GSSS1~5t>6
6E:~1 L0G~/1T/90 ~ ,~t \
IMPORTANT
If the certifiC<lte holder is an ADDITIONAL INSURED. the pollcy{les) must be endof"$ed. A statement on this
certificate doea not confer rights to the certificate holder In lieu of such endof"$ement(s).
If SUBROGATION IS WAIVED, subject to the terms and condItions of the policy, certain policies may require an
endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such
endof"$ement(s) ,
DISCLAIMER
The Certificate of Insurance on the reverse side of thi$ form does not constitute a contract between the issuing
insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively
amend. extend or alter the coverage afforded by the policies listed thereon.
. '- --...: --.1.-
,
I ~,--',
h__ ...~. 71)
..~.., .... ""'. J
ACORD 25 (2Q01/0B)
IN$025 (OlCla).06 AMS
Poge2012
EB/EB 39t1d
~~nSNI 38~nOS~I~3N3g
60SSS1Z;6v6
68:l1 L0Bl/11/90
~C~~VCU ~O(~~I,UU' ~~.~~
05/13/Za07 14:07 7145551899
:l..",J.;J;J;JU:l
ArM tt-lCEf'l'fNTCTR
OC-1'Cr J. I =>ulX<'-'C .I.I'\.OUN-'I
PAGE. 82/02
EXHlB1T B
APDITION.A4- INSURED ENDORSBMEti)'
FOR. C,QMME&ClAL GENERAL t-lABlLITY PQ1JGY
Insunmce Company ~ 'iV .~ Stl W J. en.
!hia endorsement modifies such insurance as is afforded by the provisions of Puliey
#as Dl ~'l~'* ~relating to the foliQ\Ving: ..
\
1. . Ths City of Santa Ana, :ZOo Civic Center Plaza, Santa Alia. California 9Z70l;oits
Qi'ficetS, .empLoyees, agents. voluntem and. represcntativc::s ate named as: addi~6Ml i:nst1r.edS'
("addi1ie>nal: iusuredslt) with regard to liability and defense of suits ~sing from ..the 9pmtions
and uses performed by or on behalf of the nsmed i~
2. W-im respect to claim.$ mains out of t.h:~ qperations and 1lSe.$petfQmled.bytt-b21
beha1fofthe named ins~ llUCh ~eas is affun'led bythi$polieyis.primary,tlid'ismt
addiUOI3al to or contributing with any other imurance camed by or 1hl' the benefit eftho
~ditional insureds,
3, This insuran" applies sepa:rately to eadl. Wl1red apinst whom c1:iimis:. mati~'Ot
suit is brought except with respect to the. company's litnits Qfliability. The ~kision of.'Y
person or organization as an iDSured &hall not affect lIlY right wbicll sucb pexl:orl or o~tiOJJ
woulQ have u a c1Bip1ant ifnot 50 included.
4. With respect to the additional insureds. this insuranco mall net be.can;elled. or
materially red~ in coverage or limits c:cept after thirty (30) days written notice 1:wl bi:eu
giVeIl to the City of Santa An~ 20 Civic Center Plaza, Santa Ana. Califatpia 92701.
, I
(Completion of the following, including countersignature. is required to make thizendorsement
~ effective,)
Effective'
Policy #
Issued to
Countersigned by
___ _ ~3L/--:-:-
"-'; ,.) :':"~ ~..- .
60/(;0 39';;1d
';;I~SNI 3~~nOS1Id3N38
609991(;6P6
PS:t1 L00Z/El/ge
CERTHOLDER COpy
SP
STATE
COMPENSATION
INSURANCE
I=UND
P.O. BOX 420807, SAN FRANCISCQ,CA 94142-0807
CERTIFICATE OF WORKERS'COMPENSATION INSURANCE
ISSUE DATE: 06-01-2007
GROUP: 000723
POLICY NUMBER: 0000075-2007
CERTIFICATE ID: 2
CERTIFICATE EXPIRES: 06-01-2008
06-01-2007/06-01-2008
CITY OF SANTA ANA
COMMUNITY DEVELOPMENT AGENCY
PO BOX 1988 M-25
SANTA ANA CA 92702
SP
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This pOlicy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer.
We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement. term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms, exclusions, and conditions. of such policy.
d:::"REPRESENTATI
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS:
~
PRESIDENT
$1,000,000 PER OCCURRENCE.
ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2004-06-01 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL INSURED:
CITY OF SANTA ANA
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLOERS' NOTICE EFFECTIVE 06-01-2005 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY.
EMPLOYER
BOYS AND GIRLS CLUB OF SANTA ANA (A NON PROFIT
CORPORATION)
1615 E. 17TH STREET, SUITE 150
SANTA ANA CA 92705
(REV.2-05)
PRINTED 05-17-2007
M0408