HomeMy WebLinkAboutBOSCH, WESLEY A., M.A. - 2008City of Santa Ana
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AGREEMENT TERMINATION
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CLERK OF COUNCIL
DATEAUG 15 2008
AGREEMENT WITH
WESLEY A. BOSCH, M.A.
UNDER THE WORKFORCE INVESTMENT ACT
A- 2008 -175
THIS AGREEMENT, made and entered into this 1 st day of July, 2008, by and between Wesley A_
Bosch, M.A., hereinafter referred to as "CONSULTANT ", and the City of Santa Ana, a charter city and
municipal corporation duly organized and existing under the Constitution and laws of the State of California,
hereinafter referred to as "CITY ".
W- I- T- N- E- S- S -E -T -H
Recitals:
A. CITY has been designated a Local Workforce Investment Area (LWIA) under the
Workforce Investment Act of 1998, Public Law 105 -220 ( "the Act ").
B. The State of California has created the LWIA to administer the Act programs operated
by the State of California pursuant to the Act.
C. As a LWIA, CITY is entitled to receive federal funds to establish programs to prepare .
economically disadvantaged adults and youth for entry into the labor market and to provide job training. to
those individuals who are economically disadvantaged or otherwise face serious barriers in obtaining
productive employment. One goal of California's Workforce Investment System is to provide, individuals
with the opportunities to achieve career goals that will allow them to successfully compete in the labor.-
market and prepare them for higher education.
D. CONSULTANT is experienced in operating education, training and employment
programs for economically disadvantaged adults and youth for entry into the labor market ( "said program ").
E. CONSULTANT is willing to operate said program pursuant to the Act and California
law
WHEREFORE, for and in consideration of the respective and mutual covenants and promises
hereinafter contained and made, and subject to all the terms and conditions hereof, the parties hereto do
hereby agree as follows:
1. TIME PERIOD OF AGREEMENT
This Agreement shall commence as of July 1, 2008 and all services to be performed pursuant to this
Agreement shall be completed on or before June 30, 2009. The term of this Agreement may be extended by
a writing executed by the Deputy City Manager for Development Services and the City Attorney.
2. INDEPENDENT CONTRACTOR
CONSULTANT agrees that CONSULTANT is an independent contractor and not an employee of
CITY and all of CONSULTANT'S personnel shall be employees of CONSULTANT and not employees of
the CITY. CONSULTANT shall pay all salaries and wages, employer's Social Security taxes,
unemployment insurance and wages, and similar taxes relating to employees and shall be responsible for all
applicable withholding taxes.
CONSULTANT shall not subcontract any of the services required hereunder without the prior written
approval of the CITY.
3. SCOPE OF SERVICES
For and in consideration of the hereinafter stated payment by CITY to CONSULTANT,
CONSULTANT agrees to perform, at its own cost and expense except for the compensation. specified in this
Agreement, the services specified in the scope of work attached hereto and incorporated herein as Exhibit A
to this Agreement.
4. CONSULTANT OBLIGATIONS
A. CONSULTANT agrees to maintain such records and submit such reports, data and
information, on the form and containing such information, at such times as CITY may request or require
regarding the performance of CONSULTANT'S services or activities, costs or other data, including but not
limited to,!participants' attendance, payroll records and job duty statements.
B. CITY, the State of California and the United States government and/or their
representatives shall have access for purposes of monitoring, auditing and examining of CONSULTANT'S
activities, performance, books, documents, papers, and records of CONSULTANT, subcontractors,
bookkeepers and accountants, and employees and participants related to this Agreement. Such agencies or
representatives :shall also schedule on -site monitoring in their discretion. Monitoring activities may also
include, but are not limited to, questioning employees and participants and entering any premises or onto any
site in which any of the services or activities funded hereunder are conducted or in which any of the records
,of CONSULTANT are kept. Nothing herein shall be 'construed to require access to any privileged or
confidential information as set forth in federal or state law.
In the event CONSULTANT does not make the above - referenced documents available within
the City of Santa Ana, California, CONSULTANT agrees to pay all necessary and reasonable expenses
incurred by CITY in conducting any audit at the location where said records and books of account are
maintained.
All accounting records and evidence pertaining to all costs of CONSULTANT and all
documents related to this Agreement shall be kept available at CONSULTANT'S office or place of business
for the duration of this Agreement and thereafter for three (3) years after completion of an audit. Records
which relate to (a) complaints, claims, administrative proceedings or litigation arising out of the performance
of this Agreement, or (b) costs and expenses of this Agreement to which CITY, the State of California or the
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United States Government take exception, shall be retained beyond the three (3) years until resolution of
disposition of such appeals, litigation, claims, or exceptions.
C. Without prejudice to any other section of this Agreement, CONSULTANT shall,
where applicable, maintain the confidential nature of information provided to it concerning participants in
accordance with the requirements of federal and state law. Notwithstanding the foregoing, CONSULTANT
agrees to submit to CITY, the State of California and/or the United States Government or their
representatives, all records requested for administrative purposes, including audits, examinations, monitoring
and verification of records submitted by CONSULTANT, costs incurred and services rendered hereunder_
D. CONSULTANT agrees to expend all funds in accordance with all applicable federal,
state and local laws and regulations. CONSULTANT also agrees to provide at CONSULTANT'S own
expense supplies and other costs of said PROGRAM.
E CONSULTANT shall comply with the provisions. of 48 CFR, Chapter 1, Parts 1 -31.2,
for commercial organizations and all other applicable federal statutes and executive orders and their,
implementing regulations. .
F. CONSULTANT shall comply with the provisions of E.O. 12549 and 1268% requiring
compliance with the debarment and suspension requirements contained in 29 CFR Part 98.
G. CONSULTANT shall comply with the requirements of federal regulations found at 29
CFR 93 which.provide that no appropriated funds may be expended by the recipient of 'a federal contract,
grant, loan or cooperative agreement to pay any person for influencing or attempting to influence-an officer
or employee of any agency, member of Congress or an officer or employee of a member of Congress in
connection with awarding of any federal contract, the making of any federal grant or loan, entering .into any
cooperative agreement and the extension, renewal, amendment or modification of any federal contract, grant,
loan or cooperative agreement. CONSULTANT shall sign a certification to that effect in a form as.-set .forth
in "Exhibit B," attached, hereto and by this reference incorporated herein. CONSULTANT shall. submit said
signed certification to CITY prior to performing any of its obligations under this Agreement and prior to any
obligation arising on the part of CITY to pay any sums to CONSULTANT under the terms and conditions of
this Agreement.
H. CONSULTANT agrees to provide a drug -free work place and to execute a
certification as set forth in "Exhibit C" attached hereto and incorporated herein by this reference.
I: CONSULTANT, in accordance with the Child Support Compliance Act, recognizes
and acknowledges the importance of child and family support obligations and shall fully comply with all
state and federal laws relating to child and family support enforcement, including, but not limited to:
disclosure of information and compliance with earnings assignment orders, as provided in Chapter 8
(commencing with Section 5200) of Part 5 of Division 9 of the state Family Code; and, to the best of its
knowledge is fully complying with the earnings assignment orders of all employees and is providing the
names of all new employees to the New Employee Registry maintained by the California Employment
Development Department (EDD).
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5. APPLICABLE GUIDELINES
A. The parties hereto agree that CONSULTANT shall comply with all applicable federal
and state laws and regulations, including but not limited to the U.S. Department of Labor guidelines and
regulations, including amendments or revisions made during the terms of this Agreement. Said applicable
laws are hereby incorporated by reference and made as part of this Agreement as though fully set forth
herein.
B. CONSULTANT also assures and certifies that:
1.. CONSULTANT shall comply with any and all federal laws limiting the
political: activity of employees hired under this Agreement.
2. CONSULTANT shall provide the U.S. Department of Labor and the Controller
General, by and through any authorized representative, as well, as the Santa Ana Local Workforce Investment
Area's Board, access to and the right to examine all records, books; papers or documents relating .to the
accounting and use of funds under this Agreement for a three -year period from and after the effective date of
this Agreement.
3. No person. with responsibilities in the operation of any program under the
Workforce Investment Act grant shall discriminate with respect to any program participant or any application
for participation in such program because of race, creed, color, national origin, sex, political affiliation or
beliefs.
4. CONSULTANT shall maintain appropriate standards for health and safety in
work and transportation situations.
5. CONSULTANT shall, comply with general provisions, assurances, and
certifications attached hereto as 'Exhibit M and incorporated herein.
6. Any literature distributed by CONSULTANT for the purpose of apprising
businesses, participants, or the general public of its programs under this Agreement shall state that its
programs are supported by the City of Santa Ana and the Santa Ana Workforce Investment Board, and shall
state that the program is an "equal opportunity employer /program" and that "auxiliary aids and services are
available upon request to individuals with disabilities."
7. CONSULTANT certifies that all property, finished or unfinished documents,
data, studies and reports prepared or purchased by the CONSULTANT under this Agreement, will be
disposed of in accordance with the direction of the CITY. In addition, any tools and/or equipment furnished
to the CONSULTANT by the CITY and/or purchased by the CONSULTANT with funds pursuant to this
Agreement, will be limited to use within the activities outlined in this agreement and will remain the property
of the United States Government and/or CITY. Upon termination of this Agreement, CONSULTANT will
immediately return such tools and/or equipment to the CITY or dispose of them in accordance with the
direction of the CITY.
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8. CONSULTANT certifies that this Agreement does not provide
for the advancement or aid to any religious sect, church or creed, or sectarian purpose nor does it help to
support or sustain any school, college, university, hospital or other institution controlled by any religious
creed, church, or sectarian denomination, as specified by Article XVI, Section 5, of the Constitution of the
State of California, regarding separation of church and state.
9. If the grant hereunder exceeds $100,000, CONSULTANT shall be in
compliance with Section 306 of the Clean Air Act [(42 USC 1875(h)]; Section 508 of the Clean Water Act
(33 USC 1368); Executive Order 11738 and Environmental Protection Agency ( "EPA ") regulations (40 CFR
Part 15) as any may now exist or be hereafter amended. Under these laws and regulations, the
CONSULTANT assures that:
(a) No facility to be utilized in the performance of the proposed grant has been listed on the
EPA List of Violating Facilities;
(b) It will notify CITY prior to award of the receipt of any communication from the Director,
Office of Federal Activities, U.S. EPA, indicating that a facility to be utilized for the
grant is under consideration to be listed on the EPA List of Violating Facilities;
(c) It will notify the CITY and the EPA about any known violation of the above laws and
regulations.
10. CONSULTANT may copyright any work that is subject to copyright and was,
developed, or for which ownership was purchased, under an award. The Federal awarding agency(ies) ,
reserve a royalty -free, nonexclusive and irrevocable right to reproduce, publish, or otherwise use the work for
Federal purposes, and to authorize others to do so.
11. CONSULTANT is subject to applicable regulations governing patents and
inventions, including government -wide regulations issued by the Department of Commerce at 37 CFR part
401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government
Grants, Contracts and Cooperative Agreements."
12. Based on the population eligible to be served, or likely to be directly affected
by the WIA program or activity, the services or information may need to be provided in a language other than
English in order to allow such population to be effectively informed about or able to participate in the
program or activity. Pursuant to 29 CFR 37.35, the CONSULTANT must take reasonable steps to provide
services and information in appropriate languages after considering the scope of the program or activity, and
the size and concentration of the population that needs services or information in a language other than
English.
6. COMPENSATION
CITY agrees to pay, and CONSULTANT agrees to accept for said services, total compensation in the
amount not to exceed Seventy Thousand Dollars ($70,000.00). CONSULTANT will submit a detailed
invoice evidencing services performed. Final payment by the CITY shall be within 30 days following receipt
of said invoice, subject to CITY accounting procedures.
CONSULTANT acknowledges that approval of and funding for this Agreement is contingent upon
State approval, and funds received or obligated from the State of California to CITY. If such approval of
funds is not forthcoming, or is otherwise limited, CITY shall immediately notify CONSULTANT. Within
twenty (20) days of receipt of such notice, CONTRACTOR shall modify or cease operations as directed by
CITY and negotiate necessary modification to this Agreement and/or reimbursement of costs incurred
hereunder.
7. : MISCELLANEOUS PROVISIONS
A. CONSULTANT covenants that it presently has no interest, and shall not have any interest,
direct -or indirect, which would conflict in any manner with the performance of services required hereunder.
B. CONSULTANT certifies that it will not discriminate against any employee or applicant for
employment because of race, religious creed, color, national origin, ancestry, physical disability, . mental
disability, medical condition, marital status, sex or age, in compliance with Title VII of the Civil Rights Act
of 1964 (P.L. 83 -354) and Government Code 12900, et seq.
8. HOLD HARMLESS CLAUSE
CONSULTANT agrees to indemnify, defend and hold harmless CITY, its officers,' agents,
employees, and volunteers from and against any and all loss or damage, and from any and all suits, actions
and claims filed or brought by any person or persons arising out acts or omissions of CONSULTANT or of
any approved subcontractor or of the officers, agents, employees of CONSULTANT or of its subcontractors
in the performance of this Agreement.
9. INSURANCE
CONSULTANT shall obtain and maintain for the entire term of this Agreement comprehensive
professional public liability insurance, in companies acceptable to the City, authorized to issue such
insurance in the State of California. Said insurance shall consist of the following:
a. Professional Liability Insurance. CONSULTANT agrees to obtain and keep in force during the
term of this Agreement a policy of professional public liability insurance insuring the CITY and
CONSULTANT against any liability for accident, injury or death arising out of or related to this Agreement.
Such insurance shall be in an amount not less than One Million Dollars ($1,000,000.00) for any injury to or
death of any person or persons in any single accident or occurrence. Said policy of professional liability
insurance shall be endorsed to provide to CITY at least thirty (30) days written notice prior to cancellation.
b.. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the
Labor Code, CONSULTANT, if CONSULTANT has any employees, is required to be insured against
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liability for worker's compensation or to undertake self - insurance. CONSULTANT agrees to comply with
such provisions before commencing the-performance of the work under this Agreement.
c: The following requirements apply to the insurance to be provided by CONSULTANT pursuant to
paragraph a., above:
1. A certificate of insurance, to be approved in form by the City Attorney, shall be furnished
to the City within 30 days of the execution of this Agreement.
2. Certificates and policies shall state that the policies shall not be canceled or reduced in
coverage or changed in any other material aspect without thirty (30) days prior written
notice to the City.
d. If CONSULTANT fails or refuses to produce or maintain the insurance required by this section or
fails or refuses to furnish the City with required'proof that insurance has been procured and is in force and
paid for, the City `shall have. the right, at the City's election, to forthwith terminate this Agreement. Such
termination shall not affect CONSULTANT's right to be paid for, its time and materials expended prior to
notification of termination.
10. TERMINATION
This Agreement may be terminated by either-party at its sole discretion, upon thirty (30) days
written notice to the other party. Notice shall be deemed served on the date of mailing. However,
CONSULTANT may not terminate this Agreement if undue hardship will result to any participant.
11. DISPUTES
Except as otherwise provided in this Agreement, any dispute concerning any question arising
under this Agreement shall be decided by CITY. In such a case CITY shall reduce its decision to writing and
mail or otherwise furnish a copy thereof to CONSULTANT. The decision of the CITY shall be final -and
conclusive unless within thirty (30) calendar days from the mailing or delivery of such copy, CITY receives
from CONSULTANT written request to appeal said decision.
Procedures governing the appeal shall be prescribed by CITY and/or the State of California in
accordance with the Act and all corresponding regulations and OMB circulars. Pending final disposition of
the appeal, CONSULTANT shall act in accordance with CITY's decision unless the dispute involves a
change order.
12. BREACH - SANCTIONS
If, through any cause, CONSULTANT violates any of the terms and conditions of this
Agreement, and/or prior agreements whereby grant funds were received by CONSULTANT pursuant to this
Agreement, or if CONSULTANT reports inaccurately or if any Audit Report makes disallowances,
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CONSULTANT shall promptly remedy its acts or omissions and/or repay CITY all amounts due CITY as a
result of CONSULTANT's violation. For any such-failures or violations, CITY shall also have the right at its
sole discretion to either: (1) discontinue program support until such time as CONSULTANT fulfills its
obligations or remedies all violations of this agreement or prior agreements; and/or (2) collect outstanding
amounts as determined by CITY due CITY by offsetting or debiting from current claims or invoices, if after
thirty (30) days' written notice CONSULTANT has failed to repay same or a repayment schedule has not
been made; and/or (3) terminate this Agreement by giving written notice to CONSULTANT of such
termination in accordance the notice provision contained below.
13. .: NOTICES
All notices, reports and correspondence between the parties hereto respecting this Agreement shall be
in writing and deposited in the United States Mail, postage prepaid, addressed as follows: .
To CITY:
With courtesy copy to:
Clerk of the Council
City of Santa Ana
20 Civic Center Plaza (M -30)
P.O. BOX 1988
Santa Ana, CA 92702 -1988
Telefacsimile (714) 647 -6956
Santa Ana Work Center
1000 E. Santa Ana Blvd., #200
Santa Ana, CA 92701
Telefacsimile (714) 565 -2602
To CONSULTANT: Wesley A. Bosch
24001 Muirlands Blvd., #331
Lake Forest, CA 92630 - `
Telefacsimile (714) 565 -2602
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first
above written.
ATTEST:
Clerk of the Council
APPROVED AS TO FORM:
Joseph W. Fletcher
City Attorney
CITY OF SANTA ANA
David N. Ream
City Manager-
CONSULTANT:
By: Lisa Storck Wesley A. B, sch, M.A.
Assistant City Attorney Tax ID# /SS #:
RECOMMENDED FOR APPROVAL:
&t"
ynthia J elson
Deputy City Manager for Development Services
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EXHIBIT A
WESLEY A. '80SCV, M.A.
24001 Muirlands Blvd., #331
Lake Forest, CA 92630 -1717
(949) 829 -0719 (714) 565 -2648
wbosch @santa- ana.org
Mav 13, 2008
Judy Chen -Lee
Santa Ana W / O / R/ K Center
1000 E. Santa Ana Bled., Suite 200
Santa Ana, CA 92701
Dear Ms. Chen -Lee:
I am writing to propose renewing my contract as a Career and Personal Counselor consultant for the City of
Santa Ana, the Santa Ana W /O /R /K Center (SAWC), and the Santa Ana Workforce Investment Board
(SAWIB), for the fiscal year 2008 -2009.
As the current Counselor at the SAWC, I propose continuing to provide Career Assessment/ Counseling
and Mental Health Services to the customers at the SAWC who are in the process of becoming reemployed,
retrained, or enhancing their career.
' he Mental Health Services involves consulting with customers and staff on a variety of issues and concerns
related, in general, to personal, interpersonal, and /or behavioral barriers to vocational success. With some
individuals, it becomes evident that career and personal counseling overlap, as the issues of one area are
often affected by the other. This is a unique service within the One -Stop Career Center system, addressing
needs often overlooked yet a vital factor in individuals' lives and functioning, and when successfully treated
can enhance their potential for success in the workforce.
As a Vocational Counselor, I provide Vocational or Diagnostic Assessment Services and information to case
managers and their customers for training and /or job placement consideration. The assessment process
consists of the administration, interpretation, and counseling of a multiple vocational assessment battery
of interests, aptitudes, transferable skills, personality, and work values. I also administer, score, and
report the TABS tests of basic skills.
My, fee k $40 per hour, not to exceed S70,000 in one fiscal year, Jule 1, 2008 throuC)h June 30, 2009.
Potential services for the purpose of or related to counseling and /or assessment and testing qualifying for
billed time include:
• Direct customer contact, whether in individual, group, workshop, or Resource Center settinus,
contact by telephone, casual encounter at the SAWC or at the job site when related to assigned
services
• Contact with customer family, members of their support system, employer, or other professionals
• Researching, contacting, or arranging referrals or resources for outside services or support not
provided by myself or that is outside the scope of my license, training, and /or experience
• Documentation
• Communication with SAWC staff
• Preparation time for direct client contact, such as assessment /testing material acquisition and
organization, review of files, handout development, reviewing and /or obtaining reference or
resource material, material reproduction, and consultation with staff
• Onsite visitations to resources and agencies utilized or potentially utilized in the service of the
customer
Reimbursement at cost ,vould be expected for any material that might be obtained for customer use, such
as vocational assessment instruments, pamphlets, handouts, reference books, videotapes, software, or other
related resource material obtained with prior SAWC management approval.
Thank yo_i in advance for your consideration. I would be happy to discuss any questions you may have. I can
be reached by telephone either at the Center, (714 ) 565 -2648 or at home, (949) 829 -0719, or by email at
wbosch@ santa- ana.org.
Sincerely,
Weslev A. Bosch, M.A.
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WESLEY A. BOSCH, MA
24001 Muirlands Blvd., #331 • Lake Forest, CA 92630 -1717
(949) 829 -0719 (H) • (714) 565 -2648 (W) • wbosch @santa- ana.org
PROFESSIONAL PROFILE
Highly skilled mental health professional seeks a position as a mental health and vocational
counselor to apply strong skills and successful, diverse experience. Significant qualifications
include:
• Extensive experience with all facets of vocational and mental health counseling in social
service, hospital and academic settings, with all associated assessments, counseling and
referrals
• Experierce with multi- agency environments including government services and regulations;
broad liaison experience between service providers and clients; in -depth knowledge of
mental health, social service, and vocational resources
• Case, program and project management experience under local, county and government
funded programs with all intake, reporting and administrative tasks
• Presentation and facilitation of training modules to a variety of cultural, socioeconomic and
mental health audiences
• Several years of successful private practice in office and hospital psychotherapy to
individuals, families and groups
EDUCATION AND LICENSING
Master of Arts, MFCC, Chapman University
Post Graduate Training, Bioenergetic Analysis
Bachelor of Arts, Psychology, California State University, Long Beach
Licensed Marriage and Family Therapist, California State License MFT 16179
PROFESSIONAL EXPERIENCE
COUNSELOR, SANTA ANA W /O /R /K CENTER 1997 - Present
Under contract with the City of Santa Ana Workforce Investment Board, provide personal and
career counseling, vocational assessment and testing for diverse clientele including multiethnic,
multicultural, and economically disadvantaged populations.
• As Wellness Coordinator, counsel WIA, WtW, and other Santa Ana W /O /R /K Center clients
with personal concerns related to employment status, retraining and reemployment efforts
such as grief, low self- esteem, stress, depression, anxiety, marital /family /relationship problems
and substance abuse.
• As Vocational /Career Counselor, administer multiple vocational assessment battery of
interests, aptitudes, transferable skills, personality, work values and pre - employment testing to
WIA and WtW clients; interpret results and counsel with clients to determine appropriate job
and /or training related issues and career objectives.
VOCATIONAL COUNSELOR, NORTH ORANGE CO. COMMUNITY COLLEGE DISTRICT 1998 -2003
• Counseled, interpreted vocational assessment results and assist in occupational exploration
with diverse client population including WIA, WtW and self - funded to identify viable
occupational choices for selection of vocational training and /or recommendations of
possible employment plan options.
MATRICULATION COUNSELOR, NORTH ORANGE CO. COMMUNITY COLLEGE DISTRICT 2000 - 2003
• Counseled and evaluated transcripts of adults desiring to complete high school diploma,
facilitated enrollment, career counseling, vocational assessment interpretation and
counseling, and personal counseling.
WESLEY A. BOSCH, Resume Page Two (949) 829 -0719 (H) / (714) 565 -2648 (W
VOCATIONAL COUNSELOR, SANTA ANA COLLEGE 1996 -2000
• Assisted participants in developing long- and short -term career plans through vocational
assessment and counseling; wrote reports of assessment results and conclusions.
• Assumed major role in expansion of Assessment Center; opened three additional sites, trained
new counselors and assessment technicians, developed and wrote policies and procedures,
created new report and other forms, coordinated the installation of computer systems.
• As college representative in the Unit Liaison Committee, involved in operations and
developmental plans of the Santa Ana W /O /R /K Center, a One -Stop, multiple agency
employment and training center.
• Managed the client database (Access), produced billing reports and facilitated purchase
requisitions of needed testing instruments, software and supplies.
• As Assessment Technician, administered multiple vocational assessment battery including
scanned and /or hand scoring, and created computer - generated reports.
CASE MANAGER /PROGRAM COORDINATOR, CITY OF LA HABRA 1995 - 1996
• Supervised the Aerospace Network Career Center, part of the JTPA Employment and Training
Department of the City of La Habra, under U. S. Department of Labor JTPA.
• Developed and maintained personal caseload of 85 while overseeing all other client (500)
services in the center.
• Assumed public relations role and regular interface for government agencies, private
industry, training and school facilities, as well as unresolved problems with clients.
• Provided and organized orientation sessions and job search workshops for up to 40 potential
and current clients per week.
• Directed client activity in identification of success skills, resume development, practicing and
enhancing interviewing skills, addressing personal issues in support of job search and
occupational retraining.
• Hired, trained and supervised up to nine case management and clerical staff members.
• Administrative and project management functions including authorization of client
expenditures, coordination of center relocation, computerization of the new center,
installation of software, development of relevant templates and training of staff.
PRIVATE PRACTICE PSYCHOTHERAPIST
1988 - 1994
Provided office and hospital psychotherapy to individuals, couples, families and groups.
Contracted for a portion of this period as an Employee Assistance Counselor for REACH, an
Employee Assistance Program with offices in Orange and Irvine, California, providing
assessment, counseling, and referral services.
Contracted for a portion of this period under Alan W. Levy, Ph.D., consulting with referred
hospitalized patients utilizing specialized treatment modality.
PSYCHIATRIC SOCIAL WORKER, HOAG MEMORIAL HOSPITAL
1977 - 1988
• Promoted from Psychiatric Technician to Day Treatment Coordinator and ultimately to lead
of the Social Services Department of the Mental Health Unit.
• Provided psychosocial evaluations, casework, couples and family consultation, placements,
community resources, group leadership, supervision and membership of Administrative Staff.
• Redeveloped group therapy program and expanded oulpatienl services.
• Served as the primary liaison between patients, families, staff, physicians, other medical staff
and departments and outside community resources and agencies.
Excellent professional and personal references furnished upon request.
Exhibit B
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS
and COOPERATIVE AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief, that:
1) No Federal appropriated funds have been paid or will be paid, by or on behalf of
the undersigned, to any person for influencing or attempting to influence an
officer or employee of an agency, a Member of Congress, an officer or employee
of Congress, or an employee of a Member of Congress in connection with the
awarding of any Federal contracts, the making of any Federal grant, the making
of any Federal loan, the entering into of any cooperative agreement, and the
extension, continuation, renewal, amendment or modification of any Federal
contract, grant, loan or cooperative agreement.
2) If any funds other than Federal appropriated funds have been paid or will be paid
to any person for influencing or attempting to influence an officer or employee of
any agency, a Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with this Federal contract,
grant, loan or cooperative agreement, the undersigned shall complete and
submit Standard Form - LLL, "Disclosure Form to Report Lobbying," in
accordance with its instructions.
3) The undersigned shall require that the language of this certification be included
in the award documents for all subawards at all tiers (including agreements) and
that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a
prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352.
Any person who fails to file the required certification shall be subject to a civil penalty of
not less than $10,000 and not more that $100,000 for each such failure.
Grantee /Contractor Organization ' Program Title
IN
Name of Certifying Official Sigriature
Wesley A. Bosch
WIA Various
Certification Regarding Drug -Free Workplace Requirements
The certification set out below is a material representation upon which reliance is placed
by the U.S. Department of Housing and Urban Development in awarding the grant. If it
is later determined that the contractor knowingly rendered a false certification, or
otherwise violates the requirements of the Drug -Free Workplace Act, the U.S.
Department of Housing and Urban Development, in addition to any other remedies
available to the Federal Government, may take action authorized under the Drug -Free
Workplace Act.
CERTIFICATION
A. The contractor certifies that it will provide a drug -free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture,
distribution, dispensing, possession or use of a controlled substance is
prohibited in the contractor's workplace and specifying the actions that will
be taken against employees for violation of such prohibition;
(b) Establishing a drug -free awareness program to inform employees about —
(1) The dangers of drug abuse in the workplace;
(2) The contractor's policy of maintaining a drug -free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance program; and
(4) The penalties that may be imposed upon employees for drug abuse
violations occurring in the workplace;
(c) Making it a requirement that each employee who will be engaged in the
performance of the grant be given a copy of the statement required by
paragraph (a);
(d) Notifying the employee in the statement required by paragraph -(a) that,
as a condition of employment under the contract, the employee will -
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a
violation occurring in the workplace no later than five days after
such conviction.
Pg. 2
(e) Notifying the U.S. Department of Housing and Urban Development within
ten days after receiving notice under subparagraph (d)(2) from an
employee or otherwise receiving actual notice of such conviction;
(f) Taking one of the following actions, within 30 days of receiving notice
under subparagraph (d)(2), with respect to any employee who is so
convicted -
( 1) Taking appropriate personnel action against such an employee, up
to and including termination; or
(2) Requiring such employee to participate satisfactorily in a drug
abuse assistance or rehabilitation program approved for such
purposes by a Federal, State, or local health, law enforcement, or
other appropriate agency;
(g) Making a good faith effort to continue to maintain a drug -free workplace
through implementation of paragraphs (a), (b), (c), (d), (e) and (f).
B. The contractor shall insert in the space provided on the attached "Place of
Performance" form the site(s) for the performance of work to be carried out with
the grant funds (including street address, city, county, state, and zip code) .the
contractor further certifies that, if it is subsequently determined that additional
sites will be used for the performance of work under the contract, it shall notify
the U.S. Department of Housing and Urban Development immediately upon the
decision to use such additional sites by submitting a revised "Place of
Performance" form.
Dated: �/ �/D 8
Z/
� a A�tz
Progra Operator
Wesley A. Bosch
DIVISION OF EMPLOYMENT SERVICES
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG -FREE
WORKPLACE REQUIREMENTS
Name: Wesley A. Bosch
Name of Contractor:
Contractor Number:
Date: July 1, 2008
Wesley A. Bosch
A- 2008 -175
The Contractor shall insert in the space provided below the site(s) expected to be used
for the performance of work under the contract covered by the certification:
Place of Performance (include street address, city, county, state, zip code for each site):
Santa Ana WORK Center
1000 E. Santa Ana Blvd, Suite 200
Santa Ana, CA 92701
Exhibit D
Subcontractor agrees that in addition to those agreements and obligations
specified in the contract boiler plate and scope of work, it will also adhere to and
obey the following provisions, assurances, and certifications.
ARTICLES
1) Subcontractor assures and certifies that it will not use any funds
appropriated under this agreement for religious activity or anti - religious
activity, or to promote or oppose any political candidate, parties, and /or
beliefs.
2) Subcontractor assures and certifies that any requested modification to this
agreement must be submitted in writing, explaining requested changes
and rationale. Subcontractor further assures that no modification will be
implemented without prior written approval from the Santa Ana WORK
Center.
3) Subcontractor agrees to cooperate with any monitoring, inspection, audit,
or investigations of activities related to this agreement as may be
scheduled and conducted by the Santa Ana WORK Center or the County
of Orange TANF Summer Youth Program.
4) Subcontractor agrees to acknowledge (given credit) the Santa Ana WORK
Center and the County of Orange as the source of funds in all oral
presentations, written document, publicity, and advertisements regarding
any activities that ensue from this agreement.
CN'A
HEALTHCARE PROVIDERS
SERVICE ORGANIZATION
PURCHASING GROUP
CERTIFICATE OF INSURANCE
OCCURRENCE POLICY FORM
Print Date: 07 /2 9/08
,4 _0200& -/%�7
018098 970 H 0298755008 from: 12:01 AM Standard Time on: 08/01/08
to: 12:01 AM Standard Time on: 08 /01/09
Named Insured and Address. Program Administrator "",."' "'.n..:.<
Wesley A Bosch Healthcare Providers Service Organization
1000 E Santa Ana Blvd Ste 200 159 East County Line Road
Santa Ana, CA 92701 -3900 Hatboro, PA 19040 -1218
Medical Specialty: Code: Insurance Provided b' .
Marriage /Family Counselor 80723 American Casualty Company of Reading, Pennsylvani
333 S. Wabash Avenue, Chicago, IL 60604
OVERAGE PARTS LIMITS OF LIABILITY
$ 1,000,000 each claim $ 3,000,000 aggregate
........ _ ..........
included above
....... ...._ . . .... ........ ........... ... .. .. ..
included above
4i i U,000 per proceeain
4i....... 2.S, uu U_...._....._..._.._. .. ..........._._._._a9_g_regate..
$ 10,000
aggregate
$ 2,500 per deposition
t .......5 000
aggregate
$ 10,000 ........ .. ......... .....per...incident
$... 25,000._.. ... _......_...
aggregate.......
...
21000 per person
100 000
aggregate
$ 2,500
aggregate ..
$ 500 per incident
$ 10,000
aggregate
Coverage part C. Workplace Liability does not apply if Coverage part D. General Liability
is made part of this policy.
.............
included in A. PL limit shown above
.....
. _.._..._.....
ncluded in A. PL limit shown above subject to $150,000 sub -limit
$1,000,000._....
aggregate._ ....
Coverage part D. General Liability does not apply if Coverage part C. Workplace Liability is made part of this policy.
..
none
none
_._. ......... .
none
......... _ .
...... . .
none
none
..... ......
none
.. .
Total Premium: $ 240.00 QUESTIONS? CALL: 1- 800 - 982 -9491
iPolicy forms" and endorsei'nents atfached'af inception:
,sue
G- 121500 -C G- 121503 -C G- 121501 -C1 G- 145184 -A
G- 147292 -A G- 144872 -A G- 123846 -D04 G- 123828-B I3
Master Policy # 188711433
Keep this document in a safe place. It and proof of payment are evidence of your insurance coverage.
Chairman of the Board Secretary
G- 141241 -A (07/2001) Coverage Change Date: Endorsement Change Date:
HEALTHCARE PROVIDERS
PROFESSIONAL LIABILITY INSURANCE ENDORSEMENT
Agreement to Provide Notice of Cancellation
In consideration of the premium paid, it is agreed that if the policy to which this endorsement is
attached is cancelled before the expiration date, we will endeavor to mail notice to the person or
entity named below. However, failure to mail such notice shall impose no obligation or liability of
any kind upon the company, its agents or representatives.
Person or Entity Name and Address: City of Santa Ana, its Officers Agents
and Employees
1907311-ME
•::
Santa Ana, CA 92702
This endorsement is a part of your policy and takes effect on the effective date of your policy, unless
another effective date is shown below. All other provisions of the policy remain unchanged.
Must a Completed
omp e Only When This Endorsernent Is Not Prepared w h the Policy
Or is Not to be Effective w#h the Policy
ENDT. NO.
POLICY NO.
ISSUED TO
ENDORSEMENT EFFECTIVE DATE
1
298755008
Wesley A Bosch
8/1/08
G- 123828 -B (07/2001)
NW 3124/08
Lic. No. MFC16179 Wesley A. Bosch, M.A.
1000 E. Santa Ana Blvd., #200 Santa Ana, CA 92701 (714) 565 -2648
August 2008
City of Santa Ana
Santa Ana W /O /R/K Center
1000 E. Santa Ana Blvd., Suite 200
Santa Ana, CA 92701
To Whom It May Concern:
I, Wesley A. Bosch, certify that I will immediately notify the City of Santa Ana if my
professional liability policy changes in any way or is cancelled. My policy number is
298755008 and is administered by Healthcare Providers Service Organization (HPSO) of
Hatboro, PA and provided by American Casualty Company of Reading, PA, a CNA company.
a�� al�k
Wesley A. Bosch, M.A.