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HomeMy WebLinkAboutPERFORMANCE EXCELLENCE PARTNERS, INC. 4 - 2011INSURANCE ON FILE N-2011-043 WORK MAY PROCEED UNTIL INSURANCE EXPIRES ?- g - 02 9' ?/ ?C`?? CLERK OF COUNCIL DATE: Q P R `? O Z O 11 Q ?_ C }'JA ? VJoi-k C?r??e ?- S yl via ?,?Qz2 ? ? Z AGREEMENT WITH PERFORMANCE EXCELLENCE PARTNERS, INC. UNDER THE WORKFORCE INVESTMENT ACT THIS AGREEMENT, made and entered into this 20 day of January 2011, by and between Performance Excellence Partners, Inc., 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 1 OS-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 fluids to establish programs to prepare economically disadvantaged adults, dislocated workers and youth for entry into the labor market and to provide job training to those individuals who are economically disadvantaged or otherwise face serious barriers in obtaining productive employment. One goal of California's Workforce Investment System is to provide individuals with the opportunities to achieve career goals that will allow them to successfully compete in the labor market and prepare them for higher education. D. CONSULTANT is experienced in marketing and outreach <the "program"). law. E. CONSULTANT is willing to operate said program pursuant to the Act and California 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: TIME PERIOD OF AGREEMENT Services under this Agreement shall commence as of January ?, 2011 and all services to be performed pursuant to this Agreement shall be completed on or before June 30, 2011. 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. 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 serv ices speced 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 United States Government take exception, shall be retained beyond the three (3) years until resolution of disposition of such appeals, litigation, claims, or exceptions. C. Without prejudice to any other section of this Agreement, CONSULTANT shall, where applicable, maintain the confidential nature of information provided to it concerning participants in accordance with the requirements of federal and state law. Notwithstanding the foregoing, CONSULTANT agrees to submit to CITY, the State of California and/or the United States Government or their representatives, all records requested for administrative purposes, including audits, examinations, monitoring and verification of records submitted by CONSULTANT, costs incurred and services rendered hereunder. D. CONSULTANT agrees to expend all funds in accordance with all applicable federal, state and local laws and regulations. CONSULTANT also agrees to provide at CONSULTANT'S own expense supplies and other costs of said PROGRAM. E. CONSULTANT shall comply with the provisions of 48 CFR, Chapter 1, Parts 1-31.2, for commercial organizations and all other applicable federal statutes and executive orders and their implementing regulations. F. CONSULTANT shall comply with the provisions of E.O. 12549 and 12689, requiring compliance with the debarment and suspension requirements contained in 29 CFR Part 98. G. CONSULTANT shall comply with the requirements of federal regulations found at 29 CFR 93 which provide that no appropriated funds may be expended by the recipient of a federal contract, grant, loan or cooperative agreement to pay any person for influencing or attempting to influence an officer or employee of any agency, member of Congress or an officer or employee of a member of Congress in connection with awarding of any federal contract, the making of any federal grant or loan, entering into any cooperative agreement and the extension, renewal, amendment or modification of any federal contract, grant, loan or cooperative agreement. CONSULTANT shall sign a certification to that effect in a form as set forth in "Exhibit B," attached hereto and by this reference incorporated herein. CONSULTANT shall submit said signed certification to CITY prior to performing any of its obligations under this Agreement and prior to any obligation arising on the part of CITY to_ pay any sums to CONSULTANT under the terms and conditions of this Agreement. H. CONSULTANT agrees to provide a drug-free work place and to execute a certification as set forth in "Exhibit C" attached hereto and incorporated herein by this reference. 1. 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). 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 hinds under this Agreement for athree-year period from and after the effective date of this Agreement. 3. No person with responsibilities in the operation of any program under the Workforce Investment Act grant shall discriminate with respect to any program participant or any application for participation in such program because of race, creed, color, national origin, sex, political affiliation or beliefs. 4. CONSULTANT shall maintain appropriate standards for health and safety in work and transportation situations. 5. CONSULTANT shall comply with general provisions, assurances, and certifications attached hereto as "Exhibit D" and incorporated herein. 6. Any literature distributed by CONSULTANT for the purpose of apprising businesses, participants, or the general public of its programs under this Agreement shall state that its programs are supported by the City of Santa Ana and the Santa Ana Workforce Investment Board, and shall state that the program is an "equal opportunity employer/program" and that "auxiliary aids and services are available upon request to individuals with disabilities." 7. CONSULTANT certifies that all property, finished or unfinished documents, data, studies and reports prepared or purchased by the CONSULTANT under this Agreement, will be disposed of in accordance with the direction of the CITY. In addition, any tools and/or equipment furnished to the CONSULTANT by the CITY and/or purchased by the CONSULTANT with funds pursuant to this Agreement, will be limited to use within the activities outlined in this agreement and will remain the property of the United States Government and/or CITY. Upon termination of this Agreement, CONSULTANT will immediately return such tools and/or equipment to the CITY or dispose of them in accordance with the direction of the CITY. 4 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 1 5) 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 coirununication 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 aroyalty-free, nonexclusive and irrevocable right to reproduce, publish, or otherwise use the work for Federal purposes, and to authorize others to do so. 1 1 . CONSULTANT is subject to applicable regulations governing patents and inventions, including government-wide regulations issued by the Department of Commerce at 37 CFR part 401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements." 6. COMPENSATION CITY agrees to pay, and CONSULTANT agrees to accept for said services, total compensation in the amount not to exceed Twenty-Five Thousand Dollars ($25,000.00). 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. C. CONTRACTOR agrees to provide priority of services for veterans and eligible spouses pursuant to 20 CFR part 101 O and the regulations implementing priority of service for veterans and eligible spouses in Department of Labor job training programs under the Jobs for Veterans Act published at 73 Fed.Reg. 78132 on December 19, 2008. D. Salary and Bonus Limitations. All subrecipients of WIA program funds are required to comply with federal requirements regazding the limitations on salary and bonus payments in accordance with Public Law 109-149, Section 7013. 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 azising 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 Dollazs ($1,000,000.00) for any injury to or death of any person or persons in any single accident or occurrence. Said policy of professional liability insurance shall be endorsed to provide to CITY at least thirty (30) days written notice prior to cancellation. b. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, CONSULTANT, if CONSULTANT has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. CONSULTANT agrees to comply with such provisions before commencing the performance of the work under this Agreement. paragraph a., above: c. The following requirements apply to the insurance to be provided by CONSULTANT pursuant to 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 fimiish a copy thereof to CONSULTANT. The decision of the CITY shall be final and conclusive unless within thirty (30) calendar days from the mailing or delivery of such copy, CITY receives from CONSULTANT written request to appeal said decision. Procedures governing the appeal shall be prescribed by CITY and/or the State of California in accordance with the Act and all corresponding regulations and OMB circulars. Pending final disposition of the appeal, CONSULTANT shall act in accordance with CITY'S decision unless the dispute involves a change order. 12. BREACH -SANCTIONS If, through any cause, CONSULTANT violates any of the terms and conditions of this Agreement, and/or prior agreements whereby grant funds were received by CONSULTANT pursuant to this Agreement, or if CONSULTANT reports inaccurately or if any Audit Report makes disallowances, CONSULTANT shall promptly remedy its acts or omissions and/or repay CITY all amounts due CITY as a result of CONSULTANT'S violation. For any such failures or violations, CITY shall also have the right at its sole discretion to either. <1) discontinue program support until such time as CONSULTANT fulfills its obligations or remedies all violations of this agreement or prior agreements; and/or (2) collect outstanding amounts as determined by CITY due CITY by offsetting or debiting from current claims or invoices, if after thirty (30) days' written notice CONSULTANT has failed to repay same or a repayment schedule has not been made; and/or (3) terminate this Agreement by giving written notice to CONSULTANT of such termination in accordance the notice provision contained below. 13. NOTICES All notices, reports and correspondence between the parties hereto respecting this Agreement shall be in writing and deposited in the United States Mail, postage prepaid, addressed as follows: To CITY: Clerk of the Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1 98 8 Telefacsimile (714) 647-6956 With courtesy copy to: Santa Ana Work Center 1000 E. Santa Ana Blvd., #200 Santa Ana, CA 92701 Telefacsimile (714) 565-2602 To CONSULTANT: Performance Excellence Partners, Inc. 20911 Cabrillo Lane Huntington Beach, CA 92646 Phone: 1(800)715-1 140 Fax: (714)374-1120 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: `?Y??-? i Maria D. Huizar Clerk of the Council CITY OF SANTA ANA David N. Ream City Manager APPROVED AS TO FORM: Joseph W. Fletcher City Attorney .- /? ? ?l1?( By: Lisa Storck Assistant City Attorney RECOMMENDED FOR APPROVAL: ?? ynthia elson, Dep City M ag r for Develop nt Services CONSULTANT: ,? _ ?? Tax ID#/SS#: 54-2002104 Rachel Ramirez President 9 C? PERFORMANCE EXCELLENCE PARTNERS 20911 Cabrillo lane I Huntington Beach, CA 92646 I Toll Free: 600-715-1140 I Fax: 714-3741120 January 20, 2011 Performance Excellence Partners, Inc. City of Santa Ana 2011 Marketing Development Contract To: Linda Oberman Economic Development Manager City of Santa Ana Tax I.D. No. 54-20022104 Terms: Upon Request Invoice: Santa Ana Job: Marketing and Outreach Materials Marketing Materials Annual Report Logos (3 logos for fiscal year) DOL 12 Sector Fact Sheets Electronic Newsletter Vietnamese and Spanish Translations Website Content Review 8. Recommendations Project Wrap-up and Printing • Work Center Postcards • Reference Guide • Work Center Folder • Thank You Cards • '12-Sector Fact Sheets Grand Total: Linda Oberman Date Date: 1/20/11 Fees $3,500 $7, 500 $3,500 $4, 500 $3,000 $1,500 $2,000 $25,000 Rachel Ramirez Date Calfiornla Colorado Florida Illinois New Hampshire - Washington D. C. www.psp6•.com Summary of Deliverables Annual Report Produce a poster-size, one-page, double-sided color document to promote the 2010 performance report for the Santa Ana Workforce Investment Board. Logos (3 logos for fiscal year) Produce the following logos on behalf of the Santa Ana Workforce Investment Board and the Santa Ana Work Center: . Earth Day Logo (option 1) • Earth Day Logo (option 2) • Santa Ana WIB Logo DOL 12 Sector Fact Sheets Produce one-page. 8%z x 11 Department of Labor work sector fact sheets to promote industry careers and educational needs. Electronic Newsletter Create and disseminate 6 electronic newsletters to promote the Workforce Investment Board. Vietnamese and Spanish Translations Produce Vietnamese and Spanish translations of the following marketing materials . Work Center Postcards . Reference Guide • Two informational brochures • 12-Sector Fact Sheets Website Content Review & Improvement Review website content and make changes for improvement to the Workforce Investment Board and Work Center website using its current design and site map. Project Wrap-Up and Printing Final document printing and deliverables for the following projects: . Thank You Cards • Work Center Postcards • Reference Guide • Work Center Presentation Folder • Multi-use format of all documents CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS. GRANTS. LOANS and COOPERATIVE AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: 1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress in connection with the awarding of any Federal contract, 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 than $100,000 for each such failure occurring on or before October 23, 1996, and of not less than $11 ,000 and not more than $110,000 for each such failure. Performance Excellence Partners Grantee/Contractor Organization Program Title Signature Rachel E. Ramirez Name of Certifying Official Signature EXHIBIT B DIVISION OF EMPLOYMENT SERVICES PLACE OF PERFORMANCE FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS Name: Performance Excellence Partners Name of Contractor: Rachel E. Ramirez Contractor Number: Date: April 6, 2011 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): 20911 Cabrillo Lane Huntington Beach. CA 92646 (Orange County) EXHIBIT C Certification Regarding Drug-Free Workplace Requirements The certification set out below is a material representation upon which reliance is placed by the U.S. Department of Housing and Urban Development in awarding the grant. If it is later determined that the contractor knowingly rendered a false certification, or otherwise violates the requirements of the Drug-Free Workplace Act, the U.S. Department of Housing and Urban Development, in addition to any other remedies available to the Federal Government, may take action authorized under the Drug-Free Workplace Act. CERTIFICATION A. The contractor certifies that it will provide adrug-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 adrug-free awareness program to inform employees about - (1) The dangers of drug abuse in the workplace; (2) The contractor's policy of maintaining adrug-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. EXHIBIT C 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 adrug-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 pertormance 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. Performance Excellence Partners Organization _?"?-mss ?- -- ?, April 6. 2011 Authorized Signature - Date EXHIBIT C ASSURANCES Subcontractor agrees that in addition to those agreements and obligations specified in the contract boilerplate 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 4. Subcontractor agrees to acknowledge (give credit to) the Santa Ana WORK Center in all oral presentations, written document publicity, and advertisements regarding any activities that ensue from this agreement. EXHIBIT D ?R?® CERTIFICATE OF LIABILITY INSURANCE OP ID EC DATE (MM/DD/Yl'YY) 10 1B 10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ^.ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES .FLOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED r2EP RESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. R N the certificate hol er Is an ADDITIONAL I U E , t e po Icy(ies must a en orse S OG ION IS AI ,subject to the terms and conditions of the policy, certain policies mey require an endorsement. A statement on this certificate does not confer rights to the certificate holder In Ileu of such endorsement(s). PRODUCER NAME: Sawyer Cook Sn eurance A? Ha gxt?o _.._-_.._ _._ _(A/?..I±?2: _- _ _ 1200 Cali £ornia 3t. Sta 260 ?RESS: _ ??? Radl ands CA 92374 cusro?A? MEN R?? PE RFO-7 Phone: 909-435-0230 Fax 909-798-7971 --- - --- -- - INSURER(S) AFFORDING COVERAGE NAIC q INSURED _____.. .............--.. --.-..__ INSURERA:_ Hart£Ord In9 uran C6 COmp8 ?, 22357 Partnarsnca Excellence INSURERS Philadelphia Insurance Shannon Salido INSURERC: 20911 Cabrillo Lana - - - -- ----- ---- -- -- _. _.? Huntington Beach CA 92646 INSURER O: INSURER E INSURER F THIS IS TO CERTIFY THAT THE POLICIES OF INS VRANGE LISTED BELOW HAVE BEEN ISSVED TO THE INSURED NAMED ABOVE FOR THE PO LICY PERIOD INDICATED. NOTW ITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W ITH R ESPECT TO W HICH THIS CERTIFICATE MAY BE ISSVED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUB T JEC TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ____ _ _ LTR TYPE OF INSURANCE ?-ADD B?_ - EFF -TtST_TCY D(y? - '-- - --' INSR WVD' POLICY NUMBER (MM/DD MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE "_.__ - - $ 1 OOO, OOO A X COMMERCIAL GENERAL LIABILITY 72$SAHOB229 09/2T/10 09/27/11 E IUIiER fED PREMISES Ea occurrence ._- $ 3OO OOO CLAIMS-MADE ? OCCVR _ MED EXP (grry one parson) $ 1 O , OOO - --.--.._ ... X PERSONALBADV INJURY-. $1 OOO,OOO GENERAL AGGREGATE _- $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: _ ? PRODVCTS -COMP/OP AGG S 1 OOO OOO POLICY JEGT LOC ? ?____._.. _ __ AVTOMOBILE LIABILITY -__ COMBINED SINGLE LIMIT $ A ANY AUTO 72 SSAHO8229 09/2T/ (Ea eccitlent) 1 , OOO , OOO ? ALL OW NED AUTOS 10 09/2T/11 BODILY INJURY IParP rso ) $ -- _ SCHEDULED AUTOS ( ! ? T 1 l-t F?R __ DOILY INJVRY IPar accltla I) _ __ _ $ -- X I HIRED AUTOS ?PpROVE ? PROPERTY DAMAGE (Par acdtlenl) $ X__I NON-0WNED AVTOS CK -- _ - $- --- UMBRELLALWB t YtOrneY EACH OCCURRENCE S EXCESS uAB ___.. .._ ti CLAIMS-MADE ? - />,SStSt nt ?i q y AGGREGATE g _. - i , - DEDUCTIBLE / $ RETENTION $ l .-_ _ _ $ A WORKERS COMPENSATION AND EMPLOYERS' 4ABILITY L+'E GLZ 13 09/2-!/10 ? 09/2T/11 A - \, / N ANY PROPRIETOR/PARTNER/EXEGUTIV OFFICER/MEMBER EXCLUDEDP ? I /A TORY LIMITS R _- .__..... E EL EACH ACCIDENT -_._ -. _...... $1 OOO, OOO (Mentletbry In NH) 11 es, tlescrlbe untler I E.L. DISEASE - EA EMPLOYE $ 1 , OOO , OOO DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 5 1 OOO OOO A Property Sacti on 7258ABOB229 os/zT/1o o9/zT/11 bpp 15,000 H Pro£es sional Liab PHSD561724 os/zT/1o o9/zT/11 eacl-i occ 1 000 , 000 DESCRIPTION OF OPERATION91 LOCATIONS /VEHICLES (Agacl, ACORD 10'i, Atltlltlbnal RembrftB Schotlule, IL more BpecB fa ragUlretl) City o£ Santa Ana is named as an additional insured as their interest may a ppear. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City o£ Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Community Development Agency .. C)-lri5 Dalton AVTHORIZEp REPRESENTATIVE 20 Civic Center Plaza, M-25 Santa Ana CA 92702 /) - !/ I ?ri?.C /,?j ©1 -2009 ACORD C ACORD 25 (2009/08) The ACORD name and logo are registered marks of ACORD POLICYNUMBER: 72 sBA Boszz9 ?: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDSTIONAL INSURED - OWNER, LESSEES OR CONTRACTOR CITY OF SANTA ANA SANTA ANA CA 92702 C = TY O F LONG BEACH , WORKFORCE DEV . BUREAU 3447 ATLANTIC AVE, 3RD FLOOR LONG BEACH CA 90807 ppBRO?D Rg TO FORM T ORGK L\SA EC tY pttorneY Assistant ?? Form IH 12 00 ?? 85 T SEQ. NO. 002 printed in U.S.A. Page o01 Process Date: io/zo/io Expiration Date: 09/27/11 UW COPY ADDITIONAL INSURED ENDORSEMENT Insurance Company ^T?Y??cO?C? CoLC. t.??ha 't_r14>,?,,?CrL e.© . This endorsement modifies such insurance as is afforded by the provisions of Policy # -12S8A??SG2 °? relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702; its officers, employees, agents and volunteers are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be canceled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective ?? ? 1?cG ? ?-?\O ,this endorsement form as a part of Policy # ? ZSC3'Ps'bou22G Issued to ?P?c`?ctiKrr?U.rC'?, ?TX n \\P_r o `?? ?"(1Q.?CZz?' Named Insured Countersigned by ???D,VT4'?Zo . Authorized Representative OVER AS TO FOB L?. STORCK Assistant City Attorney 3? Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions This certification is reduired by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, Section 98.510, Participants' responsibilities. The regulations were published as Part VII of the May 26, 1988 Federal Register (pages 19160-19211). (BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS FOR CERTIFICATION - Attached) (l) The prospective recipient of federal assistance funds certifies, by submission of this proposal, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded fi-om participation in this transaction by any federal. department or agency- (2) Where the prospective recipient of federal assistance funds is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal . Rachel E. Ramirez. President Name and Title of Authorized Representative ?w?/S ??? - 6/ Apri_1 6. 201 1 Signature Date EXHIBIT A INSTRUCTIONS FOR CERTIFICATION 1. By signing and submitting this proposal, the prospective recipient of federal assistance funds is providing the certification as set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective recipient of federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Govenunent, the Department of Labor (DOL.) may pursue available remedies, including suspension and/or debarment. 3. The prospective recipient of federal assistance funds shall provide iirvnediate written notice to the person to which this proposal is submitted if at any time the prospective recipient of federal assistance funds learns that its certification was erroneous when submitted or has become en-oneous by reason of changed circumstances. 4. The terms "covered transaction," "deban•ed," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective recipient of federal assistance funds agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is deban•ed, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the DOL. 6. The prospective recipient of federal assistance funds further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and voluntary exclusion -Lower Tier- Covered Transactions," without modification, in all lower tier covered transactions and in al] solicitations for lower tier covered transactio?is. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that. the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to check the List of Parties Excluded from Procurement or Non- Procurement Programs. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instnactions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded fi-om participation in this transaction, in addition to other remedies available to the Federal Govenmient, the DOL may pursue available remedies, including suspension and/or debarment. EXHIBIT A