HomeMy WebLinkAboutORANGE COUNTY YOUTH COMMISSION (5) City of Santa Ana
Clerk of the Council
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AGREEMENT TERMINATION FORM D
COTC Office Use Only
Please complete this form when the attached agreement and all
amendments (if any) are no longer in effect.
Return form to the Clerk of the Council Office (M-30).
Call 647-6520 if you have any questions.
The agreement with ( 1Otfle OL/tr1 i 401m1 %o
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No. ,-1,OI D-,2- D9 was completed on 9/ 7)O I ( and final payment has been made.
(List all amendments. Use space below if needed.)
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Department:
Phone/Ext.:
Signature:
Date:
Revised 08-23-10
y5UgN . = A-2010-120-02
W0RK MAY PR( CE-El",
1
-----! SECOND AMENDMENT TO AGREEMENT UNDER
CL(=RK l
THE WORKFORCE INVESTMENT ACT
THIS SECOND AMENDMENT, made and entered into this Is' day of July, 2011, by and between the Orange
County Youth Commission ("Contractor") 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 ("City").
RECITALS
A. The City and Contractor entered into that certain Agreement Under the Workforce Investment Act effective
July 1, 2010 (Agreement #A-2010-120-01), hereinafter referred to as "said Agreement".
B. The parties revised the Budget attached to said Agreement by the Amendment dated July 1, 2011.
C. The parties hereto now desire to further amend the Agreement by extending the Term and to revise the Budget
attached to said Agreement. Relevant exhibits affected by these changes will also be amended.
WHEREFORE, in consideration of the mutual and respective covenants and promises hereinafter contained and
made, and subject to all of the terms and conditions of said Agreement as hereby amended, the parties hereto do
hereby agree as follows:
1. Section III. "Time Period of Agreement" shall be amended through September 30, 2011, in accordance
with said term which states: "The term of this Agreement may be extended by a writing executed by the
Executive Director and the City Attorney".
2. Exhibit F to said Agreement is hereby replaced with the amended Exhibit F (Budget), attached hereto
and incorporated herein by reference. The amount of City's Obligation remains as stated in said Agreement.
3. Except as hereinabove modified, the terms and conditions of said Agreement remain unchanged and in
full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to said Agreement the date
and year first above written.
ATTEST: CITY OF SANTA ANA
Y:
Maria D. Huizar Paul Walters
Clerk of the Council Interim City Manager
APPROVED AS TO FORM:
Joseph Straka
Interim City Attorney
"CONTRACTOR"
Orange County Youth Commission
BY:*9z.iC_
Lisa E. Storck
Assistant City Attorney
CITY OF SANTA ANA
COMMUNITY DEVELOPMENT AGENChY
-AIA 4,
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BY: <???tt??/plc
Name: Kde GUn00edina
Title: Executive Director
Nancy T. Edwatds, Interim EUcecutivp 9irector
Orange County Youth Commission
Santa Ana Boxing Club
P.O. Box 1756
Santa Ana, CA.92702
Phone: (714) 542-7610
Fax: (714) 542-7610
June 22, 2011
Julie Castro-Cardenas
Workforce Specialist III
Santa Ana Youth Council
Workforce Investment Board
1000 E. Santa Ana Blvd., Suite 200
Santa Ana, CA 92701
Dear Julie,
I am requesting that we be able to revise our Budget for 2010-11. We have a lot of left
over funds due to not being able to rent the bar next door to the Boxing Club. We
would like to utilize the remaining funds for salaries, utilities and gas expenses. So that
we can follow up the exited youth from our program
Enclosed is a copy of the revised budget and the changed narrative.
Thank You for your help.
The Very Best to You,
s
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Kate,lg`unn e ma
Executive Director
? -- 2CA -X20 -c? I
"Making A Difference" by linking caring mentors with inner city youth through after school activities
Exhibit F
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Exhibit F
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BUDGET FORM
2010-2011 Administrative Program Total WIA Match/In Kind
6-1-10 to 9-30-11 No more than 10%
OC Youth Commission allowed.
Personnel Salaries*
1.Project Manager (.25 FTE) 13,000 52,000 13,000 39,000
10 hours per week
2.Sports Club Director/ Case 52,000 52,000
Manager (1.0 FTE)
3. Case Manager's Assistant 11,700 11,700
(.63 FTE) 25 hours a week
4. Tutor (.63 FTE) 25 hr. a wk. 19,800 19,800
5. Trainer (.38 FTE) 15 hr a wk 7,800 7,800
6. Gym Manager (.5 FTE) 6,500 6,500
7. Mentoring Director (.5 FTE) 15,840 15,840
20 hours a week
Benefits*
1.Medical and Vision ($303 4,619.90 4619.90
for 10 months $329 for 4
months and $373.90 for 1
month)
2. Workman's Comp and 6,557 4,028.20 2528.80
Liability Insurance
Use separate sheet if
necessary.
Total Personnel 10,400 152,993 135,288.10 33,285.
Operating Expenses
Rent or user fee* 18,000 In Kind rent
for Boxing Club
Utilities 1750. 755.44 878
Phones
Internet fees 750 750
Parking fees
Security
Maintenance
Insurance
Equipment rental fees* copier 1,737. 1,389.60
Vehicle lease*
Office expenses 1200 621.94
(consumables)
Accounting Services
Legal services
Auditing services
Indirect costs*
Staff training 500 298.19
Staff travel/mileage 2,460 1078.81 1229.
Participant Wages* Youth Representative 100 100
Support services* 4,000 1,322.50 2412.
Participant incentives* 2,000 963.42 1291.
Other (list)*
Total Operating Expenses 31,260 6,529.90 22,450
GRAND TOTAL Exhi!
184,253
141,818
55,735.
OCYC Santa Ana Boxing Club
2010-2011 Budget Narrative
July 1,2010 to September 30, 2011
SALARIES:
PROJECT MANAGER: Kate Gunn Medina
As Project Director Kate Gunn Medina will spend 10 hours, in a regular 40-hour week,
managing all aspects of the grant contract including recruitment, assessments, budget, policy
guidelines. Project Manager is responsible for approving expenditures of WIA funds.
15 months of effort: $20.00 per hour x 10 hours x 65 weeks =$13,00..
($52,000. for a 40 hour work week for 65 weeks) @ .25 FTE x $52,000= $13,000.
SPORTS CLUB DIRECTOR/ CASE MANAGER Anthony Serrano
Anthony, as Mentor/Coach will spend about 40 hours a week working with WIA youth. As
mentor, Anthony, will assist the youth to acquire necessary character traits that will help them
excel in school by using the sport of boxing. He will counsel and direct youth to make and
achieve short and long term academic and job/career goals. As coach, Anthony will provide
youth with boxing skills to cause them to know the experience of winning a losing graciously,
taking advantage of opportunities, avoiding negatives and keeping fit. Anthony will also act as
Case Manager managing case files and reports. Case Manager will motivate and coordinate
services and information to prepare participants for post secondary educational opportunities,
provide linkages between academic and occupational learning, and/or preparation for
unsubsidized employment/training opportunities, as appropriate through an academic tutoring
and employment mentoring program.
15 months of effort: $20.00 per hour X 40 hrs x 65 weeks =$52,000.
($52,000.00 annual salary) @ 1.00 FTE x $52,000 = $52,000.00
CASE MANAGER ASSISTANT : Tony Ortiz
The Case Manager Assistant will aid the Case Manager in collecting paperwork from Tutors and
Mentors that need to be in clients files. He will be responsible for doing fact finding and
information gathering for job recruitment and school placement and in assisting the Case
Manager.
12 month of effort: $9.00 x 25 hrs x 52 wks=$11,700.00
.63 FTE
TUTOR: Sarah Hernandez
Tutor will spend 25 hours a week preparing curriculum, managing the volunteer tutors and
teaching/tutoring youth to enable them to increase TABE scores and maintain or raise GPA to
3.0. As needed we will find assistant tutors for special academic needs.
12 months of effort $15.00 hr. x 1320 hours for the year = $19,800
.63 FTE
Exhibit F
TRAINER: Gaulua Taleni (Lou)
Lou will be responsible to get the youth ready to go into the ring. Helping them learn the art of
boxing and helping them to understand the importance of discipline. He will report to Anthony
Serrano his progress with the clients training.
12 months of effort @ $10.00 hr. x 15 hrs x 52 weeks = $7,800
.38 FTE
GYM MANAGER: John Ramirez
John is responsible for checking the clients into the gym, making sure they have all their
equipment for boxing and tutoring. He will also be assisting Tony in making phone calls to
clients and following up.
13 months of effort @ $500 per month $6,500
.5 FTE
MENTORING DIRECTOR: Kacey Lacativo
This person will be responsible for meeting with Anthony Serrano once a week to match up
clients with business mentors to help the clients in their career choices. This person will arrange
for guest speakers to come into the Boxing Club and inspire the youth to stay in school and to
reach for their goals.
12 months of effort @ $15.00 hr x 1,056. for the year = $15,840.
BENEFITS:
Medical
MEDICAL
This includes health insurance benefits for Anthony Serrano. The insurance cost differs among
employees dependent on age of employee. This is broken down according to percent of time
each person is giving to the WIA project
Anthony Serrano: $303.00 per month x 10 = $3,030.00and $329 per month for 4 Months=
$1,316.00 and one month at $373.90 = Totaling $4,619.90
Workman's Comn
WORKMAN'S COMPENSATION INSURANCE
Our Workman's Comp Insurance has gone lower because we have fewer people working for the
OCYC. If this budget is approved and we need to hire more people it will be higher. We are
asking for $4,028.20 of the current bill of $6,557.00. As of Nov. 2010 the only people that are on
the Workman's Comp Insurance are the people working for WIA. The Executive Director has
opted out of Workman's Comp.
Exhibit F
UTILITIES:
The electricity bill runs about $120 per month X 15 = $1,800 for the year We are requesting
$755.44 to pay for utilities for thirteen months.
EQUIPMENT RENTAL:
Copier Machine rental The copier has been moved into the Boxing Club and will be used by
clients for projects and homework. The ink and toner will be paid for by OCYC. The rental is
$115.80 per month X 15 months - $1,389.60for the year.
OFFICE EXPENSES:
WIA Clients need to make presentations and to do homework they need copy paper, folders,
pens, pencils and other consumables. We are requesting $621.94 this year toward office supplies.
STAFF TRAINING:
We are requesting $298.19 for Staff Training.
Staff Travel
STAFF TRAVEL AND MILEAGE
This mileage is used to pick up and take Young Adults to job interviews and classes for WIA
requirements. Often the Young Adults do not have cars and the bus does not go everywhere they
need to go. Total cost to OCYC : $2,750.00 We are requesting $1,078.81.
PARTICIPANT WAGES:.
Youth Council Stipend of $50 per meeting for a Client in the WIA Program.
Totaling $100 per year.
SUPPORT SERVICES:
Supportive services will be provided. Clothes for job interviews and work, books, haircuts,
school materials and bus passes for 20 Young Adults = $150 per client. We are requesting
$1,322.50for Support Services.
PARTICIPANT INCENTIVES:
Field trips, Sweat-shirts, pizza parties and gift cards to Target, Sears or Wal-Mart: rewards
will be given to deserving clients who meet specified attendance, academic or employment goals.
We are requesting $835.17 toward participant incentives.
Exhibit F
AM. CERTIFICATE OF LIABIL ITY INSURA CE DATE ( IAMfDp1Y1/y1?
PRODUCER (949) 218-0840 05/12/2011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Global Program Managers & Ina . Srvca. , Ina. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND EX
Post Office Box 7119 TEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIkS BELOW.
Capistrano Beach CA 92624-7119 INSURERS AFFORDING COVERAGE NAIC #
INSURED IHSURERA: PHILADELPHIA INDEMNITY 18058
Orange County Youth Commission INSURER e: HAR'T'FORD FIRE 19682
Post Office Box 1593 INSURER C:
IN RERO.
,Newport Beach CA 92659-
AAVCOwAL'e INS RERE:
.???? ?? .+? u.0Unnnlc LIJ ICU ou.uw rlAvt: utt:N ISSUtO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY
REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,
THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
L DD'L
TYPEOFINSURANCE
POUCYNUMBER OLtCYE FECTIVE
DATE (M PWp.C- EXP RATA N
DATfi MW
LIMITS
A GENERAL LIABILITY E
A
H
C
OCCURRENCE ! 1,000,000
X COMMERCIAL GENERAL LIABILITY p
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A
A
PREI(I 5S ;EMED 11 100,000
CLAIMS MADE 50 OCCUR PBPK 625 235 10/20/2010 10120/2011 MEOEXP one 4 5,000
1
000
00
PERSONAL a AOV INJURY ,
,
0
!
000
000
2
GENERAL AGGREGATE ,
,
4
G£NLAGGREGATE LRIMpIIT? APPLIES PER PRODUCTS - COMPIOP AGO 1 2,000,000
X POLICY JECT LOC
A AU TOMOBILE LIABILITY
ANY AUTO COMBINED SINGLE LIMIT
(Es moddem)
1,000,000
X ALL OftEDAUTOS
SCHEDULEOAUTOS PHPK 625 235 10/20/2010 10/20/2011 BODILY INJURY
(PMP-)
X
X HREDAUTOS
NON-OMEO AUTOS BODILY INJURY
(Per aaldeN
PROPERTY DAMAGE
(Per e0dderd)
!
GARAOELIABILITY APpR VED AS TO RM AUTO ONLY •EAACCIDENY !
ANY AUTO OTHERTHAN A
AUTO ONLY: AGO $
EXCESSIUMBRELLALIABILITY ElSA E. SvTORCK EACH OCCURRENCE 11
OCCUR CLAIMS MADE Assistant City Attor ey AGGREGATE !
P DEDUCTIBLE
RETENTION $
B WOPLFR COMIPPEE? NAND 72 WKC L88953 10/20/2010 10/20/2011 X T 1
ANY PROPRIETORIPARTNEWEXECUTIVE
OFFICERNEMBER EXCLUDED? E.LEACH ACCIDENT ! 1,000,000
11 ya,d*"bewW- E.L. DISEASE - EA EMPLOYE ! 1,000,000
SPECtAL PROVISIONIS Solon
OTHER E.L. DISEASE • POUCY LIMIT ! 1 , 000 , 000
DESCRIPTION OF OPERATIONSAOCATIONSNEHICLESMXCLUSIONS ADOEO BY ENDORSEMENTISPECIAL PROVISIONS
RE, ANNUAL rMDINO - BANTA ANA YOUTH COUNCIL - WORKFORCE INVESTMENT ACT
CITY OF SANTA ANA AS ADDITIONAL INSURED PER ATTACHED RUDORSUMUT
IN THE EVENT Or NON-PAYNzw or PREMIUM, TEN (10) DAYS WRITTEN NOTICE WILL BE GIVEN PRIOR TO CANCELLATION.
SHOULD AMY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
( ( - EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
030 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
CITY OF SANTA ANA FAILURE TO DO SO SHALL IMPOSE NO OBLNIATIGH OR LIANUTY OF ANY KIND UPON THE
Santa Ana Youth Council. INSURE ITS AO REP ENTATNES.
1000 E. SANTA ANA BLVD., #200 AUTHORIEDRE A
SANTA ANA CA 92701- Robert
ACORD 28 (2001108) Lle,904y #ACORD CORPORATION 1988
Q?,,; INS028(oimpt ELECTRONICLASFRFnRUC 1I _/o/.n.+n -
rage 1 or2
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(tes) must be endorsed. A statement on this
certificate does not confer rights to the certificate holder in lieu of such endorsement(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
endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this 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.
AppRpVED ?? TO FORM
LISA e. s?ORCK
Assistant CttV Attorney
ACORD 25 (2001106)
PW" tnsu26(010s).01 Page 2 aa
EXHIBIT B
ADDITIONAL INSURED ENDORSEMENT
Insurance Company Philadelphia Indemnity Insurance Company
This endorsement modifies such insurance as is afforded by the provisions of Policy Number
PHPK 625 235 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 - EXCEPT IN THE CASE OF THE CITY'S GROSS NEGLIGENCE
OR WILLFUL MISCONDUCT.
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.
IN THE EVENT OF NON-PAYMENT OF PREMIUM, ONLY TEN (10) DAYS NOTICE WILL BE
GIVEN.
(Completion of the following, including countersignature, is required to make this
endorsement effective.)
Effective 10/20/2010 this endorsement form as a part of
Policy# PHPK 625 235
Issued to Oranoe Countv Ymuth Cnmmiccfnn
Countersigned by
Named Insured
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Adthorized Representative
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