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HomeMy WebLinkAboutROADTRIP NATION ORG. - 2013 r. City of Santa Ana Clerk of the Council COTC Office Use Only AGREEMENT TERMINATION FORM Please complete this form when the attached agreement and all • amendments (if any) are no longer in effect.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 647-1520 if you have any questions. • • The agreement with .4. � [ 91) No. N-2013-032 was completed on g 30 ( 3 and final payment has been made. (List all amendments. Use space below if needed.) � Department: CD� ,A. f S Cv Phone/Ext.: I j Signature: II Date: SI1 11 , Revised 10-31-12 INSURANCE NO; ON FILE WORK MAY NOT PROCEED N-2013-032 CLERK OF COUNCIL DATEa 1 0 2413 AGREEMENT WITH 0 C b A ROADTRIP NATION.ORG syIVIQVQZc')eZ UNDER THE WORKFORCE INVESTMENT ACT THIS AGREEMENT, made and entered into this 3`d day of January, 2013, by and between Roadtrip.Nation.Org., a 501 (c)(3) non-profit corporation, 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 providing counseling and training of 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 January 3, 2013 and all services to be performed pursuant to this Agreement shall be completed on or before September 30, 2013. The term of this Agreement may be extended by a writing executed by the Executive Director of the Community Development Agency, or her designee, 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 and provide, at its own cost and expense except for the compensation specified in this Agreement, curriculum implementation for 50 youth, training and support, one introductory Roadtrip Nation RV Event, and one Final RV Event, as further specified in the Scope of Work attached hereto as-Exhibit A'and incorporated herein by reference. 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, at its own expense, 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 may 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. All such access shall be at reasonable times as may be requested by the CITY; provided, however, that the CONSULTANT shall not be obligated pursuant to this Section 4.13 to provide access to any information that it reasonably considers to be a trade secret or similar confidential information or 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 that 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 or 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 svl-1 r52 r2v2 2 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, in accordance with Section 4.13 above, 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 the form set forth in Exhibit B attached hereto and incorporated herein by reference. 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 in the form set forth in Exhibit C attached hereto and incorporated herein by 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). J. CONSULTANT agrees to comply with Title VI of the Civil Rights Act of 1964, and provisions of WIA Section 188, as well as Equal Employment Opporhmity provisions in Executive Order ("EO") 11246, as amended by EO 11375, and supplemented by the requirements of 41 CFR Part 60. Section 188 ensures nondiscrimination and equal opportunity for various categories of persons, including persons with disabilities, who apply for and SVI-I15212v2 3 participate in programs and activities operated by recipients of WIA assistance. EO 11246 specifically prohibits federal contractors and subcontractors and federally assisted construction contractors, subcontractors or subgrantees that have contracts that exceed $10,000 from discriminating in employment decisions on the basis of race, color, religion, sex, or national origin. All covered contractors must take affirmative action to ensure that equal opportunity is provided in all aspects of their employment. 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 set forth in Exhibit D attached hereto and incorporated herein by reference. 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. SVI-115212v2 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 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. CITY agrees to pay, and CONSULTANT agrees to accept for said services, total compensation in the amount not to exceed Twenty Three Thousand Seven Hundred Fifty Dollars ($23,750.00). CONSULTANT will submit a detailed invoice evidencing services performed. Payments will be made in accordance with the Milestones set forth in Exhibit A attached hereto in four payments upon completion of each of the four (4) specific components being successfully performed by CONSULTANT. Each payment by the CITY shall be made within thirty (30) days following receipt of said invoice, subject to CITY accounting procedures. sv1-115212v2 5 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 of 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. NEITHER PARTY SHALL BE LIABLE FOR ANY INDIRECT, SPECIAL, INCIDENTAL, CONSEQUENTIAL OR EXEMPLARY DAMAGES, EVEN IF A PARTY HAS BEEN INFORMED OF THE POSSIBILITY OF SUCH DAMAGE OR LOSS, WHETHER FORESEEABLE OR NOT, THAT ARE IN ANY WAY RELATED TO OR ARISE OUT OF THIS MOU, THE BREACH THEREOF, OR A LOSS OF GOODWILL OR PROFITS RESULTING THEREFROM. EXCEPT IN CONNECTION WITH THE EXPRESS INDEMNITY OBLIGATIONS HEREUNDER, AND THEN, ONLY IN CONNECTION WITH THE GROSS NEGLIGENCE OR WILFULL MISCONDUCT OF A PARTY, EACH PARTY'S TOTAL LIABILITY HEREUNDER OR IN CONNECTION WITH ANY OTHER CLAIM ARISING OUT OF THIS AGREEMENT SHALL NOT EXCEED THE FEES ACTUALLY PAID BY CITY TO CONSULTANT UNDER 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 SVI-115212v2 6 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. 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 thirty (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 parry 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, CONSULTANT shall promptly remedy its acts or omissions and/or repay SVI-I15212v2 7 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 92702-1988 Telefacsimile (714) 647-6956 With courtesy copy to: Santa Ana Work Center 1000 E. Santa Ana Blvd., 9200 Santa Ana, CA 92701 Telefacsimile (714) 565-2602 To CONSULTANT: Roadtrip Nation 853 W. 1 11 Street, Unit A Costa Mesa, CA 92627 Phone (949)764-9121/FAX (949) 764-9162 Attn: Kristen Vedder svI-I15212v2 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: Maria D. Huizar Cleric of the Council CITY OF SANTA ANA Kevin O'Rourke City Manager APPROVED AS TO FORM: Sonia R. Carvalho City Attorney By: Lisa Storck Assistant City Attorney RECOMMENDED FOR APPROVAL: Nancy T. Edw, rds Acting Execut e Director Community Development Agency CONSULTANT: Mike Marriner Founder/Director of Strategic Partnerships Tax ID#/SS#: svI-I15212vz Roadtrip Nation- Santa Ana WORK Center Roadtrip Nation Background: Roadtrip Nation is an independent organization that empowers students to define their own roads in life through resources such as its annual PBS television series, live campus events, nationally- publicized books, multi-media online content and an innovative educational curriculum. Its roots go back to 2001 when recent grads Mike Marriner, Brian McAllister and Nathan Gebhard decided to take a roadtrip in hopes of discovering their place in the world. The idea for the roadtrip was simple: if you don't know what to do with your life, go out and talk to people who are doing what they love and ask them how they got there. The trio hit the road in a mechanically unsound green RV, and three months and 17,000 miles later had interviewed an eclectic group of 85 individuals including the chairman of Starbucks, the scientist who decoded the human genome, Supreme Court Justice Sandra Day O'Connor, a lobsterman from Maine, the director of Saturday Night Live, activists, photographers, mechanics and over 77 others who connected their passions with their work to live out meaningful lives. Their trip was chronicled in Forbes Magazine, which resulted in a book deal with Random House and eventual coverage through NBC's Today Show, CBS's Early Show, Carson Daily Show, CNN News, BBC News, Newsweek, Esquire and several other national media outlets that launched Roadtrip Nation on an international scale. During the publicity campaign and public speaking engagements surrounding the book launch, it became clear that rather than simply reading their book, students across the country wanted to hit the road, meet with their own list of leaders and explore the world for themselves. To meet this need, in 2003 Marriiner, McAllister, and Gebhard created Roadtrip Nation, an organization dedicated to helping students build this experience first hand and put the spirit of exploration back into the educational process. Through its "Behind the Wheel" program and its Indie-Roadtrip network, Roadtrip Nation offers financial and logistical support to enable students to hit the road and interview their own list of leaders from across the country. Roadtrip Nation has empowered more than 50,000 students to build their own roadtrip experiences, and has then shared those learnings with millions of others through multimedia content productions and events including: * Annual PBS series, broadcasted in over 80,000,000 homes (in its 9th season) * 3 nationally-released books * 100 live campus events each year * Online video content (MSN, PBS.org, Current TV, www.roadtripnation.com) * The Roadtrip Nation Experience educational curriculum Roadtrip Nation's recent extension into academia, a non-profit educational organization called RoadtripNation.org, develops curriculum and resources to help at-risk high school students in disadvantaged communities gain access and exposure to life pathways that they may have otherwise not known existed. The Roadtrip Nation Experience connects those students to the vast Roadtrip Nation Interview Archive, which has been built over the last seven years by students EXHIBIT A svI-115212 2 to participating in Roadtrip Nation programs interviewing a wide range of individuals and recording their conversations. These videos chronicle the diverse personal stories and pathways of successful individuals from across the United States. The leaders range from CEOs of Fortune 500 companies to political activists, scientists to mechanics, artists and TV producers to accountants. All share personal tales of navigating life's many choices overcoming obstacles and working hard to define their own roads in life. The Roadtrip Nation Experience curriculum provides exposure to these stories and then motivates students to build their own local roadtrip experiences culminating in interviews with leaders in their own communities in fields that relate to students' individual passions and interests. The combination of the Interview Archive and the real world experiential learning exercises provides students with unprecedented exposure to pathways that are relevant to their individual hopes and dreams. With these strategies and tools RoadtripNation.org aims to empower young people to discover their roads in life by demonstrating the links between high school education and the compelling real world opportunities that await students after graduation. The goals of the Roadtrip Nation Experience are: 1) Increase relevance in student's educational experience by connecting them to the real world via RoadtripNation.org experiential-learning programs and engaging multi-media content. 2) Broaden student exposure to pathways and opportunities that relate to their individual passions and interests. 3) Develop students 21st century skills by leveraging RoadtripNation.org programs and resources that guide them in researching, project management, communication, team work, leadership, as well as technology and written communication skills. The Roadtrip Nation Experience Curriculum The Roadtrip Nation Experience helps high school students, many from disadvantaged communities, gain access and exposure to life pathways that they may have otherwise not known existed. By discovering new possibilities, students discover hope for their futures and a career path that best fits their interests. The Roadtrip Nation Experience gives students the tools to embark on a journey of self- discovery, using the Roadtrip Nation multimedia materials and the Interview Archive to explore the world and better understand their own passions and interests. Built around three overarching themes, Exposure, Self Construction, and Hit the Road, the curriculum guides students in exploring options, discovering their interests, setting goals and mapping out a plan for success. With the Interview Archive, students are able to hear directly from the experts - people who have followed their dreams and navigated challenges to attain success in wildly diverse fields. This direct connection with real-life experience, whether through watching taped interviews or by conducting their own, gives students a map for getting from one stage to the next in their own lives. This combination of the Interview Archive and the real world experiential learning and EXHIBIT A SVI-I 1521242 11 reflective exercises provides students with unprecedented exposure to pathways that are relevant to their individual hopes and dreams. By hearing success stories from a variety of leaders in different fields, students will benefit from multiple perspectives that they wouldn't otherwise have in their transition from youth to adulthood. Many programs have job-shadowing components, but the Roadtrip Nation Experience provides students with the chance to hear from a broad range of adults, not just one or two, through experiential learning programs and the vast Interview Archive. Additionally, the Roadtrip Nation Experience offers students the opportunity to interact with leaders of their choice, which fosters a high level of student "buy in" and keeps the activities relevant to the students' own interests. Roadtrip Nation Santa Ana WORK Center Concept: Roadtrip Nation will partner with Santa Ana WORK Center to implement the locally-based Roadtrip Nation Experience curriculum and build a range of support activities to drive youth engagement. Activities Breakdown: The following elements will comprise the Roadtrip Nation- Santa Ana WORK Center rollout: Task Work Description Fee A 1) Roadtrip Nation Curriculum Implementation: $1,813.00 Working with Santa Ana WORK Center, Roadtrip Nation will implement its project-based learning curriculum with 50 youth throughout the 2012-2013 school year. Youth will be guided in building local "Roadtrip Projects" to travel across Orange County and interview a variety of leaders from all walks of life to learn the steps they took to get where they are today. B 2) Training and Support: $6,456.04 To help support and drive fidelity of the program, Roadtrip Nation will host a series of training sessions to provide administrators with on-the-ground implementation information. In addition to the up-front training, Roadtrip Nation will also provide ongoing technology and administrative support to help drive fidelity throughout the term of the implementation. The initial educator training will last 3 hours, during which Roadtrip Nation staff will provide a comprehensive program overview. If necessary, a second session may be scheduled to accommodate all educators. An optional EXHIBIT A SVI-115212v2 12 follow-up training may be scheduled to include instruction on how to use a Bloggie (an easy-to-use video camera, which can be loaned from Roadtrip Nation or purchased at most electronic retail stores), editing tips and tricks or simply a refresher course prior to beginning instruction for the Roadtrip Project. These trainings can be done either at the site location or at the Roadtrip Nation office. Technical support will include Roadtrip Nation's web team preparing and setting up all online educator and youth accounts, as well as offering on-going tech support should there be any technical issues while accessing the websites or online Leader Interview Archive. Administrative support will include direct assistance from the Roadtrip Nation education team for any support that may be needed, such as customized implementation and subscriptions for each educator to weekly teaching tips, a monthly newsletter and educator blog. The online environment also includes many additional educator and student resource links and downloadable materials. C 3) Introduce Roadtrip Nation RV Event: $7740.48 To help drive youth engagement and build community buzz for the program region wide, the signature Roadtrip Nation RV will visit targeted sites where the program is being implemented. This event will showcase past RTN alumni who will share their stories regarding how they built their own Roadtrip Projects, and lessons to help participating Santa Ana WORK Center youth do the same. This first event will serve to introduce Roadtrip Nation to the youth and get them energized about the program and their upcoming Roadtrip Project. EXHIBIT A SV1-115212v2 13 D 4) Final RV Event: $7740.48 The second event will bring the program to a close with a finale celebration to showcase the youth and all of their hard work that they have put into their Roadtrip Projects. Costs: * 50 participating youth (full curriculum materials and online access) * Up-front training and on-going support * 2 Roadtrip Nation events to engage the youth * Total Cost: $23,750 EXHIBIT A svI-1 15212v2 14 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. Roadtrip Nation Org. Grantee/Contractor Organization Signature Mike Marriner Name of Certifying Official Signature 2 2 7 `: Date EXHIBIT B SVI-115212v2 15 DISCLOSURE OF LOBBYING ACTIVITIES Approved by OWiB Complete Ihia form to disclose 3obbying activltlas ptnatrant to 31 U.S,C. 1352 0349.0046 (See reverse for public burden dlscioaure) 1. Type of Federal Action: .2 Status of F?rai Aotlen:' Report Typo: [] a. cmhaat ] o. bidral7arlspphna1le, I] a. Initial aling 1b, grant b. intflalaward b, material change r,. anoparatlve agreement a. post-award For Material Change Only: d. loon year_ quarter a, loan gearantaa date of goal report , f, loan insurance 4.-Name »nd Addreso nt Reporting 4ntlty: ?'?p?'?' u"' 6, If Reporting Entity INo. 4 ks a Subawprdee, Enter Name anal Address C1 Prime ? isubawardes of Prime: Tier _, If known: Congressional Olstrlcl, if known: . Congressional District, If known: E FFcideral Oaparbnent(Aganoy: --.,- -Mil Programm NamegascHptlon: MA Number, if appilcatrim . _ ... ... e.W 9. Fadenrl Action Number, it known; .. . . a . ,. _ %Award Amount, If known; - 10, a. Name and Address of Loaaying? lT.. Individuals Per#arming Sarvicae { htctudhty oldness Entity If differantfrom No. 100) l itindlvlduaf, last ruens, first nsma, Mq: Oast name, first norns, Mb: (attach Coninns9e n Shael{s) SP-LLLA, ffnemaeary) 11. Amount of ayment ( cha a that apply): _ 45, Tyype o Payment (check all that scrjjcly)? $ 0 actual [,I Planned C) a. retainer I? b. one-dine fee L' o, commission 22. Form of Payment (crack all that,applylr [J d. contingerd tee a 0. Mesh © e, deferred Ll b. In-kind; sneaky: naluro__ f. other, Specify: ..Y.._.._? value 14'.8rfef Descdjrgon of 8vrvlaes?f?orfarme3 onto two Parfarmnd and Data{a »f 3arvica, lncludirip offloar(s), employea(s), or Mombar(s) contacted, for payment indicated In horn 11: attach Ccnnnumion Shestfc_) SFULA, Ifneosseary?? ' 15. Continuation Entails) 8P4.LLA attached: JYe% E) No - 16, Signature: - _ _ _ ]Information requested through thin form to Palo odzod by title 11 Print Nams: V.S.C. sootlon1352. Thin dlsdusure of lobbying activities Is a Me: material representation of fact upon watch Warm was placed Telephone Na: Dols: by the her above when tits transaction was. made or entered Into. Thgs disclosure is required pursuant to 31l U,S.C. 1352. This Information will be reported to Irw Congress sern"nbaally and will no available for puNio Inspection. Any person who fails to Ilia the required disclosure shall Im subiao€ to a civil penalty of not less that $10,000 and net more than $160,000 for each such failure. Augrodzed for Local Froproductimi Fsdera( Uaa QnfYt _______,___._?______? Standard Form LLL (Rev. 7.97) EXHIBIT C SVI-115212v2 16 INSTRUCTIONS FOR COMPLETIONOF SF-LLLr DISCLOSURE OF LOHOYING ACTIVITIES This disclosure roan all Nil be completed by the roporlIng entity, whether sub-awardsa or prime Foods? roolplads, altho Indiagoo or tocelpt of a coveted Federal action, or a amoral change ton previous filing, pursuant to line 31 G.C.C. section 1162. The filing of a form Is required for each payment or agrearrenl to make payment to any lobbying entity ror Influencing or uttempting to influence an ogloar br employee of any agency, a Member of Gong man, sit officer or employee of Congress, at on employee of a Wittiest of Congress In connection with a covered Federal action. Use the SF-LL LA Gontinuedon Sheet for additional brionnailon if the space on the term Is Inadequate. Complete all dams first apply for botltthe inltlal filing and material change report. Refer to the Implementing guldrus a published by the Office of Managamont and Durigrt for additional Information. 1. identify the type of covered Federal actlon for which Iobbying activity Is andtor has been secured to lnfluensa the outcome of a covered Federal action. 2. Idanldy inastatus of tho covered Fritterer atilati, 9. Identify the appropriate classlflostion of'tals report. If this to a f i low up raped caused by a matadal r umorl to the Information previously reported, steatite year and quarter In which the change occunad. Enter the date of the last previously subrnthed report by this reporting entity for Hite covered Federal action, 4. Enter the full more, address, city, State and zip code of the reporting entity. Include Congressional Dlstdc4 If known. Check the appropriate ciass+flcatian of rite reporting entity that deslgnolas it it is, or experts to be, a prime or sub-oward rdrdplariL Identify the Her of the sub•awardee, e.g., the that sub?awardee cribs prime Is the fat list, Sub-awards include but are not limited to aukcamracts, sub-granls and centrals awards under grants. 6. If the organization filing the report In item 4 checks "SutR-owai dee,'then enter the full name, address, city. Stara and zip code of Ilia pdme Federal recipient. Include Congressional District, it known. 6. Enter the name of the Federal agency making the eviard or lean commitment, Irlcluds at least end ergnnizationat level below agency name, if Iatown. For axtunpfd, Depadmenr of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (Item 1). If known, enter the hill Catalog of Federal Domestic Assistance (CFDA) numbos'for grants, cooperative agreements, loans, and loan commitments. 8. Enter the most appropriate Federal Wentifyaig number available for the Federal action Ideulflad in Iran) f (a.g„ Request for Propose)(RFP) number, enviiallan for Sid (IFS) hnrnhsr, grant onriouncoment number; the contract, grant, or loan award nambar, the applicatlarttproposal control number Assigned by the Federal agency), Include prefixes, a.g„ `RFP•D[5-90?0137 t" S. Fors covered Federal action wharo there has heart on award or loan commitment by the federal agency, enter the Federal amount of the awardfloan commitment for the prime frilly identllled in Item 4 at G. lg. (a) Erttar the full name, address, shy, State and zip code of the lobbying entity engaged by the reporting entity identified In Item 4 to Influence the covered Federal action. la) Enter ilia fug names of the tndPriduae(e) performing ssnica8, and include fug address itdlfferent from 14 (a). Enter test Name, First Name, and PAIddle Initial (MR). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item tit). Indicate whether the payment has been made (actor!) or will be made (planned). ChooR all boxes tart apply. it this is a material change repot, enter ilia oumunadvo amount of payment. made or planned to be made. 12. Check The appropriate bax(ea), Chock all boxes that aptly, If payment Is (tads tltrougit art lei-kind voinblbuRon. specify the nature and value of the Irv-kind payment. 13. Chock the appropriate box(se). Chock all boxes dial. apply. If other, specify nature. 14, provide a speohfic and detailed dosortpdori of the services that the lobbyist has preformed, or will be expected to perform, and die delete) of any services randarad. Include all preparatory and (stated aodvtty, not just time spent In actual contact with Federal ottlafals. Identify the Federal official($) or employee(s) contacted or the officer(s), employee(s), or Mamber(s) at Congress that were contacted. 15, Dhedc whether or not a SF-ILS.A Continuation 5host(s) is adachod. 16. The cetiifying official shall sign and date the form, print Milner Warne, tied, and telephone number. Aceardin8 to the Paperwork Reduc[kn Aok, as amended, na persona are required to respond So a collse9;#on of tnEannalion unless it displays a veld OMB Central Numadr. Thu valid OM" central numtrer for talc information rollodian Is 0"" fJo, d3M18f1g46. Pubtlo reporting burden far !leis coneclum of rnfarmellon is estimated m oserags 995 rnfnutes per response. Including date for reviewing hsslntcthm" "etching exlsfingdata ssun"n" gainsrinll and mculturing tea data needed, and ootnptottng and revtesving the coiraatfon of tnformailon, 1 W wmmore, regarding the burden estimate or any ataer aspect of this ri lemon of Information, Including suggestions for reducing (Iris burden, to the Grace of Managomont I end Sudgdl, paparv+ork 13aducton pio)eaf (!tilt-4rYld), Washhugion, bC 2415d3. EXHIBIT C SVI-II5212v2 17 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. (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 EXHIBIT C SVI-I15212v2 18 (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. Roadtrip Nation Org. Organization ?-? - 212_ /3 Authorized Signature Date EXHIBIT C SVI-I15212v2 N DIVISION OF EMPLOYMENT SERVICES PLACE OF PERFORMANCE FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS Name: Mike Marriner Name of Contractor: Roadtrip Nation Org. Contractor Number: Date: 1/3/2013 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): 853 W. 17th Street. Unit A, Costa Mesa, Orange, CA 92627 EXHIBIT C SVI-115212v2 20 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 SVi-115212v2 21