Loading...
HomeMy WebLinkAboutWEST HARTFORD PUBLIC LIBRARY 1City of Santa / a 1� Clerk of the Council AGREEMENT TERMINATION FORM 2070 FIR -6 Please complete this form when the attached agreement and6T OF $AN, amendments (if any) are no longer in effect. CLERK 2F Oi Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with Na N-2015-092 was completed on 13(i l u (List all amendments. Use space below if needed.) �C�_ C�C,�-0� Department: Q4 lS" _ 0c) -a Phone/Ext.: COTC Office Use Only 4. 24 NA IL and final payment has been made. Signature: ,S VACAC.A, Vf )AlC4'i Date: 7 4� Revised 10-31-12 N-2015-092 INSURANCE ON FILE VJURK MAY PRiJu- 0 UNTIL INRURANe,:EXPIRES CONSULTANT AGREEMENT CLERK QP GQUNOIt. INCORPORATING INSTITUTE OF MUSEUM o PATE' JUN 1 0 2015 AND LIBRARY SERVICES (IMLS) S 1 LEADERSHIP GRANT REQUIREMENTS THIS AGREEMENT, effective as of the 1" day of December, 2014, by and between West Hartford Public Library, a public entity, (hereinafter "Consultant") and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ('City"). RECITALS A. The City desires to retain West Hartford Public Library as a consultant to collect and archive community memories from new immigrants to the community for the Memories of Migration project. B. The City, as a recipient and grantee of the 2014 Federal Institute of Museum and Library Services (IMLS) IMLS National Leadership Grant Program, desires to enter this Agreement with the Consultant for the expenditure of grant finds in accordance with the General Terms and Conditions for IMLS Discretionary Awards ("IMLS Terms and Conditions") which can be found at: http://w,v" mks. ov/assets/l/assetmanaQer/etc 0414.pdf G. Consultant represents that it is able and willing to provide such services to the City, and will comply with the IMLS Terms and Conditions. D. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES West Hartford Public Library will recruit and train interns to serve for one year, as well as coterie of Teen Historians who will collect community memories from new immigrants to the community and will add the products from these events to the Memories of Migration project website, as set forth in Exhibit A, attached hereto and incorporated herein by reference. 2. COMPENSATION a. For the services provided, West Hartford Public Library will receive Twenty One Thousand Eight Hundred Seventy Dollars ($21,870.00). The largest portion of the grant funds will provide salaries for the Interns and Teen Historians. West Hartford Public Library will provide $21,860.00 in cost sharing as required by the budget approved by IMLS. The City shall also pay reasonable travel costs (limited to transportation, airfare and lodging, if any) for Consultant to perform its services pursuant to this Agreement; no travel costs will be reimbursed to the Consultant as the City will be paying such listed costs directly b. The above -stated compensation to Consultant includes reimbursement for meals and beverages (no alcohol) of $71 per day for up to seven (7) days. Consultant shall submit a reimbursement request form with receipts to City staff in order to be reimbursed, subject to City accounting procedures c. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date first written above and terminate on September 30, 2017, unless terminated earlier in accordance with Section 9, below. The Term of this Agreement may be extended by a writing executed by the City Manager and the City Attorney. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which. Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance which shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, and in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City as evidenced by a separate Additional Insured Endorsement; and (c) contain standard separation of insureds provisions. Bai ess automobyfiai'insurance,ori uivt form, with a c bi single limitof n ess than $1,000,00urrence. Such i ance shall include c ge forowned, - rend non -owned aes. c. 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. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. (iii) Certificates and policies shall state that the policies shall not be cancelled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. e. 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 effect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, which may arise from the direct or indirect operations of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. 7. CONSULTANT'S OBLIGATIONS A. Nondiscrimination. Consultant must comply with the following nondiscrimination statutes and their implementing regulations and must also comply with the requirements of any other nondiscrimination laws which may apply: (a) Title VI of the Civil Rights Act of 1964, as amended (42 U.S.C. §2000 et seq.), which prohibits discrimination on the basis of race, color, or national origin (note: as clarified by Executive Order 13166, the applicant must take reasonable steps to ensure that limited English proficient (LEP) persons have meaningful access to the applicant's programs (see IMLS guidance at 68 Federal Register 17679, April 10, 2003)); (b) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §701 et seq. including §794), which prohibits discrimination on the basis of disability (note: IMLS applies the regulations in 45 CFR Part 1170 in determining compliance with Section 504 as it applies to recipients of Federal assistance); (c) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §1681-83, § 1685-86), which prohibits discrimination on the basis of sex in education programs; and (d) the Age Discrimination in Employment Act of 1975, as amended (42 U.S.C. §6101 et seq.), which prohibits discrimination on the basis of age. B. Debarment and Suspension Grantees are prohibited from doing business with any organization or person (as a recipient, subrecipient, contractor, or key employee) if they have been debarred or suspended by any Federal department or agency. The OMB Guidelines to 4gencies on Governmentwide Debarment and Suspension (Nonprocurement) contained in 2 CFR Part 180 and the corresponding IMLS regulations contained in 2 CFR Part 3185 apply to IMLS grants. The Consultant, as a primary tier participant, is required to comply with 2 CFR Part 180 subpart C (Responsibilities of Participants Regarding Transactions Doing Business with Other Persons) as a condition of participation in the award. The Consultant is also required to communicate the requirement to comply with 2 CFR Part 180 subpart C (Responsibilities of Participants Regarding Transactions Doing Business with Other Persons) to persons at the next lower tier with whom the Consultant enters into covered transactions. C. Drug -Free Workplace The Consultant must provide a drug-free workplace by complying with the requirements in 2 CFR Part 3186 (Requirements for Drug -Free Workplace (Financial Assistance)). In particular, the Consultant must comply with drug-free workplace requirements in subpart B (or subpart C, if the recipient is an individual) of 2 CFR Part 3186. This includes, but is not limited to: making a good faith effort, on a continuing basis, to maintain a drug-free workplace; publishing a drug-free workplace statement; establishing a drug- free awareness program for the Consultant's employees; taking actions concerning employees who are convicted of violating drug statutes in the workplace; and identifying (either at the time of application or upon award, or in documents the Consultant keeps on file in its offices) all known workplaces under the Consultant's Federal awards. D. Trafficking in Persons The Consultant must comply with Federal law pertaining to trafficking in persons. Under 22 U.S.C. §7104(g), any grant, contract, or cooperative agreement entered into by Federal agency and a private entity shall include a condition that authorizes the Federal agency (IMLS) to terminate the grant, contract, or cooperative agreement if the Consultant, subgrantee, contractor, or subcontractor engages in trafficking in persons, procures a commercial sex act, or uses forced labor. 2 CFR Part 175 requires IMLS to include the following award term, which is made a part of these General Terms and Conditions: a. Provisions applicable to a recipient that is a private entity 1. You as the recipient, your employees, subrecipients under this award, and subrecipients' employees may not - i. Engage in severe forms of trafficking in persons during the period of time that the award is in effect; ii. Procure a commercial sex act during the period of time that the award is in effect; or iii. Use forced labor in the performance of the award or subawards under the award. 2. The City, as the awarding agency may unilaterally terminate this award, without penalty, if you or a subrecipient that is a private entity - i. Is determined to have violated a prohibition in paragraph a.1 of this award term; or ii. Has an employee who is determined by the agency official authorized to terminate the award to have violated a prohibition in paragraph a.I of this award term through conduct that is either - A. Associated with performance under this award; or B. Imputed to you or the subrecipient using the standards and due process for imputing the conduct of an individual to an organization that are provided in 2 CFR part 180, "OMB Guidelines to Agencies on Governmentwide Debarment and Suspension (Nonprocurement)," as implemented by IMLS at 2 CFR Chapter XXXI, part 3185. b. Provision applicable to a recipient other than a private entity The City, as awarding agency, may unilaterally terminate this award, without penalty, if a subrecipient that is a private entity - 1. Is determined to have violated an applicable prohibition in paragraph a. l of this award term; or 2. Has an employee who is determined by the agency official authorized to terminate the award to have violated an applicable prohibition in paragraph a.I of this award term through conduct that is either - i. Associated with performance under this award; or ii. Imputed to the subrecipient using the standards and due process for imputing the conduct of an individual to an organization that are provided 2 CFR part 180, "OMB Guidelines to Agencies on Governmentwide Debarment and Suspension (Nonprocurement)," as implemented by our agency at 2 CFR part 3185. c. Provisions applicable to any recipient 1. You must inform the City immediately of any information you receive from any source alleging a violation of a prohibition in paragraph a.I of this award term. 0 2. The City has the right to terminate unilaterally that is described in paragraph a.2 or b of this section: i. Implements section 106(g) of the Trafficking Victims Protection Act of 2000 ("TVPA"), as amended (22 U.S.C. §7104(g)), and ii. is in addition to all other remedies for non-compliance that are available to the City under this award. 3. You must include the requirements of paragraph a.I of this award term in any subaward you make to a private entity. E. Definitions For purposes of this award term: 1. "Employee" means either: i. An individual employed by you or a subrecipient who is engaged in the performance of the project or program under this award; or ii. Another person engaged in the performance of the project or program under this award and not compensated by you including, but not limited to, a volunteer or individual whose services are contributed by a third party as an in-kind contribution toward cost sharing or matching requirements. 2. "Forced labor" means labor obtained by any of the following methods: the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery. 3. "Private entity": i. Means any entity other than a State, local government, Indian tribe, or foreign public entity, as those terms are defined in 2 CFR 175.25. ii. Includes: A. A nonprofit organization, including any nonprofit institution of higher education, hospital, or tribal organization other than one included in the definition of Indian tribe at 2 CFR 175.25(b). B. A for-profit organization. 4. "Severe forms of trafficking in persons," "commercial sex act," and "coercion" have the meanings given at section 103 of the TVPA, as amended (22 U.S.C. §7102). F. Federal Debt Status The Consultant should not be delinquent in the repayment of any Federal debt. G. Lobbying The Consultant may not conduct political lobbying within the Federally -supported project. In addition, the Consultant may not use Federal funds for lobbying specifically to obtain awards, extensions, amendments, or other Federal actions. (31 U.S.C. §1352) Certain other lobbying restrictions, such as the following, may also apply: Lobbying Activities (Applies to Applicants Requesting Funds in Excess of $100,000) (31 U.S.C. §1352). The following provisions remain in effect for the award: (a) No Federal appropriated funds may be paid, by or on behalf of the Consultant, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal 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. (b) If any funds other than Federal appropriated funds have been paid or will be paid to any person (other than a regularly employed officer or employee of the applicant, as provided in 31 U.S.C. §1352) 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 Consultant shall complete and submit Standard Form LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. (c) The Consultant shall require that the language of the certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. In addition, no IMLS grant funds shall be used to pay the salary or expenses of any grant or contract recipient, or agent acting for such recipient, relating to any activity designed to influence legislation or appropriations pending before the Congress or any State legislature. (P.L. 111-117, Division D, Title V General Provisions, sec. 503(b)). S. ASSIGNABILITY None of the duties of, or work to be performed by, Consultant under this Agreement shall be subcontracted or assigned to any agency, consultant, or person without the prior written consent of City. Consultant must submit all subcontracts and other agreements that relate to this Agreement to City. No subcontract or assignment shall terminate or alter the legal obligations of Consultant pursuant to this Agreement. 9. TERMINATION A. This Agreement may be terminated on thirty (30) days' written notice by either party. In the event of such termination, Consultant shall only be entitled to reimbursement for approved expenses incurred to the effective date of termination. B. This Agreement may be suspended or terminated by City upon five (5) days' written notice for violation by Consultant of Federal Laws governing the use of the IMLS grant funds. In the event of such suspension or termination, Consultant shall only be entitled to reimbursement for approved expenses incurred up to the effective date of suspension or termination. C. In the event Consultant defaults by failing to fulfill all or any of its obligations hereunder, City may declare a default and termination of this Agreement by written notice to Consultant, which default and termination shall be effective on a date stated in the notice which is to be not less than ten (10) days after certified mailing or personal service of such notice, unless such default is cured before the effective date of termination stated in such notice. If terminated for cause, City shall be relieved of further liability or responsibility under this Agreement, or as a result of the termination thereof, including the payment of money, except for payment for approved expenses incurred for services satisfactorily and timely performed prior to the mailing or service of the notice of termination, and except for reimbursement of (1) any payments made for services not subsequently performed in a timely and satisfactory manner, and (2) costs incurred by City in obtaining substitute performance. 10. This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 11. VALIDITY The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any other provision of this Agreement. 12. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by facsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, California 92702-1988 Facsimile (714) 647-6956 Copies to: Parks, Recreation and Community Services Agency City of Santa Ana 20 Civic Center Plaza (M-23) P.O. Box 1988 Santa Ana, California 92702 Facsimile (714) 571-4221 City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 Facsimile (714) 647-6515 To Consultant: Patricia Holloway — Library Director West Hartford Public Library 20 South Main Street West Hartford, CT 06107-2406 Facsimile (860) 561-6950 13. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify Agency fully, including reasonable costs and attorney's fees, for any injuries or damages to Agency in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. c. No delay or omission by either party hereto to exercise any right or power accruing upon any noncompliance or default by the other party with respect to any of the terms of this Agreement shall impair any such right or power or be construed to be a waiver thereof. A waiver by either of the parties hereto of any of the covenants, conditions, or agreements to be performed by the other shall not be construed to be a waiver of any succeeding breach thereof or of any other covenant, condition or agreement herein contained. 10 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: Maria D. Huizar City Clerk APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: Lac L~ Lisa Storck Assistant City Attorney RECOMMENDED FOR APPROVAL: Gerardo Monet Executive Director Parks, Recreation and Community Services Agency 11 CITY OF SANTA ANA a Davi Cavazos City Manager CONSULTANT West Hartford Public Library By: V Patricia Holloway Library Director EXHIBIT A MCI]TD11 Memories of Migration Partners West Hartford Public Library (Consultant) will utilize the Santa Ana Public Library's Teen Historian model to provide a number of memory workshops. They will recruit and train two interns to serve for one year, as well as a coterie of Teen Historians who will collect community memories from immigrants to the community. Staff will translate the Santa Ana Public Library jumpkit materials into the appropriate languages for the immigrants being interviewed. Consultant will conduct a series of collection events during the summer and fall of 2016, and will add the products from these events to the Memories of Migration project website and the Historypin Archive. Consultant will provide reports and evaluations as required by the Institute of Museum and Library Services grant. For these deliverables, West Hartford Public Library will receive $21,870.00. The largest portion of the grant funds will provide salaries for the interns and Teen Historians. West Hartford Public Library will provide $21,860.00 in cost sharing as required by the budget approved by IMLS. 12 Client#: 160973 WESTHART ACORD. CERTIFICATE OF LIABILITY INSURANCE F-DATF CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 3/19/2/DDnvrr) 3/19/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER CONTACT NAME: USI Southwest PHONE 713 490-4600 A Est: alc, Not,713.490.4700 Three Memorial City a MAIC°' 840 Gessner, Suite 600 ADDRESS: EACH OCCURRENCE $1 000000 INSURERS) AFFORDING COVERAGE NAIC# Houston, TX 77024 INSURERA: Gemini Insurance Company 10833 INSURED INSURER B: Safety National Casualty Corp 15105 Town of West Hartford 50 South Main Street INSURER C: West Hartford, CT 06107 INSURER D: INSURER E: INSURER F: MED EXP (Any one person) COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DOIYYYY POLICY EXP MMIDDfYYYYJ LIMITS A GENERAL LIABILITY PEMOOOOOOG02 07/01/2014 07/01/2016 EACH OCCURRENCE $1 000000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence S X CLAIMS -MADE Al OCCUR MED EXP (Any one person) $ PERSONAL&ADV INJURY $ X $250,000r�yv� Retained limit GENERAL AGGREGATE $1,000,000 pp��� "y �Q/v \G✓�" q�j GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ POLICY PRO ECT LOC $ AUTOMOBILE LIABILITY /+ arj .O M INEDI SINGLE LIMIT $ BODILY INJURY (Per person) $ ANY AUTO \,J�e ALL OWNED SCHEDULED HIRED SAUTOS AUTOS S�`v,ac P ((jj CC�� PC's` J ,y�r.� \"," BODILY INJURY (Per accident) $ Parreccident AMAGE $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ E%CESS LIAB CLAIMS -MADE DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY/N OFFICERIMEMBER EXCLUDED? L N]NIA SP4051177 07/01/2014 07/01/201 XWC STATU-ORTH- E.L EACH ACCIDENT $1,000000 E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS belaw E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Effective Date: March 19, 2015 Description: Consultant Agreement- Institute of Museum and Library Services (IMLs) Leadership Grant The City of Santa Ana, its officers, employees, agents and representative are named as Additional Insured with respects to the General Liability, where required by written contract. City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1464981SIM12856917 BZLHA ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. GENERAL AMENDATORY ENDORSEMENT Named Insured: Town of West Hartford and West Hartford Board of Education Policy Number Endorsement Effective Date Endorsement Number PEM 0000006-02 March 23, 2015 15 POLICY FORM OR COVERAGE PART(S) AFFECTED PUBLIC ENTITY RETAINED LIMITS POLICY SCHOLASTIC ENTITY RETAINED LIMITS POLICY ITEM(S) AFFECTED: ® Endorsement #14 —Additional Insured — Designated Person or Organization 1-1 THE ITEM(S) CHECKED ABOVE ARE CHANGED AS FOLLOWS: Endorsement #14 — Additional Insured — Designated Person or Organization is deleted in its entirety and replaced with endorsement #16 - Additional Insured — Designated Person or Organization. PREMIUM CHARGED: $0.00 All other terms and conditions of the policy remain unchanged. day. ue�as ,d��a G pdn"�• = GSpJ Page 1 of 1 Authorized Representative a W.R. BERKLEY COMPANY CEN 1022 05/12 ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. ADDITIONAL INSURED- DESIGNATED PERSON OR ORGANIZATION Policy Number Endorsement Effective Date Endorsement Number PEM 0000006-02 March 23, 2015 16 This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE PART PUBLIC ENTITY RETAINED LIMITS POLICY SCHEDULE Name of additional insured person(s) or organizatiori The City of Santa Ana, its officers, employees, agents, and representative are named with respect to services provided as Consultant forthe Institutes of Museum and Library Services Leadership Grant. $1,000,000 Occurrence Limit $1.000.000 Aggregate With respect to the General Liability Coverage Part only, it is agreed that Definition 20. Insured, contained in the Common Conditions, Definitions and Exclusions is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule but only with respect to liability for bodily injury, property damage, personal injury, or advertising injury caused in whole or in part, by acts or omissions of the named insured or the acts or omissions of those acting on behalf of the named insured: A. In the performance of the ongoing operations of the named insured; or B. In connection with the named insured's premises owned by or rented to the named insured. If, prior to an occurrence, you have specifically agreed in a written contract to provide primary insurance for any person(s) or organizations (s) shown in the Schedule, this insurance will apply on a primary basis with respect to such occurrence and will not contribute with any other valid and collectible insurance in force for such additional insured. All other terms and conditions of this policy remain unchanged. 6b1'. Authorized Representative Page 1 of 1 a W. R. BERKLEY COMPANY Includes copyrighted material of Insurance Services Office Inc. with its permission. PEN1008 01/15 Client`: 160973 WESTHART DATE (MMIDDIYYYY) ACORDT. CERTIFICATE OF LIABILITY INSURANCE 11/17/2016 1 13YY17 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE, DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. 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). PRODUCER CONTACT NAME, USI Southwest PHONE (AIC, Na,„NE111): 713 490-4600 713-490-4700 Three Memorial City E-MAIL 840 Lessner, Suite 600 ADDRESS: .... ....... . ..... 07101/2016�07/01/2017 1 NSURER(S) AFFORDING COVERAGE NAIC # Houston, TX 77024, INSURER A: Gemini Insurance Company 10833 INSURED INSURERS Safety National Casualty Corp 15105 Town of West Hartford 50 South Main Street INSURER C! E FRVd,%SIG�.IoccINTurreI nce) West Hartford, CT 061'07 INSURER D: . - - IN SURER E C' IC.;� ,,`'I' INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSIR LTR . ..... . ......... . . ... . . ..... . ...... A dL_SUBR TYPE OF INSURANCE NSR IWVD POLICY NUMBER OLICY EXP APUIDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY PEM000000604 07101/2016�07/01/2017 EACH OCCURRENCE S1'0PQ"PPP Fwi CLAIMS -MADE LA I OCCUR E FRVd,%SIG�.IoccINTurreI nce) .. .... ..... MED EXP (Any one person) X X250,00© . .. . .. . ......... PERSONAL & ADV aNJURY S Retained Limit AGGREGATE $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRO- POUCY F7 JECT LOG R .0,GENERAL PRODUCTS-COMP/OP AGG S COMBINED SINGLE LIMIT (Ea accident) $ $ OTHER',: AUTOMOBILE LIABILITY ANY AUTO .. . . . ...... BODILY INJURY (Per person) S BODILY INJURY (Per accident) Per accId nt) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OI HIRED AUTOS AUTOS C. N $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESSLIAB CLAIMS -MADE $ DEC RETENTION S B WORKERS COMPENSATION AND EMPLOYERS LIABILITY YINSTATUTE ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIEMMBER EXCLUDED?KNi (Mandatory in NH) NIA SP4054895 $500,000 SIR 07101/2016 0710112017 XEl CTH- FR E.L EACH ACCIDENT $110 00,000 E.L. DISEASE - EA EMPLOYEE $ 'es Ifdescribe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Effective Date: March 19, 2015 Description: Consultant Agreement- Institute of Museum and Library Services (IMLS) Leadership Grant City of Santa Ana, its officers, employees, agents and representatives are named as additional insured with respects to the General Liability, when required by written contract. City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 ACORD 25 (2014101) 1:1 of 1 #S19305436IM17946798 (;ANUhLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BZLHA ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. ADDITIONAL INSURED- DESIGNATED PERSON OR ORGANIZATION Policy Number Endorsement Effective Date Endorsement Number PEM 0000006-04 July 1, 2016 14 This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE PART PUBLIC ENTITY RETAINED LIMITS, POLICY SCHEDULE Name of additional insured person(s) or organ ization(s): The City of Santa Ana, its officers, employees, agents, and representative are named with respect to services provided as Consultant for the Institutes of Museum and Library Services Leadership Grant. $1,000,000 Occurrence Limit $1,000,000 Aggregate With respect to the General Liability Coverage Part only, it is agreed that Definition 20. Insured, contained in the Common Conditions, Definitions and Exclusions is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule but only with respect to liability for bodily injury, property damage, personal injury, or advertising injury caused in whole or in part, by acts or omissions of the named insured or the acts or omissions of those acting on behalf of the named insured: A. In the performance of the ongoing operations of the named insured; or B. In connection with the named insured's premises owned by or rented to the named insured. If, prior to an occurrence, you have specifically agreed in a written, contract to provide primary insurance for any person(s) or organizations (s) shown in the Schedule, this insurance will apply on a primary basis with Page 1 of 1 a W, R, BERKLEY COMPANY Includes copyrighted material of Insurance Services Office Inc. with its permission. PEN1008 01:1/15 A respect to such occurrence and will not contribute with any other valid and collectible insurance in force for such additional insured. All other terms and conditions of this policy remain unchanged. Authorized Representative Page 2 of I a W R. BERKLEY COMPANY Includes copyrighted material of Insurance Services Office Inc. with its permission. PEN 1008 01/15 Joe Client#: 160973 WESTHART DiYYYY) ACORD,. CERTIFICATE OF LIABILITY INSURANCE =17 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ....... . .. . ....... . . . . . ......... I dkfARt: If the hOide'r is -an—ADDITIONAL INSURED, the policy(ies) must be endorsed, 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). PRODUCER CON A T _NAME: USI Southwest PHONE _(AYCNo Ext): 713.4907 -4600 713-490�-4700 9811 Katy Freeway, Suite 500. . ...... .. .... Houston, TX 77024 APPR) S.;__ . .... .. ................... .... .. . . . ..... ........ 713 490-4600 INSURERS)AFFORDING COVERAGE NAIC # ­_­.....- . . ....... INSURER A : Geruinf Insurance Company 10833 INSURED . .... . , �' C' Town of West Hartford � D, 50 South Main Street West Hartford, CT 06107 > COVERAGES CERTIFICATE NUMBER: INSURER 8 :Safety National Casualty Corp 15105 INSURER.. C INSURER D REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITIONI OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I$ SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -,- ___ — — --__ — - - -_ - _-- -- IINSR ADDL SUB LTR TYPE OF INSURANCE WVD POLICY NUMBER . . . . . .. . ......... . . ............. . .................................... . .. POLICY EFF POLICY EXP (MMfDDfYYYYJ (MMiDMYYYY) LIMITS A _.—INSR X COMMERCIAL GENERAL LIABILITY PEMOO4'000'605 07/011/2017 07/0112018 EACHOCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE R ENTED PREMISES E S . X $250,000 ... ..... . ........... . . . .. .................. MED EXP (Any one person) $ PERSONAL & ADV INJURY ...... ._._.m ....... ....... . .... ......... $ - .... . .... . . .................. Retained Limit . .... ... .. . ...................... ... GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $11,000,000 PRO - 17 F7 POLICY JECT LOG PRODUCTS - COMP/OP AGG $ $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident ) $ BODILY INJURY (Per person) $ ANY AUTO I ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per acadent) S NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ 7 UMBRELLA LIAR OCCUR E�9­OCCURRENCE _ $ EXCESS LIAB CLAIMS -MADE .. . ........ .... . . . .... .. .... .. . AGGREGATE ................. $ $ DED� RETENTION S WORKERS COMPENSATION SP4057079 O7/0112017 07101/201 x PER �ORTH- AND EMPLOYERS'LIABILITY . ANYPROPRIETORiPARTNERIEXECLTIVEY"I-N F L EACH ACCIDENT $1,000,000 OFFICEMMEMSFREXCLUDED? N E.L DISEASE - EA EMPLOYEE (Mandatory in NHJ !NIA $500,000 SIR If yes, describe under DESCRIPTION OP OPERATIONS below E.L.DISEASE - POLICY LIMIT' 51,000,000 �16A,, Z AOF DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Effective Date: March 19, 2015 -0� e) Description: Consultant Agreement- Institute of Museum and Library Services (IMLS) Leadershipl�8rant City of Santa Ana, its officers, employees, agents and representatives are named as additional insured wit 0 respects to the Generali Liability, when required by written contract. " City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 ACORD 2'5 (2014/01) 1 of 1 #S21509898,/M21258453 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BZLHA 4 ki 111110] 1"Im 461 `0k This endorsement forms a part of the policy to wh¢clh it is attached. Please read it carefUlly. ADDITIONAL INSURED- DESIGNATED PERSON OR ORGANIZATION Policy Number Endorsement Effective Date Endorsement Number PEM 0000006-05 July 1, 2017 14 This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE PART PUBLIC ENTITY RETAINED LIMITS POLICY SCHEDULE Name of additional insured person(s) or organization(s): The City of Santa Ana, its officers, employees, agents, and representative are named with respect to services provided as Consultant for the institutes of Museum and Library Services Leadership Grant. $1�,000,000 Occurrence Limit $1,000,000 Aggregate With respect to the General Liability Coverage Part only, it is agreed that Definition 20. Insured, contained in the Common Conditions, Definitions and Exclusions is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule but only with respect to liability for bodily injury, property damage, personal injury, or advertising injury caused in whole or in part, by acts or omissions of the named insured or the acts or omissions of those acting on behalf of the named insured: A. In the performance of the ongoing operations of the named insured; or B. In connection with the named insured's premises owned by or rented to the named insured. If, prior to an occurrence, you have specifically agreed in a written contract to provide primary insurance for any person(s) or organizations (s) shown in the Schedule, this insurance will apply on a primary basis with respect to such occurrence and will not contribute with any other valid and collectible insurance in force for such additional insured. All other terms and conditions of this policy remain uncha PL60Yized Representative I of I ------ . ..... a Berkley Company Includes copyrighted material of Insurance Services Office Inc. with its permission. PEN 1008 01/15