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HomeMy WebLinkAboutWISEPLACE (7)-2015A-2015-060-12 ySURANCE ON fit_ WORK MAY PROCE1 'NT11 S N t�ANCE EMERGENCY SOLUTIONS GRANT CLERK OF COUNCIL SUBRECIPIENT AGREEMENT BETWEEN DATE; �\G� THE CITY OF SANTA ANA AND WISE PLACE (24 CFR Parts 91 and 576) TRIS GRANT AGREEMENT, is hereby made and entered into this I' day of July, 2015, by and between the City of Santa Ana, a charter city and municipal corporation of the State of California, herein called the "CITY" and WISE PLACE, a California nonprofit organization, herein called the "SUBRECIPIENT". �r RECITALS: �u 1. The CITY is the recipient of Emergency Solutions Grant ("ESG") funds from the United States Department of Housing and Urban Development ("HUD"), pursuant to subtitle B of title IV of the McICimrey-Vento 8 Homeless Assistance Act [42 U.S.C. 11371-113781, for the rehabilitation or conversion of buildings for use as emergency shelter for the homeless, for the payment of certain expenses related to operating emergency shelters, for essential services a, related to emergency shelters and street outreach for the homeless, and for homelessness prevention and rapid re-housing assistance. Catalogue of Federal Domestic Assistance ("CFDA") 14.231 and Federal Award Identification Number (FAIN) E-15-MC-06-0508. 2. The CITY has approved the provision of federal funds under the ESG to be used in the operation of an emergency solutions program ('program") for the homeless or at-risk of homelessness of the City of Santa Ana as further described by Exhibit A, Scope of Work, attached hereto and by this reference incorporated herein. 3. The SUBRECIPIENT represents that it has the requisite qualifications, expertise, and experience in the provision of emergency solutions programs for the homeless or at-risk of homelessness and is willing to use said federal funds to operate said program. 4. The SUBRECIPIENT agrees to assist individuals and families that are homeless or at risk of homelessness in obtaining appropriate supportive services including, but not limited to: temporary and permanent housing, relocation and stabilization services, rapid re -housing assistance, medical and mental health treatment, counseling supervision, and other services essential for achieving independent living, as well as other federal, state, local and private assistance available for such individuals. 5. The SUBRECIPIENT has agreed to be reimbursed for the above services in an amount not to exceed $23,750 in grant finding. 6. This AGREEMENT is contingent upon the award of Emergency Solutions Grant funds from the United States Department of Housing and Urban Development. 7. The CITY and the SUBRECIPIENT have duly executed this AGREEMENT for the expenditure and utilization of said fiends. 14 NOW THEREFORE, it is agreed by and between the parties that the foregoing Recitals are a substantive part of this AGREEMENT and the following terms and conditions are approved and together with all exhibits and attachments hereto, shall constitute the entire AGREEMENTbetween the CITY and the SUBRECIPIENT: I. SCOPE OF PROGRAM A. General Administration The SUBRECIPIENT agrees to implement this activity as set forth in detail in Exhibit A, Scope of Work, which shall provide a description of each activity, including the services to be performed, the person or entity providing the service, the estimated number of recipients of the service, and the manner and means of the services. B. Levels of Accomplishment —Goals and Performance Measures The SUBRECIPIENT shall be responsible to accomplish the levels of performance as set forth in Exhibit A and report such measures quarterly to the CITY. If the SUBRECIPIENT estimates such goals will not be met, the SUBRECIPIENT is to contact the CITY, at which time the CITY will determine if any adjustments to the grant award is appropriate. C. Staffing The SUBRECIPIENT shall ensure adequate and appropriate staffing is allocated to each ESG activity. Nothing contained in this AGREEMENT is intended to, or shall be construed in any manner, as creating or establishing the relationship of employer/employee between the parties. II. TERM OF AGREEMENT This AGREEMENT shall take effect on July 1, 2015, and shall terminate on June 30, 2016, unless otherwise cancelled or modified according to the terms of this AGREEMENT. III. DISBURSEMENT AND FUNDS The City was allocated $495,617 in Emergency Solutions Grant funds under the McKinney-Vento Homeless Assistance Act for fiscal year 2015-2016 from the Department of Housing and Urban Development. CITY agrees to pay to SUBRECIPIENT when, if and to the extent federal funds are received under provisions of the Act a sum not to exceed $23,750 for SUBRECIPIENTS performance in accordance with the Budget attached hereto as "Exhibit B" during the period of this Agreement. Said sum shall be paid after CITY receives invoices submitted by SUBRECIPIENT as provided hereinabove. A. Amount and Expenditure End Date The CITY agrees to reimburse the SUBRECIPIENT a maximum amount not to exceed $23,750 from Emergency Solutions Grant (ESG) funds, as outlined in Exhibit B, Final Budget, and such funds shall be expended by the SUBRECIPIENT on or before June 30, 2016. SUBRECIPIENT has the ability to adjust line item amounts in the Budget with the written approval of the CITY's Executive Director of the Community Development Agency, so long as the total Budget amount does not increase. B. Invoicing Procedures The SUBRECIPIENT shall submit quarterly invoices (on or before the 15th day of October, January, April, and July) in a form prescribed by the CITY, detailing such expenses. Such schedule may be modified with the approval of the CITY. C. Payment Payment is subject to the receipt and approval of such invoices and quarterly activity reports, as hereinafter more fully set forth below under Reporting, with the final payment subject to the satisfaction of the condition precedent of submittal of complete invoicing and reporting information due on or before July 15 of the applicable funding year. The CITY shall pay such invoices within thirty (30) days after receipt thereof, provided the CITY is satisfied that such expenses have been incurred within the scope of this AGREEMENT and that the SUBRECIPIENT is in compliance with the terms and conditions of this AGREEMENT. The thirty (30) day period will discontinue if the reimbursement request is determined to be incomplete and will restart the thirty day timeline once the remaining required elements have been submitted. Failure to provide any of the required documentation and reporting will cause the CITY to withhold all or a portion of a request for reimbursement until such documentation and reporting has been received and approved by the CITY. D. Use of Funds The SUBRECIPIENT agrees to use said funds pursuant to this AGREEMENT to pay for necessary and reasonable costs allowable under federal law and regulations to operate said program only. Said amounts shall include and will be limited to, street outreach, emergency shelter, homelessness prevention, rapid re -housing assistance, housing relocation and stabilization services, short-term and medium-term rental assistance, and Homeless Management Information Systems ("HMIS") data contribution as set forth in 24 CFR § 576.101 — § 576.107. Allowable program costs are detailed in the Budget, as set forth in Exhibit B, attached hereto and by this reference incorporated herein. The SUBRECIPIENT'S failure to perform as required may, in addition to other remedies set forth in this AGREEMENT, result in readjustment of the amount of funds the CITY is otherwise obligated to pay to the SUBRECIPIENT pursuant to the terms hereof. The SUBRECIPIENT agrees that the homeless shelter/services under said program shall be available for the entire period during which said funds are provided. E. Condition of Funding (1) The CITY advises the SUBRECIPIENT that a significant change in entitlement funding may result in a change in the current process utilized by the CITY to determine funding allocations. The SUBRECIPIENT acknowledges that the obligation of the CITY is contingent upon the availability of Federal, State or Local government funds, which are appropriated or allocated for the payment of such an obligation. If funding levels are significantly affected by Federal budgeting or if funds are not allocated and available for the continuance of the function performed by the SUBRECIPIENT, this AGREEMENT may be terminated by the CITY at the end of the period for which funds are available. At the earliest opportunity, the CITY shall notify the SUBRECIPIENT of any service which may be affected by a shortage of funds. No penalty shall accrue to the CITY in the event this provision is exercised and the CITY shall not be liable for any damages as a result of termination under this provision of this AGREEMENT. Nothing herein shall be construed as obligating the CITY to expend funds in excess of appropriations authorized by law. (2) The SUBRECIPIENT shall allow representatives of the CITY or HUD to inspect facilities which are used in connection with the AGREEMENT or which implement programs funded under this AGREEMENT. F. Matching The SUBRECIPIENT is required to make matching contributions to supplement the ESG program in an amount that equals or exceeds the amount of ESG funds provided by HUD through the CITY. Such contributions shall be entirely consistent with the Matching Requirements as outlined by 24 CFR § 576.201. The anticipated source and 3 amount of all matching funds contributed by the SUBRECIPIENT will be enumerated in Exhibit B, Final Budget. G. Program Income (1) Definition. Program income means, as provided by 2 CFR 200.80, gross income received by the SUBRECIPIENT directly generated by a grant supported activity, or earned only as a result of the grant agreement during the grant period. For purposes of ESG, program income will also include any amount of a security or utility deposit returned to the SUBRECIPIENT. (2) Use. The SUBRECIPIENT shall use all income received from said funds only for the same purposes for which said funds may be expended pursuant to the terms and conditions of this AGREEMENT. (3) Counts toward Matching. Costs paid by program income may count toward meeting the matching requirements, provided the costs are eligible ESG costs that supplement the program. H. Separation of Accounts All funds received by the SUBRECIPIENT from the CITY pursuant to this AGREEMENT shall be maintained separate and apart from any other funds of the SUBRECIPIENT, or of any principal or member of the SUBRECIPIENT, in an account (the "Account') at a federally insured banking or savings and loan institution with record keeping of such Accounts maintained pursuant to applicable legal requirements. The SUBRECIPIENT shall keep all records of the Account in a manner that is consistent with generally accepted accounting principles. No monies shall be withdrawn from the Account except for expenditures relating to essential services, homeless prevention, and/or operations costs, as authorized hereunder. All disbursements from the Account shall be for obligations incurred in the performance of this AGREEMENT and shall be supported by contracts, invoices, vouchers, and other data, as appropriate, evidencing the necessity of such expenditure. The CITY may withhold payment allocation requests if the SUBRECIPIENT fails to comply with the above requirements until such compliance is demonstrated. I. Expenditure of Funds Much like how HUD requires the CITY, pursuant to 24 CFR 576.203, to expend all of the grant funds for eligible activity costs within 24 months after the date that HUD signs the grant agreement with the CITY, it is a requirement for the SUBRECIPIENT to expend all of the grant funds for eligible activity costs within the aforementioned period. For the purposes of this paragraph, expenditure means either an actual cash disbursement for a direct charge for a good/service or an indirect cost, or the accrual of a direct charge for a good/service or an indirect cost. Failure to expend said funds within said timeframe can result in a reallocation of funds. Prohibited Use (1) Generally. The SUBRECIPIENT hereby certifies and agrees that it will not use funds provided through this AGREEMENT to pay for meals for persons other than those identified as homeless or at risk of homelessness. Said funds shall not be used for entertainment purposes or for gifts. The SUBRECIPIENT certifies that it will not use said funds for illegal or dishonest conduct, rather, fund use will remain in compliance with all applicable federal, state, and local laws, including applicable laws not outlined in this AGREEMENT. (2) Lobbying. The SUBRECIPIENT certifies and agrees that it will comply with federal law (31 U.S.C. 1352) and regulations found at 24 CFR Part 87, 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 FUN V, 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. The SUBRECIPIENT shall sign a certification to that effect in a form as set forth in Exhibit C, attached hereto and by this reference incorporated herein. The SUBRECIPIENT shall submit said signed certification to the CITY prior to performing any of its obligations under this AGREEMENT and prior to any obligation arising on the part of the CITY to pay any sums to the SUBRECIPIENT under the terms and conditions of this AGREEMENT. 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 a "Disclosure Form to Report Lobbying," in accordance with its instructions (see Exhibit D). NOTICES The SUBRECIPIENT and the CITY agree that all notices required by this AGREEMENT shall be made in writing and delivered via mail (postage prepaid); commercial courier; personal delivery; or sent by facsimile or other electronic means (provided that receipt is confirmed). Any notice delivered or sent as aforesaid shall be effective on the date of delivery or sending. All notices and other written communications under this AGREEMENT shall be addressed to the individuals in the capacities indicated below, unless modified by subsequent written notice. Communication and details concerning the AGREEMENT shall be delivered to the office of, and directed to, the following representatives: CITY Terri Eggers Sr. Community Development Analyst City of Santa Ana Community Development Agency (M-25) 20 Civic Center Plaza P.O. Box 1988 Santa Ana, CA 92702-1988 (714) 647-5378 (714) 647-6549 FAX teggers@i�santa-ana.org GENERAL CONDITIONS A. Coordination with Continuum of Care SUBRECIPIENT: Kathleen Davis Bowman Executive Director WISE Place 1411 North Broadway Santa Ana, CA 92706 714-542-3577 714-542-3653 The SUBRECIPIENT must work with the Continuum of Care ("CoC") to ensure the screening, assessment, and referral of program participants are consistent with the CITY's written standards for providing ESG assistance as described in its consolidated plan. The SUBRECIPIENT must keep documentation evidencing the use of, and written intake procedures for, the centralized or coordinated assessment system(s) developed by the CoC in accordance with the requirements established by HUD. See 24 CFR 576.400. B. Evaluation of Program Participants Eligibility and Needs The SUBRECIPIENT must conduct evaluations and re-evaluations to determine the eligibility of each individual or family's eligibility for ESG assistance in accordance with 24 CFR 576.401. C. Terminating Assistance If a program participant violates program requirements, the SUBRECIPIENT may terminate the assistance in accordance with a formal process established by the SUBRECIPIENT that recognizes the rights of individuals affected. See 24 CFR 576.402 D. Shelter and Housing Standards The SUBRECIPIENT certifies that shelters and housing supported by ESG funds and used by ESG beneficiaries will conform to 24 CFR 576.403. E. Homeless Involvement The SUBRECIPIENT certifies that it will involve, to the maximum extent practicable, homeless individuals and families in constructing, renovating, maintaining, and operating facilities assisted under the ESG program, and in providing services for occupants of these facilities. See 24 CFR 576.405(c) and 42 USC 11375(d). F. Independent Contractor Nothing contained in this AGREEMENT is intended to, or shall be construed in any manner, as creating or establishing the relationship of employer/employee between the parties. The SUBRECIPIENT and its subcontractors shall at all times remain independent contractors with respect to the services to be performed under this AGREEMENT. The CITY shall be exempt from payment of any Unemployment Compensation, FICA, retirement, life and/or medical insurance and Workers' Compensation Insurance as the SUBRECIPIENT is an independent contractor. G. Subcontracts (1) Content Requirements. The SUBRECIPIENT will include all relevant provisions of this AGREEMENT in all subcontracts entered into as part of the activities undertaken in furtherance of this AGREEMENT and will take appropriate action pursuant to any subcontract upon a finding that the subcontractor is in violation of regulations issued by any federal agency. The SUBRECIPIENT will not subcontract with any entity where it has notice or knowledge that the latter has been found in violation of regulations under 24 CFR Part 135 (Economic Opportunities for Low- and Very Low -Income Persons) and will not allow any subcontract unless the entity has first provided it with a preliminary statement of ability to comply with the requirements of these regulations. (2) Submission to the CITY. The SUBRECIPIENT must submit all subcontracts and other agreements that relate to this AGREEMENT to the CITY. H. Licensing The SUBRECIPIENT agrees to obtain and maintain all required licenses, registrations, accreditation, and inspections from all agencies governing its operations. The SUBRECIPIENT shall ensure that its staff and subcontractors shall also obtain and maintain all required licenses, registrations, accreditation and inspections from all agencies governing the SUBRECIPIENT's operations hereunder. Such licensing requirements include obtaining a City business license, as applicable. 1. Responsibilities Toward Employee The SUBRECIPIENT accepts full responsibility for payment of any and all unemployment compensation, insurance premiums, workers' compensation premiums, income tax withholdings, social security withholdings, and any and all other taxes or payroll withholdings required for all employees engaged in the performance of the work and activities authorized by the AGREEMENT. The SUBRECIPIENT accepts full responsibility for providing workers with proper safety equipment and taking any and all necessary precautions to guarantee the safety of workers or persons otherwise affected. J. Insurance and Bonding (1)Generally. The SUBRECIPIENT shall maintain liability and property insurance to cover actionable legal claims for liability or loss which are the result of injury to or death of any person, or damage to property (including property of Grantee) caused by the negligent acts or omissions, or negligent conduct of the SUBRECIPIENT, its employees, agents or subcontractors, to the extent permitted by law, in connection with the activities pursuant to this AGREEMENT. The SUBRECIPIENT shall comply with the bonding and insurance requirements of 2 CFR 200.427, and 2 CFR 200.447. The SUBRECIPIENT shall undertake self-insurance, or shall obtain, at its sole cost, a policy or policies of commercial general liability insurance, or equivalent form. Such insurance shall: (1) name the City of Santa Ana, its officers, agents, employees and volunteers as additional insureds; (2) be primary with respect to insurance or self-insurance programs maintained by the CITY; (3) contain standard separation of insureds provisions; and (4) give to the CITY prompt and timely notice of claim made or suit instituted arising out of the SUBRECIPIENT's operations hereunder. (2) Limits. The SUBRECIPIENT shall maintain, at all times, the following minimum levels of Insurance, and shall, without in any way altering its liability, obtain, pay for, and maintain insurance for the coverages and amounts of coverage not less than those set forth below: a. Workers' Compensation. Amount must comply with State and Federal Laws b. Comprehensive General Liability. $1,000,000 combined single limit of liability for bodily injuries, death, and property damage resulting from any one occurrence, including the following coverages: Premises and Operations; and ii. Broad Form Commercial General Liability Endorsement to include blanket contractual liability (specifically covering, but not limited to, the contractual obligations assumed by the SUBRECIPIENT); Personal Injury (with employment and contractual exclusions deleted); and Broad Form Property Damage coverage. C. The SUBRECIPIENT's self-insured retention or deductible per line of coverage shall not exceed $25,000 without the permission of the CITY. (3) Proof of Insurance. The SUBRECIPIENT shall furnish the CITY's Cleric of the Council with an insurance certificate from insurance carrier certifying that it carries such insurance and that the policy shall not be canceled nor the coverage reduced except upon thirty (30) days prior notice to the CITY. The SUBRECIPIENT shall, prior to exercising any right under this AGREEMENT: a. furnish properly executed certificates of insurance and additional insured endorsement to the CITY which shall clearly evidence all coverage required above; b. provide that such insurance shall not be materially changed or terminated except on thirty (30) days prior written notice to the CITY; c. maintain such insurance for the period covered by this AGREEMENT; and d. replace such certificates for policies expiring prior to the expiration of this AGREEMENT. (4) Company Rating. All insurance coverage shall be written with a company having an A.M. Best Rating of "A" or better and financial size of VIII or larger. (5) Failure to Comply. In the event of any failure by the SUBRECIPIENT to comply with these provisions, the CITY may, after notice to the SUBRECIPIENT, suspend the program for cause until there is full compliance. K. Zoning. The SUBRECIPIENT agrees that any facility/property used in furtherance of said program shall be specifically zoned and permitted for such use(s) and activity(ies). Should the SUBRECIPIENT fail to have the required land entitlement and/or permits, thus violating any local, state, or federal rules and regulations relating thereto, the SUBRECIPIENT shall immediately make good -faith efforts to gain compliance with local, state, or federal rules and regulations following written notification of said violation(s) from the CITY or other authorized citing agency. The SUBRECIPIENT shall notify the CITY immediately of any pending violations. Failure to notify the CITY of pending violations, or to remedy such known violation(s), shall result in termination of grant funding hereunder. The SUBRECIPIENT must make all corrections required to bring the facility/property into compliance with the law within sixty (60) days of notification of the violation(s); failure to gain compliance within such time shall result in termination of grant funding hereunder. L. Displacement and Relocation. The SUBRECIPIENT must assure that it has taken all reasonable steps to minimize displacement of persons. Relocation must be consistent with requirements as set forth in 24 CFR § 576.408. M. Provisions Required by Law Deemed Inserted. Each and every provision of law and clause required by law to be inserted in this contract shall be deemed to be inserted herein and the AGREEMENT shall be read and enforced as though it were included herein, and if through mistake or otherwise any such provision is not inserted or correctly inserted, then upon the application of either party the contract shall forthwith be physically amended to make such insertion or correction. VI. ASSURANCES AND CERTIFICATIONS A. Non -Profit Status The SUBRECIPIENT certifies that: (1) The SUBRECIPIENT is a duly organized and existing non-profit corporation in good standing and authorized to do business under the laws of the State of California and in possession of required non-profit status under the United States Internal Revenue Code [for example, 26 USC § 501(c)(3)]. The SUBRECIPIENT has full right, power, and lawful authority to accept the funding hereunder and to undertake all obligations as provided herein and the execution, performance, and delivery of this AGREEMENT by the SUBRECIPIENT has been fully authorized by all requisite actions on the part of the SUBRECIPIENT. (2) If the SUBRECIPIENT's non-profit status changes at anytime during this AGREEMENT, it will advise the CITY within 15 days. (3) If the SUBRECIPIENT is a private non-profit, it hereby agrees that the members of its Board of Directors will receive no compensation, directly or indirectly, other than reimbursement for expenses, from any funds generated from or because of the ESG program, for their services. (4) As a non-profit, the SUBRECIPIENT acknowledges that administration of its operation and services are subject to the requirements as established in 2 CFR 200. B. Adherence to Federal, State, and Local Laws and Regulations (1) General. The SUBRECIPIENT agrees to comply with all requirements of the ESG program and applicable cross -cutting Federal, State, and Local requirements. (2) Economic Opportunities for Low- and Very Low-income Persons. The SUBRECIPIENT shall ensure that employment and other economic opportunities generated by the Program shall, to the greatest extent feasible, be directed to low- and very low-income persons, particularly those who are recipients of government assistance for housing. Section 3 of the Housing and Urban Development Act of 1968, 12 U.S.C. 1701u, and regulations at 24 CFR part 135 apply, except that homeless individuals have priority over other Section 3 residents in accordance with § 576.405(c). (3) Civil Rights. The SUBRECIPIENT agrees to comply with Title VI of the Civil Rights Act of 1964, as amended, Title VIII of the Civil Rights Act of 1968, as amended, Section 109 of the Title I of the Housing and Community Development Act of 1974, Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990, the Age Discrimination Act of 1975, and 41 CFR Chapter 60. (4) Nondiscrimination and Equal Employment Opportunity. During the performance under this AGREEMENT, the SUBRECIPIENT shall not discriminate against any employee or applicant for employment based on race, color, creed, religion, sex, age, handicap, disability, ancestry, national origin, marital status, familial status, sexual orientation, or any other basis prohibited by applicable law. The SUBRECIPIENT shall take affirmative action to ensure that all applicants and employees are treated without regard to race, color, creed, religion, sex, age, handicap, disability, ancestry, national origin, marital status, familial status, and sexual orientation. The SUBRECIPIENT shall comply with all provisions of Executive Order 11246, Equal Employment Opportunity, as amended by Executive Orders 11375 and 12086. (5) Nondiscrimination and Equal Opportunity in Participation. The requirements in 24 CFR part 5, subpart A are applicable, including the nondiscrimination and equal opportunity requirements at 24 CFR 5.105(a). The SUBRECIPIENT shall not discriminate against any participant on the ground of race, color, creed, religion, sex, age, handicap, disability, ancestry, national origin, marital status, familiar status, sexual orientation, or any other basis prohibited by applicable law. The SUBRECIPIENT shall, through affirmative outreach, make known that use of the facilities, assistance, and services are available to all on a nondiscriminatory basis. The SUBRECIPIENT must take appropriate steps to ensure effective communication with persons with disabilities. (6) Americans with Disabilities Act. The SUBRECIPIENT agrees to comply with any federal regulations issued pursuant to compliance with the Americans with Disabilities Act which prohibits discrimination and ensures equal opportunity for persons with disabilities in employment, State and Local government services, and public accommodations. (7) Fair Housing. Under section 808(e)(5) of the Fair Housing Act, HUD has a statutory duty to affirmatively further fair housing. HUD requires the same of its funded sub -recipients. The SUBRECIPIENT has a duty to affirmatively further fair housing opportunities for classes protected under the Fair Housing Act. C. Falsification of Information The SUBRECIPIENT represents and warrants that it has made no false statements to the CITY in the process of obtaining this award of the ESG Funds. D. Drag Free Workplace The SUBRECIPIENT represents and warrants that it has established the following drug-free workplace policy: (1) The unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace for any employee involved in a federally funded program. (2) As an employee working in conjunction with a federally funded program, the employees of the SUBRECIPIENT will be required to: a. Abide by the terms above in statement (1), and b. Notify the appropriate SUBRECIPIENT authorities and CITY officials of any criminal drug statute conviction for a violation occurring in the workplace. Such notification shall be made no later than five (5) days after conviction. (3) The CITY and the United States Department of Housing and Urban Development will be notified within 10 ten days after receiving notice of any such violation. (4) Within thirty (30) days of receiving such notice, appropriate personnel action will be taken against such employee, up to and including termination. (5) Each such employee shall be required 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. E. Religious Organization The SUBRECIPIENT may not engage in inherently religious activities, such as worship, religious instruction, or proselytization as part of said program or services. If the SUBRECIPIENT conducts such activities, the activities must be offered separately, in time or location, from said programs or services, and participation must be voluntary for the program participants. The SUBRECIPIENT shall not, in providing program assistance, discriminate against a program participant or prospective program participant on the basis of religion or religious belief. If the SUBRECIPIENT is a religious organization, it retains its independence from Federal, State, and Local governments, and may continue to carry out its mission, including the definition, practice, and expression of its religious beliefs, provided that the religious organization does not use direct ESG funds to support any inherently religious activities. The SUBRECIPIENT agrees that rehabilitation of structures by the religious organization in connection with said program must be in sound accord with the provisions under 24 CFR § 576.406. F. Additional Terms between the CITY and HUD The SUBRECIPIENT agrees further that it shall be bound by the standard terms and conditions used in the Grant Agreement between HUD and the CITY and such other rules, regulations, or requirements as HUD may reasonably impose in addition to the aforementioned assurances at or subsequent to the execution of this AGREEMENT by the parties hereto. G. OSHA Where employees are engaged in activities not covered under the Occupational Safety and Health Act of 1970, they shall not be required or permitted to work, be trained, or receive services in buildings or surroundings or under working conditions which are unsanitary, hazardous, or dangerous to the participants' health or safety. H. Hatch Act The SUBRECIPIENT agrees that no funds provided, nor personnel employed under this AGREEMENT, shall be in any way or to any extent engaged in the conduct of political activities in violation of the Hatch Act, 5 U.S.C. Section 1501 et seq. 11 I. Davis -Bacon Act All laborers and mechanics employed by contractors or subcontractors in the performance of construction work, including alterations and repairs, in excess of $2,000.00, financed in whole or in part with federal funds shall be paid wages at rates not less than those prevailing on similar construction in the locality as determined in accordance with the Davis -Bacon Act, as amended, 40 U.S.C. sections 276a - 276a-5. Any such construction contract shall include and comply with the required contract provisions and rules set forth in 29 C.F.R. §5.5. Further, the payroll reports (along with the "Statement of Compliance") and basic records are required to be maintained and submitted, or made available, pursuant to 29 C.F.R. §5.5(a)(3). No payment, advance, grant, loan or guarantee of funds shall be approved by the federal agency unless there is on file with the agency a certification by the contractor that the contractor and its subcontractors have complied with the provisions of 29 C.F.R. §5.5. A breach of the contract clauses in 29 C.F.R. §5.5 may be grounds for termination of the contract, and for debarment as a contractor/subcontractor, as provided in 29 C.F.R. §5.12. Labor standards interviews/investigations shall be made as necessary to assure compliance. See 29 C.F.R. §5.6(a)(3). VII. ADMINISTRATIVE REQUIREMENTS Generally The following requirements and standards must be complied with: 2 CFR Part 200, et al. SUBRECIPIENT shall procure all materials, property, or services in accordance with the requirements of 2 CFR 200.318-326. A. Procurement (1) Compliance. The SUBRECIPIENT shall comply with current F1UD and CITY policies concerning the procurement of equipment, goods, and services, and shall maintain inventory records of all non -expendable personal property as defined by such policy as may be procured with funds provided herein. The SUBRECIPIENT shall report to the CITY all program assets (unexpended program income, property, equipment, etc.), and upon the CITY'S request, such assets shall revert to the CITY upon termination of this AGREEMENT. (2) Pursuant to 2 CFR 200.331 (a) (4), the Indirect Cost Rate for the SUBRECIPIENT's award shall be an approved federally recognized cost rate negotiated between the SUBRECIPIENT and the Federal government, or, if no cost rate exists, the de minims indirect cost rate as defined in 2 CFR 200.414(b) Indirect (F & A) costs shall be used. For this agreement, the de minims indirect cost of 10% will apply. (3) Use and Reversion of Assets. The use and disposition of equipment under this AGREEMENT shall be in compliance with the requirements of 2 CFR Part 200. B. Reporting Reporting requirements must conform to the policies and procedures as established by the CITY and 24 CFR § 576.500. The SUBRECIPIENT shall submit to the CITY, on or before the 15"' day of October, January, April, and July, as part of the Quarterly Report: (1) Payment Request. An original request for reimbursement and true copies of invoices, receipts, agreements, or other documentation supporting and evidencing how the ESG Funds have been expended during the applicable quarter. 12 (2) Quarterly Activities and written cumulative (year-to-date) reports of activities, program accomplishments, new program information, and up-to-date program statistics on expenditures, caseload and activities. Failure to provide any of the required documentation and reporting will cause the CITY to withhold all or a portion of a request for reimbursement until such documentation and reporting has been received and approved by the CITY. (3) Matching. Quarterly certification of match, plus documentation of match source. (4) Any other such reports as the CITY (or HUD) shall reasonably require and/or request, including but not limited to the following information: monthly records of all ethnic and racial statistics of persons and families benefited by the SUBRECIPIENT in the performance of its obligations under this AGREEMENT. C. Record Keening Sufficient records must be established and maintained to enable the CITY and HUD to determine whether the ESG requirements are being met. Record keeping requirements must conform to the policies and procedures as established by the CITY. All accounting records, reports, all evidence pertaining to costs, expenses, and ESG Funds of the SUBRECIPIENT, and all documents related to this AGREEMENT shall be maintained and kept available at the SUBRECIPIENT'S office or place of business for the duration of the AGREEMENT and thereafter for five (5) years post -completion of an audit in conformity with the ESG requirements, except as hereinafter provided relating to retention of any records or documentation existing, created, or maintained in compliance with Lead-based Paint regulations, which likely require longer retention as outlined below. Records which relate to (a) complaints, claims, administrative proceedings or litigation arising out of the performance of this AGREEMENT, or (b) costs and expenses of this AGREEMENT to which the CITY or any other governmental agency takes exception, shall be retained beyond the five (5) years until complete resolution or disposition of such appeals, litigation claims, or exceptions. All said records must be retained for the greater of the aforementioned duration or the periods specified in 24 CFR 576.500(y). All records relating to, or created or maintained in compliance with, the Lead -Based Paint regulations shall be retained and maintained by the SUBRECIPIENT indefinitely, including without limitation, all inspection report(s), disclosure statement(s), and clearance report(s). Copies made by microfilming, photocopying, or similar methods may be substituted for the original records. The CITY, HUD and auditors shall have the right to access all the SUBRECIPIENT records for as long as the records are retained by the SUBRECIPIENT. In the event the SUBRECIPIENT does not make the above -referenced documents available within the City of Santa Ana, California, the SUBRECIPIENT agrees to pay all necessary and reasonable expenses incurred by the CITY in conducting any audit at the location where said records and books of account are maintained. The SUBRECIPIENT agrees to meet the requirements set forth in 24 CFR § 576.500. D. Homeless Management Information Systems (HMIS) 1. Generally. The SUBRECIPIENT must ensure that data on all persons served and all activities assisted under ESG are entered into the applicable community -wide HMIS in the area in which those persons and activities are located, or with the express knowledge and written consent of the CITY, a comparable database, in accordance with HUD's standards on participation, data collection, and reporting under a local HMIS. 2. HMIS Agency Agreement. The SUBRECIPIENT shall have an agreement in place with the HMIS lead agency to participate in the regionally HMIS system. A copy of the SUBRECIPIENTS agreement with the HMIS lead agency shall be attached to this agreement as Exhibit F. In the case of Domestic Violence service providers 13 or other agencies prohibited from entering data into HMIS, documentation from the HMIS lead agency certifying that the SUBRECIPIENT is using a comparable database shall be attached to this agreement as Exhibit D. 3. HMIS Interagency Data Sharing Agreement. The SUBRECIPIENT shall enter into an Interagency Data Sharing Agreement with the HMIS Lead Agency where the SUBRECIPIENT agrees to share FIMIS data with other ESG funded agencies regarding clients that are served in ESG funded programs, unless prohibited by law. A copy of such agreement shall be attached as Exhibit F-1. E. Audit Report Requirements The SUBRECIPIENT agrees that if the SUBRECIPIENT expends Seven Hundred Fifty Thousand Dollars ($750,000.00) or more in federal funds, the SUBRECIPIENT shall have an annual audit conducted by a certified public accountant in accordance with the standards as set forth and published by the United States Office of Management and Budget (2 CFR 200.501x). The SUBRECIPIENT shall provide the CITY with a copy of said audit by April 1 of the year following the program year in which this AGREEMENT is executed. Further, the SUBRECIPIENT shall comply and/or cause compliance with audit report(s) required by applicable provisions of the Lead -Based Paint Regulations as further detailed below. VIII. EVALUATION AND MONITORING a. Generally The CITY will monitor the performance of the SUBRECIPIENT against goals and performance standards as required herein. The SUBRECIPIENT shall provide the CITY all necessary reporting information as required by the CITY in the administration and review of the Program. Substandard performance as determined by the CITY will constitute noncompliance with this AGREEMENT. I£ action to correct such substandard performance is not taken by the SUBRECIPIENT within a reasonable period of time after being notified by the CITY, contract suspension or termination procedures will be initiated. b. Access to Records The SUBRECIPIENT gives the CITY and HUD, including their authorized representative, access to and the right to examine all records, books, papers, items, emails, and documents, both physical and electronic, relating to the program. c. Audit The CITY shall have the right to audit and monitor any program income as a result of an ESG activity. Upon request by the CITY and for audit purposes, the SUBRECIPIENT further agrees to provide all files, records, and documents pertaining to related activities and clientele demographic data. IX. LIABILITY A. Generally Each party to this AGREEMENT acknowledges that it will be liable for its own negligent acts or negligent omissions by or through itself, its employees, agents, and subcontractors. Each party further agrees to defend itself and themselves, and to pay any judgments and costs arising out of such negligent acts or omissions, and nothing in this AGREEMENT shall impute or transfer any such liability from one to the other. In other words, the 14 X. SUBRECIPIENT agrees to be fully responsible for its negligent acts or omissions, or any intentional tortuous acts which result in claims or suits against the CITY, and agrees to be liable for any damages proximately caused by said acts or omissions. Nothing herein shall be construed as consent by a State or CITY agency or subdivision to be sued by third parties in any matter arising out of any contract, and nothing herein is intended to serve as a waiver of sovereign immunity where sovereign immunity applies. B. CITY not Liable for Funds The SUBRECIPIENT further acknowledges that the source of the ESG Funds is a federal pass-through grant to the SUBRECIPIENT. The CITY shall have no obligation to advance or pay the SUBRECIPIENT with any funds other than the ESG Funds the CITY receives from HUD. C. Hold Harmless The SUBRECIPIENT shall defend, indemnify and save harmless the CITY, its officers, agents, employees, representatives, volunteers, and student externs from and against any and all damages to property or injuries to or death of any person or persons, including property and employees or agents of the CITY, and shall defend, indemnify and save harmless the CITY, its officers, agents, employees, representatives, volunteers, and student externs from and against any and all claims, demands, suits, actions or proceedings of any kind or nature, including, but not by way of limitation, workers compensation claims and attorney fees/expenses for litigation or settlement, resulting from or arising out of the negligent or wrongful acts, errors or omissions of the SUBRECIPIENT, its officers, directors, employees, agents, subcontractors, and suppliers arising out of the SUBRECIPIENT's performance of this AGREEMENT. A. Generally ESG activities are subject to environmental review by HUD under the environmental regulations in 24 CFR 50. The SUBRECIPIENT, or any contractor of the SUBRECIPIENT, may not acquire, rehabilitate, convert, lease, repair, dispose of, demolish, or construct property for a project under this part, or commit or expend HUD or local funds for eligible activities under this part, until HUD has performed an environmental review under 24 CFR part 50 and the recipient has received HUD approval of the property. The SUBRECIPIENT agrees to comply with all applicable environmental requirements insofar as they apply to the performance of this AGREEMENT, including but not limited to the Clean Air Act, the Federal Water Pollution Control Act and the Flood Disaster Protection Act. If applicable, the SUBRECIPIENT also shall comply with the Historic Preservation requirements of National Historic Preservation Act of 1966. B. Lead-based paint remediation and disclosure The Lead -Based Paint Poisoning Prevention Act (42 U.S.C. 4821-4846), the Residential Lead -Based Paint Hazard Reduction Act of 1992 (42 U.S.C. 4851-4856), and implementing regulations in 24 CPR part 35, subparts A, B, H, J, K, M, and R apply to all shelters assisted under ESG program and all housing occupied by program participants that were built before 1978. 15 C. Assignment of Responsibilities By this AGREEMENT, the SUBRECIPIENT will accept assignment from the CITY of all responsibilities set forth in Subpart K of 24 CFR 35, D. Compliance with Subpart K The purpose of Subpart K is to establish procedures to eliminate as far as practicable lead-based paint ("LBP") hazards in a residential property that receives Federal assistance under certain HUD programs for acquisition, leasing, support services, or operation. In connection with the grant funds under this AGREEMENT, the CITY requires that the SUBRECIPIENT comply and show evidence of compliance with all applicable subparts of 24 CFR 35, and especially, Subpart K ("LBP Regs"). The SUBRECIPIENT shall conduct the following activities for the dwelling unit, common areas servicing the dwelling unit, and the exterior surfaces of the building in which the dwelling unit is located: (1) A visual assessment of all painted surfaces in order to identify deteriorated paint; (2) Paint stabilization of each deteriorated paint surface, and clearance, in accordance with §§ 35.1330(a) and (b), before occupancy of a vacant dwelling unit or, where a unit is occupied, immediately after receipt of Federal assistance; and (3) Ongoing lead-based paint maintenance activities into regular building operations, in accordance with § 35.1355(a), if the dwelling unit has a continuing, active financial relationship with a Federal housing assistance program, except that mortgage insurance or loan guarantees are not considered to constitute an active programmatic relationship for the purposes of this part. (4) And, notice to occupants in accordance with §§ 35.125(b)(1) and (c), describing the results of the clearance examination. E. Notification of LBP Hazard The SUBRECIPIENT shall provide to all occupants of housing: (1) In accordance with Section 35.130 of the LBP Regs - the LBP hazard information pamphlet. The pamphlet shall be the EPA/HUD/Consumer Product Safety Commission lead hazard information pamphlet or an EPA -approved equivalent. The current form and version of the pamphlet can be found at: http://www.hud.gov/offices/lead/Ii bra ry/enforcement/fs-discl.pdf (2) In accordance with 24 CFR 35, Subpart A, all available information and knowledge regarding the presence of LBP and LBP hazards prior to leasing a housing unit. (3) In accordance with 24 CFR 35, Subpart A, notification in writing of the results of the presumption of LBP and/or LBP hazards, results of any lead hazard evaluation, and any lead hazard reduction work. 16 F. LBP Information Summary For purposes of information only and in no respect intended to be a representation or warranty of the provisions of the LBP Regulations, the CITY has caused to be prepared an information summary relating to the LBP Regulations and Application to dwelling units that may be occupied by recipients of services and/or funding from the SUBRECIPIENT under this AGREEMENT. CITY staff will cooperate with and be available to the SUBRECIPIENT to assist in implementation of compliance with the LBP Regs as to residential dwelling units to be assisted by the SUBRECIPIENT. The parties acknowledge and agree the CITY shall not be liable or responsible for the accuracy of such summary, and the SUBRECIPENT is directed to the LBP Regulations and implementing guidance published and provided by HUD relating to compliance with such LBP Regulations. G. Exemptions Section 35.115(a) provides exemptions from Subparts B through R. For example, lead-based paint requirements do not apply to housing assistance if the assistance lasts less than one hundred (100) days. X1. CONFLICTS OF INTEREST The SUBRECIPIENT shall comply with 2 CFR 200.112 with respect to the use of program funds to procure services, equipment, supplies, or other property. With respect to all other decisions involving the use of program funds, the following restriction shall apply: No person who is an employee, agent, consultant, officer, or elected or appointed official of the SUBRECIPIENT and who exercises or has exercised any functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision malting process or gain inside information with regard to such activities, may obtain a personal or financial interest or benefit from the activity, or have an interest in any contract, subcontract, or agreement with respect thereto, or the proceeds there under, either for himself or herself, or for those with who he or she has family or business ties, during his or her tenure or for one (1) year thereafter. The SUBRECIPIENT agrees to abide by the ESG Program's Conflict of Interest provisions as expressly detailed in 24 CFR § 576.404 regarding Organizational Conflicts of Interest and Personal Conflicts of Interest. All contractors of the SUBRECIPIENT must comply with the same requirements that apply to the SUBRECIPIENT under this section. XII. ASSIGNABILITY None of the duties of, or work to be performed by, the SUBRECIPIENT under this AGREEMENT shall be subcontracted or assigned to any agency, consultant, or person without the prior written consent of the CITY. The SUBRECIPIENT must submit all subcontracts and other agreements that relate to this AGREEMENT to the CITY. No subcontract or assignment shall terminate or alter the legal obligations of the SUBRECIPIENT pursuant to this AGREEMENT. XIII. EXCLUSIVITY OF AGREEMENT This AGREEMENT supersedes any and all other agreements, either oral or in writing, between the parties hereto with respect to the use of the CITY's ESG Funds by the SUBRECIPIENT and contains all the covenants and agreements between the parties with respect to such ESG Funds in any manner whatsoever. Each party to this AGREEMENT acknowledges that no representations, inducements, promises or agreements, orally or otherwise, 17 XIV XV have been made by any party, or anyone acting on behalf of any party, which are not embodied herein, and that no other agreement or amendment hereto shall be effective unless executed in writing and signed by both the CITY and the SUBRECIPIENT. AMENDMENTS OR MODIFICATIONS The SUBRECIPIENT shall not obligate, encumber, spend, or otherwise utilize program funds for any activity or purpose not included or not in conformance with the budget as apportioned and as submitted to the CITY unless: (1) The SUBRECIPlENT has received explicit written approval from the CITY to undertake such actions, or (2) Budget changes may be made among approved program activities and among approved budget categories so long as the specific project activity has been approved, there is no change to the total grant amount, and the changes to the budget are documented. Any program modification request by the SUBRECIPIENT must be requested at least forty-five (45) days prior to the end of the term of this AGREEMENT. No modification to this AGREEMENT shall be binding by either party unless in writing and signed by both parties. hi the event that the CITY approves any amendment to the funding allocation, the SUBRECIPIENT shall be notified in writing and such notification shall constitute an official amendment. The CITY may, at its discretion and upon provision AGREEMENT to conform with changes in Federal, directives, and objectives. Such amendments shall be AGREEMENT. VIOLATION OF TERMS AND CONDITIONS A. Termination of proper notice to the SUBRECIPIENT, amend this State, and/or the CITY laws, regulations, guidelines, incorporated by written amendment as a part of this If, due to any cause, the SUBRECIPIENT fails to comply with the terms, conditions or requirements of this AGREEMENT, or any prior AGREEMENT whereby ESG funds were received by the SUBRECIPIENT, whether stated in a Federal statute or regulation, an assurance, a State plan or application, a notice of award, or elsewhere, the CITY may terminate or suspend this AGREEMENT in accordance with 2 CFR 200.339 and in accordance with 2 CFR 200.340 by giving written notice, and the CITY may request in writing that all or some of the grant funds be returned even if the SUBRECIPIENT has expended the funds. If the SUBRECIPIENT reports inaccurately, or if on audit there is a disallowance of certain expenditures, the SUBRECIPIENT agrees to remedy the acts or omissions causing the disallowance and repay the CITY all amounts spent in violation thereof. If the SUBRECIPIENT engaged in fraudulent activity to obtain and/or justify expenditure of the ESG funds granted hereunder, the SUBRECIPIENT shall be required to reimburse the CITY of all such funds that were obtained and/or spent under fraudulent circumstances, and the CITY reserves the right to take other remedies that may be legally available. The SUBRECIPIENT agrees to return all funds as requested by the CITY under this section within thirty (30) days of receipt of the written request. m XX, AGREEMENT DOCUMENT, EXHIBITS, AND ATTACHMENTS All of the attachments and exhibits attached to this AGREEMENT are deemed incorporated by reference. This document may be executed in three (3) counterparts, each of which shall be deemed to be an original. 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 the CITY fully, including reasonable costs and attorney's fees, for any injuries or damages to the CITY in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. IN WITNESS WHEREOF, the parties hereto have executed this AGREEMENT on the date and year first above written. ATTEST: MARIA D. HUIZAR 64 Clerk of the Council AS TO FORM: 12 CITY OF SANTA ANA a municipal corporation J G'V DAVID CAVAZOS City Manager SUBRECIPIENT: J"/� Y� srtt� cTJ� n h y Name: Kathleen Davis Bow an Title: Executive Director Tax ID: DUNS#: Ql72322 3r>l go Any objections regarding terminations or suspensions shall be made by the SUBRECIPIENT in writing and mailed to the CITY pursuant to the above NOTICES section. XVI. CLOSE-OUT The SUBRECIPIENT agrees to comply with the closeout procedures detailed in 2 CFR 200.343, including the following: (1) SUBRECIPIENT must submit, no later than ninety (90) calendar days after the end date of the period of performance, all financial, performance, and other reports as required by the terms and conditions of the Federal award,- (2) ward;(2) Unless the CITY authorizes an extension, SUBRECIPIENT must liquidate all obligations incurred under the Federal award not later than ninety (90) calendar days after the end date of the period of performance as sepecified in the terms and conditions of the Federal award; (3) SUBRECIPIENT must promptly refund any balances of unobligated cash that the CITY paid in advance or paid and that is not authorized to be retained by SUBRECIPIENT for use in other projects (See OMG Circular A-129 and 2 CFR 200.345); (4) SUBRECIPIENT must account for any real and personal property acquired with Federal funds or received from the Federal government in accordance with 2 CFR 200.310-200.316 and 200.329; and, (5) The CITY should complete all closeout actions for the Federal award no later than one year after receipt and acceptance of all required final reports. XVII. VALIDITY AND SEVERABILITY The invalidity in whole or in part of any provision of this ARGREEMENT shall not void or affect the validity of any other provision of this AGREEMENT. Whenever possible, each provision of this AGREEMENT shall be interpreted in such manner as to be effective and valid under applicable law, but if any provision of this AGREEMENT is held to be prohibited by or invalid under applicable law, such provision shall be ineffective only to the extent of such prohibition or invalidity, without invalidating the remainder of such provisions of this AGREEMENT. XVIII. LAWS GOVERNING TIIIS AGREEMENT This AGREEMENT shall be governed by and construed in accordance with the laws of the State of California, and all applicable federal laws and regulations. XIX. WAIVER No delay or omission by the CITY hereto to exercise any right or power accruing upon any noncompliance or default by the SUBRECIPIENT 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. 19 Name of Organization: Name of Funded Program: DUNS # Contact Name and Address: ESG 2015-2016 Scope of Work W ISEPlace Steps to Independence 2322894 Street Outreach Shelti X HMIS Coordinated Assessment/Centralized Intake What is the total unduplicated number (both Santa Ana residents and Non -Santa Ana residents) that this program plans to serve during 2015-2016? 72 What is the total unduplicated number of Santa Ana residents that this program plans to serve during 2015-2016? 38 Program and Funding Description Description of Work - In the space below, describe the program to be funded during the 12 -month contract period. What specific activities will be undertaken during the contract period. Please be concise in your response. Only the viewable space will print. Steps to Independence Program is a shelter program for unaccompanied homeless women. The program includes case manager, financial empowerment, life skills classes, assess to heath care, transportation and assistance with permanent housing. Schedule of Performance/Goal Outcomes Estimate the number of ONLY unduplicated Santa Ana participants to be served by the funded program during the 12 - month contract period per quarter. (Enter number of new Santa Ana Participants served each quarter. If they were served in quarter 1 do not count them again Quarter 1: July 1 - September 30 Quarter 2: October 1 - December 31 Quarter 3: January 1 - March 31 Quarter 4: April 1 -June 30 12 42 Participants Participants Participants Participants Total Santa Ana Participants to be served. Schedule of Invoicing Estimate the amount of grant funds to be requested during the 12 -month contract period on a quarterly basis. Quarter 1: July 1 - September 30 Quarter 2: October 1 - December 31 Quarter 3: January 1 - March 31 Quarter 4: April 1 -June 30 $ 5,800.00 $ 6,100.00 $ 5,800.00 $ 5,800.00 $ 23,500.00 Total Grant Exhibit A Page 1 of 1 Organization Name Program Name Program Year 2015-2016 Final Budget WISEPlace Steps to Independence Expenditures Category Expenses Funded by Santa Ana ESG Expenses Funded by Other Sources Santa Ana CDBG Total Program Budget 30,000 Total Organizational Program Staff Salaries & Benefits* $ - $ 200,935 $ 200,935 $ 200,935 Contractual/Professional Services $ - $ 27,900 OTHER: (please indicate) Total Funds for the Program $ 595,129 $ - Safety and Security $ 13,150 $ 33,000 $ 46,150 $ 45,000 Utilities $ 8,000 $ 19,455 $ 27,455 $ 32,300 Communications etc $ 13,000 $ 13,000 $ 13,000 Insurance/ Prop. Taxes $ 28,936 $ 28,936 $ 40,113 Repairs/Maintenance $ 22,000 $ 22,000 $ 31,600 Program Expenses $ 42,000 $ 42,000 $ 42,000 Program Pass Through $ 26,000 $ 26,000 $ 39,576 Admin, other $ 189,568 $ 189,568 $ 216,397 TOTAL DIRECT COSTS $ 21,150 $ 574,894 $ 596,044 $ 688,821 (_10_%)* $ 2,350 $ 2,354 Total $ 23,500 $ 574,894 $ 598,394 $ 688,821 Indirect cost rate: 10% Non -Federal entity without federally recognized negotiated indirect cost rate, will charge a de minimis rate of 10% of modified total direct costs Benefits: Holiday, sick and vacation time can be invoiced for staff working 100% in the ESG program. LIST ALL OTHER PROGRAM FUNDS THAT HAVE BEEN SECURED FOR 15-16 (Total Funds for Program must equal Total Program Budget above) Source Amount Santa Ana ESG $ 23,500 Santa Ana CDBG $ 30,000 Program Fees $ 54,400 Individual and Corporate Contributions $ 487,229 Total Funds for the Program $ 595,129 Exhibit B Page 1 of 2 please confirm that Prog Name of Organization: Name of Program 2015-2016 Funded Personnel WISEPlace Steps to Independence NOTE: Please remember that this is only a budget and that reimbursement should be based on actual service. * Only direct hours charged to the grant will be reimursable. Timecards must demonstrate direct hours charged to the grant. Benefits (Vacation, sick and holiday) are paid for program staff who work 100% in the ESG program. PROGRAM STAFF Position Title Annual Annual Total Salary Benefits Compensation ESG Funds Percentage of Requested time in the program serving SA residents Total Amount Re uested $ Total Amount Requested 0% CONTRACTUAL/PROFESSIONAL SERVICES Tyne of Service Annual Contract Amount Total ESG Funds Percenta e of Total Amount Re uested $ Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, Section 98.510, Participants' responsibilities. The regulations were published as Part VII of the May 26,1988 Federal Register (pages 19160-19211). (BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS FOR CERTIFICATION - Attached) (1) The prospective recipient of federal assistance funds certifies, by submission of this proposal, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. (2) Where the prospective recipient of federal assistance funds is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. /Z��lI�� JJaVlS�ow_vnretri Jl�fc�fav Name and Title of Authorized Representative Date V EXHIBIT C Page 1 of 2 INSTRUCTIONS FOR CERTIFICATION 1. By signing and submitting this proposal, the prospective recipient of federal assistance funds is providing the certification as set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective recipient of federal assistance fiends knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the Department of Labor (DOL) may pursue available remedies, including suspension and/or debarment. 3. The prospective recipient of federal assistance funds shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective recipient of federal assistance funds learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective recipient of federal assistance funds agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the DOL. 6. The prospective recipient of federal assistance funds further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and voluntary exclusion - Lower Tier Covered Transactions," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to check the List of Parties Excluded fi-om Procurement or Non - Procurement Programs. S. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and infonnation of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the DOL may pursue available remedies, including suspension and/or debarment. EXHIBIT C Page 2 of 2 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, 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 cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contact, 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 subcontract, subgrants, and contracts under grants, loans, and cooperative 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 Section 1352, Title 31, U. S. Code. 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. W i!�ePtvt �) �'nApI Grantee/Contactor Organization Pr g lti �t �f do l S I oy a ✓ M9�4—LI(,dw o Name of Certifying Officer Signature Date EXHIB IT D Page 1 of 2 Title /,,6� SUBRECIPIENT warrants the following 1. SUBRECIPIENT will comply with Public Law 88-352, Title VI of the Civil Rights Act of 1964 (42 U. S. C. section 2000 or seq.) and implementing regulation in 24 CFR Part 1. 2. No person in the United States shall on the ground of race, color, religion, national origin, or sex, be excluded from participation in, or be denied the benefits of, or be subjected to discrimination tinder any program or activity funded in whole or in part with community development funds made available pursuant to the ACT. 3. All laborers and mechanics, employed by contractors or subcontractors in the performance of construction work financed in whole or in part with community development funds shall be paid wages at rates not less than those prevailing on similar construction in the locality as determined in accordance with the Davis -Bacon Act, as amended, 40 U. S. C. Sections 276 a 1-5, except for individuals who perform services for which they volunteered; do not receive compensation for such services; or are paid expenses, reasonable benefits, or a nominal fee for such services; and are not otherwise employed at any time in construction work. 4. SUBRECIPIENT will comply with all Federal statutes applicable to projects funded with community development funds, except that (a) SUBRECIPIENT does not assume CITY'S environmental responsibilities described at 24 CFR 570.604; and (b) SUBRECIPIENT does not assume CITY'S responsibility for initiating the review process under Executive Order 12372. EXHIBIT D Page 2 of 2 RPC2iUe� it(tgl1�0fa. Orange County r, The l lwr I nc(�, agency agrees to share client data among participating agencies via the LA/OC HMIS (Homeless Management Information System) for the purposes outlined below. Each participating agency must complete and comply with the Agency Agreement. Each individual HMIS user must complete and comply with the HMIS User Agreement. This document Is available on the OCHMIS website httoYlwww.ochmis arc. Uses of HMIS Data: • Coordinate housing services for families and individuals experiencing homelessness or facing a housing crisis in Orange County • Understand the extent and the nature of homelessness in Orange County • Evaluate performance and progress toward community benchmarks • Improve the programs and services available to Orange County residents experiencing homelessness or a housing crisis • Improve access to services for all Orange County homeless and at -risk populations • Reduce inefficiencies and duplication of services within our community • Ensure that services are targeted to those most in need, including "hard to serve" populations • Ensure that clients receive the amount and type of services that "best fits" their needs and preferences • Pursue additional resources for ending homelessness • Advocate for policies and legislation that will support efforts to end homelessness in Orange County Client Protection: • Informed consent must be given by clients In order for their identifying Information to be entered Into HMIS and shared among agencies in the LA/OC HMIS (see Orange County HMIS participating agencies on OCHMIS.org). Non -identifying client information may be entered in the system for all clients regardless of whether they give their informed consent and regardless of their domestic violence status. • Only non -identifying information will be entered for clients currently fleeing or in danger from a domestic violence, dating violence, sexual assault or stalking situation, • Identifying client information will only be sharedamong. agencies that have signed this agreement. At the time of informed consent, and at any point after, the client has the right to see a current list of the OC HMIS participating agencies. • Additional agencies mayjoin the _A/OC HMIS and will be added to the list of HMIS participating agencies. As part of the Informed consent process, clients must be informed that additional agencies may join the collaborative at any time and will have access to their information. • HMIS Users will maintain HMIS data in such a way as to protect against revealing the identity of clients to unauthorized agencies, individuals, or entities (see the "OC HMIS Client Consent Form," and the "Client Rights Brochure OO" available on the OCHMIS.org website). • Clients may not be denied services based on their choice to withhold their consent. Each party to this memorandum of agreement shall defend, indemnify, and hold all other parties harmless from any and all claims arlsing out of that party's negligent performance of this agreement. Any loss or liability to third partles resulting from negligent acts, errors, or omissions of a LA/CC HMIS user while acting within the scope of their authority under this Agreement shall be borne by that user exclusively. Agreed to and signed by the following agency representative: Jan 30 0£3 10111a WISEPIaoe 11145423653 p,2 Los Ar)gol"/Orange County Ilonleless Management Information System (HMIS) Collaborative UMTS Agency Agreement T. Purpose The Los Angcics/Orange County (LA/0C) Hotpcicss Management Inl'onriAlon System (I IMIS) is a web- cnabled database: used by homeless scrvicc providers within the T.os Angeles and (range Coonty region, to rupture information about the persons they Sorvc. The I.A/OC I IMIS Collabomdvc consist of four Swp¢wate Continuum of Cxn;s. 'Pile cortinuunis are, Loy Angeles Ilnmcl=s, Service Authority (LAHSA), Orange Colmty Continuum of Care, the City of Glendale and the City of Pasadena, The LA/OC TIMIS C:ollaMvadve's goal is to go hoyond the HUD mandate er producing unduplicated cuuats Of homeless poo,on», Our mission is to provide a comprehensive case management SyrtOm m advmroe the pnwiVioa of gustily services f ,r fmmelrss parMAT, lrnpr(,ve darn codewliem. and prenndte more rrsprur,rivn pnllcias to mrd httrttatarsrae:.xv In Los Anitrles rind Or(ntgc Counrias. Cl. Audience and Agreement This Participating Agency Agreement permits AGFNC:Y NAMIi and its participant;; to use the LA/OC HMIS and security .services on their compoters systems through an Int4Knet cnnnecdon, The 1.A/OC. I IMIS Collaborative and their assigned HMIS System Administrators are the primary coordinating Continuum isr Cans (,.oC.) for the I.AJOC HMIS. The Participating Agency is the "Agency" named is this agreement as' participants or the UJOC HMIS. The TIMIS "tl nor' are the guardians entrusted with personal datu to lx; entered and used in the 1,A/OC Wills and the "Clicut" is the cunsnmcr of services. All agencies which have been granted access to the LAAX: I IMIS bave agreed to abide, by till laws, and the. LA/OC AMTS Collaborative Policies and Procedurds pertaining to client canfidcnti;dity, user conduct, senurity, and the ongoing ruactionality +rrfd stability of services and equipment used to suptavt the LA/GC HMIS. ,rite signature of rite Lixecurive Director of the Farticfparing Agcney indicans agreement will' the terms set fort& for an LAtOC LLMLS vveoant for the Agency, 111, Confidentiality and lnfortmd Couse.nt The Agency agrees to abide by and uphold all privacy protection standards established by the I.A/OC ihMLS Collnhomilvc as well as their respuCtivc agency's privacy pnxedures, The. Agency will also uphold rcturmt Federal and C'allTurnivt State cnnYidcn(fality regutntioos and Inmos that protect client records, and the Agcney will uoly ecloage uonndeutial client records whh written consent by the client, or the client's guardian, unless otherwise provided for in Lite tegulations or laws. Access to the LA/OC TIMIS is granted to the, Veterans E16n based on The following, Deputises: Oral Explanadmit. All clients will be provided an oral explanxtinn swung their information will Ix: entered into a computerized recor(1 keeping system, The Agency will provide an oral explanw.ion of the LA/CX: HMIS and the tarns of WriscuL Thr agency is vaspoaeible for cosating that this pnxedmc takes place prior to every client interview. Written Rxpbmatiout l?ach client whose inf'orwation is Mang shared with another participating ugenay must ngrco via the written Client eunsrnt/Infurm:dh+n Release: Harm A client must be informed as tet what iNbrnantion is bring shirred and with whom it is bcing.hras:d. Infornxntion Ttalcasc: Tiw Agcney a.+roes not to relcnse client identifiable. information to tiny other organimtion pursuant to federal and Calil'ormn Stino law without proper diont. muscat. See attacbcd Client Consettd[nfenuallon Relcasu Form anel Rtlgulations below. HMIS Agency Agrrruwitr llu,, e f of Roiv`.t'ed 10/03/05 Jan 30 08 lotlla WISEPlaoe 17145423553 p.4 Rugulatlan The Agency will uphold all relevant Federal and Caliromla Stutc confidentiality regulations to pnnect client records and privacy. In addition, Ilia Agency will only rulause client records with written consent by the client, unterS othcrwisc provided for In the regulations, SNeiflt;Wly, but not limited to, the ILliowing: A, The Agency will abide specifically by the federal confidentiality rules as evntainul in Elie Code of Federal Regulations (CPR) 42 Part ?. Confidentiality of Alcohol and Drug Abuse Patient Records, regarding disclnsarc of alcohol und(or drug abase records. In gent❑l Terms, the Federal regulation prohibits the disclosure, or alcohol and/or drug; abuse records unless disclvsurc is expressly pertnidcd by written consent of the person to whom it pertains or aA Otherwise permitted by CFR 42 fart 2. A gcroml authorisation for the release of modiou) or other information Is not sufficient For this purpose. The Agency undor atmEls that the; paleral rules restrict tiny use of the inforniation to criminally investigate or prosecute any alcohol or drug abuse puticnts, B. Tlic Agency will abide specitically with the Hvithh Tnauranee Portability and Accountability Act of 1996 and cvrrespnnding regulation+ passed by the US. Department of Health and Human Services. In general, the rcgulutions provide consumers with new rights to cornml the releaso or medical infomiatiolL Including advance croscnl liar most dMosuips or health infornaation, the tigtu to sec a copy or health records, the right to rulltrast a correction to hetdth records, the right to obtain documcnLa6on or disctusews or infomnnion may he used or diselnecd. The current regulation provides protection for paper, end,;roil nlrctroniu infornmtion, C, The Agency will abide specifically with the California Government Codc 11015.5 regarding Personal Information Colleatcd on the laivenut.. In general, the Government Code ensures thus any electronically collcutud personal information about clients cannot bu shuNd with any third party without the client's written consent, Pogtingct Privacy and ManrGuory Coileetion notices must be posted at the agency, A. The Agency must asst. Privacy and Mandatory Collection notices at cath intake desk or coutparable location. B, Privacy and Mandatory Collection nuticev most be made avaflnbie in writing at the client's reclo"t. C. If the. Agency ninialains an agency website, it link to the privacy notice roust he On the honnupagc of the itgatcy's web itc, TV, Data Use Data cuntuiocd in the 1LA/0C HMIS will Only he used to support the dolivery of homeless services in Elie Lars Angetcs wd Orange COun[y region. &nth Usvr will ul'I'irtu the principles of ethical data use and client eontidontiathy as noted below and contained in the LA/X I IMIS User Agrcrnient, I. The: Ageocy will not solicit or input information from clients unless it is csscntisl it, provide services, or conduct evaluation or rew. rch. 2. The Agency understands that all client data will be maintained on a central carver, which will contain all client inrurninion in an cneryptcd sole. All client idcntifablc data is inaccessible w unauthorized users. 1 The Agency shall not be denied access to client data entered by the Agency. Agencies are b,mid by all restrictions placed upvo the data by the, clirut of any Participating Agency. The Agency shall diligently rvetau in the LA/OC HMIS all restrictions requested. 4. The Agency shall not knowingly enter false or toNlc,diog data under arty cirmnmsnmccs, 5, The Agency shall maintain appropriate documentation of client consent to participate in the I VOC. tiMiS, 6, Ira client withdraws consent for release of infunuauun, the Agency remains emponsihle to ensure than the client's information is unavailable It, all other Agencies, ffMlS'AgerreyAgreanuort Mtge Zof5 Revised 10103105 Jen 30 OS IOtlla WISEPlaO@ 17146423053 P.5 VII. Algia 1,A/OC FiMIS data firm ugennles within each continuum reaRici In ono contort database, Thu Agency's dura ix separntcd by security fnr wcb contmuwn. Dam sharing is currently liml0.d to Ute d:ua within the Agency's continuum The LA/OC IIMIS Collaborative reserves the right. at a latter date, to espand data sharing to include ctilubumilwi wide do(.. Thr: LNOC IIMIS Cvllltbn.n1,l' slur rescrvos all rights, including trarnirmtinn of agrcumcnls, of the LAXX: HM1S application and dx: service resources that it awns umI upemtcs. Tbm' prcuaurc t nhWl nut be onoso-ond a. a waivor of tiny rights or to LiVOC IIMIS Collaborative, nor shall they car On t with apOlic,able veto of law, VTXT, Privileges x es Tia; f.A/OC IIMIS servings and or cyaiprmal are a privilege ;end aro assigned and nwnuged by the IIMIS System A4ministrnmr(n) nr dcsig caR) of specific ystcmts. The Agency is rcrpunshoo for prepay area nl'the system ax rsdirmd in Section V). Ix. Coaf3ale)ytsatity, Although Technological and pn eighwal accurilics have bacon reasonably exhausod by the IAAJC IIMIS C111aherndvc to amwro client dao caMJnrGatily, ON system is being aimed by a mullitude of end name, and is thcmf m subf ret to the ddigeme to which the Ihulicilvding Agonies' slurtpmtwta client main1s. 'Che pmaeliuns that the WOC ttMTS Coilabomuve put in place to prda;t clicdt owd'Idcntlonty 11104/40 unmalicious with I1OD Data and T"Intloal Starcdanls [final Nmica, institution ora numdWal IIMIS training program for ad IIMIS amen, euasis(e g applicathn of potetes tad Prrtcdtars, and signed Agency Rad. door Agmoruc(a. X. Copyright Thu LA/OC] HMIS is prolentd by copyright Anil is not as be copied, except as pamiacd by law or by utmarz t with ownsofthe copyright, Tlx oumix:rol'uapi<x and distribution ofcuples are to be managed by the f IMIS Sysnms Administrator(,) of each C'X% Inorference wide mtnrsvroc used by 0npyeight holders to protect copytighlwi works Is prohibited. Agency user's storing materials copyrightod by 00104 on the systems nr displaying Ibo reactial. through web pobnts most comyty with eopyal bt laws and poi ldlinoe. Lsgalpanda i(apptleables Conmu(cr sop. and dgut arc pnoceted by copyright and in pia In be copiul, exmpt is pntrolued by law or by contract with the owner of the copyright, 'the mm. her of eoples and dimtrihution ofceliCs are to be mumosod by the IIMIS Systems Ado)nialrator(s) ormach Coc. uteneoriba compultr systems ug+cu Io Callow guidctiner tar us¢ ofeapyrightcd m:ntrwis. XI. Violations An intfSY:4un1 violating any u[ Ila: guidelines ounlimtt in chi. ugmmmmt wdil be tgpona! (mrxnlinmty upon discovery. Such suspected violations will he confidentially reported to the IIMIS SyAenr Adminlsolev4s) or the GC and or the designee of than agency. 7. TtIc AL=y shall hccp signed copies of rhe Client C:onaeni/Infonmdnn Relcum hon Arc IWOC IIMIS roar Iwriod orsun-n yuan. R. The Agcnny shut( keep lnmrgunq dmu .h.6an uSmarnanis and Chen! CnnaenUlnf erandon RCLesne form. An all inlhviduid clicnt data that L5 shared to nomcustodial agencies where the booted pdicics orthe Agency allow4 data sharing. V. ResponslblhEres The, Agency is mspunsibk, far unstring that its Staff Ines not Inrentinnnlly or unintenttnnally misuse thin system. Sutlt uses um bill no( limited To damage eatnpuGng rewumes, tdmtin extra raau eca, take minwen.9 rem anonhcr aur, Baht unuuthuriwd ucee v to rusourrus, or otherwise make um of computing regg cal'ot which pmpur uutharivadon baa not Gin given. I. The Agency will hove an my;gaimont rim,,q ill,lel ar nv,ticio,tc aces and the AGmncy'.r usarc ognc to rover use Uu system to perrnrtn nn illegal ar nudioiou. ma. Any attempt to inercxs the level nracee. s to which (.v)ha is authtuieud or any utIclbpt to dcMive cdtcr outfimbxd wets of n U'uct or ecucss to LA[W. HMIS shall be regarded at maliclo n and rimy M heat,, a an illegal act. 2 Aay ear who ('loam a )wsa fl.,,corny laprc un the sysrpo 10 repot hl o the tlMtS Synarn Admbds hew, hmnedhaaly. 3. 'ITe W(TC )IMIS Application, which has been Varord, to each pxlticiputing ugamy onus putchascd hY the 1,A/OC HMFS Cullalwmtive for each g Ile own conthtuenu. The UVOC )IMIS application onu. paid for Ihmugh IhC IlUtt gen(. TIIC maininrvncc, npgredev' and I'µtnvn Rumha.cx art: IimiWtl by the sancnrns of rhe FitN grcmL Any;ukiitinnal nwinlenantu, upgrudtw rvW license purdme. inuurtuJ "Rot the Arabi fund limn, which is duaboudud 1'1-1 hiMIS scrvicos, berm ei the srlc naRomibility of the Agency that hex accepted p eicevnn And use' or Lb, wfrwarc. rind services rorglmd Cor IIMIS 11-03-2005 13:39 WT5EPL.RCE 7145423653 PRGE6 XII Agreennew 1 have, read the. afhrcnicntioncd Agency Ageocmcnt and waiver for use of technology olUe LA/UC HMIS, Equipment and Scrviccs (if'vj7phvubIc), and thoroughly understand that this technology is for LA/UC. HMIS purposes only. This Agreement is executed h®tween WISE Place Huta) for Wemeu and UC' lwio mhi, and upon execution thu Agency will be given access to the ) IMIS. This agrccnwnt will be signed by the Rxecutive Director at the Patticipating Agency. Lxec,tive Director's Name (Print) l' hive I)irector's Signature Agency Name I v JA4'J o6 Date of Sigruirure C nti uunt Representative's Name ('Print) Continuum Representative's Signature; ContinuumNa j J Dae of SiVta ure HMSS Agericy Agra:eMe,n/ Page 5 (7j,5 Rovisely 10/03/05 t� �y , ° 7(nIM/pa/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/29/2015 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. TI -113 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, sub]act 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 ROD of such endorsement(s), PRODUCER CONCT NAME SelectSolutlons insurance Services, LLC ,� u. E.%tJ, 868,500 6359 tuc q;,,,.,555 804 84 IACNe Pax 49 " 1350 Carlback Avenue @- R Walnut Creek, CA 94596 P, rACHOCCURRCNCL .,,_,..., .... .. .. iNaUR@RISJ AFFglip{Nq COVERAI'AE MAIC # ...... ...- INauREo _ lrlsuRERA New,York-Marine, &, General_Insurance 16608 Wise lace, a Ca Corpba WI60 Sliver Center p p ter IN6URERs Phlladelphla Indemnity Insurance Cgmpany 18058 1411 N. Broadway IN611-RERC Santa Ana, CA 92706 "" .. INSURER p .,NSII,R@R E: I ........, . ............ ., ........ .,- .... .... _.,_.,,..... INSURER F . _.-.....r. COVERAGES - CERTIFICATE NUMBER: REVISION NUMFRFR- -.... __._ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LMTEO BELOW HAVE BEEN ISSUED TO THE IN5URED NAMED ABOVE FOR THC"-. POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO "11011 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. PP(1,610D FF.". DMID YEkr�" " ."..'."". ,.. '...... .--""" "-. ..,••._,.,.,.... LTR TYPE OFINSURANCE PODGY NUMaER MMlpp /ODfYYYY LIMITS GENERAL LIABILITY rACHOCCURRCNCL '$ 1000000 ✓ COMMERCIAL GENERAL LIABILI RY 19AMAGH 1OlIEN Fn -- GLAIMSMADE l ✓,..I OCCUR PREMI$E$(EW..QAGOFence) MCD C%P (Any ona PersanJ „� 60p0 B f Yes PHPK1278336 1/112015 1/112074 PERSONAL&ASV INJURY $ 1000000 II .., .....,, ..., _,.,...... OLNLRAI.AGGRC0A7G $ 2000,000 r PN'I. AGGREGATE LIMIT APPLIES PER; PRODUCTS COMP/OPAGG $2000000 jj....... ✓ PIiO- .. _. .. .. ...$ ............... POLICY LOC AUTOMOBILE LIADILITY COMBINED SINGLE LIMIT $ 1,000,000 ✓ ANYAUTO ' (Eamoodent) BODILY INJURY(Gorpel'son) $ ✓ ALL OWNED AD'I'OS Yes I IBODILYINJURY(Poreccldon) $ B ✓ SCVI EDCLEDAUTOS I PHPKI279335 1/112075 111/2018 PROPERTY DAMAGE $ IIIREDAUTOS (Per acnldent) ✓ NUN -OWNED AUTOS $ ./ UMaR a CA LIAR ✓ OCCUR CAUL OCCUHRCNCr S 1 U00 000 W, El C%cise LIAR CLAIMS MAGE '.. ...$ �ADnRLGATE,-_, .--... _.,_ 7 060 000 , ... - -1---- Yes PHUB486326 1/1,2015 1/12018 -,,,,, ...... ..,... .,., m_UEpUCnaLE ✓ RETENTION $ 10,000 $ WORKERS COMPENSATION WC 6AU ANDEMPLOY6RS'LIAEILITY YIN '.TRBYLJMIT.._ A ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER(MEM$EREXCLUDED? N/A WC201400006533 (1/75/2014 811512016 i L hAChI AGCIDI NT C -- $ 1000000 - ..-.... ..... in olaH'A •,E-hA IMPLOYF,'E $ 1000000 IfMy.Rd.tery t under ......... ........... .......... D[•:6C,RIP11MI OF OPERATIONS below F:.I..DISEA.___ 613 -POLICY hIMII $ 1,000,000 a Professional UNNI8y (Errors and Omisslons) PHPK1278335 1/1/2015 1/112078 $1,000,0001$2,000,000 DESCRIPTIONOFOPERATIONS/LOCATIONS/VEHICLES (Atineh ACORD 101, Additional Remarks 0chndulo, If more spneo In required) The City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as Addltlonal Insured with respect to General Liability policy per attached endorsoment.This Insurance is primary and non-contributory to any other Insurance provided as respects General Liability policy per attached -1 endorsement. The Prgfossional Liability Limits shown represent the Per ClaimlAggregate Limits of Liability, The 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 13E DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED RaPRESENTATIVIE roserved. �li THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY AI- State or Political Subdivision-CG2012/Primary & Non Cont Wording ADDITIONAL INSURED - STATE OR POLITICAL SUHDSVISIONS - PERMITS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Political Subdivision; City of Santa Ana, its officers, employees, agents, volunteers and representatives 20 Civic Center Plaza Santa Ana, CA 92701 It is agreed that such insurance as is afforded by this policy for the benefit of the additional insured shown shall be primary insurance and any other insurance maintained by the additional insured shall be. excess and non-contributory except for Gross Negligence or Willful Misconduct by the Additional Insured, but only with respect to liability arising out of operations performed for the additional insured by or on behalf of the named insured. (Ii no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement,) Section II - Who Is An Insured is amended to include as an insured any state or political subdivi-sion shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to opera -tions performed by you or on your behalf for which the state or political subdivision has issued a permit. 2. This insurance does not apply to: All other terms and conditions of this Policy remain unchanged. Page i of 2 `� PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY a, "Bodily injury," "property damage" or "personal and advertising injury" arising out of opera -tions performed for the state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". All other terms and conditions of this Policy remain unchanged. Page 2 of 2 4288 Wiseplace, a Ca Corp Certificate of Insurance (page 1 of 1) 10/28/201505:38:26 PM W) •`° RD' CERTIFICATE OF LIABILITY INSURANCE D TE(MM2O � 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 pollclos may require an endorsement. A statement on this certificato does not confer rights to the certificate holder in lieu of such andoreement(s). PRODUCER CQNTAQT NAME: SeleolSo[utions Insurance Services, LLC #0127711 1350 Carlback Avenue Walnut Creels, CA 945913 PI-IONo Exl :86$'500 6359 �n c No ; 855 801-1449 •MAIL ADDRES PRODUCER CUSTOMER 11) M INf1URER S AFFORDING COVERAGE mm _ NAIQ ft GENERAL LIABILITY INSURED _ INSURERA: Philadel hia lndemnit insuranGO COrYI an 18058 INSURER e : New York Marine & General Insurance 16508 Wiseplace, a Ca Corp 1411 N. Broadway Santa Ana, CA 82706 INSURER C: INSURER p ^ INSURER E : ^µ INSURER F: %1VVr_KAUC7S CERTIFICATE NUMBER- Pr-VI41nnl All IRAMMO THIS 18 T4 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE PEEN ISSUED TO THE )NSURED NAMED A13OVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR 7Ypp OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF AIMIPDIYYYY) POLICY EXP IMMIODNMI LIMITS 20 Civlo Center Plaza GENERAL LIABILITY er EACH OCCURRENCE $ 1,006,060 COMMERCIALGENE.RALLIA6ILITY CLAIMS -MADE 91 OCCUR DAMAGE TO P E ISIS RM? encs $ 1�.DDD MED EXP (Any one person) $ 5,00D A _ PHPKI278339 111/2016 1/112016 PERSONAL &, ADV INJURY S 1,000,000 _ GENERAL AGGREGATE $ 2,000,000- GEN'LAGGREGATELIMIT APPLIES PER: PRODUCTS -COMPIOPAGO $ 2,o0p,00q J POLIQYF. I El PRD, LOC g AUTOMOBILE +% LIABILITY ANY AUTO COMBINED SINGLE LIMM (>=a accident) S 1.000,000 BODILY INJURY (Per person) $ d ALLOwNFpAUTOS BODILY INJURY (Per acUdent) $ A I V SCHEDULEDAUTOS HIREDAUTOS PHPK1276335 11112015 1!112016 PROPERTY DAMAGE (Peraccidanl) $ V NON-OWNEDAUTOS g $ UMBRELLA LIAB .f OCCUR ERCHOCCURRENCE $ 1,000,000 A EXCESS LIAR CLAIMS -MADE P H UB 48 6326 11112015 1! 1!2016 AGGREGATE $ 1,000,00) DEDUCTIBLE Y' J RETENTION S 10,000 $ B WORKBRS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIrTORIPARTNERIPXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yyesC, describe unOFderOPERATIONS [.Z.E.L. pESRIPTION NIA W0201500006833 8/161/2015 6!1&!2016 VMC STATLI- OTB^ .0 ER E.L,EACHACODENT g 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,00,000 DISEASE - POLICY LIMIT $ 1,000,000 A P;orasslonal Liability (Errors and Omiaelons) , PHPK1278535 111=15 11112016 $1,))0,00015210001000 PESCRIFTlON OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Ramarha Sahednlo, If more space is required) The Professional Llabilliy Limits shown represant the Per Claim/Aggregate Limits of Liability, GER I iviCA t E HOLDER C;ANC:r=1 I ATI()N Community Development Agency SHOULD ANY OF THE ABOVE DESCRISED POLICIES BE CANCELLED BEFORE Administrative Services Divislon M-25 THE EXPIRATION DATE THEREOF, NOTICE WILL. 13E DELIVERED IN Attn: Terri Eggers, Senior Community Development Analyst ACCORDANCE WITH THE POLICY PROVISIONS. AUTRQRI2ED REPRFSFNTATIVE 20 Civlo Center Plaza Santa Ana, CA 92701 er 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 26 (2009109) The ACORD name and logo are registered marks of ACORD ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company W4fLbbFLNA N C NI' SuiZISNCE Co This endorsement modifies such insurance as is afforded by the provisions of Policy fi _ AAf Z 12 716 3 3-5 relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and representatives are named as additional insureds ("additiona[ insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion ofany person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not he cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civie Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective 00 01 f r, , this endorsement form as a part of Policy # I I k F% PI -1 fle- rZ o Issued to IJYz __ .... . Named Insured. Countersigned byfA- uthorized Representative 4286 Wiseplace, a Ca Carp Certificate of Insurance (page 1 of 1) 02/04/2016 12:37:01 PM A� R"� CERTIFICATE OF LIABILITY INSURANCE DAT2141201sYYY} 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 COVERA13E 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 poliey(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and condltfons of the pollcy, certain policles may require an endorsement. A statement on thls certffleate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CO AOT NAME: SelectSolutlons Insurance Services, LLC #0127711 1350 Carlback Avenue PHON u 868-500 8359 FAX Ne ; 865 804-8448 M L ADDRESS: INSURER(s) AFFORDING COVERAGE NAIC N Walnut Creek, CA 94596 INSURER A: New York Marine & General Insurance 16608 - TNSUREO INSURERS; Philadelphia nit Insurance Qompariy8058 INSURERC; Wlseplace, a Ca Corp 1411 N, Broadway Santa Ana, CA 92706 INSURERD; INSURER E ; INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER.- THIS UMBER: 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY WAVE BEEN REDUCED BY PAID CLAIMS, LTR TYPE OF INSURANCE Santa Ana, CA 82701 POLICYNJMBER PO ICY EFF MMIDOIYYYY POLICY EXP MMIDDfYYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADS 1-1OCCURSSDM& EACH OCCURRENCE $ 1,000,000 AMARENTED oc $ 100,000 MED EXP (Any one person) 5,000 PERSONAL &ADV INJURY $ 1,000,000 B Yes PHPK1438662 11112018 1/1/2017 GENLAGGREGATE UMITAPPUn PER: _ POLICY ❑ j10T F7 LOC GENERALAGGREGATE $ 2,000,000 PROOUCTa- COMPfOP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea aside $ 1,000,000 BODILYINJURY (Psrperson) $ ANY AUTO ALLOWNEDscHEDULED AUTas AUTOS PHPK1438852 11112018 11112017 BODILY INJURY (Per accident) $ B HIREDAUTOS, NONALTONED Yes PReCPI aiYDAMAGE - $ $ UMBRELLA t -IAB OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAR CLAIMS -MADE Yes PHUB528799 11112016 1/112017 AGGREGATE $ 1,000,000 DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE8116120'IB OFFICERfMEMBER EXCLUOEO9 Y (Mandatory In NH) NIA M201SOM06833 811612018 PER a7H- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 EL DISEASE - EA EMPLOYEE $ 1,000,000 Ifyes, desndha undar DESCRIPTION OF OPERATIONS below E,L, DISEASE- POLICY LIMIT $ 1,000000 B Professional UablLty (Errors and Omtsslons) PHPK1430052 1112016 111/2017 $1,000,0001 $2100C,000 DESCRIPTION OFOPERATiON6I LOCATIONS! VEHICLES (AGORA 101, Additional Remarks Schedule, may be attached If mom space Is required) The City of Santa Ana, Its officers, employees, agents, volunteers and representatives are named as Additional Insured with respect to General Liability policy per attached endarsement,This insurance Is Primary and Non-contributory to any other insurance provided as respects General Liability policy per attached endorsement, The Professional Liability Limits shown represent the Per Claim/Aggregate Llmlts of LlabiRy. CERTIFICATE HOLDER CANCELLATION O 1988-2014 ACORD CORPORATION. All rlghts reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 82701 AWHORIZEDR-"EE�P-�RESENTATIVE IZ,�, O 1988-2014 ACORD CORPORATION. All rlghts reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Pi-MANU-1 (01100) THIS ENDORSgMENT CHANGES THE PQJ[CY. PLEASE READ JT CAREFULLY Al- State or Political Subdivlslon-CG2012/Prlmary & Non Cont Wording ADDITIONAL ENSURED - STATE OR POLITICAL SUBDIV'ISICYS - PERMITS This endorsement modi.£ie,s insurance provided under the following: COMMERCIRL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Political Subdivision: City of Santa Ana, its officers, employees, agents, volunteers and representatives 20 Civic Center Plaza Santa Ana, CA 92701 It is agreed that such insurance as is afforded by this policy for the benefit of the additional insured shown shall be primary insurance and any other insurance maintained by the additional insured shall be excess and nan-contributory except .for Gross Negligence or Willful Misconduct by the Additional Insured, but only with respect to liaba.lity arising out of Operations performed for the additional insured by or on behalf of the named insured, flf no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) vection 1I -- Who Is An Insured is amended to include as an insured any state or political subdivi-sion shown in the Schedule, subject to the following provisions: 1. This i.n9urance applies only viith respect to opera --tions pertormed by you or on your behalf for which the state or political subdivision has issuod a permit. 2. This insurance does not apply to: All other terms and conditions of this Policy remain unchanged. Page I of 2 PI-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ 1T CAREFULLY a. "Bodily inju.ry," "property damage" or "personal, and advex'tleing injury" arising out of opera --tions performed for the state or itunicipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". All other terms and conditions of this Poliq remain unchanged. Page 2 of 2