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MDG ASSOCIATES, INC (2) - 2018
City of Santa A a Clerk of the Council corc office use or y AGREEMENT TERMINATION FORM Please complete this form in its entirety when the attached agreement and amendments (if any) are no longer in effect. ERK OF THE COUNCIL Note: If your agreement is grant related, please ensure that all grant retention requirements JI'AN 31,23 PMj:58 have been satisfied prior to signing the termination form. Is the agreements) a permanent record? Yes No Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. The agreement with l " ` / A-2018-091-01 No. was completed on l� �� �Z and final payment has been made. (List all amendments. Use space below if needed.) ,, 77 //�� Department: 6//4- Phone/Ext.: (u5 (o Signature: i).f- Date: Revised: 10-18-16 INSURANCE NOT ON FILE A-2018-091 WORK MAY NE PROCEED CLERK OF COUNCIL DATE. APR 1 2018 CONSULTANT AGREEMENT c9GP A (J-) INCORPORATING COMMUNITY DEVELOPMENT BLOCK GRANT REQUIREMENTS THIS AGREEMENT, made and entered into this eday of - l L 2018, by and between MDG Associates, Inc., a California corporation ("Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City°'). RECITALS A. The City desires to retain a consultant having special skill and knowledge in the field of grant monitoring services and technical consulting services for federal grant programs. Accordingly, the City issued a Request for Proposals for the Administration of the Community Development Block Grant Program attached hereto as Exhibit A and incorporated herein. B. The City, as an entitlement recipicnt and grantee of the United States Department of Housing and Urban Development C HUD") Community Development Block Grant ("CDBG") Program, desires to enter this Agreement with the Consultant for the expenditure of CDBG funds in accordance with Title 24, Part 570 of Code of Federal Regulations 24 CFR 570.000, et seq. ("CDBG Regs"). C. Consultant represents that Consultant is not listed as debarred, is able and willing to provide such services to the City, and will comply with the CDBG Regs. D, In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the patties agree as follows: 1. SCOPE OF SERVICES Pursuant to this Agreement, Consultant will provide administrative services for the City's CDBG Program, as set forth in Exhibit B attached hereto and incorporated herein, 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit B. The total sum to be expended under this Agreement shall not exceed one hundred thousand dollars ($100,000,00) during the term of this Agreement. b. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals and Scope of Work, which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date first written above and terminate on April 30, 2019, unless terminated earlier in accordance with Section 9, below. The Term of this Agreement may be extended by a writing executed by the City Manager and the City Attorney. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, agents, volunteers, and employees as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence. Consultant shall supply City with a fully executed additional insured endorsement upon execution of this Agreement and shall be approved in form by the City Attorney. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. 2 c. Worker's Compensation Insurance, In accordance with the provisions of Section 3300 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Consultant is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim. e. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be famished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. (iii) Certificates and policies shall state that the policies shall not be cancelled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. f. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not affect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for anywork performed prior to approval of insurance by the City. 6. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, which may arise from the direct or indirect operations of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section I of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. 7. CONSULTANT'S OBLIGATIONS A. No Conflict, To the best of Consultant's knowledge, Consultant's execution, delivery and performance of its obligations under this Agreement will not constitute a default or a breach under any contract, agreement or order to which Consultant is a party or by which it is bound. B. No Bankruptcy. Consultant is not the subject of any current or threatened bankruptcy proceeding. C. No Pending Legal Proceedings/Debarment. Consultant is not the subject of a current or threatened litigation that would or may materially affect Consultant's performance under this Agreement. Consultant further acknowledges that it is not on the list of debarred contractors. D. No Pending Investigation. Consultant is not aware that it is the subject of any current or threatened criminal or civil action investigation by any public agency, including without limitation a police agency or prosecuting authority, that would relate to affect performance of the Agreement or provision of services hereunder, E. Licensing. Consultant agrees to obtain and maintain all required licenses, registrations, accreditation and inspections from all agencies governing its operations. Consultant shall ensure that its staff shall also obtain and maintain all required licenses, registrations, accreditation and inspections from all agencies governing Consultant's operations hereunder. F. Audit Report Requirements. Consultant agrees that if Consultant expends Seven Hundred and Fifty Thousand Dollars ($750,000.00) or more in federal funds, Consultant shall have a, single audit or program specific 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. Consultant shall provide City with a copy of said audit by October 1 of the year following the program year in which this Agreement is executed, if applicable. G. Record Keeping/Reporting. Consultant shall keep and maintain complete and adequate records and reports to assist City in meeting and maintaining its record keeping responsibilities under Title 24, Part 570 of Code of Federal Regulations 24 CFR 570.000, et seq, IL Access to Records. City and the United State Government and/or their representatives shall have access for purposes of monitoring, auditing, and examining Consultant's activities and performance, to books, documents and papers, and the right to examine records of Consultant's subcontractors, bookkeepers and accountants, employees and participants in regard to said program. City and the United States Government and/or their representatives shall also schedule on -site monitoring at their discretion. Monitoring activities may also include, but are not limited to, questioning employees and participants in said program 4 and entering any premises or any site in which any of the services or activities funded hereunder are conducted or in which any of the records of Consultant are kept. Nothing herein shall be construed to require access to any privileged or confidential information as set forth in federal or state law. I. Location of Records/Required Length of Record Keeping. All accounting records, reports, and evidence pertaining to all costs, expenses and the funds received by Consultant and all documents related to this Agreement shall be maintained and kept available at Consultant's office or place of business for the duration of the Agreement and thereafter for five (5) years after completion of an audit in conformity with the CDBG Regulations. Records which relate to (a) complaints, claims, administrative proceedings or litigation arising out of the performance of this Agreement, or (b) costs and expenses of this Agreement to which City or any other governmental agency takes exception, shall be retained beyond the four (4) years until complete resolution or disposition of such appeals, litigation claims, or exceptions. In the event Consultant does not make the above -referenced documents available within the City of Santa Ana, California, Consultant agrees to pay all necessary and reasonable expenses incurred by City in conducting any audit at the location where said records and books of account are maintained. J. Confidentiality. Without prejudice to any other provisions of this Agreement, Consultant shall, where applicable, maintain the confidential nature of information provided to it concerning participants in accordance with the requirements of federal and state law. However, Consultant shall submit to City and or HUD or its representatives, all records requested, including audit, examinations, monitoring and verifications of reports submitted by Consultant, costs incurred and services rendered hereunder. K. Lobbying. Consultant certifies 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 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. 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, L. Financial Interest. Consultant agrees that except for the use of funds to pay salaries and other related, administrative or personnel costs, no persons who exercise or have exercised any function with respect to activities assisted under the terms of this Agreement, or who are in a position to participate in a decision -making process or gain inside information with regard to such activities, may obtain a financial interest or benefit from a City -assisted activity of 5 Consultant, either for themselves or those with whom they have family or business ties, during their tenure or for one year thereafter. This prohibition applies to any person who is an agent, employee, consultant, officer, or elected or appointed official of City, or of any designated public agency, or the Consultant. M. Drug Free Workplace. Consultant certifies 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 Consultant will be required to: a) Abide by the terms above in statement 1. b) Notify appropriate officials of Consultant and City officials of any criminal drug statute conviction for a violation occurring in the workplace not later than five days after such conviction. 3. The City and the United State Department of Housing and Urban Development will be notified within ten days after receiving notice of any such violation. 4. Within 30 days of receiving such notice, appropriate personnel action will be taken against such employee, up to and including termination. 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. N. Nondiscrimination. Consultant agrees that no person on the ground of race, age, color, national origin, disability, religion or sex will be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity funded in whole or in part with funds received pursuant to this Agreement. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. O. Conflict of Interest. Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. Further, any conflict or potential conflict of interest of any employee/officer of Consultant shall be fully disclosed in writing prior to the execution of this Agreement and said writing shall be attached and deemed fully incorporated as a part hereof. Notice shall be sent by Consultant to City regarding any changes or modifications to its board of directors and list of officers. P. Prohibition of Nepotism. Consultant agrees not to hire or permit the hiring of any person to fill a position funded through this Agreement if a member of that person's immediate family is employed in an administrative capacity by Consultant. For the purposes of this section, the term "immediate family" means spouse, child, mother, father, brother, sister, brother-in-law, sister-in-law, father-in-law, mother-in-law, son-in-law, daughter-in-law, aunt, uncle, niece, nephew, stepparent and stepchild. The term "administrative capacity" means having selection, hiring, supervisor or management responsibilities. 8. ASSIONABLUITY None of the duties of, or work to be performed by, Consultant under this Agreement shall be subcontracted or assigned to any agency, consultant, or person without the prior written consent of City. Consultant must submit all subcontracts and other agreements that relate to this Agreement to City. No subcontract or assignment shall terminate or alter the legal obligations of Consultant pursuant to this Agreement. 9. TERMINATION A. This Agreement may be terminated on thirty (30) days' written notice by either party. In the event of such termination, Consultant shall only be entitled to reimbursement for approved expenses incurred to the effective date of termination, B. This Agreement may be suspended or terminated by City upon five (5) days' written notice for violation by Consultant of Federal Laws governing the use of Community Development Block Grant Funds. In the event of such suspension or termination, Consultant shall only be entitled to reimbursement for approved expenses incurred up to the effective date of suspension or termination. C. Pursuant to 24 CFI2 85.43, in the event Consultant defaults by failing to fulfill all or any of its obligations hereunder, City may declare a default and termination of this Agreement by written notice to Consultant, which default and termination shall be effective on a date stated in the notice which is to be not less than ten (10) days after certified mailing or personal service of such notice, unless such default is cured before the effective date of termination stated in such notice. If terminated for cause, City shall be relieved of further liability or responsibility under this Agreement, or as a result of the termination thereof, including the payment of money, except for payment for approved expenses incurred for services satisfactorily and timely performed prior to the mailing or service of the notice of termination, and except for reimbursement of (1) any payments made for services not subsequently performed in a timely and satisfactory manner, and (2) costs incurred by City in obtaining substitute performance. D. The grant of funds under this Agreement may be terminated for convenience in accordance with 24 CFR 85.44. 10. VENUE/JURISDICTION This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 11. 'VALIDITY The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any other provision of this Agreement. 12. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by facsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, California 92702-1988 Facsimile (714) 647-6956 With courtesy copies to: Community Development Agency City of Santa Ana 20 Civic Center Plaza (M-25) P.O. Box 1988 Santa Ana, California 92702-1988 Facsimile (714) 647-6549 City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 Facsimile (714) 647-6515 To Consultant: MDG Associates, Inc, 10722 Arrow Route, Suite 822 Rancho Cucamonga, California, 91730 Phone: (909) 476-9696 Facsimile: (909) 476-6086 13. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify Agency fully, including reasonable costs and attorney's fees, for any injuries or damages to Agency in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. c. No delay or omission by either party hereto to exercise any right or power accruing upon any noncompliance or default by the other party with respect to any of the terms of this Agreement shall impair any such right or power or be construed to be a waiver thereof A waiver by either of the parties hereto of any of the covenants, conditions, or agreements to be performed by the other shall not be construed to be a waiver of any succeeding breach thereof or of any other covenant, condition or agreement herein contained. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: ill�f� MAR �A D. IUIII Y }'mil yeti. ClerkCity M APPROVED AS TO FORM: SOr City 0 ROEERT ZUR S H IEDE Interim Executive Director Community Development Agency 10 CITY OF SANTA ANA RAUL GODINEY II City Manager CONSULTANT President Tax ID# ow-05-"bk13 EXHIBIT A REQUEST FOR PROPOSALS 11 REQUEST FOR PROPOSALS FOR ADMINISTRATION OF THE COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM Proposal Due Date: March 16, 2018 4pm CITY OF SANTA ANA COMMUNITY DEVELOPMENT AGENCY 20 Civic Center Plaza Santa Ana, CA 92701 1 PURPOSE The City of Santa Ana is seeking proposals from qualified consultants, knowledgeable in the administration and oversight of Community Development Block Grant programs to bridge the staffing needs of the City until the permanent administrator is on -board. SCOPE OF WORK Community Development Block Grant (CDBG) administration, Responsibilities of the Consultant: • Provides day-to-day administration of the CDBG program which involves the distribution of funds among various activities, and requires the majority of grant individuals benefiting from the programs/projects be low -to moderate -income persons. • Plans, manages, monitors and evaluates program activities to ensure projects are carried out effectively and in compliance with federal regulations and City requirements, • Conducts surveys such as eligibility of capital improvement projects; analyzes survey results to ensure program compliance. • Prepares contracts with program sub -recipients and provides technical assistance. • Oversees the budgets and expenditures of sub -recipients; prepares grant draws • Ensures recipients, including non-profit organization and other City departments comply with federal regulations and coordinate with these groups to process invoice packages accurately in accordance with applicable federal regulations and local financial procedurals. * Carries out environmental reviews for small projects; • Maintains financial and programmatic records, including tabulating and reporting accomplishment entries in the HUD management information system, and preparation for submission of compliance reports including Section 3 compliance, MBE/WBE reporting, and other reports as needed. Please submit a brief proposal outlining your experience administering a Community Development Block Grant program, your hourly consultant rate and proposed number of hours to be on -site at the City of Santa Ana. At is anticipated that the consultant will be needed for approximately eight to twelve weeks. 2 INFORMATION REQUESTED FROM PROPOSER To achieve a uniform review process and obtain the maximum degree of comparability, it is required that proposals be organized in the manner specified below: 1. Title Show the RFP subject, the name of proposer firm, local address, telephone munber, name of contact person and date. 2. Letter of Transmittal Briefly state the proposer's understanding of the work to be done and make a positive commitment to perform the work within the specified time period. Give the names of the persons who will be authorized to make representations for the proposer, their titles, addresses, e-mail addresses, telephone numbers, and fax numbers. 3. Profile and Qualifications of the Proposer Identify personnel who will provide the day to day administration of the CDBG program including their resumes, Describe recent CDBG experience similar to the type requested. 4. References Give names, addresses, and telephone numbers of three (3) client contacts for such audits. ADDITIONAL INFORMATION AND CONTACT Neither the City nor the Community Development Agency will be liable for any costs not included in the proposal and subsequent -for costs. The City or the Agency reserves the right to reject any and all proposals, the right in its sole discretion to accept the proposal it considers most favorable to its interest, and the light to waive minor irregularities in the procedures. Additional information or clarification should be directed to: Terri Eggers Senior Community Development Analyst City of Santa Ana 20 Civic Center Plaza M-25 Santa Ann, CA 92702 (714) 647-5378 TEggers@santa-ano.org santa-ano.org DEADLINE OF RESPONSES Responses to this request for proposal should be received and time stamped no later than 4:00 P,M. on March 16, 2018. Three (3) copies of proposals are required. 1M-1� PROPOSAL 12 M d G ASSOCIATES • INC. k •17-IfETELOPlYiENT BLOCK GRANT PROGRAM CORPORATE HEADQUARTERS 10722 ARROW ROUTE, SUITE 822 RANCHO CUCAMONGA, CA 91730 TELEPHONE; 909/ 476.9696 FAX NO.: 909/ 47&6086 M D V ASSOCIATES, INC.. March 13, 2018 City of Santa Ana Ms. Terri Eggers Senior Community Development Analyst Community Development Agency 20 Civic Center Plaza M-25 Santa Ana, CA 92702 Subject: Proposal to provide Administration Services for the Community development Block Grant. Program Dear Ms.. Eggers: MDG Associates, Inc. (MDG) is pleased to submit its qualifications to provide assistance.in the administration of the City's Community Development Grant (CDBC) Program. MDG, along with its affiliate LDM Associates, Inc. (LDM), have been providing high,goality services to municipal agencies, the U.S. Department of Housing and Urban Development (HUD) and private clients for over 27 years. MDG's emphasis and capabilities are in the grants management of HUD funded Community Planning and Development (CPD) Programs such as Community Development Block Grant (CDBG), HOME investment Partnerships (HOME) and Emergency Solutions Grant (ESG) in addition to one-time entitlement grants such as the Neighborhood Stabilization Programs and the Hofnelessness Prevention and Rapid Rehousing Program ('I-IPRP), The firm provides administration and/or implementation services for programs such as housing rehabilitation, commercial rehabilitation, first time homebuyer and labor compliance services (both State and Federal). MDG Is a registered California Corporation and is a certified Minority Business Enterprise (MBE). Our connsulting team is comprised of highly qualified professional staff with expertise in all aspects of CDBC Program administration and Implementation. We hope this proposal conveys our firm's ability to provide consulting services to assist you in meeting your needs, Provides( herewith, is the Information requested in your Request for Proposals (RFP), You may contact me at the following address, telephone number or e-mail should you have any questions regarding this proposal: MDG Associates, Inc. 10722 Arrow Route, Suite 822 Rancho Cucamonga, CA 91730 (909) 476.9696 r uI c�lmd-dm,conn TOM Arrow Route ■ Suite 822 a Rancho Cucamonga ■ California 91730 (909) 42MG96 ■ Fax (909) 476-6066 If you have any questions regarding this matter, Tease do not hesitate to call me at your convenience, Enclosure: Proposal 10722 Arrow Route ■ Suite 022 w Rancho Cucamonga w California 91730 (909) 476.9696 e fax (909) 476.6086 CITY OF SANTA ANA PROPOSAL ADMINISTRATION OF THE COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM TABLE Of CONTENTS Section 1. Description of Firm, Qualifications, and Experience ................................ 7 Section 11, Approach and Scope of Work ....................... 3 Section Ill. References 5 Section IV. Budget and Schedule of Hourly Billing Rates ........ 6 Resumes of Key Personnel SECTION 1. DESCRIPTION OF FIRM, QUALiFIC'ATIONS, AND EXPERIENCE MDG Associates, Inc. (MDG) was established III 1991 and has undergone steady growth since its Inception. MDG Is a corporation registered In the State of California. MDG is a registered Minority Business Enterprise (MBE) and a Small Disadvantaged Business (SDB/DBE), In response to our clients' needs, MDG and Its affiliate LDM Associates, Inc. (LDM provide a wide variety of Community Development consulting services Including, but notlimited to: Grants Management; Project Management, Construction Management; Architectural Design; Urban Planning; and Labor Compliance Monitoring, MDG, Associates, Inc: Is comprised of individuals with a wide variety of expertise including the services specifically requested by the City. Currently, MDG has twenty-eight (2.6) staff members, Thirteen (13) of the 26 staff members are, knowledgeable and experienced in the administration of CDBG, HOME, ESG, and the CalHome Programs in addition to projects funded udder these Programs. M.DG provides administrative and management services to cities that.are seeking a consultant thatcan act as an extension of their staff and look after the best interest of the City, Grants Management: MDG currently provide administration and Implementation services for the Community Development Block Grant (CDBG), HOME Investment Partnerships (HOME), Emergency Solutlons. Grant (ESG), Community Development Block Grant -Disaster Recovery (CDBG-DR), and Neighborhood Stabilization Programs (NSP). MDG has managed other grants such as State grants (Parks and Recreation, CalHOME, State HOME, Prop. 40, etc,), CDBG �- Recovery,grant, Homeless Prevention and Rapid. Rehousing (HPRP) grants, In addition, MDG Implements activities funded under the aforementioned programs such as Residential Rehabilitation, Commercial Rehabilitation; and First -Time Homebuyer, Economic Development, and Labor Compliance Monitoring and Enforcement Services. MDG staff maintains an excellent relationship with the local HUD offices as well as at the headquarters level (Washington D,C:), MDG staff currently provides technical assistance (TA) to grantees throughout the country on behalf of HUD Headquarters through the OneCPD and. Community Compass Programs. The technical assistance is provided to states, counties, cities and other HUD -funded grantees in conjunction with the CDBG, HOME, and NSP programs as well as the IRIS and DRGR HUD reporting systems. Our staff has been tasked by HUD Headquarters to provide national training on their behalf to grantees and HUD Staff, The training has been in the.areas of "Basically CDBG," Assessment of Fair Housing (AFH), Disaster Recovery Grant Reporting (DRGR.), eCon Planning Suite, CPD Maps, andthe integrated Disbursement information System (IRIS). Our staff is also tasked with providing assistance to grantees through the HUD Resource Exchange Ask a Question (AAQ) program in the areas of CDBG, HOME, and DRGR, MDG and Its affiliate LDM are currently under direct contract with 18 cities and two (2) counties throughoutthewestern United States with funds from HUD totaling approximately 2&5 million dollars. The services are primarily for the day-to-day Implementation of their CPD Programs. For others, MDG provides services on specific tasks such as IDIS input, Project monitoring, federal labor standards (Davis - Bacon) compliance, monitoring CDBG/HOME and ESG grants, preparatlon of Consolidated Plan/Action Plan, and the preparation of Consolidated Annual Performance and Evaluation Report (CAPER). As HUD CPD program management consultants, MDG assists with the day-to-day administration of the programs, including the preparation of Five•Year Consolidated Plans, OneNear Action Plans, and CAPERs. We conduct the monitoring of public service activities and capital improvement projects for Page 118 compliance with the CDBG, OMB (2 CFR Part 200), Davis -Bacon Act requirements, and other cross- cutting requirements. The day-to-day services include, but are not limited to setting up budgets based on the adopted Annual Action Plans; assist in preparing agreements and purchase orders; reviewing invoices and supporting documentation for compliance with applicable requirements (e,g„ procurement, contracts, and Davis - Bacon compliance, etc.), We assist in setting up draws in the IDIS system upon reconciliation of grantees general ledger; completing conducting programmatic and financial monitoring of subreciplents and City Departments to assure activities are compliant with the agreement/MOU and all applicable requirements, We assist in inputting quarterly accomplishments in IDIS; conducting annual reconciliations of City's accounts as compared to the data in IDIS; tracking accounts/budgets for any carryovers, or unexpended funds upon activity close-out; monitor and maintain program Income and or loan portfolio. We also assist the City during the single -audit process, providing requested information to the auditor. Housing Rehabilitation: MIX along with its affiliate LDM are currently under contract with 15 cities for the day -today management and implementation of their housing rehabilitation programs and Inspection services for their programs. Last year, the firm processed and completed the rehabilitation of approximately 225 residential dwellings for the 15 different cities. The programs included the use of CDBG finds, HOME funds, State HOME funds and CalHome funds, Commercial Rehabilitation Program Administration and Implementation Experience: During the past 15 years, our firm has been assisting cities in the dayto�day administration and implementation of their Commercial Rehabilitation Programs, During the past five (5) years, we have assisted eight (8) Cities with the rehabilitation of approximately 55 commercial buildings. In addition, we are In the process of setting up two (2) new programs for the Cities of Buena Park and Hesperia, The level of service requested by each City differs, however in most cases we provide the overall administration .and implementation services. These include inspection, design services, project management and Davis -Bacon Compliance monitoring. Labor Compliance (Davis -Bacon Act): We are currently under contract to provide Labor Compliance services to 14 cities in Southern California. Our typical scope of work includes preparation and reviewof bid documents for compliance with Federal labor standards and requirements Including Davis -Bacon and Related Acts, Section 3, and DOL regulations; attend pre.construction meeting and present information on Davis -Bacon and Section 3 requirements; review submitted bid documents for compliance; establish and maintain contractor and subcontractor labor files; conduct employee field Interviews and document posting compliance; reconcile weekly certified payroll reports and supporting documentation; monitor contractors for Section 3 accomplishments; schedule labor compliance file reviews prior to release of retention funds; and address and resolve any underpayment or deficiency issues. Section 3: Our staff is experienced in the implementation of the Section 3 employment, contracting and training requirements. Currently, we monitor labor compliance activities on 15 projects with a combined construction value of over $12.5 million. Of these projects, ten (10) arc Section 3,covered projects with contracts in excess of $I00,000. Page 218 SECTION M PROJECT APPROACH AND SCOPE OF WORK The members of our consulting group proposed to provide administrative services for the City's Community Development Block Grant program include Mr. Rudy Munoz, President; and Ms. Esther Luis, Senior Associate, Mr, Munoz will be overseeing the contract and will be available on all as needed basis to address any contract or staffing related issues, Ms. Esther Luis, Senior Associate will bethe main contact and responsible for the day -today administration of the CDBG program. Rudy Mufloz, President,- Mr. Rudy Munoz has been providing community developmentt consulting services to municipal agencies with MDG Associates since he founded the Company in 1991. Mr. Muho>_ has more than 30 years of overall experience in the community development field, including grants management of federal, county, and local grants including those offered by the U.S. Department of Housing and Urban Development, He is responsible for assisting municipalities with all aspects of Community Development Slogk Grant (CDBG), HOME Investment Partnership Act (HOME), Neighborhood Stabilization Program (NSP) and Emergency Solutions Grant (ESG) administration -and implementation. Mr. Munoz focuses on strategic community investment, development of implementation tools to facilitate the management of programs, developing tools and conducting training for HUD individual and multiple grantees and in the development of Policies and Procedures for programs (HOME, CDBG, NSP) and activities funded under these. programs (Housing Rehabilitation, Commercial Rehabilitation and Homebuyer Programs). His work In these areas includes 36 Consolidated Plans, over 200 Action Plans -arid .CAPER:s, and 12 Analysis of Impediments to Fair Housing Choice. Mr, Munoz has been providing HUD grantees; through its Technical Assistance Program, Basically CDBG Program, Disaster Recovery Grant Reporting (DRGR), and CPD Monitoring training throughout the country in addition to the Commonwealth of Puerto Rico (training conducted in Spanish). Mr. Munoz is a certified HOME Specialist (Regulations) and Is a national technical assistance provider through HUD's OneCPD and Community Compass; initiatives. Mr, Munoz worked for a number of municipalities in. Southern California in the Community Development field overseeing Planning, Code Enforcement, Grants Management, and Building Departments, Mr. Munoz received a Bachelor of Architecture from California Polytechnic University irr Pomona, Esther Luis, Senior Associate, Ms, Esther Luls Joined MDG Associates; Inc. in June of 2000 and currently serves as a Senior Associate oil the Housing and Community Development team. Ms. Luis has more than 19 years of experience in the planning and Implementation of federal grants including those offered by the U.S, Department of Housing and Urban Development - Office of Community Planning and Development. Ms. Luis' grants management experience includes federally. and County -funded Community Development Block Grant (CDBG) Programs, administration of housing and commercial rehabilitation programs and the oversight other state and federal grants. Ms. Luls' capabilities include knowledge of federal and state grant guidelines, grant application requirements, as well as the ability to administer and manage grants. She has worked on both sides of the CDBG program to include oversight as a County staff member overseeing Urban County grantees, working with Urban County grantees reportingto the County and working for entitled grantees working directly with HUD. Ms. Luis primary focus is on the day-to-day CDBG program administration and management, subrecipient (public service) management and monitoring, labor standards enforcement, compliance Page 318 with federal reporting requirements Including the Consolidated Annual Performance and Evaluation Report (CAPER), and all other aspects of program administration, implementation and compliance, Ms, Luis has worked with multiple cities in the administration of their programs. Prior to her career in the private sector, Ms. Luis held the position of Development Specialist and Program Specialist for the Community Development Commission of the County of Los Angeles and Economic Development Analyst, The resumes of the staff members are included in the Resumes of Key Personnel section of this document. SCOPE OF WORK M©G proposes to provide staffing and other resources required to provide administrative services for the City's CDBG projects and programs, Those duties include; Community Development Block Grant (CDBG) Administration, Provides day-to-day administration of the CDBG program which involves the distribution of funds among various activities and requires the majority of grant individuals benefiting from the programs/projects be low to moderate4ncome persons. * Plans, manages, monitors and evaluates program activities to ensure projects are carried out effectively and in compliance with federal regulations and City requirements. • Conducts surveys such as eligibility of capital Improvement projects; analyzes survey results to ensure program compliance, o Prepares contracts with program sub -recipients and provides technical assistance. Overseas the budgets and expenditures of sub -recipients; prepares grant draws Ensures recipients, including non-profit organization and other City departments comply with federal, regulations and coordinate with these groups to process invoice%packages accurately in accordance with applicable federal regulations and local financial procedurals. • Carries out environmental reviews for small projects; • Maintains financial and programmatic records, including tabulating and reporting accomplishment entries in the HUD management information system, and preparation for submission of compliance reports Including Section 3 compliance, MBE/WBE reporting, and other reports as needed, Page 418 SECTION fit. REFERENCES HUD Entitlement Cities: �• u=�• . �Wv V I uai aI n narnrnistranon ana HUML Technical Assistance including all aspects of the CDBC Pragrann as well as assistance with affordable housing projects and Davis -Bacon Compliance Monitoring. Date .of Contract: 2010 to Present Phone Number: (951) 739.4963; email. address: Cynthia Lara4cf corona ca City of Fontana [)avid &a r Q ,n, jV e a Services Provided: CDBC/HOME/CDBG7R/N5P Program 7A; Analysis of Impediments to Fair blousing (AI); Consolidated Plan/Action Plan/CAPER preparation; DavisBacon/Sectlon 3 Compliance; Policies ai)d Procedures for FTHB and Hosing Rehabilitation progtams Cate of Contract) 2609 to Present Contact Person: Phone Number: (909) 350r0739; email address: dgdt;al'9(p na or& — Y - o 1 iuvivauo twi u,P jrivivic rrogram Aamfnlstratlon and Technical Assistance; CDBC and.HOME funded Housing Rehabilitation Program Implementation,• RDA.funded Commercial Rehabilitation Program Implementation; Analysis of Impediments to Fair Housing (Al); Consolidated Plan/Action Plan/CAPER preparation.. Date of Contract: 2002 to 2010 and 2014 to Present Phone Number; (310) 349-2976; email address; mguerreroarityofhawthrolna era arrrvices rrovioeo: (-trutr/htUME/CDBC-R/HPRP Program Administration and Technical Assistance; Redevelopment consultation, CDBC and HOMEfunded Housing Rehabilitation Program Implementation; Analysis of Impediments to Fair Housing (AI); Consolidated Plan/Action Plan/CAPER.preparation, Davis Bacon and Section 3 Compliance, Date of Contract: 2001 to Present Phone Number: (949) 724.7452; email address: gh2kg2ci Irvine cads City of Newport Ba�;ERin Mr lamr s Campb 11 Pried al planner Services Provided: CDBC Program Technical Assistance; Davis -Bacon and Section 3 Compliance; Analysis of Impediments;. Consolidated Plan/Action Plan/CAPER preparation; affordable housing monitoring, Date of Contract: 2000 to Present Phone Number: (949) 644-3210; email address: 9M12hell1'1_11ewnor ac a, wv Ci11,1 f Paramount - ICarina (at„�rt Liu Finance Directnr Services Provided: CDBC/CDBC-R/NSP/FIQME Program Administration; Redevelopment Consultation; CDBG and HOME funded Housing Rehabilitation and Commercial Rehabilitation Program Implementation; Homebuyer Assistance Program; Analysis of Impediments to Fair Housing (AI); Consolidated Plan/Action Plan/CAPER preparation; 5 Year Implementation Plan (Redevelopment); Davis - Bacon Compliance; and affordable housing monitoring. Dates of Cantract: 2003 to Present Phone Number: (562) 220-2210; email address: Ili Paw i o atCity cgs Page 518 City of Rialto tdI14 torys City Admiaistrafor 150 S. Palm Avenue, Rialto, CA 92376 Services Provided: CDBG Program Administration; CDBG-R Program Administration; NSP1 and NSP3 Program Administration; Homelessness Prevention and Rapid Rehousing (HPRP) Program Administration; Commercial Rehabilitation Program implementation; Project/Construction Management; Davis -Bacon; Consolidated Plan/Action Plan/Analysis of Impediments/CAPER preparation. Date of Contract: 2000 to Present Contact Person: Phone Number (909) 820.2689; e-mail address: Administration@rlaltoca,gov a- Ymm rrvviueu: c.ursw r^rogram iechnlcar Assistance; CalHome and RDA funded Housing (Rehabilitation Program lmjilementation (4 separate programs); RDA funded Commercial Rehabilitation Program Implementation; CalHome and RDA funded Homebuyer Assistance Program; Project/Construction Management; ,Davis,Bacon and Section 3 Compliance; Analysis of Impediments; Planning Services; Analysis of Impediments to fair Housing (AI); Consolidated Plan/Action Plan/CAPER preparation; affordable housing monitoring, Date of Contract: 2004 to Present Phone Number: (909) 931.4148; email address: I ck@cj Wland c_ ,us Phone Number (909) 593.7543; email address: tweiiie cl walinit ca usus Urban County Cltles! City of Asioura Ffitlis Dour Harmer Director of Planning 5ervrces Provided; CDBG Program Administration (Urban County with LACDC); CDBG/RDA funded. Housing Rehabilitation Program implementation; Davis -Bacon and Section 3 Compliance Monitoring. Date of Contract: 1999 to Present Phone Number (818) 597,7342; email address: dhooperdici agQura-hills.ca. s oelm,es rruviaea: LooLi rrograrn Administration, as a participant in the LACDC Urban County Program and assistance.with the City's: State CDBG Program, federal Labor Compliance services. Date of contract: 2015 to Present Phone Number: (626) 812.5236; email address: Kchristipp�ejn@ci azusg ca usus Chef Claremont — Austin Ramirez Management Analyst Services Provided; CDBG Program Administration (Uriaii Countywith LACDC); CDBG funded Housing Rehabilitation Program implementation; publie service program technical assistance; Davis-Bacon:and Section 3 Compliance, Date of Contract: 2010 to Present Phone Number (909) 399-5473; email addross:afamlrez@ci cl•tremontca ys City of Quarte — Rafael Casi s P lic Work,, n a. Services Provided: CDBG Program Administration, as a participant in the .LACDC Urban County Program and assistance with the City's State CDBG Program, federal Labor Compliance services, and the City's annual Housing Element Update to the General Plan, Pate of Contract: 2015 to Present Phone Number:. (626) 357-7931; email address: rcaci I s a cessduarte com Page 618 —t; " au- m4tP,ea uommunity Pr�Y�e�nnment M Services Provided: CDBG Program Administration (Urban County with LACDC); public service program technical assistance; Davis -Bacon and Section 3 Compliance, Date of Contract:2000 to Present Phone Number (310) 973-3240; email address: 5inoore@lnwndal itv "r Services: Los Angeles County Community Development Commission - Administration of CDBG Program Administration; implementation of CDBG Home Improvement Program; Davl&-Bacon and Section 3 Compliance. Date of Contract: 2002 to Present Phone Number (310) 544.5247; email address;,taftagr v a ov wwl vlWwp l uvj =u. %..Tapia rrug' am homntistration (urban Lounty with LACDG); CDBG funded Housing Rehabilitation Program implementation; public service program technical assistance; Davis -Bacon and Section 3:Compliance. Date of Contract; 2000 to Present Phone Number (909) 595.7543; email address: 1wgiuw9gl yvalnut ca 4is Page 71S SECTION IV. BUDGET AND SCHEDULE OF HOURLY BILLING RATES BUDGET PROPOSAL MDG proposes to provide administrative services for the City of Santa Ana's CDSG program for a period of approximately eight to twelve weeks or as requested by the City. MDG anticipates being on. site approximately from 8 to 16 hours per week depending on the City's needs, Based on prior history, we believe that the number of hours budgeted is sufficient#o address the scope of work. MDG proposes to bill on a time and material basis based on the schedule of hourly billing rates, SCHEDULE OF HO m BILLING RATFC Rates effective as of July 1, 2017 uAff—ux HOURLY RATE President/Senior Vice President $ 11 0,00/1-1r, Vice President $105.00/Hr. Manager $ 95..00/Hr. Senior Associate $ 90.00/Hr. Associate $ 80,00/1-1r. Senior Project Assistant $ 65,00/1-ir, Project Assistant $ 60.00/1-1r, Secretary $ 45,00/1-Ir, Note: If MDG staff is requested by the City to attend a meeting not considered a part of this Proposal or on a day in which a consultant is not scheduled to be on site, the City shall be billed for the time it takes to drive to and from the City and its corporate office. RM,HURSABLE ITEMS^ - Project Supplies - at Cost Plus 10% Surcharge (If applicable) • Prints/Reproductions - at Cost plus 10% surcharge (If applicable) - Postage - at Cost plus 10% surcharge (If applicable) 13aPe 818 M D G ASSOCIATES • mc. Rudy E. Munoz President PROFESSIONAL EXPERIENCE: MDG Associates, Inc. - Rancho Cucamonga, CA President;1991 Present rounder and President of MDG Associates, Inc„ a community development consulting firms specializing in administration and implementation services to a number of municipal agencies.. Over 30 years of experience In the community development field that Includes strategic development of implementation tools to facilitate the management of programs; classroom training, administration and implementation of programs and designing programs for state; county and local governments. Specializes In the oversight of U.S, Housing and Urban Development (HUD) programs to government agencies as well as HUD technical services providers. under the OneCPD and Community Compass Technical Assistance program, The services to government agencies Include providing day-to-day administration services for the Community Development Block Grant (CDBG), Home Investment :Partnershlps Act (HOME), Neighborhood Stabilization Program (NSP), and Homelessness Prevention and, Rapid Rehousing Programs (HPRP). Responsible for designing, developing, administering, and implementing housing rehabilitation, commercial rehabilitation, and FlrstTime Homebuyer programs for a, number of grantees In Southern California, Services provided to HUD service providers includes HOME and CDBG Program technical assistance; training on the. Disaster Recovery and Grant Reporting (DRGR) system, Basically CDBG, e-Con Planning Suite and CPD Maps, Part of HUDs Ask a Question (AAQ) team for the DRGR reporting system, HOME Program, and the 141S Reporting system in addition to being a part of HUD's Policy and Procedure Work Group responsible for developing policy and procedures for CPD Programs, Has provided training and technical assistance (TA) through HUD service providers to tl•re Commonwealth of Puerto Rico In Spanish. This includes the translation of CPD training materials,. checklists, and training slides In Spanish. City of Huntington Park - Huntington Party CA Ass, Director of Comm, Development/Redevelopment: 1987 - 1991 Assisted the Director of Community Development in the administration of the department, Directly responsible for the day-to-day administration and management of municipal staff on the CDBG and HOME programs, current and advanced planning functions and code enforcement activities. Acted as Secretary to the City's Planning Commission, City of Bell - Bell, CA City Planner 1986 -1987 Under the direction of the Community Development Director, administered the City's current and advanced planning activities, assisted in the development of a new General Plan, Responsible for reviewing and processing Subdivision Review, Zoning Review, Environmental Review; and Design Review functions. Responsible for the administration of the CDBG Program funded and the Urban County Program, 0 MOG ASSOCIATES, INC. M Rudy E. Munoz P . 2 City of Montclair - Montclair, CA Associate Planner (started as Assist, Planner):1985 - 1986 Asslsted in the daily planning functions including, California Environmental Quality Act (CEQA) review, Design Review, Subdivisions, Annexations, Development proposals. Responsible- for reviewing and processing .Zone Changes, Variances, Conditional Use Permits, and other entitlements, Booth -Good Architects: Walnut, CA Project Assistant 1962.1985 Under the direction of the Project Architect, assisted in the design development, and preparation of construction drawings for a variety of building types Including single family residential, multi -family residential and commercial developments. EDUCATION: Bachelor of Architecture (5-Year Degree) California State, Polytechnic University,, Pomona AFFILIATIONS/ REGISTRATIONS: ICBO , International Conference of Building Officials NAFIRO- National Association of Flouring and Redevelopment Officials AIA - Prior Associate member of the American institute..of Architects Licensed State General Contractor - California License No.681042 ICSO - Earthquake Retrofit of Wood Frame. Homes Certification Certified HOME Program Regulation's, HUD (Technical Assistance Provider) 0 MDGA.SSOCIA,TES,INC. Is Esther Luis Senior Associate PROFESSIONAL EXPERIENCE: MDG/LDM Associates, Inc. - Senior Associate Responsible for the administration and implementation of CDBG Programs and activities funded witnd and commeral rehabilitation lion programs. HOME nd CRA Assist inuthe prelparattiion of rive•YeareConosolidatehousild Plans, Analysisciof Impediments to Fair Housing Choice (At), Annual Action Plans and Consolidated Annual Performance and Evaluation Reports in connection with U.S. Department of Housing and Urban Development (HUD) programs. Serves as the lead consultant with assigned ,clients and is responsible to coordinate the work of assigned consultants to ensure work flow efficiency and quallty. Provide technical assistance to Cities to enhance their capacity in the administration of federal and state grant programs Community Development Commission County of Los Angeles - Development Specialist I Responsible for monitoring Cities, Community Based Organizations (CBO?s) and County Departments to ensure compliance with Community Development Block Grant (CDBG) regulations; provider,) technical assistance to CDBG grant recipients in identifying appropriate systems that can be implemented to meet CDBG requirements; reviewed and responded to eligibility inquires for proposed CDBG projects; provided CDBG compliance training to grant recipients; reviewed construction projects for compliance with Davls-Bacon requirements, and prepared recommendations for corrective actions. Community Development Commission County of Los Angeles - Program Specialist Reviewed applications for subsidized housing from Community. Based, Organizations (CBO's) serving the homeless and low-income persons with HIV or AID's; negotiated lease contracts With private owners; verified tenant eligibility using files and computer based records; resolved disputes between owners, tenants and the Housing Authority; counseled tenants with regard to housing and economic concerns; maintained files and records; and provided program information to the public. EDUCATION: Bachelor of Arts - Sociology/Business Administration University of California, Los Angeles (UCLA) TECHNICAL SKILLS: Computer Skills: Microsoft Office (Word, Excel; PowerPoint, Outlook) and Window Operating Systems, Bilingual/Bi-literate - Fluent In Spanish AFFILIATIONS/REGISTRATIONS: Notary Public for the State of California 14 MI)G ASSOCIATES, INC. ■ IDIS Online Access Request U.S. Department of Housing and Urban Development Office of Community Planning and Development OMBAppree d No. 2506-0171cup 04/30/2020 Privacy Act Statement: Public Lew 97.255, Flnancial Integrity Act, 31 U.S.C. 3512, authcHEee the Department of Housing and Urban Development (HUD) to collect all the Information whlch WII be used by HUD m Protect disbunennI data from fraudulent arH ,B The purpose of the data Is to safeguard the Integrated Disbursement and Information System iID151 from una uthorlaed access. The data are used to ensure that individuals who no longer require access to IDIS have their accese capability Prempap deleted. This Inferm rile, will not be otherwise duel osed or released outside of HUD, axceptas permitted or required by law. Failure to provide the Information requested on the form may delay the p Dessmar, of yourapproval for access to IDIS, Public Reporting burden for this Information EDlleRlon Is estimated to avenge 30 minutes Including time for collecting, reviewing, and "porting data, HUD may not collect thls Information, and respondents are not required to mmpletb this form, unless It displays a cunantly valid OMB central Number. GRANTEE & REQUE$TOR INFORMATION REQUEST TYPE ■IIIR7l�I11�wwa�r�l��.�� New Request ❑ ❑ Drop from IDIS Renew Lapsed ID ❑ Change Function or Program Area ❑ Change Name ❑ Add Access for Another Grantee t .. Please create a flue digit pin that will be used for password resets. [ 9] [ 11 (3 ] [ 7 ] (l j Requestor's Name (Last, First, MI): Office E-mail Address: Luis, Esther eluis@mdg-Idm.com Office Address: Office Phone: ext.: 10722 Arrow Route, Suite 822., Rancho Cucamonga, CA 91730 (909) 476-9696 107 Grantee Name in IDIS: .. ,, ......... ............. ._...._.. ......._ .. _.._ GR/dN'PBBTYPE... City of Santa Ana City ® County ❑ State Non Profit ❑Sub Grantee* ❑ Please Mark All tJecessary Functions & Programs - Set Up Activity ® Request Drawdown us g ApproveDrawdown❑ Local IDIS Administratorn ' CDBG ® HOME ® ESG ❑ HOPWA ❑ HESG ® HOPWA-C ❑ HTF ❑ Other; If other, please specify name of program *Approval of Sta#e Sub Grantee Request — CPD State Coordinator or State Official name, signature and date: Name: Signature: Date: Can Plan.'. Create/Edit/Submit ® Edit ® View Caper: Create/Edit/Submit Edit ® View IDIS Online Rules of Behavior September IA, 201E Introduction This Rules of Behavior (ROB) procedure was developed as a guide to ensure that all users of IDIS Online are made aware of their security responsibilities before accessing IDIS Online. The ROB defines responsibilities and procedures for secure use of IDIS Online. By reading and acknowledging these rules, users accept the responsibility to protect IDIS Online and data. Users are accountable for their actions and the requirements to protect IDIS Online data and equipment from both malicious and accidental loss and damage. These rules clearly delineate the responsibilities of and expectations for all individuals with access to IDIS Online. Non-compliance with these rules will be enforced through sanctions commensurate with the level of infraction. Responsibilities All authorized users who have access to IDIS Online are required to read, acknowledge understanding, and sign the ROB before accessing IDIS Online and associated data. This acknowledgement must be completed annually thereafter. By agreeing to and signing these rules, the user signifies: 1. Understanding that access is given only to IDIS Online to which the user requires access in the performance of their official duties and the user will not attempt to access systems they are not authorized to access. ALL PREVIOUS Val Some OFTHIS FORM WILL NOT BE ACCEPTED OR PROCESSED. BUD FORM 27055105-15-20171 Page l F?I 2. Understanding of the IDIS Online Rules of Behavior (IDIS ROB) security requirements. 3. Acknowledgement that disciplinary action may be taken based on violation of the IDIS ROB. The IDIS Online System Security Administrator (SSA) verifies that the users who require access to IDIS Online have read and accepted (via signature on the acceptance form) this IDIS ROB. Other Policies and Procedures This IDIS ROB Is intended to enhance and further define the specific rules each user must follow while accessing IDIS Online. The rules are consistent with the policy and procedures described in the following directives: Application Rules Because written guidance cannot cover every contingency, you are asked to go beyond the stated rules, using your best judgment and highest ethical standards to guide your actions. These rules are based on Federal laws and regulations and HUD policies. As such there are consequences for non-compliance. The following IDIS ROB is the minimum rules for users who are requesting an IDIS Online user account: 1. You are aware of the existence of and penalty for violating 18 USC 1030 and abide by: a. The elements of 18 USC 1030(a)4, "Accessing to Defraud and Obtain Value" are: I. Knowingly accessing a protected computer without or in excess of authorization; ii. With intent to defraud; M. Access furthered the intended fraud; and iv. Obtain anything of value b. The penalty for violating this statute Includes a fine and imprisonment of not more than ten years, or both. 2. You must adhere to HUD's policy requiring a separation of duties between the requestor and approver for financial transactions: a. Effective December 14, 2001, the same person can no longer both request and approve a given draw down in IDIS Online. b. While individual persons may have the power to both request and approve draws, this rule prevents an individual from approving a draw that he or she created. IDIS Online requires two people to be involved in every draw down of funds. 3. Currently, the IDIS Online Local Administrator initially defines what a person can do in IDIS Online, carrying out the wishes of each grantee's authorizing official — mayor, grant holder, CEO, CFO, etc. Some users have full rights, while others have limited rights of various kinds. You understand that you are given access only to IDIS Online to which you require access in the performance of your official duties and that you will not attempt to access systems that you are not authorized to access. 4. You are prohibited from misusing IDIS Online, i.e, exceeding your authority. Your level of access to IDIS Online is limited to ensure your access is not more than necessary to perform your legitimate tasks or assigned duties. If you believe you are being granted access that you should not have, you must immediately notify the IDIS Online SSA via email at IdisUserid Reauestsg hu d.gov. 5. You must immediately notify your Supervisor, CIBD Field Office Administrator, and/or your Local Grantee Administrator if your access/privilege are no longer required, termination, promotion, and transferred. 6. You must maintain the confidentiality of your authentication credentials such as your password. Do not reveal your authentication credentials to anyone and do not record passwords on paper or in electronic form. 7. You must report all security incidents or suspected Incidents (e.g., lost passwords, improper or suspicious acts) related to IDIS Online to the HUD Computer Incident Response Team at CIRT hud.eov. 8. Your IDIS Online password expires every 90 days., so ensure you access IDIS at least once a month. Users who do not use IDIS within a 90 day period will find their accounts are de -activated. ALL PBPVIOUS VEPRONS OF TRIPS FORM WILL I BE ACCEPTED OR PMCF55ED IIUO FORM 3]05$(05Bi30111 9. You must follow proper logon/logoff procedures. You must manually logon to your session; do not store your password locally on your system or utilize any automated logon capabilities. You must promptly logoff when session access is no longer needed. If a logoff function is unavailable, you must close your browser. Never leave your computer unattended while logged into IRIS Online. 10. You must not establish any unauthorized interfaces between IDIS Online and other non -HUD systems. 11. Your access to IDIS Online constitutes your consent to the retrieval and disclosure of the Information within the scope of your authorized access, subject to the Privacy Act, and applicable Federal laws. 12. You must safeguard IDIS Online resources against waste, loss, abuse, unauthorized use of disclosure, and misappropriation. 13. You must not process classified national security information on IDIS Online. 14. You must not browse, search or reveal IDIS Online data except in accordance with that which is required to perform your legitimate tasks or assigned duties. You must not retrieve data, or in any other way disclose data, for someone who does not have authority to access that information. 15. By your signature or electronic acceptance (such as by clicking an acceptance button on the screen), you must agree to these rules User Acknowledgement and Certification— I acknowledge and certify that: 1. 1 understand the IDIS RoB and Federal Government policies as set forth above regarding security awareness and practices when accessing and utilizing IDIS Online. 2. 1 have read and understand the IDIS RoB governing my use of IDIS Online and agree to abide by them, 3. 1 understand my responsibilities and the penalties for NOT ADHERING to the IDIS RoB. 4. 1 understand that failure to comply will result In disciplinary action against me which may include, but are not limited to, a verbal or written warning, removal of system access, reassignment to other duties, demotion, suspension, reassignment termination, and possible criminal and/or civil prosecution. Requestor Name: L G{ f S Signature: � � Date. 3/38f j y GRANTEE APPROVING OFFICIAL NOTARY Ap{pJroving Official's Name: The Approving Official's signature must be notarized to I`s�uL t (JOR N62-1I verify the identity of the individual who signed this document using the appropriate notary certificate of the Titl state, territory or insular area. Once completed, attach the completed notary certificate to this form and send i to your local HUD CPD Field Office. If your state, Office one: ext.: `jt • (pr (') -5�0 - territory or insular area does not require a notary certificate, use the space below. Of✓rfii�c/�e�Address: Ziipp,�))pp 2V civic /('Strret9e�tt,, I.LF iClittyy,l�Stattyee�,,{ YLA1LTi ��� Date: WA I C+ q2im I Signature: Signature: Date lauthor". hepersonaho,ero aveeccesstolD15functlDnschecked. HUD FIELD OFFICES Field Office Approval (CPD Director or Designee) Name: Signature: Date: ALL PREVIOUS VEHISONS OF THIS FORM WILL NOT BE ACCEPTED OP PROCESSED, MIS MAM 2705105.1530111 Page R I I ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On April 19, 2018 before me, Rosa A. Flores . Notary Public (insert name and title of the officer) personally appeared Raul Godinez II. who proved tome on the basis of satisfactory evidence to be the personFsJwhose name_(.sj is /ere subscribed to the within instrument and acknowledged tome that he/shekhey executed the same in his/herA.heir authorized capacity(tes), and that by his/her/th-eir signature�s)'bn the instrument the personK, or the entity upon behalf of which the persoR(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature A00 - 0 , ItA (Seal) OMB Approval No. 2506-0171 exp 04/30/2020 IDIS Online Access Request U.S. Department of Housing and Urban Development Office of Community Planning and Development ' • Roleto be Performed by Headgl Privacy Act Statement: Public Low 97-255, FlnmpA Integrity Act, 31 U.S.C. 3512, aulhotlzes flue Deparcment of Housing and uebon Development{HUOI to collect all the Information purpose ofe, dome IHUDm prat the daxatrmentandInformation the purpose m urodata ism access, Tithe integrated Disbursement and Information System require from unauthorized access. The data are used to ensure that Individuals who no longer requireaceesato IDS have their access outside of promptly deleted. This Information will not be otherwisedlsde the Ior nformation outsideof HUD, except as mpermittede required by law. AWILL,, to MAIo, at ,.lnforma[lon requested on ehafarm may delaythe proressing of your apR'oval for asessmiDiS Public Reporting burden for this information coliectle, Is estimated to average 30 minutes Including time for collecting, reviewing, and reporting data. HUD may not collect this Information, and respondents are not required to complete this form, unless It displays a currently valid 01,13 Control Number New Request ❑ Dropfrom IDIS ❑ Renew Lapsed ID ❑ Change Function or Program Area ❑ Change Name ❑ Add Access for Another Grantee Please create a five digit pin that will be used far password resets. [ 91 [ S ] [ 7][ 41 [ 51 Requester's Name (Last, First, MI): Office E-mail Address: Perez, Frank fperez@mdg-Idm.com Office Address: Office Phone: 10722 Arrow Route, Suite 822, Rancho Cucamonga, CA 91730 (909) 476-9696 Grantee Name in IDIS: GRANTEE TYPE City of Santa Ana City ® County ❑ State Please Mark All Necessary Functions & Programs Set Up Activity -Z Request Drawdown ❑ Approve Drawdown❑ Local IDIS Administrator ❑ CDBG [Z HOME ® ESG ❑ HOPWA ❑ HESG ® HOPWA-C ❑ HTF F] Other: .. If other, please specify name of program *Approval of State Sub Grantee Request— CPU State Coordinator or State Official name, signature and date: Name: Signature: Date: •• - Con Plan: Create/Edit/Submit W] Edit [1 View [Z Caper: Create/Edit/Submit [Z Edit Z View ext.: 112 ❑Nan -Profit ❑Sub Grantee* ❑ IDIS Online Rules of Behr September 14, 2015 Introduction This Rules of Behavior (Ro6) procedure was developed as a guide to ensure that all users of IDIS Online are made aware of their security responsibilities before accessing IDIS Online. The RaB defines responsibilities and procedures for secure use of IDIS Online. By reading and acknowledging these rules, users accept the responsibility to protect IDIS Online and data. Users are accountable for their actions and the requirements to protect IDIS Online data and equipment from both malicious and accidental Joss and damage. These rules clearly delineate the responsibilities of and expectations for all Individuals with access to IDIS Online. Non-compliance with these rules will be enforced through sanctions commensurate with the level of infraction. Responsibilities All authorized users who have accessto IDIS Online are required to read, acknowledge understanding, and sign the RoB before accessing IDIS Online and associated data. This acknowledgement must be completed annually thereafter. By agreeing to and signing these rules, the user signifies: 1. Understanding that access is given only to IDIS Online to which the user requires access in the performance of their official duties and the user will not attempt to access systems they are not authorized to access, ALL PREVIOUS VENSnNS of THIS MR WILL. NOT aE ACCEPTED OR PROCV5EEN HUD MIM2losi 05 HE .11) 2. Understanding of the IDIS Online Rules of Behavior (IDIS RoB) security requirements. 3. Acknowledgement that disciplinary action may be taken based on violation ofthe IDIS RoB. The IDIS Online System Security Administrator (SSA) verifies that the users who require access to IDIS Online have read and accepted (via signature on the acceptance form) this IDIS RoB. Other Policies and Procedures This IDIS RoB is intended to enhance and further define the specific rules each user must follow while accessing IDIS Online. The rules are consistent with the policy and procedures described in the following directives: npym,anun nu¢e5 Because written guidance cannot cover every contingency, you are asked to go beyond the stated rules, using your best judgment and highest ethical standards to guide your actions. These rules are based on Federal laws and regulations and HUD policies. As such there are consequences for non-compliance. The following IDIS RoB is the minimum rules for users who are requesting an IDIS Online user account: 1. You are aware of the existence of and penalty for violating 18 USC 1030 and abide by: a. The elements of 18 USC 1030(a)4, "Accessing to Defraud and Obtain Value" are: i. Knowingly accessing a protected computer without or in excess of authorization; ii. With intent to defraud; iii. Access furthered the intended fraud; and iv. Obtain anything of value b. The penalty for violating this statute includes a fine and imprisonment of not more than ten years, or both. 2. You must adhere to HUD's policy requiring a separation of duties between the requester and approver for financial transactions: a. Effective December 14, 2001, the same person can no longer both request and approve a given draw down in IDIS Online. b. While individual persons may have the power to both request and approve draws, this rule prevents an individual from approving a draw that he or she created. IDIS Online requires two people to be involved in every draw down of funds. 3. Currently, the IDIS Online Local Administrator initially defines what a person can do in IDIS Online, carrying out the wishes of each grantee's authorizing official — mayor, grant holder, CEO, CFO, etc. Some users have full rights, while others have limited rights of various kinds. You understand that you are given access only to IDIS Online to which you require access in the performance of your official duties and that you will not attempt to access systems that you are not authorized to access. 4. You are prohibited from misusing IDIS Online, i.e., exceeding your authority. Your level of access to IDIS Online is limited to ensure your access is not more than necessary to perform your legitimate tasks or assigned duties. If you believe you are being granted access that you should not have, you must immediately notify the IDIS Online SSA via email at IdisUser!dRequests@hud.gov. 5. You must immediately notify your Supervisor, CPD Field Office Administrator, and/or your Local Grantee Administrator if your access/privilege are no longer required, termination, promotion, and transferred. 6. You must maintain the confidentiality of your authentication credentials such as your password. Do not reveal your authentication credentials to anyone and do not record passwords on paper or in electronic form. 7. You must report all security incidents or suspected incidents (e.g., lost passwords, improper or suspicious acts) related to IDIS Online to the HUD Computer Incident Response Team at CIRTfL@hud.Rov. 8. Your IDIS Online password expires every 90 days, so ensure you access IDIS at least once a month. Users who do not use IDIS within a 90 day period will find their accounts are de -activated. ALL PREVIOVS VERISONS OF THIS FORM W ILL NOT BE ACCEMEO 01 PROCESSED HUD FORM 27055 ( 0515 E017) RAIC f, 9. You must follow proper logon/logoff procedures. You must manually logon to your session; do not store your password locally on your system or utilize any automated logon capabilities. You must promptly logoff when session access is no longer needed. If a logoff function is unavailable, you must close your browser. Never leave your computer unattended while logged into IDIS Online. 10. You must not establish any unauthorized interfaces between IDIS Online and other non -HUD systems. 11. Your access to IDIS Online constitutes your consent to the retrieval and disclosure of the information within the scope of your authorized access, subject to the Privacy Act, and applicable Federal laws. 12. You must safeguard IDIS Online resources against waste, loss, abuse, unauthorized use of disclosure, and misappropriation. 13. You must not process classified national security information on IDIS Online. 14. You must not browse, search or reveal IDIS Online data except in accordance with that which is required to perform your legitimate tasks or assigned duties. You must not retrieve data, or in any other way disclose data, for someone who does not have authority to access that information. 15. By your signature or electronic acceptance (such as by clicking an acceptance button on the screen), you must agree to these rules User Acknowledgement and Certification— I acknowledge and certify that: 1. 1 understand the IDIS RoB and Federal Government policies as set forth above regarding security awareness and practices when accessing and utilizing IDIS Online. 2. 1 have read and understand the IDIS RoB governing my use of IDIS Online and agree to abide by them. 3. 1 understand my responsibilities and the penalties for NOT ADHERING to the IDIS RoB. 4. 1 understand that failure to comply will result in disciplinary action against me which may include, but are not limited to, a verbal or written warning, removal of system access, reassignment to other duties, demotion, suspension, reassignment, termination, and possible criminal and/or civil prosecution. GRANTEE APPROVING OFFICIAL ApprovingOfficial's Nam e: AUi_ 60DirJE2 uy Title: G1i~( MAN!�c1 • Office Phone: ext.: V11•I) ULA I..S 2oo Office Address: (Street, City, State, Zip) 20 C,iV)C, G6HR_f- P (_ft7-A ShrJTR At46, CA 1421D r Signature: Dater I j� I authorize the person above J have access to IDIS functions checked. Date: 9'()H91 rey _ `J The Approving Official's signature must be notarized to verify the identity of the individual who signed this document using the appropriate notary certificate of the state, territory or insular area. Once completed, attach the completed notary certificate to this form and send to your local HUD CPD Field Office. If your state, territory or insular area does not require a notary certificate, use the space below. Date: Signature: HUD FIELD OFFICES Field Office Approval (CPD Director or Designee) Name: Signature: Date: ALL PREVIOUS VERISOLE OF THIS FORM WILL NOT ED ACCEPTED OR PROCESSED. HUD FORM 22055( 0515 2017) Pagc 3 & 3 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange ) On April 19, 2018 before me, Rosa A. Flores, Notary Public (insert name and title of the officer) personally appeared Raul Godinez II. who proved tome on the basis of satisfactory evidence to be the personks-'whose nameWisa/are subscribed to the within instrument and acknowledged to me that he/sheAth executed the same in his/her4thair authorized capacity(les), and that by his/heratheir signature(wron the instrument the personks); or the entity upon behalf of which the personoyacted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature CI�1 tee` (Seal) ACORD® CERTIFICATE OF LIABILITY INSURANCE Dl�z$�2o e ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMPCT Chip Francis PHONE (626)396-103$ AIC No: (626)396-1045 EMAILESS,chip@kjains.com Kelley Jiggins and Associates Insurance Brokers PO Box 60310 INSURERS AFFORDING COVERAGE NAIC # INSURERA:Ohio SeOuritV 27082 Pasadena CA 91116-6310 INSURED INSURER B:American Fire 5 Casualty Co 24066 INSURER C: INSURER D: MDG Associates, Inc. INSURER E: 10722 Arrow Route STE 822 INSURER F: Rancho Cucamonga CA 91730 COVERAGES CERTIFICATE NUMBER:2018 2018 GL Auto 5 UMB REVISION NUMBER! THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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. ILTR TYPE OFINSURANCE 0 SD B BR AVID POLICY NUMBER POLICY MM/DDN YV POLCYEXP MMIDDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PREMISES fro occurrence) $ 200F000 A CLAIMS MADE EIOCCUR MED EXP (Any one arson $ 15,000 X y BM57179298 7/1/2017 7/1/2018 PERSONAL &ADV INJURY $ 1,000,000 GERL AGGREGATE LIMIT APPLIES PER: POLICY PRO- ❑ LOD `Y JECT GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGO $ 2,000,000 Employee Benefits $ 1,000,000 OTHER: LIABILITY COMBINED SINGLE LIMIT Ea accitlent $ 1,000,000 $ A ANY AUTO AUTOrALL 0ED SCHOEDULED X y BA557179298 7/1/20177/1/2018HIRED NOMOBILE AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE $ Medical a manta $ 5,000 UMBRELLA LIAR EACH OCCURRENCE $ 4,000,000 +,{ HOOCUR AGGREGATE $ 4,000,000 B I EXCESS LIAR CLAIMS -MADE DED I RETENTION$ $ ESM717929B 7/1/2017 7/1/2018 WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA PER OT - STTUTE ER E.L EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYE $ (Mandatory In NH) f yes, describe under E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) The City of Santa Ana, Its officers, employees, agents and volunteers and named additional insured, but only as respecys the insured's operations as it relates to their signed contract in regards to the CDBG Administration Consluting Services per form CG8810 0413Primay Insurance and Transfer of rights or recovery against others is included in the form. Auto Al CABB10 0113 *30days notice of cancellation except 10 days for non-payment. City of Santa Ana Attn.: Terri Eggers, Community Development 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Senior Mgmt. Analyst ACCORDANCE WITH THE POLICY PROVISIONS. Agency AUTHORIZED REPRESENTATIVE Jiggins/CHIPi�-- no a CrlRn CrlRPr1RATIr1M All Al hf .em .A ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS026 (201401) AC �® DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 01/31/2018 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 IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the CorRisk Solutions 225 W. Washington St. Suite 1560 Chicago, IL 60606 MDG Associates, Inc. 10722 Arrow Route Suite 822 Rancho Cucamonga, CA 91730 COVERAGES ,Tome"" Karen Bronson Pua�Ho, EN"312-637-8755 iN�, EDDRES kbronson@corrisksolutions.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: New Hampshire Insurance Company 23841 INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: 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 HAVE BEEN REDUCED BY PAID CLAIMS. INSft LTR TYPE OF INSURANCE ADD1 INSRD SUER MID POLICY NUMBER POLICY EFP (MMIDDIYYYY) POLICY EXP (MMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURANCE COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurance) MED EXP (Any one person) DOES NOT APPLY PERSONAL 8 AND INJURY GENERAL AGGREGATE ' PRODUCTS - COMP/OP AGO GEML AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea Ealaert) BODILY INJURY (Per person) ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS DOESNOTAPPLY BODILY INJURY (Per accident) PROPERTY DAMAGE(Par accltlenll HIRED AUTOS NONAWNED AI IT(1R UMBRELLA LIAB OCCUR EACH OCCURANCE AGGREGATE EXCESS LIAB CLAIMS MADE DOES NOT APPLY DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC STATU- TORV LIMITS OTHER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICE/MEMBER (Mandatory in NH) EXCLUDED? Y/N (Mandatory in NH) ❑ OPERATIObe antler DESCRIPTION OF It yes, OPERATIONS below N/A DOES NOT APPLY E.L. EACH ACCIDENT ILL. UItlESAE- EA EMPLOYEE E.L. DISEASE - POLICY LIMIT A Professional Liability 064991891- 01 07/O1/17 07/O1/18 Per Occurrence: $1, 000, 000 Annual Aggregate: $1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACCORD 101, Additional Remarks Schedule, if more space is required) CEK I IHICA I E HULUEK CANCELLATIUN City of Santa Ana, Community Development SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE Agency THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, Attn.: Terri Eggers, Sr. Mgmt. Analyst 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 ACORD 25 (2010/05) 61988-2010 ACORD CORPORATION. Allrlghts reserved. .p k, The ACORD name and logo are registered marks of ACORD „0 CERTIFICATE OF LIABILITY INSURANCE F D1�zs�2ole ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Amorelli, Rosentann & Associates Insurance Services 3333 E Concours St Building 9-200 Ontario CA 91764 CONTACT LiZette Barges PHONE (909)987-7600 NC N (909)98?-7656 E:t,,,tteb@arainsurance.com ADDRE S: INSURERS AFFORDING COVERAGE NAICN INSURERA:State Comp. Insurance Fund 35076 INSURED Mdg Associates, Inc. 10722 Arrow Route Ste 822 Rancho Cucamonga CA 91730 INSURERS INSURER C: INSURER D: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:CL1762916976 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 rypE OF ADDLSUBR POLICY NUMBER POLICY EFF tMMi POLICY EXP MMIDDM'YY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE I RENTED PREMISES Ea occurrence $ GENL MED I(Any one person) $ PERSONAL B ADV INJURY $ AGGREGATE LIMIT APPLIES PER: O- PRO- JECTPRLOG OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ S AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NONOWNEOY HIRED AUTOS AUTOS D SINGLE LIMIT nt $ J URY(Per person) $ JURY(Per accident) $ DAMAGE entUMBRELLA gC $ LIAB EXCESS LEAS OCCUR CLAIMS-MAOETE CURRENCE $ $ DIED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOWPARTNEWEXECUTIVE ❑N/A OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DE SCRIPTION OF OPERATIONS below 1980750-17 7/1/2017 7/1/2018 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000 000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) PROOF OF INSURANCE FOR CITY OF SANTA ANA COMMUNITY DEVELOPMENT AGENCY. CITY OF SANTA ANA ATTN: TERRI EGGERS, SENIOR MONT ANALYST COMMUNITY DEVELOPMENT AGENCY 20 CIVIC CENTER PLAZA SANA ANA, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE izette Hargas/CHELS ©1988.2014 ACORD CORPORATION. All riahts reservec ACORD 25 (2014/01) INS025 (901401t The ACORD name and logo are registered marks of ACORD MDG Associates, Inc. P011cy # BKW 57179298 Policy Period 7.1-17 to 7-1.18 COMMERCIAL GENERAL LIABILITY CO 88 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modlfles insurance Provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART F. NON -OWNED AIRCRAFT 2 NON -OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY -ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES AAND 0 3 ADDITIONAL INSUREDS - qY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 8 ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORSIMALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES 8 NEWLY FORMED ORADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES T d KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT T LIBERALIZATION CLAUSE T e BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE e WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - B WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU 0 2013LIbony Mutual Ineurance 00 Bit 10 04 13 Includes copyrlphted meterlal of Insurance Servlcse Office, Inc., with Ito pmmisslon. Page 1 of 8 V� V vV T z ■ With respect to ooveregs afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodgy Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It Is not owned by any Insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot In command holds a currently effective certificate, Issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the Insurance afforded by this provision does not apply If there Is available to the insured other valid and collectible Insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the lose covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft Is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that Is: (a) Lase than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY - ELEVATORS 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Llabll. Ity, Subparagraphs (3), (4) and (6) of exclusion J. Damage To Properly do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are IIRs or hoists used In automobile service or repair operations. 2. The following Is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The Insurance afforded by this proviaion of this endorsement is excess over any property Insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section i - Coverage A - Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion J. Damage To Property Is replaced by the follow- Ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property, demage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (1) Premises rented to you for a period of 7 or fewer consecutive days; or (II) Contents that you rent or lease as pert of a premises rental or lease agreement for a period of more then 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described In Section III - Limits of Insurance. 0 2013 Liberty Mutual Insurance Al, CO 0010 0413 Includes copyrighted material of Insurance8aMces Office, Ino., with Ito permlaslon. Page 2 of 8 1�t b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of Insurance applies to Damage To Premises Rented To You as described In Section III - Limits Of Insurance. 2. Paragraph S. under Section III - Llmho Of Insurance Is replaced by the following: 8. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit Is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occi pled by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 8. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph B.a. of Definitions Is replaced with the following: B.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnlAes any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included In your premises rental or lease agreement, is not an "Insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments Is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are Incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES AAND B 1. Under Supplementary Payments - Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. All reasonable expenses Incurred by the Insured at our request to assist us In the Investigation or defense of the claim or "cult", Including actual loss of earnings up to $NO a day because of time off from work. 0. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2, under Section II - Who Is An Insured la amended to Include as an Insured any person or organization whom you have agreed to add as an additional Insured in a written contract, written agreement or permit. Such person or organization is an additional Insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused In whole or in part by: a. Your acts or omissions, or the acts or omissions of those soling on your behalf, In the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily Injury" or "properly, damage" occurs, or the "pen sonal and advertising Injury" Is committed, subsequent to the signing of such written contract or written agreement; or m 2013LbertyMutual lnsurance CO 88 10 04 19 Includes oopyrighted material of Insurance Services Ofice, Inc., with Its permission. Page 8 of 8 (��/ �o "\VF,/ b. Premises or faclitles rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has Issued a permit subject to the following additional provisions: (1) This Insurance does not apply to "bodily injury", "properly damage", or "personal and ad- vertising Injury" arising out of the operations performed for the state or political subdivision; ® (2) This Insurance does not apply to "bodily Injury" or "properly damage" Included within the "completed ® operations hazard". (3) Innsuran applies to premises you own, rent, or control but only with respect to the following (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, swnings, canopies, cellar entrances, coal holes, driveways, manholes, marquess, Ild hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- ® sures; or ® (b) The construction, erection, or removal of elevators; or ® (c) The ownership, maintenance, or use of any elevators covered by this insurance. = However. 1. The Insurance afforded to such additional Insured only applies to the extent permitted by law; and 2. If coverage provided to the additional Insured is required by a contract or agreement, the Insu• ante afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional Insured. With respect to Paragraph Co. above, a person's or organization's status as an additional Insured under this endorsement ends when: (1) All work, Including materials, parts or equipment fumished In connection with such work, on the project (other than service, maintenance or repairs) to be perforated by or on behalf of the additional Insured(s) at the location of the covered operations has been completed; or (2) That portion OF "your work" out of which the Injury or damage arises has been put to its Intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to Paragraph 1.b. above, a person's or organization's status as an additional Insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. c With respects to Paragraph 1.m above, We Insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The Insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily Injury" or "property damage". We have no duty to defend an additional Insured under this endorsement until we receive writen notice of a "suit" by the additional Insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Uablllly Condl• Vona. O 2013LIberly Mutual Insurance CG 06 10 04 13 Includes copyrighted material of Insurance Services l3Mcs, In%,wlth Its permisslon. Page 4 of 8 ffi I With respect to the Insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I • Coverage A - Bodily Injury And Property Damage Liability: This insurance doss not apply to: a. "Bodily Injury" or "property damage" arising from the sole negligence of the additional Insured. b. "Bodily Injury" or "property damage' that occurs prior to you commencing operations at the location where such "bodily Injury' or "property damage" occurs. o. "Bodily Injury", "property damage' or "personal and advertising injury arising out of the render- Ing of, or the failure to render, any professional architectural, engineering or surveying services, Including: (1) The preparing, approving, or falling to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, Inspectlon, architectural or engineering activities. This exclusion applies even If the claims against any Insured allege negligence or other wrongdoing In the supervision, hiring, employment, training or monitoring of others by that insured, y the "oocur- renoe" which caused the "bodily Injury" or 'property damage', or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. 'Bodily Injury" or "property damage" occurring after. (1) All work, Including materials, parts or equipment, furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional Insured(s) at the location of the covered operations has been completed; or (2) That potion of "your work" out of which the Injury or damage arises has been put to its Intended use by any person or organization other than another contractor or subcontractor engaged In performing operations for a principal as a part of the some project. e. Arry person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement Is- sued by us and made a part of this policy. 3. With respect to the Insurance affrirded to these additional Insureds, the following Is added to Section III Limits Of Insurance: H coverage provided to the additional Insured is required by a contract or agreement, the most we will pay on behalf of the additional Insured Is the amount of Insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever Is less. This endorsement shall not Increase the applicable Limits of Insurance shown in the Declaratio ns. H. PRIMARY AND NONCONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional Insured under any forth or endorsement under this policy. Condition 4. Other Insurance of SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS Is amend- ed as follows: a. The following Is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed In a written contract or written agreement to provide the additional Insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional Insured's policy for damages we cover. ® 2013Liberty Mutual Insurenoe CO 88 10 04 13 Includes copyrighted material or Insuranoe 8ervloes Office, Inc.,wlth its pennisslon. Page 5 of 9 r 9 b. The following Is added to Paragraph b. Exam Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit Issued by a state or political subdivision between you and an additional Insured does not require this Insurance to be primary or primary and noncontributory, this Insurance Is excess over any other Insurance for which the addi- tional Insured Is designated as a Named Insured. Regardless of the written agreement between you and an additional Insured, this Insurance Is excess over any other Insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional Insured on other policies. 1. ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional Insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Soft: An additional Insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result In a claim or "suit" under this Insurance to us; b. Tender the defense and Indemnity of any claim or "suit" to all insurers whom also have Insurance available to the additional Insured; and c. Agree to make available any other Insurance which the additional Insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or Indemnify an additional insured under this endorsement until we receive written notice of a "suit by the additional Insured. 2. The limits of Insurance applicable to the additional Insured are those specified In a written contract or written agreemert or the limits of insurance as stated in the Declarations of this policy and defined in Section III - L1mBs of Insurance of this policy, whichever are less. These limits are Inclusive of and not In addition to the limits of Insurance available under this policy. J. WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/ MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II - Who Is An Insured Is replaced with the following: (1) "Bodily Injury" or "personal and advertising Injury": (a) To you, to your partners or members (If you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while In the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workera" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that oo-"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (a) For which there Is any obligation to share damages with or repay someone also who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or falling to provide professional health care services. However, If you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or If coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to "bodily Injure or "personal and advertising Injury" caused by an "employee" who Is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, Includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are Insureds for "bodily Injury" or "personal and 0 20181.Ibedy Mutual Insurance CG 88 10 04 18 Includes copyrighted material of Insurance Services Ofnce, Inc., with Its pennlsslon. Page 8 of 8 " advertising Injury" arising out of their willful conduct, which is daflnad as the purposeful or willful Intent to cause "bodily Injury" or "personal and advertising injury", or caused in whole or in part by their krtoxics- don by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable Insurance available to your "employee". K. NEWLY FORMED ORADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II - Who Is An Insured Is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority Interest, will qualify as a Named Insured If there Is no other similar Insurance available to that organization. However. a. Coverage under this provision Is afforded only until the expiration of the policy period In which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily Injury" or "properly damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising Injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization Is an Insured with respect to the conduct of any current or past partnership, joint venture or gmited liability company that Is not shown as a Named Insured In the Declarations or qualifies as an Insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV - Commercial General Liability Condtions, the following Is added to Condition 8. Repre- sentations: Your failure to disclose all hazards or prior "occurrences" existing as of the Inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior 'occurencee" Is not Intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability Conditions, the following Is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence", offense, claim or "autt" by an agent, servant or "employee" of any Insured shall not In Itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II - Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits' shall have received such notice from the agent, servant or "employee'. N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the Coverage as of the day the revision Is effective In your stale, O, BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3, is replaced by the following: 3, 'Bodily Injury" means physical Injury, sickness or disease sustained by a person. This Includes mental anguish, mental injury, shock, fright or death that results from such physical injury; ale*. ness or disease. O 20131.jbany Mutual Insurance CO 88 10 04 13 Includes copyrighted material or insuranceSarVices Oitios, Ino.,with its permission. Page 7 of 8 ` V 5 i e P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY Is replaced by the following: a. Expected Or Intended Injury "Bodily Injury" or "properly damage" expected or Intended from the standpoint of the Insured. This exclusion does not apply to "bodlly Injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV • Commercial General Liability Conditions, the following Is added to Condition 8. Trans. for Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for Injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "productocompieted operations hazard° provided: f. You and that person or organization have agreed In writing In a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. 0 2673 Liberty Mutual Insurance CIS 88 10 04 13 IncludoswWghted material of Insurance services Office, Inc., with its permission. Page 8 of 8 MDG Associates, Inc. Policy # BASS7179298 Policy Period 7-1-17 to 7-1-18 COMMERCIAL AUTO CA 88 10 0113 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies Insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified ® by fhmi endorsement. COVERAGEINDEX ®SUBJECT PROVISION NUMBER 5 =ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT 3 ® ACCIDENTAL AIRBAG DEPLOYMENT 12 AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 10 AMENDED FELLOW EMPLOYEE EXCLUSION AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 5 13 BROAD FORM INSURED 1 BODILY INJURY REDEFINED 22 EMPLOYEES AS INSUREDS (Including employee hired auto) 2 EXTENDED CANCELLATION CONDITION 23 EXTRA EXPENSE -BROADENED COVERAGE 10 GLASS REPAIR- WAIVER OF DEDUCTIBLE 18 HIREDAUTO PHYSICAL DAMAGE (including employee hired auto and loam of use) 8 HIREDAUTO COVERAGE a TERRITORY 20 LOAN / LEASE GAP 14 PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) 18 PERSONAL EFFECTS COVERAGE 11 PHYSICAL DAMAGE - ADDITIONAL TRANSPORTATION EXPENSE COVERAGE B RENTAL REIMBURSEMENT g SUPPLEMENTARY PAYMENTS 4 TOWING AND LABOR 7 TWO OR MORE DEDUCTIBLES 17 UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 18 WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US 20 SECTION 11- LIABILITY COVERAGE is amended as follows: 1. BROAD FORM INSURED * SECTION II - LIABILITY COVERAGE, paragraph A.I. - WHO IS AN INSURED Is amended to Include the following as on Insured: d. Any legally Incorporated entity of which you own more than 50 percent of the voting stock during the policy period, However, "Insured' does not Include any organization that, (1) Is a partnership or Joint venture; or (2) Is an Insured under any other automobile policy; or (3) Has exhausted Its Limit of Insurance under any other automobile policy. Paragraph d. (2) of this provision does not apply to a policy written to apply specifically In excess of this policy. e. Any orgenizetion you newly acquire or form, other than a partnership or Joint venture, of which you own more than 50 percent of the voting stack. This automatic coverage to afforded only for 180 days from the date of acquisition or formation. However, coverage under this provision does not apply: (1) If there Is similar Insurance or a astf-Insured retention plan available to that organlzatlon; 0 2013 Liberty MuWel insurance CA 88 10 0113 Includes copyrighted materiel of Insurance Services Office, Inc., with Its permission. Page 1 of 7 3 (2) If the Limits of Insurance of any other Insurance policy have been exhausted; or (3) To "bodily Injury" or "properly damage" that occurred before you acqulmd or formed the organization. 2. EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE, Paragraph A.I. - WHO IS AN INSURED is amended to Include the fallowing as an Insured: L Any "employee" of yours while using a covered "auto' you do not own, hire or borrow, but only far acts within the scope of their employment by you. Insurance provided by this endorse- ment is excess over any other Insurance available to any 'employee". g. An "employee" of yours while operating an 'auto" hlmd or borrowed under a written contract or agreement In that "employes'a" name, with your permission, while performing duties re- lated to the conduct of your business and within the scope of their employment, Insurance provided by this endorsement Is excess over any other insurance available to the 'amployea". 3. ADDITIONAL INSURED SY CONTRACT, AGREEMENT OR PERMT SECTION II - LIABILITY COVERAGE, paragraph A.I. - WHO IS AN INSURED Is emended to Include the following as an Insured: In. Any person or organization with respect to the operation, maintenance or use at a covered "auto", provided that you and such person or organization have agreed In a written contract, agreement, or permit Issued to you by governmental or public authority, to add such person, or organization, or governmental or public authority to this policy as an "Insured'. However, such person or organization Is an "Insured': (1) Only with respect to the operation, maintenance or use of a covered "auto'; (2) Only for "bodily Injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or agreement, or the permit has been Issued to you; and (3) Only for the duration of that contract, agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II - LIABILITY COVERAGE, Coverage Extensions, 2.a, Supplementary Payments, para- graphs (2) and (4) are replaced by the following: (2) Up to $3,000 for cost of bell bonds (Including bonds for related traffic violations ) required because of an "aocklemP we cover. We do not have to furnish these bonds. (4) All reasonable expenses Incurred by the Insured at our request, including actual loss of earn - Inge up to $500 a day because of lime off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law, fellow employees are riot entitled to the protection afforded to the employer by the workers compensatlon exclusivity rule, or similar protection, the following provision Is added: SECTION ti - LIABILITY, exclusion B.S. FELLOW EMPLOYEE does not apply If the "bodily Injury" results from the use of a covered "auto" you own or hire. SECTION III -PHYSICAL DAMAGE COVERAGE Is amended as follows; S. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4. Coverage Extensions of SECTION III - PHYSICAL DAMAGE COVERAGE, Is amended by adding the following: If hired "autos" are covered "autce" for Liability Coverage, and If Comprehensive, Specified Causes o; Loss or Colllsicn coverage are provided under the Business Auto Coverage Form for arty "auto" you own, than the Physical Damage coverages provided are extended to "autos": a. You hire, rent or borrow; or 0 20131.1berly Mutual Insurance CA 00 10 0113 Includes copyrighted mafedal of Insurance Services Office, Imo., with Its permission. Page 2 of 7 b. Your "employee" hires or rents under a written contract or agreement In that "employee's" name, but only If the damage occurs while the vehicle Is being used In the conduct of your business, subject to the following limit and deductible: A. The most we will pay for "lose" In any one "aooldent" or "lose" Is the smallest of: (1) $50,000; or (2) The actual cash value of the damaged or stolen properly as of the time of the "loss"; or (3) The coat of repairing or replacing the damaged or stolen property with other property of like kind and quality, minus a deductible. S. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. C. Subject to the limit, deductible and excess provisions described In this provision, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. D. Subject to a maximum of $1,000 per "accident", we will also cover the actual loss of use of the hired "auto" N It results from an "accident", you are legally !labia and the lessor Incurs an actual financial lose. E. This coverage extension does not apply to: (1) Any "auto" that Is hired, rented or borrowed with adriver, or (2) Any 'auto" that is hired, rented or borrowed from your nompioyea". For the purposes of this provision, SECTION V - DEFINITIONS Is amended by adding the following: "Total loss' means a "loss" In which the cost of repairs plus the selvage value exceeds the actual cash value. TOWING AND LASOR SECTION III - PHYSICAL DAMAGE COVERAGE, paragraph A.2. Towing, is amended by the addition of the following: We will pay rowing and labor Coate Incurred, up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type, "light truck" or 'medium truck" is dis- abled: a. For private passenger type vehicles, we will pay up to $50 per disablement. b. For "light trucks", we will pay up to $50 per disablement. "Light trucks" are trucks that have a gross vaNds weight (GVW) of 1D,000 pounds or lose. a. For "medium trucks" , we will pay up to $150 per disablement. "Madium trucks" are trucks that have a grass vehicle weight (GVW) of 10ADI - 20,000 pounds. However, the labor must be performed at the place of disablement PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph AA.a., Coverage Extension of SECTION III - PHYSICAL DAMAGE COVERAGE, Is amend- ed to provide a limit of $50 per day and a maximum limit of $1,500 0 2c19Libarly Mutual Insurance CA SS 10 01 13 Includes copyrighted material of Insurance Services OIBoe, Ina, with Its parmleslon. Page 3 of 7 9. RENTAL REIMBURSEMENT SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, Is amended by adding the following: a. We will pay up to $75 per day for rental reimbursement expenses Incurred by you for the rental of an "auto" because of "accident or "loss", to an "auto" for which we also pay a "loss" under Comprehensive, Spedfied Causes of Lose or Collision Coverages. We will pay only for those expenses Incurred after the firat 24 hours following the 'sooldent' or "loss" to the covered 'auto.' b. Rental Reimbursement will be based on the rental of a comparable vehicle, which In many cases may be substantially lose then $75 per day, and will only be allowed for the period of time It should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. a We will also pay up to $500 for reasonable and necessary expenses Incurred by you to remove and replace your tools and equipment from the covered "auto". d. This coverage dose not apply unless you have a business necessity that other 'autos" avail- able for your use and operation cannot fill. a. If "loss' results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which Is not already provided under Paragraph 4. Coverage Extension. L No deductible applies to this coverage. For the purposes of this endorsement provision, materals and equipment do not Include "personal effects" as defined In provision 11. 10. EXTRA EXPENSE -BROADENED COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. The maximum amount we will pay fs $1,000. 11. PERSONAL EFFECTS COVERAGE A. SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, to amended by adding the following: If you have purchased Comprehensive Coverage on this policy for an "auto' you own and that "auto" Is stolen, we will pay, without application of a deductible, up to $801) for "personal aftaW stolen with the "auto." The insurance provided under this provision is excess over any other collectible Insurance. B. SECTION V - DEFINITIONS Is amended by adding the following: For the purposes of this provision, "personal effects" mean tangible properly that is worn or carried by an Insured' "Personal effects" does not Include tools, equipment, jewelry, money or securities. x 12. ACCIDENTAL AIRBAG DEPLOYMENT Y SECTION III - PHYSICAL DAMAGE COVERAGE, S. EXCLUSIONS is amended by adding the follow- ing: v If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for "loss" relating to mechanical breakdown does not apply to the accidental discharge of an alrbag. Any insurance we provide shell be excess over any other collectible Insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other cov- erage or warranty. 13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE, 0. EXCLUSIONS, exception paragraph a. to excltt alone Co. and Col. Is deleted and replaced with the following: CA 80 10 01 13 includes copyrighted 2013 Liberty Mutual Insurance copyrighted material of InsuranceServlcae Office, Ina, with its permission. Papa 4 of 7 a x s Exclusion 4.0. and 4.d, do not apply to: a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, If the equipment Is permanently installed In the covered "auto" at the time of the'loas" and such equipment Is designed to be solely operated by use of the power from the "autda" electrical system, In or upon the covered "auto" and physical damage coverages are provided for the covered "auto'; or If the "lose" occurs solely to audio, visual or data electronic equipment or accessories used with this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a $100 deductible. 14. LOAN f LEASE GAP COVERAGE A. Paragraph C., LIMIT OF INSURANCE of SECTION III - PHYSICAL DAMAGE COVERAGE Is amended by adding the following: The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any one "accident" Is the greater of the: 1. Balance due under the terns of the loan or lease to which the damaged covered "auto" is subject at the time of the "lose' lees the amount of; a. Overdue payments and financial penalties associated wRh those payments as of the dale of the "lass", b. Financial penalties Imposed under a lease due to high mileage, excessive use or ab- normal weer and tear, c. Costs for extended warranties, Credit Ufa Insurance, Health, Accident or Disability Insurance purchased with the loan or lease, d. Transfer or rollover balances from previous bans or lessee, a. Final payment due under s "Balloon Loan", E The dollar amount of any unrepalred damage which occurred prior to the "total lass" of a covered 'auto", g. Security deposits not refunded by a [savor, h. All refunds payable or pail to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto", I. Any amount representing taxes, J. Loan or lease termination fees; or 2. The actual cash value of the damage or stolen property as of the time of the "lose". An adjustment for depreciation and physical condition will be made In determining the actual cash value at the time of the "lose". This adjustment Is not applicable In Texas. 0. ADDITIONAL CONDITIONS This coverage applies only to the original loan for which the covered 'auto' that Incurred the loss serves as collateral, or lease written on the covered "auto" that incurred the loss. C. SECTION V - DEFINTIONS Is changed by adding the following: As used In this endorsement provision, the following definitions apply: 'Total loss" means a "lose' In which the coat of repairs plus the salvage value exceeds the actual cash value. A "balloon loan" Is one with periodic payments that are Insufficient to repay the balance over the term of the loan, thereby requiring a large final payment. CA 8810 01 18 Includes0 2013 Uberly Mutual Insurance copyrighted material of Insurance Sarvioss plAce, Inc., with Its permission, page 5 of 7 E 15. GLASS REPAIR- WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE Is amended by the addition of the following: No deductible applies to glass damage If the glass Is repaired rather than replaced. 10. PARICEDAUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE Is amended by the addition of the following: The deductible does not apply to "lose" caused by collision to such covered "auto' of the private passenger type or light weight truck with a gross vehicle weight of 10,000 ]be. or lees as defined by the manufacturer as maximum loaded weight the 'auto" Is designed to carry while It Is: a. In the charge of an'Insured"; b. Legally parked; and c. Unoccupied, The "loss" must be reported to the police suthorIlles within 24 hours of known damage. The total amount of the damage to the covered "auto" musk exceed the deductible shown In the Declarations. This provision does not apply to any 'loss" If the covered "auto' Is In the charge of any person or organization engaged In the automobile business. 17. TWO OR MORE DEDUCTIBLES Under SECTION III PHYSICAL DAMAGE COVERAGE, If two or more company pollclee or coverage forms apply to the same accident, the following applies to paragraph D. Deductible; a. If the applicable Business Auto deductible is the smaller (or smallest) deductible It will be walved; or b. If the applicable Business Auto deductible Is not the smaller (or smallest) deductible It will be reduced by the amount of the smaller (or smallest) deductible; or c. If the loss Involves two or more Business Auto coverage forma or policies the smaller (or smallest) deductible will be valved. For the purpose of this endorsement company means any company that Is part of the liberty Mutual Group. SECTION IV - BUSINESS AUTO CONDITIONS is amended as hollows: 18. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV- BUSINESS AUTO CONDITIONS, Paragraph B.2. is amended by adding the following: If you unintentionally fall to disclose any hazards, exposures or material facts existing as of the Inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this policy will not be prejudiced. However, you must report the undisclosed hazard of exposure as soon as practicable after IM discovery, and we have the right to collect additional premium for any such hazard or exposure. 18. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.2.a. Is replaced In its entirety by the following: a. In the event of "sacldenr, claim, "sult" or "loss", you must promptly notify us when It Is known to: 1. You, if you are an Individual; 2. A partner, if you are a partnership; 9. Member, If you are a limited liability company; 4. An executive officer or the "employee" designated by the Named Insured to give such notice, If you are a corporation. ® 2013Ubarty Mutual Insurance CA 88 10 01 13 Includes copyrighted material of Insurance Services Office, Inc., with Its pemniasion. Page 6 of 7 ie ti t To the extent possible, notice to us should Include: (1) How, when and where the "accident' or "lase" took place; (2) The "Insureds' name and address; and (3) The names and addresses of any injured persons and witnesses. 20. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.B., Transfer of Rights of Recovery Against Others to Us, Is amended by the addition of the following: If the person or organization has waived those rights before an 'accident" or "lose", our rights are waived also. 21. HIRED AUTO COVERAGE TERRITORY SECTION IV - BUSINESS AUTO CONDITIONS, paragraph B.T., Policy Period, Coverage Territory, Is amended by the addition of the following: L For "autos' hired 30 days or leas, the coverage territory Is anywhere In the world, provided that the Insured's responsibility to pay for damages Is determined In a "eulV, on the marks, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto' hired, leased, ranted or borrowed with a driver. SECTION V - DEFINITIONS Is amended as follows: 22. BODILY INJURY REDEFINED Under SECTION V - DEFINTIONS, definition C. is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, Including mental anguish, mental Injury, shock, fright or death resulting from any of These at any Ems. COMMMON POLICYCONDITIONS 23. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS, paragraph A. - CANCELLATION condition applies except as fol- lows: If we cancel for any reason other than nonpayment of premium, we wail mall to the first Named Insured written notice of cancellation at least SD days before the effective date of cancellation. This provision does not apply In those states which require more than 00 days prior notice of cancelis- tion. CA 8010 01 13 Includes® 2013 Liberty Mutual Insurance capyrightsd materiel of Insurance Services Office, Inc., with Its permission. Page 7 of 7 ACC>RD CERTIFICATE OF LIABILITY INSURANCE ik.� DATE(MMIDDNYYY) 5/31/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER AM _aONTADT Chip Francis PHONE (626)396-1035 FAX o:(62tl)396-1045 Kelley Jiggins and Associates Insurance Brokers i 21AIL chPPt°i k ains.com ADDRESS: PO BOX 60310 INSURERS AFFORDING COVERAGE HAIG0 Pasadena CA 91116-6310 - INSURERA:Weet American Insurance Com an 44393 INSURED INSURERB:OhiO Security 27082 INSUR,RC:A0lerican Fire & Casualt CO 24066 MDG Associates, Inc. INSURER D: 10722 Arrow Route STE 822 INSURER,: Rancho Cucamonga CA 91730 INSURER F: .....................�... 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 HAVE BEEN REDUCED BY PAID CLAIMS, INSR L.POLICY TYPE OF INSURANCE DL im. UBR NUMBER POUCYEFF PO I UCYEKP LIMITS A $ COMMERCIAL GENERAL LIABILITY CLAMS -MADE OCCUR EACH OCCURRENCE $ 11000,000 DAMAGETO ENTEO ISE E ccu $ 200, 000 MED EXP An one Person X DEN57179298 7/1/2019 7/1/2019 $ 15,000 PERSONAL &ADV INJURY $ 11000,000 GENLAGGREGATELIMITAPPLIE8 X PER: POLICY O PRO- ❑ JECT LOC GENERAL AGGREGATE $ 2,000.000 PRODUCTS-COMP/OP AGO $ 2,000,000 Employee Banefila $ 11000,000 OTHER: AUTO MOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 11000.000 B X ANY AUTO OWNEDALL AO UTOSCHEDULED AUTOSX HIRED AUTOS X NON -OWNED AUTO$Us BA357179298 7/1/2018 7/1/2019 BODILY INJURY (Par person) $ X BODILY INJURY (Per acciden0 $ PPROPCF"DAMAGE $ Madlcal osmares $ 5,000 UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 4, 000 000 X GGREGATE 8 4,000,000 C EXCESS UAe CLAIMS -MADE DED 1 1 RETENTION $ RSA57179298 7/1/2D18 7/1/2019 WORKERS COMPENSATION ANDEMPLOYERS-LIABILITY YIN ANY PROPRIETOMPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatmy In NH) If yes, describe under NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT I $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addldonal Remarks Schedule, may be attached Nmore space Is required) The City of Santa Ana, Its officers, employees, agents and volunteers and named additional insured, but only as respecys the insured's operations as it relates to their signed contract in regards to the CDBG Administration Consluting Services per form CG8810 0413Primay Insurance and Transfer of rights or recovery against others is included in the form. Auto Al CA8810 0113 ^ tQk , •30days notice of cancellation except 10 days for non-payment. Cab\ City of Santa Ana Attn.: Terri Eggers, Senior Mgmt. Analyst Community Development Agency 20 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Jiggins/CHIP i`-- 9)'1988.2014 ACORO CORPORATION All A..H.� . ._.ea 2 ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) A�� o�® CERTIFICATE OF LIABILITY INSURANCE _ 06/18/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI 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 IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the CorRisk Solutions 225 W. Washington St. Suite 1560 Chicago, IL 60606 Karen Bronson 312-637-8755 iu"a.„eeN.. kbronson@corrisksolutions.com IINSURERA: New Hampshire Insurance Company 1 23841 I INSURED INSURER B: MDG Associates, Inc. INSURERC: 10722 Arrow Route Suite 822 INSURER D: Rancho Cucamonga, CA 91730 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 TYPE OF INSURANCE ADD'L SUER POLICY NUMBER POLICY EFF POLICY UP UNITS LTR INSRD MD (MWDDNYYY) (MMIDDIYYYY) GENERAL LIABILITY EACH OCCURANCE COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occurance) CLAIMS MADE OCCUR MED UP (Any one person) DOES NOT APPLY PERSONAL & AND INJURY GENERALAGGREGATE PRODUCTS-COMPIOP AGG GENT AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (ER amicent) BODILY INJURY(Par parson) ANY AUTO AD SCHEDULED UTICIS AUTOSDOES NOT APPLY BODILY INJURY(P., emdeM) PROPERTY DAMADE (Per aaRNaml HIRED AUTOS NON -OWNED HIRED Alnnc UMBRELLA LIAR OCCUR EACH OCCURANCE AGGREGATE EXCESS LIAe CLAIMS MADE DOES NOT APPLY DED RETENTIONS WORKERS COMPENSATION WC STATU- OTHER AND EMPLOYERS' LIABILITY TORY LIMBS ANY PROPRIETORIPARTNERIEXECUTNE E.L. EACH ACCIDENT OFFICFIMEM EXCLUDED? NIA E.L. OIStSAl,-FA Y/N NH) (Mandatory in NH) DOES NOT APPLY Ityes, a underDESCRIPTION OF ❑ EMPLOYEE E.L. DISEASE OMIT OPERATIONS below -POLICY 064991891— er Occurrence: $2,000,000 r A Professional Liability 07/01/18 07/01/19 Annual Aggregate: 02 $2 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACCORD 101, Additional Remarks Schedule,if morespaceis required) A U �\ CERTIFICATE HOLDER CANCELLATION City of Santa Ana, Community Development SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE Agency THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn.: Terri Eggers, Sr. Mgmt. Analyst AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza Santa Ana, CA 92701 � ACORD 25 (2010/05) 01988-2010 ACORD CORPORATION. Allrights reserved. The ACORD name and logo are registered marks of ACORD A� H CERTIFICATE OF LIABILITY INSURANCE ATE (MMMDIYYYY D6/28/20 e ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Llzette Barges Amorelli, Roseman & Associates Insurance Services PHONE (909)987-7600 aC No:(909)987-7656 -MAIL lizetteb@arainsurance.com ADDRESS: 3333 E Concours St Building 9-200 INSURERS AFFORDING COVERAGE NAIC B INSURERA:State Comp. Insurance Fund 35076 Ontario CA 91764 INSURED INSURER B : INSURERC: Mdg Associates, Inc. INSURER D : INSURER E: 10722 Arrow Route Ste 022 INSURER F: Rancho Cucamonga CA 91730 COVERAGES CERTIFICATE NUMBER:18/19 WC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 7ypE OF INSURANCE ADD BR POLICY NUMBER POLICY EFF (MMIDDprfYY1 POLICY EXP IMMIDDIVYYY1LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED MI EB Ea occurtence $ MED EXP(My one person) $ PERSONALS ADV INJURY $ GENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ POLICY PRO-JECT LOC PRODUCTS-COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per Person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccidenl $ NON -OWNED HIRED AUTOS AUTOS 8 UMBRELLALIAB EACH OCCURRENCE $ HOCCUR AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION $ WORKERS COMPENSATION ANDEMPLOYERS'UABILITY YIN PER OTH- R STATUTE ER E.L EACH ACCIDENT $ 1,000,000 ANY PROPRIETOWPARTNERIEXECUTIVE A (FFICEWMEMBER EX ❑NIA Mandtory in NH)CLUDED7 1980750-18 7/1/201B 7/1/2019 E.L. DISEASE -EA EMPLOYE $ 1,000,000 H yes, tlescdbe under DESCRIPTION OF OPERATIONS bad. E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) PROOF OF INSURANCE FOR CITY OF SANTA ANA COMMUNITY DEVELOPMENT AGENCY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: TERRI EGGERS, SENIOR MGMT ANALYST ACCORDANCE WITH THE POLICY PROVISIONS. COMMUNITY DEVELOPMENT AGENCY AUTHORIZED REPRESENTATIVE 20 CIVIC CENTER PLAZA SANA ANA, CA 92701 _ Lizette Bazgas/JULIO 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) INS025 oounn The ACORD name and logo are registered marks of ACORD CITY OF SANTAANA BUSINESS TAX SECTION (M-15) 20 CIVIC CENTER PLAZA, FIRST P.O. BOX 1964, SANTA ANA, CA92702 (714) 647-5447 CITY OF SANTA ANA BUSINESS LICENSE TAX RECEIPT BUSINESS TAX NUMBER: 345731 TAX PERIOD: 41112018 - 3/3112019 BUSINESS NAME: MDG ASSOCIATES, INC. AMOUNT PAID: $55.00 BUSINESS ADDRESS: 10722 ARROW ROUTE, SUITE 822 RANCHO CUCAMONGA, CA91730 DATE PAID: 02120/2018 OWNER NAME: MDG ASSOCIATES, INC. THIS IS NOT BILL ATTACHED BELOW IS YOUR CITY OF SANTA ANA BUSINESS LICENSE TAX RECEIPT PLEASE DETACH AND POST IN A CONSPICUOUS LOCATION (SEE REVERSE SIDE OF BUSINESS LICENSE TAX RECEIPT FOR POSTING REQUIREMENTS) CITY OF SANTA ANA BUSINESS LICENSE TAX RECEIPT This business license tax account is void upon sale or transfer of a business Every business is responsible for the annual renewal of their business license tax account It is the responsibility of the applicanNicensee to ensure that the business compries with all applicable City codes, City zoning ordinances and all Local, State and Federal Laws. Contact the Business License Tax Office at (714) 647-5447 prior to any of the following changes: Name change • Location Change • Ownership or representative change • Business activity change The business license tax receipt must be displayed at the place of business. See reverse side for posting requirements. See.21.18. - No required permits waived. The business license issued pursuant to the provisions of this Chapter [Santa Ana Municipal Code (SAMC) Chapter 21] constitutes a receipt for the license fee paid and shall have no other legal effect A business license is a requirement, not a permit, to transact and carry on any business activity within the city. The business license tax receipt is evidence only of the fact that such tax has been paid. Neither the payment of the tax nor the possession of the business tax receipt authorizes, permits or allows the doing of any act which the person paying or holding the same would not otherwise be entitled to do; and any permit, license, variance or other instrument of approval or evidence that any conditions exist as required by any other Section of this Code [SAMC] or by any statute or code provisions of the state must first be obtained or compiled with before the doing of any act or thing for which it is required. (Ord. No. NS-1922, § 1, 7-20-87) The person, firm or corporation named below has been issued this business license tax receipt pursuant to the provisions of the City Business License Tax Code (SAMC Chapter 21). Issuance of this receipt for the business license tax paid shall have no other legal effect (SAMC Sec. 21-18) and is not an endorsement, nor certification of compliance with other ordinances or laws. It is the responsibility of the appllcant/licensee to ensure that the business is operated in compliance with the laws, ordinances and regulations that are now or may hereafter be in force by the United States Government, State of California, and the City of Santa Ana pertaining to such business. In the event it is determined that the applicant/licensee fraudulently applied for or renewed this business license tax account, the account may be suspended or revoked. This business license tax account is nontransferable. Please note that it is your responsibility to renew and update this license annually. CITY OF SANTA ANA -TREASURY M-15 20 CIVIC CENTER PLAZA -PO BOX 1964 SANTA ANA, CALIFORNIA 92702 PHONE (714) 647-5447 MDG ASSOCIATES, INC. PO BOX 368 RANCHO CUCAMONGA, CA 91729 THIS LICENSE MUST BE DISPLAYED AT THE PLACE OF BUSINESS BUSINESS TAX NO. 345731 TAX PERIOD: 41112018 - 313112019 BUSINESS TYPE CONSULTING, MISC. BUSINESS ADDRESS: 10722 ARROW ROUTE, SURE 322 RANCHO CU BUSINESS NAME: MDG ASSOCIATES, INC. OWNERIREP: MDG ASSOCIATES, INC. EXPIRATION DATE: 0313112019