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HomeMy WebLinkAboutA8845 - FIND FOOD BANKA De t }- CONTRACT ABSTRACT Contract Company Name: Company Contact: Summary of Services: I Contract Price: Funding Source: Contract Term: r- ei L6ri'r'i-ii FIND Food Bank 2021 APR 28 PM 12: 54 Debbie Espinoz2r, PWsA6rit & C80 Ci_F Mobile Food Market at Desert Highland Gateway Esates Community $35,305.00 CDBG-CV 137-4822-45826 FY 2020-21 July 1, 2020 to June 30, 2021 Contract Approvals City Council Approval Date: Agenda Item No./ Resolution Number: Agreement No: A S�45 July 9, 2020 — Item 2.A 24781 Contract Administration Lead Department: Community & Economic Development Contract Administrator: Jay Virata, Director Contract Compliance Exhibits: Yes Signatures: Yes Insurance: Yes Bonds: N/A Contract prepared by: Jay Virata Submitted on: 4/26/2021 By: Annie Rodriguez, Housing Program Assistant COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROGRAM COVID-19 EMERGENCY RESPONSE SUBRECIPIENT AGREEMENT BETWEEN THE CITY OF PALM SPRINGS AND FIND FOOD BANK (Federal Grant No. [9-W- dW-01c-LD Dl l) THIS AGREEMENT (herein "Agreement"), is made and entered into this 23rd day of February 2021, by and between the CITY OF PALM SPRINGS, (herein "City), a municipal corporation and charter city, and the FIND FOOD BANK Federal Tax Number: [ #33-0006007 j (herein "Provider"). WHEREAS, on March 27, 2020, the President of the United States signed H.R. 748, known as the Coronavirus Aid, Relief, and Economic Security ("CARES") Act, which provides an additional $5 billion of Community Development Block Grant — Coronavirus ("CDBG-CV") funds to rapidly prepare, prevent, and respond to the coronavirus pandemic; and WHEREAS, the City has received CDBG-CV CARES Act, Public Law 116-136 from the United States Department of Housing and Urban Development ("HUD"); and WHEREAS, CARES Act provides that the City may grant the CDBG-CV funds to nonprofit organizations for certain purposes allowed under the CARES Act, namely according to HUD, the City "may use the funds for a range of eligible activities that prevent and respond to the spread of infectious disease such as the coronavirus"; and WHEREAS, the Provider is a nonprofit organization that operates a program that is eligible for a grant of CDBG-CV funds and the City desires to assist in the operation of the program by granting CDBG-CV Funds to the Provider to pay for all or a portion of those costs incurred in operating the program permitted by the Act and the Regulations on terms and conditions more particularly set forth herein; WHEREAS, according to federal regulations (24 CFR 570.503), before disbursing any CDBG funds to a subrecipient, a written agreement shall be signed by the recipient and subrecipient; and NOW, THEREFORE, the parties hereto agree as follows: 1.0 SERVICES OF PROVIDER. 1.1 Scope of Services. Activities funded with CDBG-CV funds must meet one of the Program's National Objectives (Title 24, Part 570, Sections 570.200(a)(2) and (3), 570.208(a)-(d), and 570.208). For purposes of this Agreement, Provider agrees to provide services meeting the National Objective of benefitting low and moderate - income area benefit, or low and moderate income limited clientele. Provider agrees to 55575.18175\33228209.1 provide to City all of the services specified and detailed in Exhibit A. Provider represents and warrants to City that it is able to provide, and will use funds granted by the City to provide the services as represented herein. City provided funds shall be used only for those purposes specified as contained in this Agreement. 1.2 Compliance with Law. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, and regulations of the City and any Federal, State or local governmental agency of competent jurisdiction. 1.3 Reports. No later than ten (10) days prior to any payment date specified in Section 2.0, within ten (10) days following the termination of this Agreement, and at such other times as the Contract Officer shall request, Provider shall give the Contract Officer a written report describing the services provided during the period of time since the last report and accounting for the specific expenditures of contract funds hereunder, if applicable. At the times and in the manner required by law, the Provider shall provide to the City, the Department of Housing and Urban Development, the Comptroller General of the United States, any other individual or entity, and/or their duly authorized representatives, any and all reports and information required for compliance with the Act and the Regulations. Provider shall, at minimum, maintain the following records and reports to assist the City in complying with its record keeping requirements. a) Documentation (Exhibit B) of the income level, ethnicity, age of persons and/or households participating in or benefiting from the Provider's program; b) Documentation (Exhibit B) of the number of persons and/or households participating in or benefiting from the Provider's program, c) Documentation (Exhibit B) of the impact of the Coronavirus on the assisted household and that no other financial resource is available to provide assistance; d) Documentation of all CDBG-CV funds received from the City; e) Documentation of expenses as identified in the report and reimbursement requests; f) Documentation of how and when a determination was made as to the eligibility status of persons assisted, including evidence that the persons assisted are domiciled within the approved area of service, if any; g) Documentation of compliance with any applicable Equal Employment Opportunity guidelines and evidence of any actions undertaken by the Provider to ensure equal employment opportunities to all persons; and h) Any such other related records as the City shall require or as are necessary pursuant to 24 CFR 570.506. 55575.18175\33228209.1 - 2 - 1.4 Financial Reporting. Any Provider receiving or due to receive $20,000.00 or more from the City during the 2020 — 2021 Fiscal Year shall provide to City a financial statement prepared by a recognized accounting firm approved by or satisfactory to City's Finance Director completed within the most recent twelve (12) months showing the Provider's financial records to be kept in accordance with generally accepted accounting standards. The report shall include a general ledger balance sheet that identifies revenue sources and expenses in sufficient detail to demonstrate contract compliance and be balanced to bank statements. Any organization receiving or due to receive less than $20,000.00 in the current fiscal year from the City shall provide a copy of the organization's most recent charitable trust report to the Attorney General, or other financial information satisfactory to City's Finance Director. The financial information provided for in this paragraph shall be furnished not later than January 31 st of the current fiscal year. 1.5 Records/Audit. Provider shall maintain separate accounting records for the CDBG-CV funds provided by the City. The City, HUD, the Comptroller General of the United States, or any of their duly authorized representatives shall have access to all books, documents, papers and records maintained by Provider in connection with the services for the purpose of audit, examination, excerpts and transcriptions. Unless otherwise notified by the City, Provider shall retain all financial records, supporting documents and statistical reports related to the project identified under this Agreement until June 30, 2026. All records subject to an audit finding must be retained for five (5) years from the date the finding is made or until the finding has been cleared by appropriate officials and Provider has been given official written notice. The City shall have the right to ensure that necessary corrective actions are made by the Provider for any audit findings pertinent to Provider handling of funding attributable to the CDBG-CV Program. In response to audit deficiencies or other findings of noncompliance with this agreement, the City may impose additional conditions on the use of the CDBG-CV and/or CDBG funds to ensure future compliance, or provide training and technical assistance as needed to correct noncompliance. 1.6 Client Data and Other Sensitive Information. Provider is required to maintain data demonstrating client eligibility for activities provided under this Agreement. Such data may include, but not be limited to, client name, address, income level or other basis for determining eligibility, and description of activities provided. Provider must comply with 2 CFR §200.303 and take reasonable measures to safeguard protected personally identifiable information, as defined in 2 CFR § 200.82, and other information HUD or Provider designates as sensitive or Provider considers sensitive consistent with applicable Federal, state, local, and tribal laws regarding privacy and obligations of confidentiality. Protected personally identifiable information means an individual's first name or first initial and last name in combination with any one or more of types of information, including, but not limited to, social security number, passport number, credit card numbers, clearances, bank numbers, biometrics, date and place of birth, mother's maiden name, criminal, medical and financial records, educational transcripts. This does not include personally identifiable information that is required by law to be disclosed.(2 CFR § 200.82.) 55575.18175\33228209.1 _ 3 _ 2.0 COMPENSATION. 2.1 Contract Sum. The City shall pay to the Provider on a reimbursable basis for its services a sum not to exceed Thirty five thousand, three hundred and five dollars ($35,305) (the "Contract Sum") in accordance with the Budget attached hereto in Exhibit C and incorporated herein by this reference, and as herein provided. The budget cost categories set out in Exhibit C are general guidelines and if mutually agreed by both parties, may be amended administratively by no more than 10%, without the requirement of a formal amendment to this Agreement, but in no event shall such adjustments increase the Contract Sum. The Provider shall submit to the City periodic statements, in the form of Exhibit D, on reimbursable expenditures pursuant to the attached Budget along with pertinent supporting documentation. Payroll records, receipts and paid invoices including an itemized statement of all costs are samples of appropriate methods of reimbursement documentation. The City shall promptly review the monthly expenditure statements and, upon approval, reimburse the Provider its authorized operating costs. 2.2 Payroll Records. In cases where the Contract Sum will reimburse payroll expenses as part of operations, the Provider will establish a system of maintaining accurate payroll records which will track daily hours charged to the project by the Provider's respective employees, as set forth in OMB Circular A-122 Attachment B.6. 2.3 Draw Downs. Failure b y 3.1 Representative of Provider. The following principals of Providers are hereby designated as being the principals and representatives of Provider authorized to act in its behalf with respect to the work specified herein and make all decisions on behalf of Provider in connection therewith: Debbie Espinosa, President & CEO Find Food Bank ,83775 Citrus Avenue Indio, CA, 92201. 760.775.3663 3.2 Contract Officer. The Contract Officer shall be such person as may be designated by the City Manager of City. 3.3 Prohibition Against Subcontracting or Assignment. Provider shall not contract with any other entity to perform in whole or in part the services required hereunder without the prior, express written approval of the City. Neither this Agreement, nor any interest herein, including the right to any monies due hereunder, may be assigned or transferred, voluntarily or by operation of law, without the prior written approval of the City. 55575.18175\33228209.1 - 4 - 3.4 Independent Contractor. Neither the City nor any of its employees shall have any control over the manner, mode or means by which Provider, its agents or employees, perform the services required herein, except as otherwise set forth herein. Provider shall perform all services required herein as an independent contractor of City and shall remain at all times as to City a wholly independent contractor with only such obligations as are consistent with that role. Provider shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of City. 4.0 COMPLIANCE WITH FEDERAL REGULATIONS. 4.1 The Provider acknowledges that the funds being provided by the City for the Project are distributed pursuant to the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act"), Public Law 116-136. The Provider agrees to comply with the requirements of the CARES Act, Public Law 116-136, and any implementing regulations and programmatic requirements. Further, the Provider agrees to comply with the requirements of Title 24 of the Code of Federal Regulations, Part 570 (the U.S. Housing and Urban Development regulations concerning Community Development Block Grants (CDBG)) including subpart K of these regulations, except that (1) the Provider does not assume the City's environmental responsibilities described in 24 CFR 570.604 and (2) the Provider does not assume the City's responsibility for initiating the review process under the provisions of 24 CFR Part 52. The Provider also agrees to comply with all other applicable Federal, state and local laws, regulations, and policies governing the funds provided under this Agreement including: financial standards according to OMB Circular A-22 (non-profit), OMB Circular A-87 "Cost Principles for State and Local Governments, OMB Circular A-133 "Audits of State and Local Government and Non -Profit Organizations." The Provider further agrees to utilize funds available under this Agreement to supplement rather than supplant funds otherwise available. 4.2 The Provider shall maintain records of its operations and financial activities in accordance with the requirements of the Housing and Community Development Act and the regulations promulgated thereunder, which records shall be open to inspection and audit by the authorized representatives of the City, the Department of Housing and Urban Development and the Comptroller General during regular working hours. Said records shall be maintained for such time as may be required by the regulations of the Housing and Community Development Act, but in no case for less than five years after the close of the program. 4.3 The Provider certifies it shall adhere to and comply with the following as they may be applicable, and as may be amended from time to time: (a) Submit to City through its Community and Economic Development Department semi-annual reports on program status (Exhibit E); (b) Section 109 of the Housing and Community Development Act of 1974, as amended and the regulations issued pursuant thereto; 55575.18175\33228209.1 (c) Section 3 of the Housing and Urban Development Act of 1968, as amended; (d) Executive Order 11246, as amended by Executive Orders 11375 and 12086, and implementing regulations at 41 CFR Chapter 60; (e) Executive Order 11063, as amended by Executive Order 12259, and implementing regulations at 24 CFR Part 107; (f) Section 504 of the Rehabilitation Act of 1973 (P.L. 93-112), as amended, and implementing regulations; (g) The Age Discrimination Act of 1975 (P.L. 94-135, as amended, and implementing regulations; (h) The relocation requirements of Title II and the acquisition requirements of Title III of the Uniform Relocation Assistance and Real Property Acquisition at 24 CFR Part 42; (i) The restrictions prohibiting use of funds for the benefit of a religious organization or activity as set forth in 24 CFR 570.200 0); (j) The labor standard requirements as set forth in 24 CFR Part 570, Subpart K and HUD regulations issued to implement and requirements; (k) The Program Income requirements as set forth in 24 C.F.R. 570.504(c) and 570.503(b)(8), which are hereby incorporated by reference; (1) The Provider is to carry out each activity in compliance with all Federal laws and regulations described in 24 C.F.R. 570, Subpart K, except that the Provider does not assume the City's environmental responsibilities described at 24 C.F.R. 570.604; nor does the Provider assume the City's responsibility for initiating the review process under the provisions of 24 C.F.R. Part 52, (m) Executive Order 11988 relating to the evaluation of flood hazards and Executive Order 11288 relating to the prevention, control and abatement of water pollution; (n) The flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93- 234); 55575.18175\33228209.1 _ 6 _ (o) The regulations, policies, guidelines and requirements of 24 CFR 570; the "Common Rule", 24 CFR Part 85 and subpart J; OMB Super Circular 2 CFR 200 as they relate to the acceptance and use of federal funds under the federally - assisted program, (p) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) and implementing regulations issued at 24 CFR Part 1; (q) Title VIII of the Civil Rights Act of 1968 (P.L. 90-284) as amended; (r) The lead -based paint requirements of 24 CFR Part 35 issued pursuant to the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.); (s) Procure, use, manage and dispose of personal property in accordance with 2 CFR 200.310 and 2 CFR 200.312 through 2 CFR 200.316; (t) Reversion of asset. Upon the Expiration of the agreement, the Subrecipient shall transfer to the City any CDBG funds on hand at the time of expiration and any accounts receivable attributable to the use of CDBG funds. Additionally, any real property under the Subrecipient's control that was acquired or improved in whole or in part with CDBG funds (including CDBG funds provided to the Subrecipient in the form of a loan) in excess of $25,000 is either: (i) Used to meet one of the national objectives in Section 570.208 (formerly Section 570.901) until five years after expiration of the agreement, or for such longer period of time as determined to be appropriate by the City; or (ii) Not used in accordance with paragraph (t)(i) above, in which event the Subrecipient shall pay to the City an amount equal to the current market value of the property less any portion of the value attributable to expenditures of non-CDBG funds for the acquisition of, or improvement to, the property. The payment is program income to the City. (No payment is required after the period of time specified in paragraph (t) of this section.) (u) Conflict of Interest. The Provider is required to disclose to the City in writing any potential conflict in accordance with 24 CFR Part 570.611; and 55575.18175\33228209.1 _ 7 - (v) Such other City, County, State, or Federal laws, rules, and regulations, executive orders or similar requirements which might be applicable. (w) The federal uniform administrative requirements, as described in § 570.502. (x) Provider shall not carry out any of the activities under this agreement in a manner that results in a prohibited duplication of benefits as defined by the CARES Act. Provider must comply with HUD's requirements for duplication of benefits, imposed on the City, which are: CDBG-CV grant funds may not be used to pay costs if another source of financial assistance is available to pay that cost. (y) Provider hereby certifies to City that Provider will provide a drug -free workplace, in accordance with federal law. 4.4 The City shall have the right to periodically monitor the program operations of the Provider under this Agreement. 4.5 At the end of the program year, the City may require remittance of all or part of any program income balances (including investments thereof) held by the Provider (except those needed for immediate cash needs, cash balances of a revolving loan fund, cash balances from a lump sum drawdown, or cash or investments held for section 108 security needs). 4.6 Subrecipient shall be subject to audit requirements contained in the Single Audit Act Amendment of 1996 (31 USE 7501 — 7507) and revised OMB Circular A- 133. Subrecipient shall be subject to random audits by City, HUD, and the Comptroller General of the United States or any of their authorized representatives, at any time during normal business hours, as often as deemed necessary to audit, examine, and make excerpts or transcripts of all relevant data in its administration of the CDBG-CV Program and federally funded activity. All CDBG-CV funded activity records and related documents shall be made available as well as required financial records/data for the Subrecipient. Failure of Subrecipient to comply with the above audit requirement will constitute a violation of this Agreement and may result in the withholding of future payments and/or reimbursement of funds paid. Subrecipient agrees to have an annual agency audit conducted in accordance OMB Circular A-133. 4.7 Subrecipent shall comply with City policy concerning the purchase of equipment, fixed assets, and other similar items and shall maintain inventory records of all non -expendable personal property as defined by such policy as may be procured with funds provided herein. All program assets (unexpended program income, property equipment, etc) shall revert to City upon termination of this Agreement. Unless specified otherwise within this Agreement, Subrecipient shall procure all materials, property, or services in accordance with the requirements of 24 CFR 84.40-48. 55575.18175\33228209.1 _ $ _ 4.8 Subrecipient certifies that they will not or have not used federal appropriated funds to pay any persons or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, or offier or employee of Congress in connection with obtaining any Federal contract, grant, loan, cooperative agreement, or any other award including the extension, continuation, renewal, or modification of same. Subrecipient shall disclose any lobbying with non- federal funds that takes place in conjunction with obtaining any federal award. 5.0 INSURANCE AND INDEMNIFICATION. 5.1 Insurance. The Provider shall procure and maintain, at its cost, and submit concurrently with its execution of this Agreement, public liability and property damage insurance against claims for injuries against persons or damages to property resulting from Provider's acts or omissions arising out of or related to Provider's performance under this Agreement. Provider shall also carry Workers' Compensation Insurance in accordance with State Workers' Compensation laws. Such insurance shall be kept in effect during the term of this Agreement and shall not be cancelable without thirty (30) days' prior written notice of the proposed cancellation to City. A certificate evidencing the foregoing and naming the City, its elected officials, officers, employees and agents as additional insureds shall be delivered to and approved by the City's Risk Manager prior to commencement of the services hereunder. The procuring of such insurance or the delivery of policies or certificates evidencing the same shall not be construed as a limitation of Provider's obligation to indemnify the City, its elected officials, officers, employees or agents. The amount of insurance required hereunder shall be as required by the Contract Officer not exceeding One Million Dollars ($1,000,000). 5.2 Indemnification. The Provider shall defend, indemnify and hold harmless the City, its elected officials, officers, employees and agents, from and against any and all actions, suits, proceedings, claims, demands, losses, costs, and expenses, including legal costs and attorneys' fees, for injury to or death of person(s), for damage to property (including property owned by the City) arising out of or related to Contractor's performance under this Agreement, except for such loss as may be caused by City's own negligence or that of its officers or employees. 6.0 CITY OFFICERS AND EMPLOYEES: NON-DISCRIMINATION, TERMINATION, AND ENFORCEMENT. 6.1 Non -Liability of City Officers and Employees. No officer or employee of City shall be personally liable to the Provider, or any successor -in -interest, in the event of any default or breach by City or for any amount which may become due to the Provider or its successor, or for breach of any obligation of the terms of this Agreement. 6.2 Conflict of Interest. Provider acknowledges that no officer or employee of the City has or shall have any direct or indirect financial interest in this Agreement nor shall Provider enter into any agreement of any kind with any such officer or employee during the term of this Agreement and for one year thereafter. Provider warrants that Contractor has not paid or given, and will not pay or give, any third party any money or other consideration in exchange for obtaining this Agreement. 55575.18175\33228209.1 - 9 - 6.3 Covenant Against Discrimination. In connection with its performance under this Agreement, Provider shall not discriminate against any employee or applicant for employment because of actual or perceived race, religion, color, sex, age, marital status, ancestry, national origin (i.e., place of origin, immigration status, cultural or linguistic characteristics, or ethnicity), sexual orientation, gender identity, gender expression, physical or mental disability, or medical condition (each a "prohibited basis"). Provider shall ensure that applicants are employed, and that employees are treated during their employment, without regard to any prohibited basis. As a condition precedent to City's lawful capacity to enter this Agreement, and in executing this Agreement, Provider certifies that its actions and omissions hereunder shall not incorporate any discrimination arising from or related to any prohibited basis in any Provider activity, including but not limited to the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship; and further, that Provider is in full compliance with the provisions of Palm Springs Municipal Code Section 7.09.040, including without limitation the provision of benefits, relating to non-discrimination in city contracting. 6.4 Term. Unless earlier terminated in accordance with Section 6.5 of this Agreement, this Agreement shall continue in full force and effect until completion of the services, but not exceeding one (1) year from the date hereof, unless extended by mutual agreement based on HUD guidance or regulations. 6.5 Termination Prior to Expiration of Term. a. In accordance with 2 CFR 200.339, the City may suspend or terminate, in whole or in part, this Agreement if Provider fails to comply with any term of this Agreement or the terms and conditions of the subaward; b. In accordance with 2 CFR 200.339, the City may terminate this Agreement with the consent of the Provider after both parties have agreed upon the termination conditions, including the effective date and, in the case of a partial termination, the portion to be terminated; and c. The Provider may terminate this Agreement at any time, with or without cause, upon thirty (30) days' notification setting forth the reason(s) for such termination, the effective date and, in the case of partial termination, the portion to be terminated. Upon receipt of the notice of termination the Provider shall immediately cease all services hereunder except as may be specifically approved by the Contract Officer. However, if the City determines in the case of partial termination that the reduced or modified portion of the subaward will not accomplish the purposes for which the subaward was made, the City may terminate the subaward in its entirety. Provider shall be entitled to compensation for all services rendered prior to receipt of the notice of termination and City shall be entitled to reimbursement for any services which have been paid for but not rendered. 55575.18175\33228209.1 - 10 - 7.0 MISCELLANEOUS PROVISIONS. 7.1 Notice. Any notice, demand, request, consent, approval, or communication that either party desires, or is required to give to the other party or any other person shall be in writing and either served personally or sent by pre -paid, first- class mail to the address set forth below. Notice shall be deemed communicated seventy-two (72) hours from the time of mailing if mailed as provided in this Section. Either party may change its address by notifying the other party of the change of address in writing. TO CITY: City of Palm Springs 3200 East Tahquitz Canyon Way Palm Springs, CA 92262-6959 Attn: City Manager WITH COPY TO: City of Palm Springs 3200 East Tahquitz Canyon Way Palm Springs, CA 92262-6959 Attn: City Attorney TO PROVIDER: Debbie Espinosa, President & CEO id Food ai MWAG11 .. 7.2 Amendment. This Agreement may be amended at any time by the mutual consent of the parties by an instrument in writing. IN WITNESS WHEREOF, the parties have executed and entered into this Agreement as of the date first written above. [ End — Signatures on Next Page ] 55575.18175\33228209.1 - 11 - ATT T: By: V y rL�� Clerk CITY OF PALM SPRINGS a munici al corporation By: City M nagger APPROVED AS TO FORM: APPROvED BYeny COUNCIL By: City A torney PROVIDER: Check one: _ Individual _ Partnership -� Corporation (Corporations require two notarized signatures: One signature must be from the Chairman of Board, President, or any Vice President. The second signature must be from the Secretary, Assistant tary, Treasurer, Assistant Treasurer, or Chief Finan . I Officer). By' - By. I,(ita zed Signa a of Chairman of Board, otarized Signature Secretary, President or any Vice President Asst Secretary, Treasurer, Asst Treasurer or Chief Financial Officer Name: Title: / i UT £ GZn State of _ County of 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 Lv 1 e 6 A I ) County of ) ss. Name: Title:/ a dtl/- State of ) County of ) ss 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 L a f ) County ofJE 1, d i) SS On h U o i u, a&b i before me, On 11 before me, !dersonally appeared �% 14 a%r 11 ! p41 it-, personally appeared who proved to r3ay I C fU �r� who proved to me,., me on the basis of satisf tory evidence to be the person on t e basis f sa A factory evidence to be the persora(sj whose namei are subscrib to the within instrument 8nd whose name sore subsc ed to the within instrument and acknowledged of me that he/ h they executed the saw in a nowledged to me that � he/they executed the same in his/�ierRheir authorized capaci yi, and that b his ierdheir �ii/her/their authorized capacity(if and that by �er/their signafure(5,on the instrument the person, or the entity sianature(sl''on the instrument the persons , or the entity upon upon behalf of which the personjs?(act6d, executed the behalf of which the person(s acted, executed the instrument. 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 hanp and offiIZ/11'11 at se&+- Notary Signature. Notary Seal: MARANAMAR --------- CM LAM Fa COIM1. i12b16760 NO rW K= • C�ALFORNR �■.ww� �a�a+------ - ------------------------------- I I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. � . WITNESS my Notary Signature:X-AMMf Notary Seal: fL - - 6-C&M'"Goftwom -----O--M----A L--- EM1N COIF. N2336M NOTAR11i1m •cumm I fm 55575.18175\33228209.1 - 12 - CITY OF PALM SPRINGS EXHIBIT A Scope of Services Proiect/Activity Title: Proiect Number: Find Food Bank Name/Address of Provider: Find Food Bank 83775 Citrus Avenue, Indio, CA, 92201 Objectives/Activities During the COVID-19 crisis, the need for food in our community increased dramatically. At the FIND Food Bank Desert Highland Gateway Estates food distribution, attendance has increased 283% from the pre- COVID-19 attendance numbers in February 2020. To address this increase in need, FIND Food Bank will continue to serve the Desert Highland Gateway Estates community in Palm Springs. FIND Food Bank will provide Mobile Markets with healthy food, with a strong balance of fresh produce, protein, dairy and grain items, to this community twice per month. FIND's Mobile Markets are specialized or converted refrigerated beverage trucks that are filled at the FIND warehouse with a wide variety of fresh produce, frozen meat, refrigerated products, dairy, bakery, and dry goods designed. Objective 1: Assist the City by timely providing any additional information requested TARGET DATE ACTIVITY #1 Ongoing Make readily available any information relative to the successful implementation of the activity. Objective 2: Establish and maintain a programmatic and financial record keeping process. TARGET DATE ACTIVITY #1 Ongoing Establish and maintain an efficient program process/procedure for proper record keeping. Set-up a filing system for CDBG files only. Document and maintain all records related to this program in a stable and secure location. Objective 3: Advertise, market and publicize the program to facilitate positive promotion for all parties (i.e., Provider, City, CDBG, etc.). TARGET DATE ACTIVITY #1 Ongoing Promote and publicize the Desert Highlands Gateway Estates food distribution through the FIND food Bank website, outreach flyers and networking with other agencies. Objective 4: Maintain records for all CDBG activities related to this program. TARGET DATE ACTIVITY #1 Ongoing Document and maintain all records related to this program, including those required, in accordance with HUD Regulations, in a stable and secure location. ACTIVITY #2 Ongoing Submit Semi -Annual reports — referenced Exhibit E within fifteen (15) calendar days of the program mid -year, December 31st, and program completion, June 301n Objective 5: Manage/monitor program activities. TARGET DATE ACTIVITY #1 Ongoing Perform monitoring activities necessary to ensure that the program is being conducted in compliance with the CDBG policies, federal regulations, and local statues, including Davis -Bacon Act, Copeland Act, and Non-discrimination / EEO requirements. Objective 6: Provide an evaluation within fifteen (15) calendar days of the program completion or final reimbursement. TARGET DATE ACTIVITY #1 07/15/21 Provide an evaluation and final report on all programmatic and financial activities. Objective 7: Personnel support for program roll -out TARGET DATE ACTIVITY #1 Ongoing Provide FIND's CalFresh Outreach Team with every food distribution to secure participation for, individuals who qualify, for the California CalFresh Food Stamp program TARGET DATE ACTIVITY #2 Ongoing Provide a FIND Community Health Worker at every distribution, which includes follow-up client services of approximately 16 hours per distribution. Objective 8: Program Roll -out TARGET DATE ACTIVITY #1 Within 60 days Provide safety equipment including masks, gloves, vests, pop-up tents, tables, clipboards, after receipt of signage, traffic cones during distribution to preserve the safety of our clients and to address grant the COVID-19 social distancing mandates TARGET DATE ACTIVITY #2 Ongoing Provide Mobile Markets with healthy food, with a strong balance of fresh produce, protein, dairy and grain items, to a target of 2,500 (unduplicated) beneficiaries for the grant period. TARGET DATE ACTIVITY #3 Ongoing Deliver up to 10,000 pounds of foods at each FIND Mobile Market food distribution. General Administration Provide the management oversight and leadership to address specific operational tasks in meeting the established performance levels, as well as perform supportive activities (i.e., clerical, monitoring, etc.) CITY OF PALM SPRINGS EXHIBIT B Beneficiary Qualification Statement Proiect/Activity Title: Project Number: Find Food Bank Name/Address of Provider: Find Food Bank, 83775 Citrus Avenue, Indio, CA, 92201 BENEFICIARY QUALIFICATION STATEMENT This statement must be completed and signed by each person or head of household (legal guardian) receiving benefits form the described projectlactivity. Please answer each of the following questions. 1. How many persons are in your household? For this question a household is a group of related or unrelated persons occupying the same house with at least one member being the head of the household. Renters, roomers, or borders cannot be included as household members. 2. Circle your combined gross annual income (Riverside -San Bernardino -Ontario, CA MSA— 07/01/2020) AREA MEDIAN NUMBER OF PERSONS IN YOUR HOUSEHOLD: INCOME (AMI) 1 2 3 4 5 6 7 8 LEVEL - $75,300 EXTREMELY LO INCOME $15,850 $18,100 $21,720 $26,200 $30,680 $35,160 $39,640 $44,120 0 - 30% of AMI LOW INCOME $26,400 $30,150 $33,900 $37,650 $40,700 $43,700 $46,700 $49,700 30 - 50% of AMI MODERATE INCOME $42,200 $48,200 $54,250 $60,250 $65,100 $69,900 $74,750 $79,550 50 - 80% of AMI NON LOW & MOD INCOME $42,201+ $48,201+ $54,251+ $60,251+ $65,101+ $69,901+ $74,751+ $79,551+ > 80% 3. What race/ethnicity do you identify yourself as; please note that this self -identification is voluntary in accordance with equal opportunity laws? ❑ White ❑ American Indian or Alaska Native AND White ❑ Black/African American ❑ Asian AND White ❑ Asian ❑ Black/African American AND White ❑ American Indian or Alaskan Native ❑ American Indian/Alaska Native AND Black/African American ❑ Native Hawaiian or Other Pacific Islander ❑ Other: HISPANIC/LATINO ETHNICITY ❑ Yes ❑ No If yes, check one: ❑ Mexican/Chicano ❑ Puerto Rican ❑ Cuban ❑ Other: 4. Are you female Head of Household? ❑ YES 5. Do you have a disability? ❑ YES 6. Have you been impacted by the Coronavirus? ❑ NO ❑ NO If YES, please describe: ❑ YES ❑ NO If YES, please describe: ACKNOWLEDGEMENT AND DISCLAIMER 1 CERTIFY UNDER PENALTY OF PERJURY THAT INCOME AND HOUSHOLD STATEMENTS MADE ON THIS FORM ARE TRUE. NAME: DATE: ADDRESS: PHONE NO: SIGNATURE: The information you provide on this form is confidential and is only utilized for Community Development Block Grant (CDBG) program purposes, a Federally -funded program, governmental reporting purposes to monitor CITY OF PALM SPRINGS EXHIBIT C Budget Summary Proiect/Activity Title: Project Number: Find Food Bank Name/Address of Provider: Find Food Bank 83775 Citrus Avenue, Indio, CA, 92201 BUDGET SUMMARY COST CATEGORY CDBG SHARE OTHER SOURCES TOTAL COST 1 Personnel $17,100 $17,100 2 Consultant/Contract Services Architectural Services - - 3 Travel $3,960 $3,960 4 Space Rental - - 5 Consumable Supplies $11,005 $15,995 $27,000 6 Rental, Lease or Purchase of Equipment - - 7 Insurance - - 8 Administrative $3,240 $3,240 TOTALS $35,305 $15,995 $51,300 If costs are to be shared by other sources of funding, including CDBG funds from other jurisdictions, identify the source of funding, grantor/lending agency, and cost category information. Progress payments, approved by the Subrecipient and based upon the percentage of completion of the work with a 10% retention, shall be paid by the 30"' day of each month, provided that the payment application has been submitted to the City on or before the first working day of the month. The Subrecipient shall receive reimbursements and/or its suppliers/vendors shall receive direct payments by way of a two-party check, in accordance with the aforementioned cost categories and line items which are subject to receipt of an acceptable requisition in the form of a monthly Request for Reimbursement. The Subrecipient recognizes that the CDBG Funds are received from the HUD, and that the obligation of the City to make payment to Subrecipient is contingent upon receipt of such funds from HUD. In the event that said funds, or any part thereof, are, or become, unavailable, then the City may immediately terminate or amend this Agreement. Services are to be performed over a twelve month period of July 1, 2020 through June 30, 2021 with funds allocated from 2020 — 21 Program Year. CITY OF PALM SPRINGS EXHIBIT D Request for Reimbursement Project/Activity Title: Project Number: Find Food Bank Name/Address of Provider: Find Food Bank 83775 Citrus Avenue, Indio, CA, 92201 BENEFICIARY QUALIFICATION STATEMENT Approved Current Prior Total Grant Description Grant Reimbursement Reimbursement YTD Balance Amount Period Period(s) Reimbursement (Over/ Under) TOTAL il $35,305 11$35,305 I CERTIFY THAT, (a) the City of PALM SPRINGS, as grantee of the CDBG, has not previously been billed for the costs covered by this invoice, (b) funds have not been received from the Federal Government or expended for such costs under the terms of the Agreement or grant pursuant to FMC-74-4 & 24 CFR Part 58;(c) this agency is in full compliance with all applicable provisions under the terms of the Contractor grant; and (d) this agency is in full compliance with all applicable tax laws and hereby affix original signatures. PREPARED BY: Name, Title, Date APPROVED BY: Name, Title, Date City of PALM SPRINGS Use Only Audited by: Examined by: Approved by: If necessary, additional sheet(s) must be attached detailing cost breakdowns, and verified by original signatures. CITY OF PALM SPRINGS EXHIBIT E Semi -Annual Program Progress Report Project/Activity Title: Project Number: Find Food Bank Name/Address of Provider: Find Food Bank 83775 Citrus Avenue, Indio, CA, 92201 PROGRAM PROGRESS REPORT Period: DIRECT BENEFIT REPORT ♦ Number of First -Time Program Beneficiaries Serviced: # of Households # of Persons < or = 30%: 30-50%: 50-80%: > 80%: ♦ Number of First -Time Female Headed Households: ♦ Counts by Race/Ethnicity: White American Indian or Alaska Native AND White Black/African American Asian AND White Asian Black/African American AND White American Indian or Alaskan Native American Indian/Alaska Native AND Black/African American Native Hawaiian or Other Pacific Islander Other: HISPANIC/LATINO ETHNICITY: Mexican/Chicano Cuban ♦ Number of Disabled: ♦ Number of Homeless Persons Given Overnight Shelter: Puerto Rican Other: ACCOMPLISHMENT NARRATIVE LEVERAGING RESOURCES NARRATIVE Signed Title Date ACOROO® CERTIFICATE OF LIABILITY INSURANCE `� DATE (MMIDD/YYYY) 1 12/14/2020 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 have ADDITIONAL INSURED provisions or 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 Arthur J. Gallagher Risk Management Services, Inc. 2850 Golf Road Rolling Meadows IL 60008 CONTACT NAME: Jeremiah Polk PHONE . 630-773-3800 a No]: 630-285-4062 A DRIESS, INSURERS AFFORDING COVERAGE NAIC # INSURER A: Carolina Casualty Insurance Company 10510 INSURED FOODINN-01 Food Need of Distribution, Inc. 83-775 Citrus Avenue INSURER B : Service American Indemnity Company INSURER C: Philadelphia Indemnity Insurance Company 18058 INSURER D: Indio CA 92202 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:857921064 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. INPOLICY TR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER EFF MM/DD/YYYY POLICY EXP MWDD/YYYY LIMITS C X COMMERCIAL GENERAL LIABILITY PHPK2215397 12/15/2020 12/15/2021 EACHOCCURRENCE $1,000,000 X CLAIMS -MADE OCCUR PREMI ERENTED PREMISESS Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 3,000,000 X POLICY JERCO7- ❑ LOC PRODUCTS-COMP/OPAGG $3,000,000 $ OTHER: C AUTOMOBILE LIABILITY PHPK2215397 12/15/2020 12/15/2021 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ ANY AUTO 1X OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY C X UMBRELLALIAB X OCCUR PHUB749260 12/15/2020 12/15/2021 EACH OCCURRENCE $3,000,000 AGGREGATE $ 3,000,000 EXCESS LIAB CLAIMS -MADE X DED X RETENTION$ in onn $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N SATIS0022500 7/1/2020 7/1/2021 X STATUTE ERH ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE -EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Dire ctors &Officers DCP-1795595-P2 12/15/2020 12/15/2021 LIMIT $1,000,000 Professional Liability AGGREGATE LIMIT $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) The City of Palm Springs, its officials, employees and agents are listed as additional insured. The insurance is primary and non-contributory over any insurance or self-insurance the City may have. Should the above described policies be cancelled before the expiration date thereof, the issuing company will mail 30 days written notice to the certificate holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Palm Springs AUTHORIZED REPRESENTATI E 4tbl. 4wwzv� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT— CALIFORNIA We have the right to recover our payments from anyone liable for an injurycovered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you per- form work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be otherwise due on such remuneration. Person or Organization City of Palm Springs Job Description 0 . 0 5 0 % of the California workers' compensation premium Schedule 3200 E. Tahquitz Canyon Way, Palm Springs, CA 92262 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Date: 01 / 01 / 2 021 Policy No. SATI S 0 0 2 2 5 0 0 Endorsement No. Policy Effective Date: 07/01/2020 to 07/01/2021 Premium $ Insured: Food in Need of Distribution, Inc. D BA: Carrier Name / Code: Service American Indemnity Company Countersigned by WC 04 03 06 (Ed.4-84) Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY POLICY INFORMATION PAGE ENDORSEMENT The following item(s) ❑ Insured's Name (WC 89 06 01) ❑ Policy Number (WC 89 06 02) ❑ Effective Date (WC 89 06 03) ❑ Expiration Date (WC 89 06 04) ❑ Insured's Mailing Address (WC 89 06 05) ❑ Experience Modification (WC 89 04 06) ❑ Producer's Name (WC 89 06 07) ❑ Change in Workplace of Insured (WC 89 06 08) ❑ Insured's Legal Status (WC 89 06 10) WC 89 06 00 B (Ed. 7-01) p Item 3.A. States (WC 89 06 11) ED Item 3.6. Limits (WC 89 06 12) 0 Item 3.C. States (WC 89 06 13) 0 Item 3.D. Endorsement Numbers (WC 89 06 14) 0 Item 4 * Class, Rate, Other (WC 89 04 15) 0 Interim Adjustment of Premium (WC 89 04 16) 0 Carrier Servicing Office (WC 89 06 17) 0 Interstate/Intrastate Risk ID Number (WC 89 06 18) 0 Carrier Number (WC 89 06 19) 0 Issuing Agency/Producer Office Address (WC 89 06 25) is changed to read: Effective 1/1/21 added SWOS in favor of City of Palm Springs at 3200 E. Tahquitz Canyon Way, Palm Springs, CA 92262 * Item 4. Change To: Classifications Code No. Premium Basis Total Estimated Annual Remuneration Rate Per $100 of Remuneration Estimated Annual Premium Total Estimated Annual Premium $ 3 5_ 5 R ti Minimum Premium $ 1, 000 Deposit Premium $ All other terms and conditions of this policy remain unchanged. New Estimated Premium 35,586.00 New Estimated Tax Less Previously Billed 35,434.00 Less Previously Billed Additional Due 152.00 Additional Due 1,217.00 1,213.00 4.00 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Date: 01 / 01 / 2 0 21 Policy No. SAT I S 0 0 2 2 5 0 0 Endorsement No. Policy Effective Date: 07/01/2020 to 07/01/2021 Premium $ 152.00 Insured: Food in Need of Distribution, Inc. DBA: Carrier Name / Code: Service American Indemnity Company NCCI Carrier Code No. 3 8 3 6 9 Countersigned by WC 89 06 00 B (Ed.7-01) © 2001 National Council on Compensation Insurance. Page 1 of 1 ® ACORO CERTIFICATE OF LIABILITY INSURANCE `, DATE IMMIDD/YVVY) 12/29/2022 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 have ADDITIONAL INSURED provisions or be endorsed. It 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 Arthur J. Gallagher Risk Management Services, Inc. 2850 Golf Road Rolling Meadows IL 60008 NAM: CONTACT Jeremiah Polk P,20.16. , 630-773-3800 FAX N :630.285�062 EJAAIL ADDRESS: INSURERSAFFORDING COVERAGE NAICi INSURER A: Service American Indemnq Company 39152 INSURED FOODINN-01 Food In Need of Distribution, Inc. 83-775 Citrus Avenue INSURER B: Philadelphia Indemnity Insurance Company 18068 INsuRERc: Carolina Casualty Insurance Company 10510 INSURER O: Indio CA 92202 INSURER E : _ INSURER F : COVERAGES CERTIFICATE NUMBER: 834984006 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. In TYPE OF INSURANCE Iwo Su POLICY NUMBER M�D/YYYY M Y EFF POLICY LIMITS B X COMMERCIAL GENERAL LIABILITY PHPK2497833 12/1512022 12/1512023 EACHOCCURRENCE S1,000,000 X CLAIMS -MADE OCCUR PREMISES EA oocurmnce $100.000 MED EXP (Any we men) $ 5,000 PERSONAL S ADV INJURY $1.000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 53,000,000 PRODUCTS-COMP/OP AGG 33.0c0,ODO %t POLICY El JER T El LOC _ - S OTHER: B AUTOMOBILELIABILITY PHPK2497833 12/15/2022 12/15/2023 a IN LIMIT $1,000.000 BODILY INJURY (Per Demon) S X ANY AUTO OWNED SCHED AUTOS ONLY AAUTOSULEO HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per aaiden0 S S -. _. PPRO RTY DAMAGE S B X UM SRELLA LIAR X OCCUR PHUBB43920 12/1512022 12/15/2023 EACH OCCURRENCE $3,000,000 AGGREGATE $3,000,000 EXCESS LIAR CLAIMS -MADE X I DEC) I X I RETENTION S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY IN ANYPROPRIETOWPARTNERFXECUTIVE Y❑ SATIS0022502 7/1/2022 7/1/2023 X I STAT E ER E.L. EACH ACCIDENT $1,000.000 OFFIOERIM EMBER EXCLUDED? (MerMsrory In NH) NIA E.L DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1.000,000 8 yes, deecdbe under DESCRIPTION OF OPERATIONS below C Oilectors4ONcem Pmfessionel Liability I OCP-1795595-P4 12/15/2022 12/15/2023 LIMIT AGGREGATE LIMIT $1,000.000 $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may m attached if more ePaw is required) City of Palm Springs is an Additional Insured as respects to the general liability policy, pursuant to and subject to the policy's tern Mit�itions and exclusions. JAN 0 9 2023 City Han Reception Desk CFRTIFICATF HOI. nFR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cityy of Palm Springs ACCORDANCE WITH THE POLICY PROVISIONS. 3200 E Tahqultz Canyon Way AUTHORIMDREPRESENTATIVE Palm Springs CA 92262 USA 01988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Arthur J. Gallagher Risk Management Services, Inc. 2850 Golf Road Rolling Meadows IL 60008 MDG2022 DOW3514 01 IIu.I,.,LuIIIIIhP,t,m,n„Il,l,hlhddllel,dldlll,ht City of Palm Springs 3200 E Tahquitz Canyon Way Palm Springs, CA 92262 We are providing you with a Certificate of Insurance confirming our client's coverage. Want to get certificates of insurance faster? "Go Green with Gallagher" by receiving digital copies of certificates via e-mail in the future. Or, do you no longer require a certificate of insurance for our client? Please contact us at COI.UpdateMyEmail@AJG.com and provide the following information for processing: 1. Confirmation that a certificate of insurance is no longer required; or 2. E-mail address to send future certificates of insurance in lieu of U.S. Mail delivery 3. Insured Code: FOODINN-01 4. This Certificate Number: 834984006 To learn more about the Insurance and Risk Management Services offered by Gallagher, please visit us at www.ajg.com/us/about-us/how-we-work/core-360. Gallagher does not share your e-mail as detailed in our privacy policy found at https:// www.ajg.com/us/privacy-policy/. n