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HomeMy WebLinkAboutA6507 - DESERT AIDS PROJECT - CDBG SUBRECIPIENT AGR SUBRECIPIENT AGREEMENT n� THIS AGREEMENT(herein"Agreement"), is made and entered into thie�Z day of`�be-< 2019, by and between the CITY OF PALM SPRINGS, (herein "City), a municipal corporation and charter city,and the Desert AIDS Project, Inc. , (herein"Provider"). WHEREAS, the City has entered into various funding agreements with the United States Department of Housing and Urban Development ("HUD"), which agreements provide funds ("CDBG Funds") to the City under the Federal Housing and Community Development Act of 1974 (42 U.S.C. Section 5301 et seg.), as amended from time to time (the "Act"), and the regulations promulgated thereunder(24 C.F.R. Section 570 et seg. ("Regulations"); and WHEREAS, the Act provides that the City may grant the CDBG Funds to nonprofit organizations for certain purposes allowed under the Act; and WHEREAS,the Provider is a nonprofit organization which operates a program which is eligible for a grant of CDBG funds and the City desires to assist in the operation of the program by granting CDBG 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; NOW,THEREFORE, the parties hereto agree as follows: 1.0 SERVICES OF PROVIDER. 1.1 Scope of Services. Provider agrees to provide to City all of the services specified and detailed in its application for funding and 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 represented in the Provider's application for funding. City provided funds shall be used only for those purposes specified in such application and 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. 1.4 Financial Reporting. Any Provider receiving or due to receive $20,000.00 or more from the City during the 2019 — 2020 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 which 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. 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 ONE HUNDRED SEVENTY-FIVE THOUSAND AND THREE HUNDRED TWENTY-SEVEN DOLLARS ($175,3 77.00) (the "Contract Sum") in accordance with the Budget attached hereto in Exhibit B and incorporated herein by this reference; and as herein provided. The budget cost categories set out in Exhibit B 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 F, on reimbursable expenditures pursuant to the attached Budget along with pertinent supporting 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 by Provider to request reimbursement or encumbrance of at least 25% of the total grant by the end of each fiscal year quarter(September 30, December 30, March 31, and June 30)shall result in the immediate forfeiture of 25%of the total grant. 3.0 COORDINATION OF WORK. 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 in connection therewith: William VanHemert Director ot Grants 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 express written approval_ of the City. Neither this Agreement nor any interest herein may be assigned or transferred,voluntarily or by operation of law,without the prior written approval of the City. 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 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 -2- 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. 4.2 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; (b) Section 109 of the Housing and Community Development Act of 1974, as amended and the regulations issued pursuant thereto; (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); Q) The labor standard requirements as set forth in 24 CFR Part 570, Subpart K and HUD regulations issued to implement and requirements; M The Program Income requirements as set forth in 24 C.F.R. 570.504(c) and 570.503(b)(8); (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); (o) The regulations, policies, guidelines and requirements of 24 CFR 570; the "Common Rule", 24 CFR Part 85 and subpart J; OMB Super -3- 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 seg.); (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 (v) Such other City, County, State, or Federal laws, rules, and regulations, executive orders or similar requirements which might be applicable. 4.3 The City shall have the right to periodically monitor the program operations of the Provider under this Agreement. 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 -4- foregoing and naming the City as an additional insured shall be delivered to and approved by the City 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 officers, or employees. 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 officers and employees, 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. 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. 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 - 5 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. 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: Desert AIDS Proiect— D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 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] -6- CITY OF PALM SPRINGS ATT T: I corporation B By: ClerkVL—� City Manager APPROVED AS TO FORM: APPROVED BY CITY COUNCIL By, ♦ry/ ��, AS6�_ C t5 E-L f City Attorney PROVIDER: Check one: _Individual _Partnership X 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, Assista cretary, Treasurer, Assistant Treasurer, or Chief Financial Officer By: By: Not ed Signature of Chairman of Board, Notari a at ign ecretary,Asst Secretary, President or any Vice President Treasu a Asst Tre surer or Chief Financial Officer Name: David Brinkman Name: Judith Stith Title: Chief Executive Officer Title: �n1Chief Financial Officer State of w' y,-V ) State oC. -6)A-v ) County of i-4AV4b )ss County of'%-1A-VC61&L4 ss A notary public or other officer completing this certificate A notary public or other officer completing this certificate verifies only the identity of the individual who signed the verifies only the identity of the individual who signed the document to which this certificate is attached, and_not document to which this certificate is attached, and not the truthfulness,accuracy,or validity of that document. the truthfulness,accuracy,or validity of that document. State of C"A• ynL* ) � , /�. County ofT-6Vr r6 )ss. State of lam• rn'w u r County of �\`y—G-� %L- JII,s`s. On�1)l��f o2,a�>"a o��� before me, On \O L, 0 0` C y i V vli before me, Q0 Vj(XW •�-r�r tr personally appeared .{�Yl{LL Ll- 6 F.Irr t" personally appeared Y,.,k 6,,M,,— who proved to S-� U— who proved to me on the basis of satisfactory evidence to be the personaey me on a basis of satisfactory evidence to be the personH whose name4o is/dye subscribed to the within instrument and whose name(5�4s/armsubscribed to the within instrument and acknowledged to me that he/,51 t p executed the same in acknowledged to me that be/she*my executed the same in hislj�Wthetf authorized capacityAes'J,and that by his/pef/t eTr JzWher/their authorized capacity(ia&),and that byxs/hereeir signature4s3 on the instrument the persoa(5J, or the entity signature fg) on the instrument the person(*,-or the entity upon behalf of which the personM acted, executed the upon behalf of which the perso*) acted, executed the instrument. instrument. I certify under PENALTY O PERJURY under the laws of the I certify under PENALTY OF PERJURY under the laws of the State of California that t e egoing paragraph is true and State of California that t oregoing paragraph is true and correct. correct. WITNESS my hand and ffici I. e::)WITNESS my hand an fficia sqral Notary Notary Si a Notary Seal: Notary Seal: - SHELIA BARNETT SHELL,BARNETT < .-� Notary Public-California Z Notary Public-California Z. Riverside County Z a -o�' a Riverside County _Z Commission N 2170231 = Z Commission rr 2170231 M Comm,E Ires Nov 29,2020 ..,!---MY Comm.Expires Nov 29.2020 ArinieR/CCBG 19.20DAP_SubrecipAg nnntSEPT19 -7- CITY O.F PALM SPRINGS ,. Mani EXHIBIT A Scope of Services Prolect/Activity Title: Project Number: Desert AIDS Project/ 0002 Fire Suppression/Life &Safety Improvement Name/Address of Provider: Desert AIDS Project- D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 Objectives/Activities The intent of this program is to provide the most comprehensive direct client services and advocacy to help people living with HIV/AIDS manage their disease, including a state-of-the-art medical center to a nutritionally balanced food voucher program, to case management, legal services, education, prevention, anonymous testing, wellness, dental, transportation, housing assistance and home health services. This will be accomplished through the continuation of the facility upgrades to provide access to essential, in many cases life-saving, services for one of the community's most vulnerable populations in the event of a building fire. The upgrades will be a phased installation of a fire sprinkler system, designed to National Fire Protection Association (NFPA). D.A.P. service area covers Riverside and San Bernardino Counties, roughly the size of the state of Massachusetts which this immense area is recognized as the fifth largest concentration of HIV/AIDS population in the United States, serving 2,300 clients Valley-wide and 1,196 Palm Springs' clients. The Provider shall be responsible for the completion of the following objectives/activities in a manner acceptable and satisfactory to the City and consistent with the standards required as a condition of providing these CDBG funds. Objective 1: Assist the City by timely providing any additional information requested. TARGET DATE ACTIVITY#1 On-Going 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 On-Going 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 On-Going Draft a promotional piece and submit to City for approval. Advertise in the Desert Sun's daily general circulation. Submit final publication to City. Objective 4: Enroll and income gualify at least a total of one thousand and one hundred ninety-six (1,196) extremely low income to moderate-income Palm Springs residents in accordance with Exhibit D for improved access to the facility. TARGET DATE ACTIVITY#1 On-Going Provide direct client services and advocacy to help 2,300 Valley-wide residents living with HIV/AIDS manage their disease. Maintain records of names, addresses, demographics and service dates for all assistance. Objective 5: Maintain records for all CDBG activities related to this program. TARGET DATE ACTIVITY#1 On-Going 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 On-Going Submit Semi-Annual reports — referenced Exhibit E within fifteen (15) calendar days of the program mid-year, December 31st, and program completion, June 30tn. Objective 6: Manage/monitor program activities. TARGET DATE ACTIVITY#1 On-Going 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 7: Make improvements through Architectural & Engineering Services (A&E) and site Preparation for the installation of fire sprinkle system which will ensure the ability to maintain direct client services, and to preserve perishable medications and food in the event of a building fire. TARGET DATE ACTIVITY#1 On-Going Conduct activities to improve availability/accessibility in accordance with an 'open competitive' procurement process as stipulated in this Agreement and in consultation with the City. Objective 8: Provide an evaluation within fifteen N 5) calendar days of the program completion or final reimbursement. TARGET DATE ACTIVITY#1 07/15/20 Provide an evaluation and final report on all programmatic and financial activities. 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.) r CITI(,OFRALM SPRINGS EXHIBIT B Budget Summary Pro'tect/Activity Title: Project Number: Desert AIDS Project/ 0002 Fire Supperssion/Life&Safety Improvement Name/Address of Provider: Desert AIDS Project- D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 _,._. COST CATEGORY CDBG OTHER TOTAL SHARE SOURCES COST 1 Personnel -0- $4,410. $4,410. 2 Consultant/Contract Services $29,767. -0- $29,767. Architectural Services 3 Travel -0- -0- -0 - 4 Space Rental -0- -0- -0- 5 Consumable Supplies -0- -0- -0 - 6 Rental, Lease or Purchase of -0- -0- -0- Equipment 7 Insurance -0- -0- -0- 8 Other— $137,155. $117,841. $254,996. Construction/Rehabilitation Permit Fees $8,405. -0- -0 - ' 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. Other funding sources may include County of Riverside Economic Development Agency CDBG Award ($90,000), and D.A.P.'s contribution($32,251),totaling$122,251. 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 301h 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, 2019 through June 30, 2020 with funds allocated from 2019-20 Program Year. CITY OF PALM SPRINGS EXHIBIT C Insurance Inventory Proiect/Activity Title: Project Number: Desert AIDS Project/ 0002 Fire Supperssion/Life& Safety Improvement Name/Address of Provider: Desert AIDS Project- D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 INSURANCE INVENTORY LIABILITY INSURANCE POLICY Name of Provider's Insurance Company National Fire and Marine Insurance Co. Effective Dates of Policy 10/05/2019 to 10/05/2020 Claims Made Policy / / Per Occurrence Policy Limits of Liability $3,000,000 Deductibles: Per Occurrence Annual Aggregate Additional Insured Endorsement (Certificate Holder) Q Yes ❑ No Original Certificate of Insurance Attached ❑ Yes Q No WORKER'S COMPENSATION POLICY Name of Provider's Insurance Company Non Profits' United Workers' Compensation Group and Safety National Casualty Corp Effective Dates 01/01/2019 to 01/01/2020 Limits of Liability $2M Per Occurrence Underlying Coverage Limits Original Certificate of Insurance Attached ❑ Yes 0 No CITY S OF PALM SPRING t... .. EXHIBIT D Beneficiary Qualification Statement Proiect/Activity Title: Proiect Number: Desert AIDS Project/ 0002 Fire Suppression/Life&Safety Improvement Name/Address of Provider: Desert AIDS Project-D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 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—06/28/19) AREA MEDIAN NUMBER OF PERSONS IN YOUR HOUSEHOLD: INCOME(AMI) 1 2 3 4 5 6 7 8 LEVEL-$65,800 EXTREMELY LO INCOME $15,100 $17,250 $21,330 $25,750 $30,170 $34,590 $39,010 $43,430 0-30%of AMI LOW INCOME $25,150 $28,750 $32,350 $35,900 $38,800 $41,650 $44,550 $47,400 30-50%ofAMI MODERATE INCOME $40,250 $46,000 $51,750 $57,450 $62,050 $66,650 $71,250 $75,850 50-80%of AMI NON LOW&MOD INCOME $40,250+ $46,000+ $51,750+ $57,450+ $62,050+ $66,650+ $71,250+ $75,850+ >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 ❑ NO 5. Do you have a disability? ❑ YES ❑ NO If YES,please describe: ACKNOWLEDGEMENT AND DISCLAIMER I 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 compliance. CITY OF PALM SPRINGS EXHIBIT E Semi-Annual Program Progress Report Project/Activity Title: Project Number: Desert AIDS Project/ 0002 Fire Suppression/Life&Safety Improvement Name/Address of Provider: Desert AIDS Project-D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 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 Puerto Rican Cuban Other: ♦ Number of Disabled: ♦ Number of Homeless Persons Given Overnight Shelter: ACCOMPLISHMENT NARRATIVE LEVERAGING RESOURCES NARRATIVE Signed Title Date CITY OF PALM SPRINGS EXHIBIT F Request for Reimbursement Proiect/Activity Title: Project Number: Desert AIDS Project/ 0002 Fire Suppression/Life&Safety Improvement Name/Address of Provider: Desert AIDS Project-D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 BENEFICIARY QUALIFICATION STATEMENT Approved Current iFnor TotaP` Grant lDescnption Grant Reimbursement Reimbursement Balance 1 Amount' Period lPer`iod(s) ;Reimbursement 7{Oven Under) v# onsultant/Contract Services Architectural Services $29,767. Other— Construction/Rehabilitation $137,155.- Permit Fees $8,405. 37OTAL1. ^` $175,327 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: APPROVED BY: Name, Title, Date 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 G Employment Restrictions 1. Labor Standards The PROVIDER agrees to comply with the requirements of the Secretary of Labor in accordance with the Davis-Bacon Act as amended, the provisions of Contract Work Hours and Safety Standards Act, the Copeland "Anti-Kickback" Act (40 U.S.C. 276a-276a-5;40 USC 327 and 40 USC 276c)and all other applicable Federal,state and local laws and regulations pertaining to labor standards insofar as those acts apply to the performance of this contract. The PROVIDER shall agree to submit documentation provide by the CITY which demonstrates compliance with hour and wage requirements of this part. The PROVIDER agrees that, all general contractors or subcontractors engaged under contracts in excess of$2,000.00 for construction,renovation or repair work financed in whole or in part with assistance provided under this contract, shall comply with Federal requirements adopted by the CITY pertaining to such contracts and with the applicable requirements of the regulations of the Department of labor, under 29 CFR Parts 1, 3, 5 and 7 governing the payment of wages and ratio of apprentices and trainees to journeyworkers; provided, that if wage rates higher than those required under the regulations are imposed by state and local law, nothing hereunder is intended to relieve the PROVIDER of its obligation, if any, to require payment of the higher wage. The PROVIDER shall cause or require to be inserted in full,in all such contracts subject to such regulations,provisions meeting the requirements of this paragraph. 2. "Section 3 Clause" a. Compliance Compliance with the provisions of Section 3,the regulations set forth in 24 CFR 135,and all applicable rules and orders issued hereunder prior to the execution of this contract,shall be a condition of the Federal financial assistance provided under this Contract and binding upon the CITY, the PROVIDER and any of the PROVIDER'S subrecipients and subcontractors. Failure to fulfill these requirements shall subject the CITY,the PROVIDER and any of the PROVIDER'S subrecipients and subcontractors, their successors and assigns, to those sanctions specified by the Agreement through which Federal assistance is provided. The PROVIDER certifies and agrees that no contractual or other disability exists which would prevent compliance with these requirements. The PROVIDER further agrees to comply with these "Section 3" requirements and to include the following language in all subcontracts executed under this Agreement: "The work to be performed under this contract is a project assisted under a program providing direct Federal financial assistance from HUD and is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.0 1701. Section 3 requires that to the greatest extent feasible opportunities for training and employment be given to low- and very low-income residents of the project area and contracts for work in connection with the project be awarded to business concerns that provide economic opportunities for low-and very low-income persons residing in the metropolitan area in which the project is located." The PROVIDER further agrees to ensure that opportunities for training and employment arising in connection with a housing rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to low-and very low-income persons residing within the metropolitan area in which the CDBG- funded project is located;where feasible,priority should be given to low-and very low-income persons within the service area of the project or the neighborhood in which the project is located,and to low-and very low-income participants in other HUD programs; and award contracts for work undertaken in connection with a housing rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to business concerns that provide economic opportunities for low-and very low-income persons residing within the metropolitan area in which the CDBG-funded project is located; where feasible, priority should be given to business concerns which provide economic opportunities to low-and very low-income residents within the service area or the neighborhood in which the project is located,and to low-and very low-income participants in other HUD programs. The PROVIDER certifies and agrees that no contractual or other legal incapacity exists which would prevent compliance with these requirements. b. Notifications The PROVIDER agrees to send to each labor organization or representative of workers with which it has a collective bargaining agreement or other contract or understanding, if any, a notice advising said labor organization or worker's representative of its commitments under this Section 3 clause and shall post copies of the notice in conspicuous places available to employees and applicants for employment or training. SUBRECIPIENT AGREEMENT ,r� cewrbt,r- THIS AGREEMENT(herein "Agreement"), is made and entered into thisl "day of 2018, by and between the CITY OF PALM SPRINGS, (herein "City), a municipal corporation and charter city,and the Desert AIDS Project. Inc. , (herein "Provider"). WHEREAS, the City has entered into various funding agreements with the United States Department of Housing and Urban Development ("HUD"), which agreements provide funds ("CDBG Funds") to the City under the Federal Housing and Community Development Act of 1974 (42 U.S.C. Section 5301 et sec.), as amended from time to time (the "Act"), and the regulations promulgated thereunder(24 C.F.R.Section 570 et seg. ("Regulations"); and WHEREAS, the Act provides that the City may grant the CDBG Funds to nonprofit organizations for certain purposes allowed under the Act;and WHEREAS, the Provider is a nonprofit organization which operates a program which is eligible for a grant of CDBG funds and the City desires to assist in the operation of the program by granting CDBG 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; NOW, THEREFORE, the parties hereto agree as follows: 1.0 SERVICES OF PROVIDER. 1.1 Scope of Services. Provider agrees to provide to City all of the services specified and detailed in its application for funding and 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 represented in the Provider's application for funding. City provided funds shall be used only for those purposes specified in such application and this Agreement. 1.2 Comoliance 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. 1.4 Financial Reporting. Any Provider receiving or due to receive $20,000.00 or more from the City during the 2018 — 2019 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 Providers financial records to be kept in accordance with generally accepted accounting standards. The report shall include a general ledger balance sheet which 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 s`of the current fiscal year. ORIGINAL BID AND/OR AGREEMENT 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 ONE HUNDRED TWENTY-THREE THOUSAND AND TWO HUNDRED SEVENTY-FIVE DOLLARS ($123.275.00) (the "Contract Sum") in accordance with the Budget attached hereto in Exhibit B and incorporated herein by this reference; and as herein provided. The budget cost categories set out in Exhibit B 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 F, on reimbursable expenditures pursuant to the attached Budget along with pertinent supporting 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 CircularA-122 Attachment B.6. 2.3 Draw Downs. Failure by Provider to request reimbursement or encumbrance of at least 25% of the total grant by the end of each fiscal year quarter(September 30, December 30, March 31,and June 30)shall result in the immediate forfeiture of 25%of the total grant. 3.0 COORDINATION OF WORK. 3.1 Reoresentative 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 in connection therewith: Darrell Tucci,Chief Development Officer Shen Saenz,Director of Administration&Human Resources 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 express written approval of the City. Neither this Agreement nor any interest herein may be assigned or transferred, voluntarily or by operation of law,without the prior written approval of the City. 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 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 -2 - 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. 4.2 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; (b) Section 109 of the Housing and Community Development Act of 1974, as amended and the regulations issued pursuant thereto; (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); (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); (o) The regulations, policies, guidelines and requirements of 24 CFR 570; the "Common Rule", 24 CFR Part 85 and subpart J; OMB Super -3 - 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 (txi) 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 (v) Such other City, County, State, or Federal laws, rules, and regulations, executive orders or similar requirements which might be applicable. 4.3 The City shall have the right to periodically monitor the program operations of the Provider under this Agreement. 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 -4 - foregoing and naming the City as an additional insured shall be delivered to and approved by the City 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 officers, or employees. 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 officers and employees, from and against any and all actions, suits, proceedings, claims, demands, losses, costs, and expenses, including legal costs and attomeys'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 tens 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. 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. 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 - 5- 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. 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: Desert AIDS Proiect— D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Sorinas, CA 92263-2890 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] -6 - CITY OF PALM SPRINGS ATT S unici al corporation By' Bv:, 61"ClIerk City Manager APP VEDAS OFORM: APPROVE06Y CITY COUNCIL B� _ a AU501 City Attorney PROVIDER: Check one: _Individual _Partnership X 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 S retary, Treasurer,Assistant Treasurer, or Chief Financial Officer). By: By: N.A..—r/�lJ Notar&d5 Signature of Chairman of Board, Notarized Signature Secret ,Asst Secretary, President or any Vice President Treasurer,Asst Treasurer or ief Financial Officer Name: David Brinkman Name: David Benjamin Title: Chief Executive Officer Title: Chief Financial Officer State of (L) Stale of CA IlTw/li at, ) County of Rislotsok )ss County of 2i✓'Q#S IeLE )ss A notary public or other officer completing this certificate A notary public or other officer completing this certificate verifies only the identity of the individual who signed the verifies only the identity of the individual who signed the document to which this certificate is attached, and not document to which this certificate is attached, and not the truthfulness,accuracy,or validity of that document. the truthfulness,accuracy,or validity of that document. State of CA I oryt rF ) State of CA h4r in i h ) County of// )55. County of fZ�y¢Si dc )ss. F� CO,n OG�� ui t Z.W1 before me, On oc 1 V r-Y .7-(... 7,011 0 before me, � 0r 'S�s4, A�E/f-�+-( 911hi-, personally appeared SUtr; �+L A141yp,���personally appeared EV;CL a rAk-iat /r— !/rt. (� Lcs'1 who proved to ,(72Vid �i2lldHliIN who proved to me on the basis of satisfactory evidence to be the person(rpl me on the basis of satisfactory evidence to be the person(,.d) whose nameO is/aA subscribed to the within instrument and whose name(?)is/ice subscribed to the within instrument and acknowledged to me that hels¢B/they executed the same in acknowledged to me that helsl;ieltheyexecuted the same in his/Vr/thpt authorized capacity(io),and that by his/hpr/tt}Eir his/}per/tVir authorized capacityf9d), and that by hismVRhpii signature(,) on the instrument the person(ly, or the entity signature(al on the instrument the pemoi-W, or the entity upon behalf of which the person($) acted, executed the upon behalf of which the person(s) acted, executed the instrument. instrument. I certify under PENALTY OF PERJURY under the laws of the I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and State of California that the foregoing paragraph is true and correct. correct. WITNESS my hand and official seal. WITNESS my hand and official seal. Notary Signature: Notary Signature: Notary Seal: SHERI SAENZ Notary Seal: Notary Public-CaliforniaHERISAENZornia Nota Riverside County ry Public-California Commission#2249370 - Riverside County F My Comm.Expires Aug 7,2022 Commission#2249370 *MYCQmm.Expires Aug 7,2022 oateClcosc1&I 9oAP-sobre pAgm,nt,DWB -7 - CITY OF PALM SPRINGS EXHIBIT A Scope of Services Proiect/Activity Title: Project Number: DesertAIDS Project! 0001 Fire Suppressf9p/4TA$S,Jety Impruvsment Name/Address of Provider: DesertAIDSrojec PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 Obi ectives/Activities The intent of this program is to provide the most comprehensive direct client services and advocacy to help people living with HIV/AIDS manage their disease, including a state-of-the-art medical center to a nutritionally balanced food voucher program, to case management, legal services, education, prevention, anonymous testing, wellness, dental, transportation, housing assistance and home health services. This will be accomplished through the continuation of the facility upgrades to provide access to essential, in many cases life-saving, services for one of the community's most vulnerable populations in the event of a building fire. The upgrades will be a phased installation of a fire sprinkler system, designed to National Fire Protection Association (NFPA). D.A.P. service area covers Riverside and San Bernardino Counties, roughly the size of the state of Massachusetts which this immense area is recognized as the fifth largest concentration of HIV/AIDS population in the United States, serving 2,300 clients Valley-wide and 1,196 Palm Springs' clients. The Provider shall be responsible for the completion of the following objectives/activities in a manner acceptable and satisfactory to the City and consistent with the standards required as a condition of providing these CDBG funds. Objective 1: Assist the City by timely providing any additional information reguested. TARGET DATE ACTIVITY#1 On-Going 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 On-Going 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 On-Going Draft a promotional piece and submit to City for approval. Advertise in the Desert Sun's daily general circulation. Submit final publication to City. Objective 4: Enroll and income qualify at least a total of one thousand and one hundred ninety-six (1,196) extremely low income to moderate-income Palm Springs residents in accordance with Exhibit D for improved access to the facility. TARGET DATE ACTIVITY#1 On-Going Provide direct client services and advocacy to help 2,300 Valley-wide residents living with HIV/AIDS manage their disease. Maintain records of names, addresses, demographics and service dates for all assistance. Objective 5: Maintain records for all CDBG activities related to this program. TARGET DATE ACTIVITY#1 On-Going 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 On-Going Submit Semi-Annual reports — referenced Exhibit E within fifteen (15) calendar days of the program mid-year, December 31st, and program completion, June 301h. Objective 6: Manage/monitor program activities. TARGET DATE ACTIVITY #1 On-Going 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 7: Make improvements through Architectural & Engineering Services (A&E) and site preparation for the installation of fire sprinkle system which will ensure the ability to maintain direct client services, and to preserve perishable medications and food in the event of a building fire. TARGET DATE ACTIVITY#1 On-Going Conduct activities to improve availability/accessibility in accordance with an 'open competitive' procurement process as stipulated in this Agreement and in consultation with the City. Objective 8: Provide an evaluation within fifteen (15) calendar days of the program completion or final reimbursement. TARGET DATE ACTIVITY#1 07/15/19 Provide an evaluation and final report on all programmatic and financial activities. 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 Budget Summary Proiect/Activity Title: Proiect Number: Desert AIDS Project/ 0001 Fire Supperssion/Life &Safety Improvement Name/Address of Provider: Desert AIDS Project- D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 - COST CATEGORY CDBG OTHER TOTAL SHARE SOURCES COST 1 Personnel -0 - $4,113. $4,113. 2 Consultant/Contract Services $113,400. -0 - $113,400. Architectural Services 3 Travel -0 - -0 - -0 - 4 Space Rental -0 - -0 - -0 - 5 Consumable Supplies - 0 - -0 - -0 - 6 Rental, Lease or Purchase of -0- -0 - -0- Equipment 7 Insurance -0 - -0 - -0- 8 Other— $9,875. $39,750. $49,625. Construction/Rehabilitation Contingency -0 - $18,213. $18,213. TOTALS $123,275. $62,076. $185,351. 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. Other funding sources may include City of Palm Desert CDBG Award ($30,000), and D.A.P.'s contribution ($32,076),totaling$62,076. 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, 2018 through June 30, 2019 with funds allocated from 2018— 19 Program Year. CITY OF PALM SPRINGS EXHIBIT C Insurance Inventory Proiect/Activity Title: Project Number: Desert AIDS Project/ 0001 Fire Supperssion/Life & Safety Improvement Name/Address of Provider: Desert AIDS Project- D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 INSURANCE INVENTORY LIABILITY INSURANCE POLICY Name of Provider's Insurance Company National Fire and Marine Insurance Co. Effective Dates of Policy 10/05/18 to 10/05/19 Claims Made Policy I / Per Occurrence Policy / I Limits of Liability $3,000,000 Deductibles: Per Occurrence Annual Aggregate Additional Insured Endorsement (Certificate Holder) 0 Yes ❑ No Original Certificate of Insurance Attached ❑ Yes Q No WORKER'S COMPENSATION POLICY Name of Provider's Insurance Company Non Profits' United Workers' Compensation Group and Safety National Casualty Corp Effective Dates 01/01/18 to 01/01/19 Limits of Liability $2M Per Occurrence Underlying Coverage Limits Original Certificate of Insurance Attached 0 Yes 21 No AC"R& CERTIFICATE OF LIABILITY INSURANCE DATE(MMDDYYYY 10/5/2019 10/2/2018 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(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 endorsements . PRODUCER Lockton Insurance Brokers,LLC CNAME ONTACT CA License N01715767 PHONE FAX _ INC,INC No.Ex0 I No: 725 S.Figueroa Street,35th tl. E-MAIL Los Angeles CA 90017 ADDRESS: 213-689-0065 INSURERS AFFORDING COVERAGE NAIC M INSURER A:National Fire and Marine Insurance Co 20079 INSURED Desert AIDS Project Inc. INSURER a_Travelers Property Casualty Co of America 25674 1419776 - _— 1695 N.Sunrise Way INSURER C Palm Springs CA 92262 INSURER D INSURER E INSURER F: COVERAGES DESAI01 CERTIFICATE NUMBER: 14321290 REVISION NUMBER: XXXXXXX 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 - ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMI D A X COMMERCIAL GENERAL LIABILITY Y N HN017770 10/5'2018 10/5/2019 1 EACH OCCURRENCE $ 1,000,000 � CLAIMS-MADE x l OCCUR ' PREMISES Ea occurrence) $ 250,000 MED EXP(Any one Person) $ XXXXXXx PERGONALBADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3000000 POLICY JECOT I_', LOC PRODUCTS,COMPlOPAGG $ 3,000,000 OTHER $ B AUTOMOBILE LIABILITY N N 810-6H460446-TIL-I8 10/5'2018 10/5/2019 COMBINED SINGLE LIMIT $ Ea accident 1,000,000 I ANY AUTO BODILY INJURY(Per person) $ XXXXXXX AUTOS ONLYOWNED SCHEDULED BODILY INJURY(Par accident) $ XXXXXXX AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX AUTOS ONLY AUTOS ONLY Par accident Com /Coll Ded $ 1,000 UMBRELLA LIAR OCCUR NOTAPPLICABLE EACH OCCURRENCE $ XXXXXXX EXCESS LIAS CLAIMS-MADE AGGREGATE $ XXXXXXX DIED RETENTION$ $ XXXXXXX WORKERS COMPENSATION NOT APPLICABLE PER OTH. i AND EMPLOYERS'LIABILITY STATUTE ER RI 1 ANY PROPRIETOPARTNEWEXECUTIVE YIN STATUTE EACH ACCIDENT $ XXXXXXX OFFICERMEMBER EXCLUDED? MIA --- (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I $ XXXXXXX DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES tACORD 101,Additional Remarks Schedule,maybe anached if more space is required) City of Palm Springs,it's officers,employees and agents are included as additional insumds with respect to General Liability.General Lia ility coverage shall be primary and non-connibutory.A thirty(30)day notice of cancellation applies. D ., § p OOT 3 CERTIFICATE HOLDER CANCELLATION Y 14321290 City of Palm Springs SHOULD ANY OF THE ABOVE DESCRIBED POL CANCELLED EFORE Attn: Finance THE EXPIRATION DATE THEREOF, NOTICE W DELIV ED IN 277 N Avenida Caballeros ACCORDANCE WITH THE POLICY PROVISIONS. Palm Springs CA 92262 AUTHORRED REPR 7 01 88-201 rACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD TE CERTIFICATE OF WORKERS' COMPENSATION COVERAGE Nov02,2018 PRODUCER NonProfits'Unitcel Workcrs'Compensation Group THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLY 610 Fulton Avenue,Suite 200 AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. Sacramento,CA 95825 Phone:(916)868-6231 THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE Fax:(916)880-5251 COVERAGE AFFORDED BY THE POLICIES BELOW. Arthur J.Gallagher&Co Insurance Brokers of California,Inc 1255 Battery Street#450 INSURERS AFFORDING COVERAGE San Francisco,CA 94111 INSURED INSURER A: NonProflts' United Workers' Compensation Group Desert AIDS Project INSURER B: Safety National Casualty Corp [NAIC u 151051 1695 N Sunrise Way Palm Springs,CA 92262 INSURER C: INSURER D: INSURER E. COVERAGES This Certificate is not intended to specify all endorsements,coverages,terms,conditions and exclusions of the policies shown. THE POLICIES OF COVERAGE LISTED BELOW HAVE BEEN ISSUED TO THE AFFILIATE MEMBER 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 COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY ILTR TYPE OF COVERAGE POLICY NUMBER POLICY EFFECTIVE DATE EXPIRATION LIMITS DATE GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ CLAIMS MADE I JOCCUR MED EXPENSE(Any one person) $ GENERAL AGGREGATE LIMIT APPLIES PER: PERSONAL&ADV INJURY $ POLICY I I PROJECT I LOC GENERAL AGGREGATE $ PRODUCTS-COMPIOPAGG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Each accident) $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) $ MIRED AUTOS BODILY INJURY $ NON OW NED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) $ X I PER OTHER WORKERS'COMPENSATION STATUTE A AND NPU-WCG 001-2018 1/1/18 1/l/19 E.L EACH ACCIDENT $500,000 EMPLOYERS LIABILITY E.L.DISEASE-EA EMPLOYEE is500,000 E.L.DISEASE-COVERAGE LIMIT $500,000 OTHER Limit Per Occurrence-Statutory * EXCESS Workers'Compensation SP 4057827 1/1/18 1/1/19 EL Per Occ&Agg $2,000,000 xs of$500,000 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIALIPROVISIONS Evidence of Workers'Compensation Coverage: Waiver of Subrogation provided by Endorsement NPUWCG-DAID- NpU o8 CERTIFICATE HOLDER CANCELLATION NPUWCG-DAID-024R SHOULD ANY OF THE ABOVE DESCRIBED POLIC CELLE BEFORE THE EXPIRATION DATE THEREOF NOTICE WILL RED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Palm Springs 3200 Tahquitz Canyon Way Palm Springs,CA 92262 6959 _ City Clerk Based on ACORD 25(2014101) NONPROFITS UNITE01 THIS ENDORSEMENT CHANGES THE MEMORANDUM OF COVERAGE PLEASE READ IT CAREFULLY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Nonprofits' United Workers' Compensation Group Memorandum of Coverage: NPU-WCG 001-2018 This endorsement modifies the coverage provided under the following: Memorandum of Coverage: PART ONE: WORKERS' COMPENSATION COVERAGE Paragraph H. RECOVERY FROM OTHERS is amended with respect to the following: Name and Address of Person or Organization: City of Palm Springs 3200 Tahquitz Canyon Way Palm Springs, CA 92162-6959 DESCRIPTION OF OPERATIONS/LOCATIONS ADDED BY ENDORSEMENT: - With regard to the City of Palm Springs, its employees and officers. NPU-WCG waives any right of recovery it may have against the person or organization shown above because of payments made by NPU-WCG for injury or damage arising out of the Members' operations done under a contract with that person or organization shown above and included in the coverage provided by the Memorandum of Coverage. This waiver applies only to the person or organization shown on the Schedule Above. This endorsement is part of the Memorandum of Coverage and is effective on the date shown below. All other terms and conditions remain unchanged. Effective Date: January 1. 2018 Exoiration Date: January 1. 2019 Member: Desert AIDS Project Endorsement No: NPUWCG-DAID-024R Date Issued: Nov 2. 2018 Authorized Representative for NPU-WCG e Nov 08RfCp �0 Y NPU-WCG Pagel PU-W0000 -2018 CITY OF PALM SPRINGS EXHIBIT D Beneficiary Qualification Statement Proiect/Activity Title: Proiect Number: Desert AIDS Project/ 0001 Fire Suppression/Life & Safety Improvement Name/Address of Provider: Desert AIDS Project- D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 BENEFICIARY QUALIFICATION STATEMENT This statement must be completed and signed by each person or head of household (legal guardian) receiving benefits form the described project/activity. 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,roamers,or borders cannot be included as household members. 2. Circle your combined gross annual income(Riverside-San Bernardino-Ontario,CA MSA—04101118) AREA MEDIAN NUMBER OF PERSONS IN YOUR HOUSEHOLD: INCOME(AMI) 1 2 3 4 5 6 7 8 LEVEL-$65,800 EXTREMELY LO INCOME $14,150 $16,460 $20,780 $25,100 $29,420 $33,740 $38,060 $42,380 0-30%of AMI LOW INCOME $23,600 $27,000 $30,350 $33,700 $36,400 $39,100 $41,800 $44,500 30-50%of AMI MODERATE INCOME $37,750 $43,150 $48,550 $53,900 $58,250 $62,550 $66,850 $71,150 50-80%of AMI NON LOW 8 MOD INCOME $37,751+ $43,151+ $48,551+ $53,901+ $58,251+ $62,551+ $66,851+ $71,151+ >80% 3. What race/ethnicity do you identify yourself as; please note that this self-identification is voluntary in accordance with equal opportunity laws? [I 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 ❑ NO 5. Do you have a disability? ❑ YES ❑ NO If YES,please describe: ACKNOWLEDGEMENT AND DISCLAIMER I 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 compliance. CITY OF PALM SPRINGS EXHIBIT E Semi-Annual Program Progress Report Project/Activity Title: Project Number: Desert AIDS Project/ 0001 Fire Suppression/Life &Safety Improvement Name/Address of Provider: Desert AIDS Project- D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 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 Puerto Rican Cuban Other: ♦ Number of Disabled: ♦ Number of Homeless Persons Given Overnight Shelter: ACCOMPLISHMENT NARRATIVE LEVERAGING RESOURCES NARRATIVE Signed Title Date CITY OF PALM SPRINGS EXHIBIT F Request for Reimbursement Proiect/Activity Title: Proiect Number: Desert AIDS Project/ 0001 Fire Suppression/Life &Safety Improvement Name/Address of Provider: Desert AIDS Project- D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 BENEFICIARY QUALIFICATION STATEMENT 11111 Iry 6111 ( S�dilxIflErcyl� I onsultant/Contract Services Architectural Services $113,400. ther— Construction/Rehabilitation $9,875. Ey }#}y ialx��r Ri tE,::i $123,275. 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: APPROVED BY: Name, Title, Date 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 G Employment Restrictions 1. Labor Standards The PROVIDER agrees to comply with the requirements of the Secretary of Labor in accordance with the Davis-Bacon Act as amended, the provisions of Contract Work Hours and Safety Standards Act, the Copeland "Anti-Kickback" Act (40 U.S.C. 276a-276a-5;40 USC 327 and 40 USC 276c)and all other applicable Federal, state and local laws and regulations pertaining to labor standards insofar as those acts apply to the performance of this contract. The PROVIDER shall agree to submit documentation provide by the CITY which demonstrates compliance with hour and wage requirements of this part. The PROVIDER agrees that, all general contractors or subcontractors engaged under contracts in excess of$2,000.00 for construction, renovation or repair work financed in whole or in part with assistance provided under this contract, shall comply with Federal requirements adopted by the CITY pertaining to such contracts and with the applicable requirements of the regulations of the Department of labor, under 29 CFR Parts 1, 3, 5 and 7 governing the payment of wages and ratio of apprentices and trainees to journeyworkers; provided,that if wage rates higher than those required under the regulations are imposed by state and local law, nothing hereunder is intended to relieve the PROVIDER of its obligation, if any, to require payment of the higher wage. The PROVIDER shall cause or require to be inserted in full, in all such contracts subject to such regulations,provisions meeting the requirements of this paragraph. 2. "Section 3 Clause" a. Compliance Compliance with the provisions of Section 3, the regulations set forth in 24 CFR 135, and all applicable rules and orders issued hereunder prior to the execution of this contract, shall be a condition of the Federal financial assistance provided under this Contract and binding upon the CITY, the PROVIDER and any of the PROVIDER'S subrecipients and subcontractors. Failure to fulfill these requirements shall subject the CITY,the PROVIDER and any of the PROVIDER'S subrecipients and subcontractors, their successors and assigns, to those sanctions specified by the Agreement through which Federal assistance is provided. The PROVIDER certifies and agrees that no contractual or other disability exists which would prevent compliance with these requirements. The PROVIDER further agrees to comply with these "Section 3" requirements and to include the following language in all subcontracts executed under this Agreement: "The work to be performed under this contract is a project assisted under a program providing direct Federal financial assistance from HUD and is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.0 1701, Section 3 requires that to the greatest extent feasible opportunities for training and employment be given to low- and very low-income residents of the project area and contracts for work in connection with the project be awarded to business concems that provide economic opportunities for low-and very low-income persons residing in the metropolitan area in which the project is located." The PROVIDER further agrees to ensure that opportunities for training and employment arising in connection with a housing rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to low-and very low-income persons residing within the metropolitan area in which the CDBG- funded project is located;where feasible, phodty should be given to low-and very low-income persons within the service area of the project or the neighborhood in which the project is located, and to low-and very low-income participants in other HUD programs; and award contracts for work undertaken in connection with a housing rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to business concerns that provide economic opportunities for low-and very low-income persons residing within the metropolitan area in which the CDBG-funded project is located; where feasible, priority should be given to business concerns which provide economic opportunities to low-and very low-income residents within the service area or the neighborhood in which the project is located,and to low-and very low-income participants in other HUD programs. The PROVIDER certifies and agrees that no contractual or other legal incapacity exists which would prevent compliance with these requirements. b. Notifications The PROVIDER agrees to send to each labor organization or representative of workers with which it has a collective bargaining agreement or other contract or understanding, if any, a notice advising said labor organization or worker's representative of its commitments under this Section 3 clause and shall post copies of the notice in conspicuous places available to employees and applicants for employment or training. SUBRECIPIENT AGREEMENT THIS AGREEMENT (herein "Agreement"), is made and entered into this K day of m , 2017, by and between the CITY OF PALM SPRINGS, (herein "City), a municipal corporation and charter city, and the Desert AIDS Project, Inc. , (herein "Provider"). WHEREAS, the City has entered into various funding agreements with the United States Department of Housing and Urban Development ("HUD"), which agreements provide funds ("CDBG Funds") to the City under the Federal Housing and Community Development Act of 1974 (42 U.S.C. Section 5301 et seq.), as amended from time to time (the "Act"), and the regulations promulgated thereunder(24 C.F.R. Section 570 et seq. ("Regulations"); and WHEREAS, the Act provides that the City may grant the CDBG Funds to nonprofit organizations for certain purposes allowed under the Act; and WHEREAS, the Provider is a nonprofit organization which operates a program which is eligible for a grant of CDBG funds and the City desires to assist in the operation of the program by granting CDBG 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; NOW, THEREFORE, the parties hereto agree as follows: 1.0 SERVICES OF PROVIDER. 1.1 Scope of Services. Provider agrees to provide to City all of the services specified and detailed in its application for funding and 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 represented in the Provider's application for funding. City provided funds shall be used only for those purposes specified in such application and 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. 1.4 Financial Reporting. Any Provider receiving or due to receive $20,000.00 or more from the City during the 2017 — 2018 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 which 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 315t of the current fiscal year. ORIGINAL BID ANDIOR AGREEMENT 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 SEVENTY-ONE THOUSAND, EIGHT HUNDRED AND SEVENTY-SIX DOLLARS ( 71 876.00)(the "Contract Sum") in accordance with the Budget attached hereto in Exhibit B and incorporated herein by this reference; and as herein provided. The budget cost categories set out in Exhibit B 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 F, on reimbursable expenditures pursuant to the attached Budget along with pertinent supporting 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 by Provider to request reimbursement or encumbrance of at least 25% of the total grant by the end of each fiscal year quarter (September 30, December 30, March 31, and June 30)shall result in the immediate forfeiture of 25% of the total grant. 3.0 COORDINATION OF WORK. 3.1 Reoresentative 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 in connection therewith: Darrell Tucci, Chief Development Officer 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 express written approval of the City. Neither this Agreement nor any interest herein may be assigned or transferred, voluntarily or by operation of law, without the prior written approval of the City. 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 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. - 2 - 4.2 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; (b) Section 109 of the Housing and Community Development Act of 1974, as amended and the regulations issued pursuant thereto; (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); (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); (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; - 3 - (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 sec.); (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 (v) Such other City, County, State, or Federal laws, rules, and regulations, executive orders or similar requirements which might be applicable. 4.3 The City shall have the right to periodically monitor the program operations of the Provider under this Agreement. 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 cant' 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 as an additional insured shall be delivered to and approved by the City 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 -4 - to indemnify the City, its officers, or employees. 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 officers and employees, 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 Contractors 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 DISCRIMINATION, TERMINATION, AND ENFORCEMENT. 6.1 Covenant Against Discrimination. Provider covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them that there shall be no discrimination against or segregation of any person or group of persons on account of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, pregnancy, marital status, age, sex, sexual orientation, gender identity, or any other basis Protected Characteristic by applicable federal, state or local law in the performance of this Agreement. Provider shall take affirmative action to insure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, sexual orientation, gender identity, marital status, physical or mental disability, national origin, ancestry or any other basis Protected Characteristic by applicable federal, state or local law. 6.2 Term. Unless earlier terminated in accordance with Section 6.3 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. 6.3 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 G. 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. 7.0 MISCELLANEOUS PROVISIONS. 7.1 Notice. Any notice, demand, request, document, consent, approval, or communication either party desires or is required to give to the other party shall be in writing and either - 5 - served personally or sent by prepaid, first-class mail to the address set forth below, or such other addresses as may from time to time be designated by mail. 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: Desert AIDS Project— D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 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 ] -6 - CITY OF PALM SPRINGS ATTE a municipal cor oration By: B . / y Clerk City Manager APP VED A O F APPROVED BY CITY COUNCIL B . ,�,�LN� �. • .�? 111 A oSo City Attorney la 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 Secretary, Treasurer, Assistant Treasurer, or Chief Financial Office . By: By: Nato Tzed Signature of Chairman of Board, Notarized Signature Seclpry,Asst Secretary, President or any Vice President Treasurer,Asst Treasurer o Chief Financial Officer Name: David Brinkman Name: David D. Benjamin Title: Chief Executive Officer Title: Chief Financial Officer State of o `r r o l k ) State of C o Y oL ) County of 1 rS )ss County of' v lr )ss A notary public or other officer completing this certificate A notary public or other officer completing this certificate verifies only the identity of the individual who signed the verifies only the identity of the individual who signed the document to which this certificate is attached, and not document to which this certificate is attached, and not the truthfulness,accuracy,or validity of that document. the truthfulness,accuracy,or validity of that document. State of R fnrw ) State of 4-Vorosi�r ) County oftZWtra I& )ss. Countyof VWr.rbr )ss. OnL)Cklxf ao� , a� before me, On`�1 �ab�e.r�yyo`?DkQQ0L1 before me, S )tkic ,`�r�yOUA-a `n�n,personallyappeared �C Ikcl(L r� heY4Y1fe� AN ,personallyappeared G.y t d 3 Y 1 n�r. . r who proved to V td Pj Cr1,l(,r'ty w)�} who proved to me on the basis of satisfactory evidence to be the persons) me on the basis of s tisfactory evidence to be the personK whose namg(sa isloFe subscribed to the within instrument and whose name(erislam subscribed to the within instrument and acknowledged to me that hel>ba/tbelrexecuted the same in acknowledged to me that he/;hetpey executed the same in his/her/0yetr authorized capacity(Jes), and that by hislh~ir his/ber/tpeir authorized capacityOW,,and that by his/ber it signatureW on the instrument the person(.e9, or the entity signature(k) on the instrument the persorlW, or the entity upon behalf of which the person(zl acted, executed the upon behalf of which the persor*<acted, executed the instrument. instrument. I certify under PENALTY OF PERJURY under the laws of the I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and State of California that the foregoing paragraph is true and correct. correct. WITNESS my hand andfoTd9j seal. WITNESS my hand and vial I. Notary Sig Notary Sign Notary 1' Notary Seal: SHELIA BARNETT 0S09'6l AON my a2 vwo3 n Notary Public-Califomia tELoLIZ#r uolsolwwoo z Z Riverside County = R1un0�aPlawalN a z Commission 12170231 e1W01111e3- 0114nd AMON My Comm.Ex9fts Nov 29,2020 L 113N B V113NS GBWn=BG,-1 ] SHELIA BARNETT _ 7_ Notary Public-California a z : Riverside County z Commission#r 2170231 My Comm.Ex Tres Nov 29,2020 CITY OF PALM SPRINGS EXHIBIT A Scope of Services Proiect/Activity Title: Project Number: Desert AIDS Project/ 0002 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project- D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 O b i ectives/Activities The intent of this program is to provide the most comprehensive direct client services and advocacy to help people living with HIV/AIDS manage their disease, including a state-of-the-art medical center to a nutritionally balanced food voucher program, to case management, legal services, education, prevention, anonymous testing, wellness, dental, transportation, housing assistance and home health services. This will be accomplished through the continuation of the facility upgrades to provide access to essential, in many cases life-saving, services for one of the community's most vulnerable populations in the event of power loss caused by natural disaster or other event. The upgrades will be a phased installation of an Environmental Protection Agency (EPA) certified emergency back-up generator. D.A.P. service area covers Riverside and San Bernardino Counties, roughly the size of the state of Massachusetts which this immense area is recognized as the fifth largest concentration of HIV/AIDS population in the United States, serving 2,165 clients Valley-wide and 1,114 Palm Springs' clients. The Provider shall be responsible for the completion of the following objectives/activities in a manner acceptable and satisfactory to the City and consistent with the standards required as a condition of providing these CDBG funds. Objective 1: Assist the City by timely providing any additional information requested. TARGET DATE ACTIVITY#1 On-Going 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 On-Going 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 On-Going Draft a promotional piece and submit to City for approval. Advertise in the Desert Sun's daily general circulation. Submit final publication to City. Objective 4: Enroll and income qualify at least a total of one thousand and one hundred-fourteen (1,114) extremely low income to moderate-income Palm Springs residents in accordance with Exhibit D for improved access to the facility. TARGET DATE ACTIVITY#1 On-Going Provide direct client services and advocacy to help Palm Springs residents living with HIV/AIDS manage their disease. Maintain records of names, addresses, demographics and service dates for all assistance. Objective 5: Maintain records for all CDBG activities related to this program. TARGET DATE ACTIVITY#1 On-Going 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 On-Going Submit Semi-Annual reports — referenced Exhibit E within fifteen (15) calendar days of the program mid-year, December 315t, and program completion, June 30`h. Objective 6: Manage/monitor program activities. TARGET DATE ACTIVITY#1 On-Going 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 7: Make improvements through Architectural & Engineering Services (A&E) and site preparation for the installation of an emergency back-up generator which will ensure the ability to maintain direct client services, and to preserve perishable medications and food in the event of a power outage or natural disaster. TARGET DATE ACTIVITY#1 On-Going Conduct activities to improve availability/accessibility in accordance with an 'open competitive' procurement process as stipulated in this Agreement and in consultation with the City. Objective 8: Provide an evaluation within fifteen 05) calendar days of the program completion or final reimbursement. TARGET DATE ACTIVITY#1 07/15/18 Provide an evaluation and final report on all programmatic and financial activities. 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 Budget Summary Proiect/Activity Title: Project Number: Desert AIDS Project/ 0002 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project- D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 COST CATEGORY CDBG OTHER TOTAL SHARE SOURCES COST 1 Personnel -0 - $4,113. $4,113. 2 Consultant/Contract Services $34,000. 9,000. $43,000. Architectural Services 3 Travel -0- -0 - -0 - 4 Space Rental -0- -0 - -0 - 5 Consumable Supplies -0- -0 - -0 - 1 6 Rental, Lease or Purchase of -0- -0 - -0 - Equipment 7 Insurance -0 - - 0 - -0 - 8 Other— $37,876. $84,124. $122,000. Construction/Rehabilitation Contingency -0 - $12,200. $12,200. TOTALS $71,876. $109,437. $181,313. 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. Other funding sources may include Riverside County and City of Palm Desert CDBG Awards, and private donations. 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, 2017 through June 30, 2018 with funds allocated from 2017— 18 Program Year. CITY OF PALM SPRINGS EXHIBIT C Insurance Inventory Proiect/Activity Title: Proiect Number: Desert AIDS Project/ 0002 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project- D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 INSURANCEINVENTORY LIABILITY INSURANCE POLICY Name of Provider's Insurance Company National Fire and Marine Insurance Co. Effective Dates of Policy 10/05/17 to 10/05/18 Claims Made Policy / / Per Occurrence Policy Limits of Liability $3,000,000 Deductibles: Per Occurrence Annual Aggregate Additional Insured Endorsement (Certificate Holder) 0 Yes ❑ No Original Certificate of Insurance Attached ❑ Yes 0 No WORKER'S COMPENSATION POLICY Name of Provider's Insurance Company Non Profits' United Workers' Compensation Group and Safety National Casualty Corp Effective Dates 01/01117 to 01/01/18 Limits of Liability $2M Per Occurrence Underlying Coverage Limits Original Certificate of Insurance Attached 0 Yes 21 No A4C4I CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDD/YYYY) lill 10/5/2018 11/9/2017 '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 LOckton Insurance Brokers,LLC NAME CT CA Licence#OF 15767 PHONE FAX A/C No Ext: AIC No): 725 S.Figueroa Street,35th fl. E-MAIL Los Angeles CA 90017 ADDRESS: 213-689-0065 INSURER(S)AFFORDING COVERAGE NAIC M INSURER A:National Fire and Marine Insurance Co 20079 INSURED Desert AIDS Project Inc. INSURER B:Travelers Indemnity Co of CT _ 25682 1419776 1695 N.Sunrise Way INSURER C: _ Palm Springs CA 92262 INSURER D: INSURER E: INSURER F: COVERAGES DESAIO1 CERTIFICATE NUMBER: 14321290 REVISION NUMBER: XXXXXXX 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR N POLICY NUMBER MM/DD/YYYY MM/DDlYYYY 7MERCIAL GENERAL LIABILITY / EACH OCCURRENCE $ 1000 000 A Y N HN017770 IU.Si2017 10/5/2018 DAMAGE TO RENTED CLAIMS-MADE E�OCCUR PREMISES Ea occurrence s 250,000 _ MED EXP(Any one person) $ xxxxxxx PERSONAL 8 ADV INJURY $ 1000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 3000000 POLICY D PROJECT LOC PRODUCTS-COMP/OPAGG $ 3 O00 000- OTHER: $ B AUTOMOBILE LIABILITY N N 810-6H460446-TCT-17 10/5/2017 10/5/2018 COMBINED SINGLE LIMIT $ Ea accident 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED SCHEDULED BODILY INJURY accident) $ XXXXXXX AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX AUTOS ONLY AUTOS ONLY Per accident Como/Coll Ded s 1,000 UMBRELLA LIAR OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE AGGREGATE s XXXXXXX DED RETENTION$ $ XXXXXXX WORKERS COMPENSATION NOT APPLICABLE PER OTH- I AND EMPLOYERS'LIABILITY STATUTE ER YIN ANY PROPRIETOR/PARTNER/EXECLrTIVE ❑ E.L.EACH ACCIDENT $ XXXXXXX OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX If yes,describe under E.L.DISEASE-POLICY LIMIT $ XXXXXXX DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Palm Springs,it's officers,employees and agents are included as additional insureds with respect to General Liability.General Liability coverage shall be primary and non-contributory.A thirty(30)day notice of cancellation applies. CERTIFICATE HOLDER CANCELLATION 14321290 City of Palm Springs SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE THEREOF, Attn: City Clerk ACCORDANCEION WITH DATE THEPOLICY PROVISIONS.E WILL BE DELIVERED IN 3200 E.Tahquitz Canyon Way Palm Springs CA 92262-6959 AUTHORIZED REPR @ 1688-201nCIII CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF WORKERS' COMPENSATION COVERAGE Dec20 2016 PRODUCER Nonprofits'United Workers'Compensation Group THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLY 610 Fulton Avenue,Suite 200 AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. Sacramento,CA 95825 Phone:(916)868-6231 THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE Fax:(916)880-5251 COVERAGE AFFORDED BY THE POLICIES BELOW. Arthur J.Gallagher&Co Insurance Brokers of California,Inc 1255 Battery Street 14150 San Francisco,CA 94111 INSURERS AFFORDING COVERAGE INSURED INSURER A: NOnProflts' United Workers'Compensation Group Desert AIDS Project INSURER B: Safety National Casualty Corp [NAIL#I51051 1695 N Sunrise Way Palm Springs,CA 92262 INSURERC INSURER D: INSURER E: COVERAGES This Certificate is not intended to specify all endorsements,coverages,terms,conditions and exclusions of the policies shown. THE POLICIES OF COVERAGE LISTED BELOW HAVE BEEN ISSUED TO THE AFFILIATE MEMBER 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 COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY POLICY LTR TYPE OF COVERAGE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS DATE GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ CLAIMS MADE I OCCUR MED EXPENSE(Any one person) $ GENERAL AGGREGATE LIMIT APPLIES PER: PERSONAL 8 ADV INJURY $ POLICY PROJECT I LOC GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANYAUTO (Each accident) $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNEO AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) $ PER X OTHER WORKERS'COMPENSATION sTATUTE A AND NPU-WCG001-2017 1/1/17 1/1/18 E.L.EACH ACCIDENT $500,000 EMPLOYERS LIABILITY E.L.DISEASE-EA EMPLOYEE $500,000 E.L.DISEASE-COVERAGE LIMIT $500,000 OTHER Limit Per Occurrence-Statutory B EXCESS Workers'Compensation SP4056129 1/1/17 1/1/18 EL Per Occ&Agg $2,000,000xs of$500,000 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAUPROVISIONS Evidence of Workers'Compensation Coverage: Re:DAP's Emergency Preparedness Generator Phase I,for the 15-16 CDBG Program Year;Waiver of Subrogation provided by Endorsement NPUWCG-DAID-025 CERTIFICATE HOLDER CANCELLATION NPIJWGG-DAID-025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED s BEFORE THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED City of Palm Springs - IN ACCORDANCE WITH THE POLICY PROVISIONS. Community Dev Admin PO Box 2743 Palm Springs,CA 92262S L Based on ACORD 25(2014/01) -. • � NorrPltaF UNITED ,r THIS ENDORSEMENT CHANGES THE MEMORANDUM OF COVERAGE PLEASE READ IT CAREFULLY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US NonProfits' United Workers' Compensation Group Memorandum of Coverage: NPU-WCG 001-2017 This endorsement modifies the coverage provided under the following: Memorandum of Coverage: PART ONE: WORKERS' COMPENSATION COVERAGE Paragraph H. RECOVERY FROM OTHERS is amended with respect to the following: Name and Address of Person or Organization: City of Palm Springs PO Box 2743 Palm Springs, CA 92263 DESCRIPTION OF OPERATIONS/LOCATIONS ADDED BY ENDORSEMENT: With regard to the City of Palm Springs,its employees and officers. NPU-WCG waives any right of recovery it may have against the person or organization shown above because of payments made by NPU-WCG for injury or damage arising out of the Members' operations done under a contract with that person or organization shown above and included in the coverage provided by the Memorandum of Coverage. This waiver applies only to the person or organization shown on the Schedule Above. This endorsement is part of the Memorandum of Coverage and is effective on the date shown below. All other terms and conditions remain unchanged. Effective Date: January 1. 2017 Expiration Date: January 1 2018 Member: Desert AIDS Project Endorsement No: NP W G-DAID-02 Date Issued: Dec 19 2016 Aut orized Representative for NPU-WCG NPU-WCG Page 1 MOC:NPU-WCG 001-2017 CITY OF PALM SPRINGS EXHIBIT D Beneficiary Qualification Statement Project/Activity Title: Project Number: Desert AIDS Project/ 0002 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project- D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 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-04101/17) AREA MEDIAN NUMBER OF PERSONS IN YOUR HOUSEHOLD: INCOME(AMI) 1 2 3 4 5 6 7 6 LEVEL-$61,400 EXTREMELY LOW INCOME $13,550 $16,240 $20.420 $24,600 $28,780 $32,960 $37,140 $41,320 0 30%of AMI LOW INCOME $22,600 $25,800 $29,050 $32,250 $34,850 $37,450 $40,000 $42,600 30-50%of AMI MODERATE INCOME $36,150 $41,300 $46,450 $51,600 $55,750 $59,900 $64,000 $68,150 50-80 10 AMI NON LOW&MOD INCOME $36,151 $41,301 $46,451 $51,601 $55,751 $59,901 $64,001 $68,151 >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 ❑ NO 5. Do you have a disability? ❑ YES ❑ NO If YES,please describe: ACKNOWLEDGEMENT AND DISCLAIMER I 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 compliance. CITY OF PALM SPRINGS EXHIBIT E Semi-Annual Program Progress Report Proiect/Activity Title: Project Number: Desert AIDS Project/ 0002 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project- D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 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 Puerto Rican Cuban Other: • Number of Disabled: ACCOMPLISHMENT NARRATIVE LEVERAGING RESOURCES NARRATIVE Signed Title Date CITY OF PALM SPRINGS EXHIBIT F Request for Reimbursement Proiect/Activity Title: Project Number: Desert AIDS Project/ 0002 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project- D.A.P. PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 BENEFICIARY QUALIFICATION STATEMENT RJ El — ^^YY (d�� i � I�l l onsultant/Contract Services Architectural Services $34,000. Other— Construction/Rehabilitation $37,876. 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: APPROVED BY: Name, Title, Date 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 G Employment Restrictions 1. Labor Standards The PROVIDER agrees to comply with the requirements of the Secretary of Labor in accordance with the Davis-Bacon Act as amended, the provisions of Contract Work Hours and Safety Standards Act, the Copeland "Anti-Kickback" Act (40 U.S.C. 276a-276a-5; 40 USC 327 and 40 USC 276c)and all other applicable Federal, state and local laws and regulations pertaining to labor standards insofar as those acts apply to the performance of this contract. The PROVIDER shall agree to submit documentation provide by the CITY which demonstrates compliance with hour and wage requirements of this part. The PROVIDER agrees that, all general contractors or subcontractors engaged under contracts in excess of$2,000.00 for construction, renovation or repair work financed in whole or in part with assistance provided under this contract, shall comply with Federal requirements adopted by the CITY pertaining to such contracts and with the applicable requirements of the regulations of the Department of labor, under 29 CFR Parts 1, 3, 5 and 7 governing the payment of wages and ratio of apprentices and trainees to journeyworkers; provided, that if wage rates higher than those required under the regulations are imposed by state and local law, nothing hereunder is intended to relieve the PROVIDER of its obligation, if any, to require payment of the higher wage. The PROVIDER shall cause or require to be inserted in full, in all such contracts subject to such regulations,provisions meeting the requirements of this paragraph. 2. "Section 3 Clause" a. Compliance Compliance with the provisions of Section 3, the regulations set forth in 24 CFR 135, and all applicable rules and orders issued hereunder prior to the execution of this contract, shall be a condition of the Federal financial assistance provided under this Contract and binding upon the CITY, the PROVIDER and any of the PROVIDER'S subrecipients and subcontractors. Failure to fulfill these requirements shall subject the CITY, the PROVIDER and any of the PROVIDER'S subrecipients and subcontractors, their successors and assigns, to those sanctions specified by the Agreement through which Federal assistance is provided. The PROVIDER certifies and agrees that no contractual or other disability exists which would prevent compliance with these requirements. The PROVIDER further agrees to comply with these "Section 3" requirements and to include the following language in all subcontracts executed under this Agreement: "The work to be performed under this contract is a project assisted under a program providing direct Federal financial assistance from HUD and is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.0 1701. Section 3 requires that to the greatest extent feasible opportunities for training and employment be given to low- and very low-income residents of the project area and contracts for work in connection with the project be awarded to business concerns that provide economic opportunities for low-and very low-income persons residing in the metropolitan area in which the project is located." The PROVIDER further agrees to ensure that opportunities for training and employment arising in connection with a housing rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to low-and very low-income persons residing within the metropolitan area in which the CDBG- funded project is located;where feasible, priority should be given to low-and very low-income persons within the service area of the project or the neighborhood in which the project is located, and to low- and very low-income participants in other HUD programs; and award contracts for work undertaken in connection with a housing rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to business concerns that provide economic opportunities for low-and very low-income persons residing within the metropolitan area in which the CDBG-funded project is located; where feasible, priority should be given to business concerns which provide economic opportunities to low-and very low-income residents within the service area or the neighborhood in which the project is located,and to low-and very low-income participants in other HUD programs. The PROVIDER certifies and agrees that no contractual or other legal incapacity exists which would prevent compliance with these requirements. b. Notifications The PROVIDER agrees to send to each labor organization or representative of workers with which it has a collective bargaining agreement or other contract or understanding, if any, a notice advising said labor organization or worker's representative of its commitments under this Section 3 clause and shall post copies of the notice in conspicuous places available to employees and applicants for employment or training. RESOLUTION NO. 24196 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PALM SPRINGS, CALIFORNIA, APPROVING THE 2017-2018 COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) ANNUAL ACTION PLAN; APPROVING THE COMMUNITY DEVELOPMENT BLOCK GRANT BUDGET FOR FISCAL YEAR 2017-2018; AUTHORIZING THE SUBMITTAL OF THE PLAN AND BUDGET TO THE UNITED STATES DEPARTMENT OF HOUSING & URBAN DEVELOPMENT (HUD); AND AUTHORIZING THE CITY MANAGER TO EXECUTE THE APPROVAL/AGREEMENT (GRANT # B-17-MC-06-0561) WITH HUD — IN THE AMOUNT OF $387,462 AND TO EXECUTE ALL SUBRECIPIENT AGREEMENTS. WHEREAS, as a Community Development Block Grant entitlement community, the City of Palm Springs is required to prepare and submit a Five-Year Consolidated Plan and Annual Action Plan for the use of the federal funds received; and WHEREAS, the City of Palm Springs is eligible to receive an estimated Fiscal Year 2017 entitlement of $387,462 of Community Development Block Grant funds under the U.S. Department of Housing & Urban Development regulations; and WHEREAS, the funds must be used for eligible activities that principally benefit low and moderate income persons; and WHEREAS, pursuant to the requirements of including citizen involvement in the allocation process, a Citizens' Advisory Committee was established and a public hearing was held on February 23, 2017, to receive citizen input on the allocation of these funds; and WHEREAS, the proposals have been reviewed by the CDBG Citizens' Advisory Committee based on the needs of low and moderate income persons and the other National Objectives to benefit the maximum number of people; and WHEREAS, the City Council held a public hearing on March 15, 2017, to receive public input on the allocation of these funds; NOW THEREFORE, THE CITY COUNCIL OF THE CITY OF PALM SPRINGS DOES HEREBY RESOLVE AS FOLLOWS: SECTION 1. The 2017-2018 Annual Action Plan is hereby approved. The City Manager or his designee is authorized to submit the Plan to the United States Resolution No. 24196 Page 2 Department of Housing & Urban Development, accurately reflecting the 2017-2018 CDBG budget and projects approved by the City Council. SECTION 2. The total Community Development Block Grants funds available for 2017-2018, by authorized category of basic eligibility, are approved as follows: Public Facilities & Capital Improvements $252.333. ........................................ Public Services (includes Fair Housing)..............................................57,637. TOTAL PROGRAMMATIC FUNDS.................................................$309.970. ADMINISTRATION (includes Citizen Participation & FairHousing).......................................................... ..............$77,492. TOTAL CDBG 2017-2018 FUNDING $387,462. SECTION 3. The City Manager is hereby authorized to accept and execute the Funding Approval/Agreement (Grant #: B-17-MC-06-0561) with HUD, in the amount of $387,462, for the Fiscal Year 2017-2018 CDBG Program, 43'd Program Year. SECTION 4. The City Manager is hereby authorized to execute the following Subrecipient Agreements and all necessary documents, in a form acceptable to the City Attorney: Desert AIDS Project—A6507 i Emergency Preparedness Generator $77,000 Mizell Senior Center—A6392 Energy-Saving Patio Enclosure $52,350 City of Palm Springs Department of Public Works& Engineering— Citywide ADA Curb Ramp and Sidewalk $88,983 City of Palm Springs Department of Public Works& Engineering— Main Library Sidewalk $34,000 Fair Housing Council of Riverside, Inc. —A6510 Fair Housing Services $42,637 Senior Advocates of the Desert—A6667 Senior Emergency Assistance $15,000 SECTION 5. The City Manager is authorized and directed to prorate and adjust the award amounts for funding provided by the Subrecipient Agreements in Section 4 of this resolution, to apportion the funding amounts to reflect a reduction in funding should the final award from HUD be reduced from the estimated funding of$387,462 available for the 2017-2018 fiscal year. Resolution No. 24196 Page 3 ADOPTED THIS 15T" DAY OF MARCH, 2017. David H. Ready, Esc{. City Manager ATTEST: L�� Kathleen D. Hart, MMC Interim City Clerk CERTIFICATION STATE OF CALIFORNIA ) COUNTY OF RIVERSIDE ) ss. CITY OF PALM SPRINGS ) I, KATHLEEN D. HART, Interim City Clerk of the City of Palm Springs, hereby certify that Resolution No. 24196 is a full, true and correct copy, and was duly adopted at a regular meeting of the City Council of the City of Palm Springs on March 15, 2017, by the following vote: AYES: Councilmembers Kors, Roberts, and Mayor Moon NOES: None ABSENT: Councilmember Mills, and Mayor Pro Tern Foat ABSTAIN: None Kathleen D. Hart, MMC Interim City Clerk SUBRECIPIENT AGREEMENT THIS AGREEMENT(herein "Agreement"), is made and entered into this day of*e&w 1-4e- 2016, by and between the CITY OF PALM SPRINGS, (herein "City), a municipal corporation and charter city, and the Desert AIDS Project. Inc. . , (herein"Provider"). WHEREAS, the City has entered into various funding agreements with the United States Department of Housing and Urban Development ("HUD"), which agreements provide funds ("CDBG Funds") to the City under the Federal Housing and Community Development Act of 1974 (42 U.S.C. Section 5301 et seg.), as amended from time to time (the "Act"), and the regulations promulgated thereunder(24 C.F.R. Section 570 et sea. ("Regulations"); and WHEREAS, the Act provides that the City may grant the CDBG Funds to nonprofit organizations for certain purposes allowed under the Act; and WHEREAS, the Provider is a nonprofit organization which operates a program which is eligible for a grant of CDBG funds and the City desires to assist in the operation of the program by granting CDBG 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; NOW, THEREFORE, the parties hereto agree as follows: 1.0 SERVICES OF PROVIDER, 1.1 Scope of Services. Provider agrees to provide to City all of the services specked and detailed in its application for funding and 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 represented in the Provider's application for funding. City provided funds shall be used only for those purposes specked in such application and 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. 1.4 Financial Reporting. Any Provider receiving or due to receive $20,000.00 or more from the City during the 2016 — 2017 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 which 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"of the current fiscal year. ORIGINAL BID AND/ORAGREEMENT 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 FORTY-SEVEN THOUSAND, SIX HUNDRED AND FIFTY-ONE DOLLARS($47.651.00)(the"Contract Sum")in accordance with the Budget attached hereto in Exhibit B and incorporated herein by this reference; and as herein provided.The budget cost categories set out in Exhibit B 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 F, on reimbursable expenditures pursuant to the attached Budget along with pertinent supporting 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 by Provider to request reimbursement or encumbrance of at least 25% of the total grant by the end of each fiscal year quarter (September 30, December 30, March 31, and June 30)shall result in the immediate forfeiture of 25%of the total grant. 3.0 COORDINATION OF WORK. 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 in connection therewith: Brande Orr. Director of Grants 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 express written approval of the City. Neither this Agreement nor any interest herein may be assigned or transferred,voluntarily or by operation of law,without the prior written approval of the City. 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 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 dose of the program. -2 - 4.2 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; (b) Section 109 of the Housing and Community Development Act of 1974, as amended and the regulations issued pursuant thereto; (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); Q) 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(bx8); (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); (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; -3 - (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 (v) Such other City, County, State, or Federal laws, rules, and regulations, executive orders or similar requirements which might be applicable. 4.3 The City shall have the right to periodically monitor the program operations of the Provider under this Agreement. 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 as an additional insured shall be delivered to and approved by the City 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 -4 - to indemnify the City, its officers, or employees. 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 officers and employees, 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 DISCRIMINATION TERMINATION AND ENFORCEMENT. 6.1 Covenant Against Discrimination. Provider covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them that there shall be no discrimination against or segregation of any person or group of persons on account of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, pregnancy, marital status, age, sex, sexual orientation, gender identity, or any other basis Protected Characteristic by applicable federal, state or local law in the performance of this Agreement. Provider shall take affirmative action to insure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, sexual orientation, gender identity, marital status, physical or mental disability, national origin, ancestry or any other basis Protected Characteristic by applicable federal, state or local law. 6.2 Term. Unless earlier terminated in accordance with Section 6.3 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. 6.3 Termination Prior to Exoiration 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. 7.0 MISCELLANEOUS PROVISIONS. 7.1 Notice. Any notice, demand, request, document, consent, approval, or communication either party desires or is required to give to the other party shall be in writing and either served personally or sent by prepaid, first-class mail to the address set forth below, or such other addresses as may from time to time be designated by mail. -5 - 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: Desert AIDS Proiect—D.A.P. PO Box 2890 1695 N Sunrise Way Palm Sorinas CA 92263-2890 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 -6 - CITY OF PALM SPRINGS ATTEST: municipal corporatIpn j By: / y Clerk �City Manager APPROV D TO FO M: APPROVED BY CITY COUNCIL By: Nh abW�12 b Ib P.bb01 City Attor ey PROVIDER: Check one: _Individual —Partnership X 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, Assista Secretary, Treasurer, Assistant Treasurer, or Chief Financial Officer). By: � BY: Nothrized Signature of Chairman of Board, Notarized Signature Secr ary,Asst Secretary, President or any Vice President Treasurer Asst Treasurer or Chief_Financial Officer Name:—T��&..0 �Er:nkw.c.v. Name: a 17Rv �.17./ wSn�, J Title: �cf� E�er�a%te nf4 cep Title: e+r-Io` ✓+nrs' S'fc c State of '^ ls. State of .(4 '�r A 14- ) County of i r ,t ))as County of 'rei , as A notary Public or other officer completing this certificate A notary public or other officer completing this certificate verifies only the identity of the individual who signed the verifies only the identity of the individual who signed the document to which this certificate is attached, and not document to which this certificate is attached, and not the truthfulness,accuracy,or validity of that document. the truthfulness,accuracy,or validity of that document State of Le4h .c rn'� ) State of 0 4 o rn,,- ) County of� k✓zC Lk_ )as. County of 4vc ri 1 )ss. j On `III I, �I�J��I)I6 before me, `- before me, On_ r1 p t' rl I K(t^ �'Xtr/ 'r�� �t� ' "Jar /tii�"�"f ersonall a eared personally peered (( P Y PP 6 r r n It Fn1" who proved to m A �Cr7�`YY "� who proved to me on the basis of satisfactory evidence to be the person(s) me on the basis of satisfactory evidence to be the person(s) whose name(s)Ware subscribed to the within instrument and whose name(s)is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in acknowledged to me that he/shelthey executed the same in his/her/their authorized capacity(ies), and that by his/her/their his/her/their authorized cepaoity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the upon behalf of which the person(s) acted, executed the instrument. instrument. I certify under PENALTY OF PERJURY under the laws of the I certify under PENALTY OF PERJURY under the laws of the State of California that the regoing paragraph is true and State of California that the foregoing paragraph is true and correct. correct. WITNESS my hand o cial sal. WITNESS my hand and ffficialseal. Notar a Notary Signet Koa s SNELIABARNETT Not" Commission rM NETT 7 SHELIA BARNETT i -i Notary Public •California � _ Commission 8 7999407 z Riverside County �=-�- - Notary Public •California M Comm.Ex fires Now 29.2016 Riverside County ow Comm.Expires Nov 29.2018 inencoec,snwa_smsv+am,aseou e - 7 - CITY OF PALM SPRINGS EXHIBIT A Scope of Services Proiec Activity Title: roiect Number: DesertAIDS Project/ 0015 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project-DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 Ob iectives/Activities The intent of this program is to provide the most comprehensive direct client services and advocacy to help people living with HIV/AIDS manage their disease, including a state-of-the-art medical center to a nutritionally balanced food voucher program, to case management, legal services, education, prevention, anonymous testing, wellness, dental, transportation, housing assistance and home health services. This will be accomplished through the continuation of the facility upgrades to provide access to essential, in many cases life-saving, services for one of the community's most vulnerable populations in the event of power loss caused by natural disaster or other event. The upgrades will be a phased installation of an Environmental Protection Agency (EPA) certified emergency back-up generator. DAP service area covers Riverside and San Bernardino Counties, roughly the size of the state of Massachusetts which this immense area is recognized as the fifth largest concentration of HIV/AIDS population in the United States, serving 2,032 clients Valley-wide and 1,048 Palm Springs'clients. The Provider shall be responsible for the completion of the following objectives/activities in a manner acceptable and satisfactory to the City and consistent with the standards required as a condition of providing these CDBG funds. Objective 1: Assist the City by timely providing any additional information requested. TARGET DATE ACTIVITY#1 On-Going 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 On-Going 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 On-Going Draft a promotional piece and submit to City for approval. Advertise in the Desert Sun's daily general circulation newspaper or its weekly Palm Springs geo-targeted newspaper. Submit final publication to City. CITY OF PALM SPRINGS EXHIBIT B Budget Summary ProiecNActivity Title: Project Number: Desert AIDS Project/ 0015 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project-DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 COST CATEGORY CDBG OTHER TOTAL SHARE SOURCES COST 1 Personnel -0- $10,726. $10,726. 2 Consultant/Contract Services $30,000. 15,000. $45,000. Architectural Services 3 Travel -0 - -0- -0 - 4 Space Rental -0- -0- -0 - 5 Consumable Supplies -0- -0 - -0- 6 Rental, Lease or Purchase of 0 - 0- 0 - E ui ment 7 Insurance -0- -0- 0- 8 Other— $17,651. $161,349. $194,000. Con struction/Rehabilitation Contingency -0 - $30,000. $30,000. TOTALS $47,651. $202,075. $249,726. * 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. Other funding sources may include Riverside County and City of Palm Desert CDBG Awards and private donations. 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, 2016 through June 30, 2017 with funds allocated from 2016—17 Program Year. CITY OF PALM SPRINGS EXHIBIT C Insurance Inventory Proiect/Activity Title: Proiect Number: Desert AIDS Project/ 0015 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project- DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 INSURANCE INVENTORY LIABILITY INSURANCE POLICY Name of Provider's Insurance Company National Fire and Marine Insurance Co. Effective Dates of Policy 10/05/16 to 10/05/17 Claims Made Policy I / Per Occurrence Policy / I Limits of Liability $3,000,000 Deductibles: Per Occurrence Annual Aggregate Additional Insured Endorsement (Certificate Holder) 0 Yes ❑ No Original Certificate of Insurance Attached ❑ Yes 0 No WORKER'S COMPENSATION POLICY Name of Provider's Insurance Company Non Profits' United Workers' Compensation Group Effective Dates 01/01/16 to 01/01/17 Limits of Liability $2M Per Occurrence Underlying Coverage Limits Original Certificate of Insurance Attached 0 Yes 10 No CERTIFICATE OF LIABILITY INSURANCE DATE IMWDDNYYY) L� 10/5/2017 10/13/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Lockton Insurance Brokers,LLC CONTACT NAME: CA Licence#01715767 PHONE FAX 725 S.Figueroa Street,35th fl. E-MAIL a/c No Los Angeles CA 90017 ADDRESS: 213-689-0065 INSURERS AFFORDING COVERAGE NAIL$ INSURER A:National Fire and Marine Insurance Co 20079 INSURED Desert AIDS Project INSURER B:Travelers IndemnityCo of CT 25682 1419776 1695 N.Sunrise Way INSURER C Palm Springs CA 92262 INSURER D: INSURER E NSURER F: COVERAGES DESAI01 CERTIFICATE NUMBER: 14321290 REVISION NUMBER: }{7{){}{xxx 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICYNUMBER MWO MWD LIMITS COMMERCIAL GENERAL LIABILFTY EACH OCCURRENCE $ 1000 000 A X Y N HNOI7770 10/$/2016 10/5/2017 CLAIMS-MADE L X1 OCCUR DAMAGE TO PREMISES RENTED nce E 250 000 MED D(P(Anyone Pinson) $ }{}{pL7C7{$J{ PERSONAL aADV INJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY❑JET LOG PRODUCTS-COMP/OP AGO $ 3,000,000 OTHER: $ B AUTOMOBILELABILnY N N $10-6H46tk146-TCT-16 10/5/2016 10/$/2017 COMBINED SINGLE LIMIT $ Ea accident) I NUN X ANYAUTO BODILY IWURY(Par Person) $ x)Cx}Cxxx OWNED AUTOS ONLYH AUTOSULED BODILY INJURY(Per accident) $ �C}C]{}CXXX HIRED NON�WNEX AUTOS ONLY AUTOS ONLOY Pena den DAMAGE $ Xx)C}{XXX .../ oil Ded $ 1,000 UMBRELLA LIAa OCCUR NOT APPLICABLE EACH OCCURRENCE $ }{$}{J xxx EXCESS LAB NOT ZIAADE AGGREGATE $ )C]{JC{Y{]{a' OED I RETENTION$ $ }{J{]{J{xxx WORKERS COMPENSATION NOT APPLICABLE PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROFRIETORI➢ARTNER/EXECUTIVE E.L.EACH ACCIDENT $ A'J{}{J{xxx OFFICERIMEMBER EXCWDED7 ❑ NIA (Vyardar yIn NH) E.L.DISEASE-EA EMPLOYEE $ }{]{}CJ{YXX DESCRikm,m dff IPTIONOF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ }{]{}C]C](]QC 77 DESCRIPTWNOFOPERATIONSILOCATIONSIVEHICLES (ACORD 101,Additional Remarks Schedule,may baaNach Nmonapaca I'mQuImto Certificate Holder is included as additional insured with respect to General Liability. CERTIFICATE HOLDER CANCELLATION 14321290 City of Palm Springs SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3200 E.Tahquitz Canyon Way THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Palm Springs CA 92262-6959 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPR ®ifts-2oitAcORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD A��& CERTIFICATE OF LIABILITY INSURANCE 1jJ9�o�DDIYYYY) 15 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 endorsements. PROWLER CONTACT NAME: Arthur J. Gallagher&Co. PHONE FAX Insurance Brokers of California, Inc. LIC#0726293 LAIC N EWAIL 1255 Battery Street#450 San Francisco CA 94111 INSURE S AFFORDING COVERAGE NAIC rt INSURERA:NonProfits'United Workers'Com ens INSURED NONPUNI-01 INSURER a:Safety National Casualty Corporatio 15105 Desert AIDS Project INSURER C: 1695 N Sunrise Way Palm Springs, CA 92262 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:393965312 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. ICYEXP LM TYPE OF INSUSR RANCE IN$D YIVD POLICY NUMBER MWDDIIYYYY MP D LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAM A ET NT CLAIMS-MADE OCCUR PREMI E Ea occurrence $ MED EXP(Airy we onson) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PET LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY Ea accident $ ANY AUTO BODILY INJURY(Per person) $ AUTOSMEO AUTOSULED BODILY INJURY(Per accident) $ HIREDAUTOS NON-O MEO PR PERTY DAMAGE $ AUTOS Perawident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERSCOMPENSATION NPU-WCG 001-2016 1/1/2016 1/1/2017 PER X OTH- AND EMPLOYERS'WBILITY YIN STATIlrE ER ANY PROPRIETOR/PARTNERI ECURVE ❑ NIA E.L.EACH ACCIDENT $500,0W OFFICERMIEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $500,000 If yes,describe under DES CRIPTIONOFOPERATIONSbel. E.L.DISEASE.POLICY LIMIT $500,000 B Exosss Wokers'Comp SP 4052095 1/1/2016 1/1/2017 Limit Per Occurence Statutory E.L.Per Occ&Agg 2,000,000 XS of 500.000 DESCRIPTKINOFOPERATIONS/LOCATKINS/VENICLES(ACORD101,AMMomi Remarks SehaduM,maybaaf ce Bmoreapacelareulmd) Desert AIDS Projects: Energy-Efficiency Retrofitting and Energy-Efficiency Roofing Upgrades CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Palm Springs ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 2743 Palm Springs CA 92262 USA AAUU� ORORIZEDRREPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD CITY OF PALM SPRINGS EXHIBIT D Beneficiary Qualification Statement Proiectf ity Title: Protect Number: Desert AIDS Project/ 0015 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project-DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 BENEFICIARY QUALIFICATION STATEMENT This statement must be completed and signed by each person or head of household(legal guardian) receiving benefits form the described project/activity. 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—03128116) AREA MEDIAN NUMBER OF PERSONS IN YOUR HOUSEHOLD: INCOME(AMI) 1 2 3 4 5 6 7 8 LEVEL-$61,400 EXTREMELY LO INCOME $13,450 $16,020 $20,1600 $24,300 $28,440 $32,680 $36.730 $40,890 0 30%of AMI LOW INCOME $22,400 $26,600 $28,800 $31,950 $34,550 $37,100 $39,650 $42,200 30-50%of AM] MODERATE INCOME $35,800 $40,900 $46.000 $51,100 $55,200 $59,300 $63,400 $67,500 50-80%of AMI NON LOW&MOD INCOME $35,801 $40,901 $46,001 $51,101 $55,201 $59,301 $63,401 $67,501 80% 3. What racelethnicity 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: HISPANICMTINO ETHNICITY ❑ Yes ❑ No If yes,check one:0 Puerto RICcaN�no •❑ Cuban ❑ Other: 4. Are you female Head of Household? ❑ YES ❑ NO 5. Do you have a disability? ❑ YES ❑ NO If YES,please describe: ACKNOWLEDGEMENT AND DISCLAIMER I 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(COBG)program purposes.a Federally-funded program,governmental reporting purposes to monitor compliance. CITY OF PALM SPRINGS EXHIBIT E Semi-Annual Program Progress Report Proiect/Activity Title: Project Number: Desert AIDS Project/ 0015 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project-DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 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: HISPANICILATINO ETHNICITY: MexicanfChicano Puerto Rican Cuban Other: ♦ Number of Disabled: ACCOMPLISHMENT NARRATIVE LEVERAGING RESOURCES NARRATIVE Signed Title Date The PROVIDER further agrees to ensure that opportunities for training and employment arising in connection with a housing rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to low-and very low-income persons residing within the metropolitan area In which the CDBG- funded project is located;where feasible, priority should be given to low-and very low-income persons within the service area of the project or the neighborhood in which the project is located,and to low-and very low-income participants in other HUD programs; and award contracts for work undertaken in connection with a housing rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to business concems that provide economic opportunities for low-and very low-income persons residing within the metropolitan area in which the CDBG-funded project is located; where feasible, priority should be given to business cencems which provide economic opportunities to low-and very low-income residents within the service area or the neighborhood in which the project is located,and to low-and very low-income participants in other HUD programs. The PROVIDER certifies and agrees that no contractual or other legal incapacity eztsts which would prevent compliance with these requirements. b. Notifications The PROVIDER agrees to send to each labor organization or representative of workers with which it has a collective bargaining agreement or other contract or understanding, if any, a notice advising said labor organization or worker's representative of its commitments under this Section 3 clause and shall post copies of the notice in conspicuous places available to employees and applicants for employment or training. CITY OF PALM SPRINGS EXHIBIT F Request for Reimbursement ProiecUActivity Title: Project Number: Desert AIDS Project/ 0015 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project-DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 BENEFICIARY QUALIFICATION STATEMENT Approved Current _ Pdor Total Grant Description Omni tRalmburoement Reimbursement.. YiD �� = Balance Amount Period `PeAod(s) Rolmbursemeni (Ovid Under) onsultant/Contract Services Architectural Services $30,000. Other— Construction/Rehabilitation $17,651 TOTAL $47,651 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: APPROVED BY: Name, Title, Date 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 G Employment Restrictions 1. Labor Standards The PROVIDER agrees to comply with the requirements of the Secretary of Labor in accordance with the Davis-Baron Act as amended, the provisions of Contract Work Hours and Safety Standards Act, the Copeland "Anti-Kickback" Act(40 U.S.C. 276a-276a-5;40 USC 327 and 40 USC 276c)and all other applicable Federal,state and local laws and regulations pertaining to labor standards insofar as those acts apply to the performance of this contract. The PROVIDER shall agree to submit documentation provide by the CITY which demonstrates compliance with hour and wage requirements of this part. The PROVIDER agrees that, all general contractors or subcontractors engaged under contracts in excess of$2.000.00 for construction, renovation or repair work financed in whole or in part with assistance provided under this contract,shall comply with Federal requirements adopted by the CITY pertaining to such contracts and with the applicable requirements of the regulations of the Department of labor, under 29 CFR Parts 1, 3, 5 and 7 governing the payment of wages and ratio of apprentices and trainees to joumeyworkers; provided, that if wage rates higher than those required under the regulations are imposed by state and local law, nothing hereunder is intended to relieve the PROVIDER of its obligation, if any, to require payment of the higher wage. The PROVIDER shall cause or require to be Inserted in full, in all such contracts subject to such regulations,provisions meeting the requirements of this paragraph. 2. "Section 3 Clause" a. Compliance Compliance with the provisions of Section 3,the regulations set forth in 24 CFR 135, and all applicable rules and orders issued hereunder prior to the execution of this contract,shall be a condition of the Federal financial assistance provided under this Contract and binding upon the CITY, the PROVIDER and any of the PROVIDER'S subrecipients and subcontractors. Failure to fulfill these requirements shall subject the CITY,the PROVIDER and any of the PROVIDER'S subrecipients and subcontractors, their successors and assigns, to those sanctions specified by the Agreement through which Federal assistance is provided. The PROVIDER certifies and agrees that no contractual or other disability exists which would prevent compliance with these requirements. The PROVIDER further agrees to comply with these "Section 3" requirements and to include the following language in all subcontracts executed under this Agreement: "The work to be performed under this contract is a project assisted under a program providing direct Federal financial assistance from HUD and is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.0 1701. Section 3 requires that to the greatest extent feasible opportunities for training and employment be given to low- and very low-Income residents of the project area and contracts for work in connection with the project be awarded to business concems that provide economic opportunities for low-and very low-income persons residing in the metropolitan area in which the project is located" SUBRECIPIENT AGREEMENT THIS AGREEMENT(herein "Agreement"), is made and entered into this.G day of 4 (1S 2015, by and between the CITY OF PALM SPRINGS, (herein "City), a municipal corpora ' n and charter city, and the Desert AIDS Proiect, Inc. , (herein "Provider"). WHEREAS, the City has entered into various funding agreements with the United States Department of Housing and Urban Development ("HUD"), which agreements provide funds ("CDBG Funds") to the City under the Federal Housing and Community Development Act of 1974 (42 U.S.C. Section 5301 et sea.), as amended from time to time (the "Act"), and the regulations promulgated thereunder(24 C.F.R. Section 570 et sea. ("Regulations"); and WHEREAS, the Act provides that the City may grant the CDBG Funds to nonprofit organizations for certain purposes allowed under the Act; and WHEREAS, the Provider is a nonprofit organization which operates a program which is eligible for a grant of CDBG funds and the City desires to assist in the operation of the program by granting CDBG 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; NOW, THEREFORE, the parties hereto agree as follows: 1.0 SERVICES OF PROVIDER. 1.1 Scope of Services. Provider agrees to provide to City all of the services specified and detailed in its application for funding and 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 represented in the Provider's application for funding. City provided funds shall be used only for those purposes specified in such application and 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 Resorts. 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. 1.4 Financial Reporting. Any Provider receiving or due to receive $20,000.00 or more from the City during the 2015 — 2016 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 Providers financial records to be kept in accordance with generally accepted accounting standards. The report shall include a general ledger balance sheet which 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 3155 of the current fiscal year. 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 SEVENTY-TWO THOUSAND, TWO HUNDRED NINETY-FOUR DOLLARS ($72.294.00) (the "Contract Sum") in accordance with the Budget attached hereto in Exhibit B and incorporated herein by this reference; and as herein provided. The budget cost categories set out in Exhibit B 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 F, on reimbursable expenditures pursuant to the attached Budget along with pertinent supporting 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 Providers respective employees, as set forth in OMB Circular A-122 Attachment B.6. 2.3 Draw Downs. Failure by Provider to request reimbursement or encumbrance of at least 25% of the total grant by the end of each fiscal year quarter(September 30, December 30, March 31, and June 30) shall result in the immediate forfeiture of 25% of the total grant. 3.0 COORDINATION OF WORK. 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 in connection therewith: Brande Orr, Director of Grants 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 express written approval of the City. Neither this Agreement nor any interest herein may be assigned or transferred, voluntarily or by operation of law,without the prior written approval of the City. 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 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. - 2 - 4.2 The Provider certifies it shall adhere to and comply with the following as they may be applicable: (a) Submit to City through its Community and Economic Development Department semi-annual reports on program status; (b) Section 109 of the Housing and Community Development Act of 1974, as amended and the regulations issued pursuant thereto; (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); (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); (o) The regulations, policies, guidelines and requirements of 24 CFR 570; the "Common Rule", 24 CFR Part 85 and subpart J; OMB Circular Nos. A-102, Revised, A-87, A-110 and A-122 as they relate to the acceptance and use of federal funds under the federally- assisted program; - 3 - (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) Maintain property inventory system to numerically identify HUD purchased property and document its acquisition date as is set forth in OMB Circular A-110 Attachment N Property Management Standard 6d; and (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) Such other City, County, State, or Federal laws, rules, and regulations, executive orders or similar requirements which might be applicable. 4.3 The City shall have the right to periodically monitor the program operations of the Provider under this Agreement. 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 as an additional insured shall be delivered to and approved by the City 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 officers, or employees. The amount of insurance required hereunder shall be as required by the Contract Officer not exceeding One Million Dollars($1,000,000). - 4 - 5.2 Indemnification. The Provider shall defend, indemnify and hold harmless the City, its officers and employees, 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 DISCRIMINATION, TERMINATION, AND ENFORCEMENT. 6.1 Covenant Against Discrimination. Provider covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them that there shall be no discrimination against or segregation of any person or group of persons on account of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, pregnancy, marital status, age, sex, sexual orientation, or any other basis Protected Characteristic by applicable federal, state or local law in the performance of this Agreement. Provider shall take affirmative action to insure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, marital status, physical or mental disability, national origin, ancestry or any other basis Protected Characteristic by applicable federal, state or local law. 6.2 Term. Unless earlier terminated in accordance with Section 6.3 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. 6.3 Termination Prior to Expiration of Term. Either party may terminate this Agreement at any time, with or without cause, upon thirty (30) days' written notice to the other party. 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. 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. 7.0 MISCELLANEOUS PROVISIONS. 7.1 Notice. Any notice, demand, request, document, consent, approval, or communication either party desires or is required to give to the other party shall be in writing and either served personally or sent by prepaid, first-class mail to the address set forth below, or such other addresses as may from time to time be designated by mail. 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: Desert AIDS Project- DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 - 5 - 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 ] -6 - CITY OF PALM SPRINGS ATT T: a municipal corporation B City Clerk City Manager APPROV TO FORM: APPROVED BY CITY COUNCIL City Attorney 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 etary, Treasurer, Assis nt Treasurer, or Chief Financial Officer). By: --- By: Z � .i Notan ignature of Chairman of Board, Notarize gnatul Secretary,Asst Secretary, President or any Vice President Treasurer, nAs t Trea rer or Chief Financial Officer 1 Name: uIt 4 -;Ak.WlR n Name: I/I G /`f Y raGWIL Title: C C—'O Title: �— A notary public or other officer completing this certificate A notary public or other officer completing this certificate verifies only the identity of the individual who signed the verifies only the identity of the individual who signed the document to which this certificate is attached, and not document to which this certificate is attached, and not the truthfulness, accuracy,or validity of that document. the truthfulness,accuracy,or validity of that document. State ofn(�-t•u�ni0. ) State of C"/�t�w-(n j 4 ) County of (Z.:Jc/S iel.t )ss. Countyof Kil/YJ$iGt¢ )as. On / tAf�WCf� fir f �Irj before me, On// 4'r -lus� (32-or S/ before me, /5 VvW r —;&4A7— , personally appeared Srl2n sa, ,7, jj.+ 7 Q b).4. ,personally appeared ,VAN"-& who proved to ✓� C' �'G-i,L who proved to me on the basis of satisfactory evidence to be the person(p)) me onm — Ih�of satisfactory evidence to be the personK whose nameO is/ap6 subscribed to the within instrument and whose name(�ris/ar6 subscribed to the within instrument and acknowledged to me that he/sWthpy executed the same in acknowledged to me that Wshel"y executed the same in his/hethgif authorized capacity(ieA, and that by his/hpMVir fKher/heir authorized capacity(os), and that by whedth€r signature(e) on the instrument the person(p), or the entity signature(gj on the instrument the persor((), or the entity upon behalf of which the person() acted, executed the upon behalf of which the persons) acted, executed the instrument. instrument. I certify under PENALTY OF PERJURY under the laws of the I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and State of California that the foregoing paragraph is true and correct. correct. WITNESS my hand and official seal. — / WITNESS my hand and official seal. / Notary Signature: i ./ Notary Signature: Notary ea 3HERI SAEN2 Notary Seal: Commission•2074134 t 4'"' ? SNERI SAENZ z C + Notary Public-California !r� - Commission 12074134 Notary Public-Cs lwma z z Riverside County z MY Comm. Expires Auo 1 2010+ Riverside Corapy a M Comm.Elft PA 7 Y01 OebGCCBGiSi6➢FP_S,daa^gmnl.Ju115 - 7 CITY OF PALM SPRINGS EXHIBIT A Scope of Services Proiect/Activity Title: Project Number: Desert AIDS Project! 0002 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project- DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 O bi ectives/Activities The intent of this program is to provide the most comprehensive direct client services and advocacy to help people living with HIV/AIDS manage their disease, including a state-of-the-art medical center to a nutritionally balanced food voucher program, to case management, legal services, education, prevention, anonymous testing, wellness, dental, transportation, housing assistance and home health services. This will be accomplished through the continuation of the facility upgrades to provide access to essential, in many cases life-saving, services for one of the community's most vulnerable populations in the event of a disaster. The upgrades will phase the installation of an Environmental Protection Agency (EPA) certified emergency back-up generator. DAP service area covers Riverside and San Bernardino Counties, roughly the size of the state of Massachusetts which this immense area is recognized as the fifth largest concentration of HIV/AIDS population in the United States, serving 2,376 clients Valley-wide and 1,212 Palm Springs' clients. The Provider shall be responsible for the completion of the following objectives/activities in a manner acceptable and satisfactory to the City and consistent with the standards required as a condition of providing these CDBG funds. Objective 1: Assist the City by timely providing any additional information requested. TARGET DATE ACTIVITY#1 On-Going 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 On-Going 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 On-Going Draft a promotional piece and submit to City for approval. Advertise in the Desert Sun's daily general circulation newspaper or its weekly Palm Springs geo-targeted newspaper. Submit final publication to City. Objective 4: Enroll and income qualify at least a total of one thousand two hundred and twelve (1,212) extremely low income to moderate-income Palm Springs residents in accordance with Exhibit D for improved access to the facility. TARGET DATE ACTIVITY#1 On-Going Provide direct client services and advocacy to help Palm Springs residents living with HIV/AIDS manage their disease. Maintain records of names, addresses, demographics and service dates for all assistance. Objective 5: Maintain records for all CDBG activities related to this program. TARGET DATE ACTIVITY#1 On-Going 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 On-Going Submit Semi-Annual reports — referenced Exhibit E within fifteen (15) calendar days of the program mid-year, December 31�. and program completion, June 30t' Objective 6: Manage/monitor program activities. TARGET DATE ACTIVITY#1 On-Going 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 7: Make improvements through Architectural & Engineering Services (A&E) and site preparation for the installation of an emergency back-up generator which will ensure the ability to maintain direct client services, and to preserve perishable medications and food in the event of a power outage or natural disaster. TARGET DATE ACTIVITY#1 On-Going Conduct activities to improve availability/accessibility in accordance with an 'open competitive' procurement process as stipulated in this Agreement and in consultation with the City. Objective 8: Provide an evaluation within fifteen (15) calendar days of the program completion or final reimbursement. TARGET DATE ACTIVITY#1 07/15/16 Provide an evaluation and final report on all programmatic and financial activities. 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 Budget Summary Proiect/Activity Title: Proiect Number: Desert AIDS Project/ 0002 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project- DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 COST CATEGORY CDBG OTHER TOTAL SHARE SOURCES COST 1 Personnel -0 - $8,306. $8,306. 2 Consultant/Contract Services $51,294. $506. $51,800. Architectural Services 3 Travel - 0- - 0- -0 - 4 Space Rental - 0- - 0 - -0 - 5 Consumable Supplies -0 - -0 - -0 - 6 Rental, Lease or Purchase of -0 - -0 - -0 - Equipment 7 Insurance -0 - -0 - -0 - 8 Other— $21,000. $24,500. $45,500. Construction/Rehabilitation Contingency -0 - $15,841. $15,841. TOTALS $72,294. $49,153. $121,447. 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. Other funding sources may include Riverside County and City of Palm Desert CDBG Awards and private donations. Progress payments, approved by the Subrecpient 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, 2015 through June 30, 2016 with funds allocated from 2015—16 Program Year. CITY OF PALM SPRINGS EXHIBIT C Insurance Inventory Proiect/Activity Title: Proiect Number: Desert AIDS Project/ 0002 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project- DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 INSURANCEINVENTORY LIABILITY INSURANCE POLICY Name of Provider's Insurance Company Markel American Insurance Co. Effective Dates of Policy 10/05/14 to 10/05/15 Claims Made Policy ! I Per Occurrence Policy I / Limits of Liability $3,000,000 Deductibles: Per Occurrence Annual Aggregate Additional Insured Endorsement (Certificate Holder) Q Yes ❑ No Original Certificate of Insurance Attached ❑ Yes Q No WORKER'S COMPENSATION POLICY Name of Provider's Insurance Company Non Profits' United Workers' Compensation Group Effective Dates 01/01/15 to 01/01/16 Limits of Liability $2M Per Occurrence Underlying Coverage Limits Original Certificate of Insurance Attached 0 Yes 71 No DESEAID-03 SINSAI CERTIFICATE OF LIABILITY INSURANCE OATDIYYYY) 7131123112015 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 endorsemem(s). PRODUCER License#0564249 CONTACT NAME: Heffernan Insurance Brokers PHONE FAX 6 Hutton Centre Drive,Suite 500 Arc No Eai:1 (714)361-7700 ac Re): 1 714) 361-7701 Santa Ana,CA 92707 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC e INSURERA-MarkelInsuranceCompan 38970 INSURED INSURER B Desert AIDS Project INSURER C: 1695 N Sunrise Way INSURER D: Palm Springs,CA 92262 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 rypE OF INSURANCE POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MMIDDIYYYY LIMITS A X COMMERCIAL GENERALLIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE O OCCUR X 8502SS329818-5 10105/2014 10/05/2015 PREMISES Eacccurrence $ 1,000,00 NED EXP(Any one Person) S 10,000 PERSONAL B ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMRAPPLIES PER: GENERALAGGREGATE $ 3,000,000 POLICY PEA LOC PRODUCTS-COMPIOP AGO $ 3,000,000 OTHER: PROFESSIONAL LI $ 1,000,000 AUTOMOBILE LIABILITY Ea.cccideIDSINGLE LIMIT $ 1,000,000 A X ANY AUTO 1002SS329819-5 10106/2014 10/0512015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident AUTOS AUTOS ( ) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Par acutleM X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAR CLAIMS-MADE 4602SS329821-5 1010512014 10105/2015 AGGREGATE $ 2,000,000 DEE) X I RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICERNEMBER EXCLUDED' NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yas,descnbe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached n more space is required) Re: D.A.P.'s Emergency Preparedness Generator Phase 1,for the 16-16 CDBG Program Year. The City of Palm Springs and Its officials,employees and agents are named as additional insured on General Liability policy If required by written contract per attached endorsement CERTIFICATE HOLDER CANCELLATION DT V LS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Palm Springs THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN I� N z a q I Palm Springs, Canyon ACCORDANCE WITH THE POLICY PROVISIONS. 3200 E.Tahquit Cnyon Way IUIIUI AUG 17 REH J'� AUTHORIZED REPRESENTATIVE BY / ®1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD DATE CERTIFICATE OF WORKERS' COMPENSATION COVERAGE Aug5,,2015 PRODUCER Nonprofits'United Workers'Compensation Group THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLY 610 Fulton Avenue,Suite 200 AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. Sacramento,CA 95825 Phone:(916)868-6231 THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE Fax:(9t6)880-5251 COVERAGE AFFORDED BY THE POLICIES BELOW. Arthur J.Gallagher&Co Insurance Brokers of California,Inc 1255 Battery Street#450 INSURERS AFFORDING COVERAGE San Francisco,CA 94111 INSURED INSURER A-. Nonprofits' United Workers' Compensation Group Desert AIDS Project INSURER a Safety National Casualty Corp (NAIC# 151051 1695 N Sunrise Way Palm Springs, CA 92262 INSURER C INSURER D: INSURER E' COVERAGES This Certificate is not intended to specify all endorsements,coverages,terms,conditions and exclusions of the policies shown. THE POLICIES OF COVERAGE LISTED BELOW HAVE BEEN ISSUED TO THE AFFILIATE MEMBER 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 COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY POLICY INSR TYPE OF COVERAGE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS DATE GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ CLAIMS MADE I JOCCUR MED EXPENSE(Any one Person) $ GENERAL AGGREGATE OMIT APPLIES PER: PERSONAL&ADV INJURY $ POLICY I I PROJECT I LOC GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Each accident) $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per amaen0 $ PROPERTY DAMAGE $ (Per accident) $ WC STAT X OTHER IMITS WORKERS'COMPENSATION A AND NPU-WCG 001-2015 111115 1/1/16 E.L.EACH ACCIDENT $500,000 EMPLOYERS LIABILITY E.L.DISEASE-EA EMPLOYEE $500,000 E.L.DISEASE-COVERAGE LIMIT $500,000 OTHER Limit Per Occurrence-Statutory B EXCESS Workers'Compensation SP 4052095 1/1/15 1/1/16 EL Per Occ&Agg $2,000,000 xs of$500,000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIALIPROVISIONS Evidence of Workers'Compensation Coverage: Re:DAP's Emergency Preparedness Generator Phase I,for the 15-16 CDBG Program Year;Waiver of Subrogation provided by Endorsement NPU WCG-DAID-049 CERTIFICATE HOLDER CANCELLATION EJq' i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED City of Palm Springs AUG 7 PLC J I IN ACCORDANCE WITH THE POLICY PROVISIONS. Community Dev Admin lllj Pal Box 2743 —� Palm Springs,CA 92262 Based on ACORD 25(2014101) CITY OF PALM SPRINGS EXHIBIT D Beneficiary Qualification Statement ProjecUActivity Title: Project Number: Desert AIDS Project/ 0002 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project - DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 BENEFICIARY QUALIFICATION STATEMENT This statement must be completed and signed by each person or head of household (legal guardian) receiving benefits form the described project/activity. 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-03106115) AREA MEDIAN NUMBER OF PERSONS IN YOUR HOUSEHOLD: INCOME(AMI) 1 2 3 4 5 6 7 6 LEVEL-$60,500 EXTREMELY LOW INCOME $13,100 $15,930 $20,090 $24,250 $28,410 $32,570 $36,730 $40,890 0 30°%of AMI LOW INCOME $21,750 $24,850 $27,950 $31,050 $33,550 $36,050 $38,550 $41,000 30-50%of AMI MODERATE INCOME $34.800 $39,800 $44,750 $49,700 $53,700 $57,700 $61,650 $65,650 50-80%of AMI NON LOW&MOD INCOME $34,801 $39,801 $44,750 $49,701 $53,701 $57.701 $61,651 $65,651 >80% 3. What racelethnicity 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 ❑ NO 5. Do you have a disability? ❑ YES ❑ NO If YES,please describe: ACKNOWLEDGEMENT AND DISCLAIMER I 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 compliance. CITY OF PALM SPRINGS EXHIBIT E Semi-Annual Program Progress Report Proiect/Activity Title: Proiect Number: Desert AIDS Project/ 0002 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project- DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 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 Puerto Rican Cuban Other: ♦ Number of Disabled: ACCOMPLISHMENT NARRATIVE LEVERAGING RESOURCES NARRATIVE Signed Title Date CITY OF PALM SPRINGS EXHIBIT F Request for Reimbursement Proiect/Activity Title: Proiect Number: Desert AIDS Project/ 0002 Emergency Preparedness Generator Name/Address of Provider: Desert AIDS Project- DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 BENEFICIARY QUALIFICATION STATEMENT Ilf"9 II IF ( ) } J ° ( �� onsultant/Contract Services Architectural Services $51,294. ther— Construction/Rehabilitation $21,000 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: APPROVED BY: Name, Title, Date 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 G Employment Restrictions 1. Labor Standards The PROVIDER agrees to comply Wth the requirements of the Secretary of Labor in accordance with the Davis-Bacon Act as amended, the provisions of Contract Work Hours and Safety Standards Act, the Copeland "Anti-Kickback" Act (40 U.S.C. 276a-276a-5;40 USC 327 and 40 USC 276c)and all other applicable Federal,state and local laws and regulations pertaining to labor standards insofar as those acts apply to the performance of this contract. The PROVIDER shall agree to submit documentation provide by the CITY which demonstrates compliance with hour and wage requirements of this part. The PROVIDER agrees that, all general contractors or subcontractors engaged under contracts in excess of $2,000.00 for construction, renovation or repair work financed in whole or in part with assistance provided under this contract, shall comply with Federal requirements adopted by the CITY pertaining to such contracts and with the applicable requirements of the regulations of the Department of labor, under 29 CFR Parts 1, 3, 5 and 7 governing the payment of wages and ratio of apprentices and trainees to joumeyworkers; provided, that if wage rates higher than those required under the regulations are imposed by state and local law, nothing hereunder is intended to relieve the PROVIDER of its obligation, if any, to require payment of the higher wage. The PROVIDER shall cause or require to be inserted in full, in all such contracts subject to such regulations, provisions meeting the requirements of this paragraph. 2. "Section 3 Clause" a. Compliance Compliance with the provisions of Section 3, the regulations set forth in 24 CFR 135, and all applicable rules and orders issued hereunder prior to the execution of this contract, shall be a condition of the Federal financial assistance provided under this Contract and binding upon the CITY, the PROVIDER and any of the PROVIDER'S subrecipients and subcontractors. Failure to fulfill these requirements shall subject the CITY, the PROVIDER and any of the PROVIDER'S subrecipients and subcontractors, their successors and assigns, to those sanctions specified by the Agreement through which Federal assistance is provided. The PROVIDER certifies and agrees that no contractual or other disability exists which would prevent compliance with these requirements. The PROVIDER further agrees to comply with these "Section 3" requirements and to include the following language in all subcontracts executed under this Agreement: "The work to be performed under this contract is a project assisted under a program providing direct Federal financial assistance from HUD and is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.0 1701. Section 3 requires that to the greatest extent feasible opportunities for training and employment be given to low- and very low-income residents of the project area and contracts for work in connection with the project be awarded to business concerns that provide economic opportunities for low-and very low-income persons residing in the metropolitan area in which the project is located." y The PROVIDER further agrees to ensure that opportunities for training and employment arising in connection with a housing rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to low-and very low-income persons residing within the metropolitan area in which the CDBG- funded project is located;where feasible, priority should be given to low-and very low-income persons within the service area of the project or the neighborhood in which the project is located, and to low- and very low-income participants in other HUD programs; and award contracts for work undertaken in connection with a housing rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to business concerns that provide economic opportunities for low- and very low-income persons residing within the metropolitan area in which the CDBG-funded project is located; where feasible, priority should be given to business concerns which provide economic opportunities to low-and very low-income residents within the service area or the neighborhood in which the project is located,and to low-and very low-income participants in other HUD programs. The PROVIDER certifies and agrees that no contractual or other legal incapacity exists which would prevent compliance with these requirements. b. Notifications The PROVIDER agrees to send to each labor organization or representative of workers with which it has a collective bargaining agreement or other contract or understanding, if any, a notice advising said labor organization or worker's representative of its commitments under this Section 3 clause and shall post copies of the notice in conspicuous places available to employees and applicants for employment or training. SUBRECIPIENT AGREEMENT THIS AGREEMENT(herein "Agreement"), is made and entered into thisof 2014, by and between the CITY OF PALM SPRINGS, (herein "City), a municipal corporation a charter city, and the Desert AIDS Proiect, Inc. , (herein"Provider"). WHEREAS, the City has entered into various funding agreements with the United States Department of Housing and Urban Development ("HUD"), which agreements provide funds ("CDBG Funds") to the City under the Federal Housing and Community Development Act of 1974 (42 U.S.C. Section 5301 et seg.), as amended from time to time (the "Act"), and the regulations promulgated thereunder(24 C.F.R. Section 570 et seq. ("Regulations"); and WHEREAS, the Act provides that the City may grant the CDBG Funds to nonprofit organizations for certain purposes allowed under the Act; and WHEREAS, the Provider is a nonprofit organization which operates a program which is eligible for a grant of CDBG funds and the City desires to assist in the operation of the program by granting CDBG 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; NOW, THEREFORE,the parties hereto agree as follows: 1.0 SERVICES OF PROVIDER. 1.1 Scope of Service Services. Provider agrees to provide to City all of the services specked and detailed in its application for funding and Exhibit A, and to conduct all programs specified therein in a manner to reflect credit upon the City and Provider. Provider represents and warrants to City that it is able to provide, and will use funds granted by the City to provide the services represented in the Provider's application for funding. City provided funds shall be used only for those purposes specified in such application. 1.2 Compliance with Law. Al 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 2.2, 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. 1.4 Financial Financial Repo cortinn . Any Provider receiving or due to receive or due to receiver $20,000.00 or more from the City during the 2014 — 2015 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 which 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 s`of the current fiscal year. : IG1:%LAL �JIV Aptw/0R AGRE:EM�f+ 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 NINETY THOUSAND DOLLARS ($90,000.00) (the "Contract Sum") in accordance with the Budget attached hereto in Exhibit B and incorporated herein by this reference; and as herein provided. The budget cost categories set out in Exhibit B 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 monthly statements on reimbursable expenditures pursuant to the attached Budget along with pertinent supporting 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 by Provider to request reimbursement or encumbrance of at least 25% of the total grant by the end of each fiscal year quarter (September 30, December 30. March 31, and June 30)shall result in the immediate forfeiture of 25%of the total grant. 3.0 COORDINATION OF WORK. 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 in connection therewith: Brande Orr, Director of Grants 3.2 Contract Officer. The Contract Officer shall be such person as may be designated by the chief administrative officer 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 express written approval of the City. Neither this Agreement nor any interest herein may be assigned or transferred,voluntarily or by operation of law,without the prior written approval of the City. 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 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 dose of the program. - 2 - 4.2 The Provider certifies it shall adhere to and comply with the following as they may be applicable: (a) Submit to City through its Community and Economic Development Department semi-annual reports on program status; (b) Section 109 of the Housing and Community Development Act of 1974, as amended and the regulations issued pursuant thereto; (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); Q) 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); (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); (o) The regulations, policies, guidelines and requirements of 24 CFR 570; the "Common Rule", 24 CFR Part 85 and subpart J; OMB Circular Nos. A-102, Revised, A-87, A-110 and A-122 as they relate to the acceptance and use of federal funds under the federally- assisted program; - 3 - (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) Maintain property inventory system to numerically identify HUD purchased property and document its acquisition date as is set forth in OMB Circular A-110 Attachment N Property Management Standard 6d; and (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 farm 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 (s)(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 (s) of this section.) (u) Such other City, County, State, or Federal laws, rules, and regulations, executive orders or similar requirements which might be applicable. 4.3 The City shall have the right to periodically monitor the program operations of the Provider under this Agreement. 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 as an additional insured shall be delivered to and approved by the City 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 officers, or employees. The amount of insurance required hereunder shall be as required by the Contract Officer not exceeding One Million Dollars($1,000,000). - 4- 5.2 Indemnification. The Provider shall defend, indemnify and hold harmless the City, its officers and employees, 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 DISCRIMINATION, TERMINATION,AND ENFORCEMENT. 6.1 Covenant Against Discrimination. Provider covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them that there shall be no discrimination against or segregation of any person or group of persons on account of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, pregnancy, marital status, age, sex, sexual orientation, or any other basis Protected Characteristic by applicable federal, state or local law in the performance of this Agreement. Provider shall take affirmative action to insure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, marital status, physical or mental disability, national origin, ancestry or any other basis Protected Characteristic by applicable federal, state or local law. 6.2 Term. Unless earlier terminated in accordance with Section 6.3 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. 6.3 Termination Prior to Expiration of Term. Either party may terminate this Agreement at any time, with or without cause, upon thirty (30) days' written notice to the other party. 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. 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. 7.0 MISCELLANEOUS PROVISIONS. 7.1 Notice. Any notice, demand, request, document, consent, approval, or communication either party desires or is required to give to the other party shall be in writing and either served personally or sent by prepaid, first-class mail to the address set forth below, or such other addresses as may from time to time be designated by mail. 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: Desert AIDS Project- DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 - 5- 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] - 6 - CITY OF PALM SPRINGS ATTEST: a municipal corporation Bye B Sty Clerk City Manager APPROV �f�TO F By: OR M: ,�,/�1� ry� �( � � /� PPROVcD BY CITY COUNCIL Ci4y tt rney ' - Y"V ' -' A- � kN—,\ 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 cretary, Treasurer, Assistant Treasurer, or Chief Financial Officer). By: By: cc otarized Signat0e of Chairman of Board, Notari d Sig ure Secretary,Asst Secretary, President or any Vice President Treasurer, sst easurer or Chief Financial Officer Name:',Ear b f-cl. XeII�ef Name: MCirU A yle Title: Board C }'1Gt r Title: e I=Z State of Cal rfor It l 4 = State of Clay J 0t 1"w- County/of (ZAr'el51d' =as CountyyOf- tl�=_ss A On -LCCA. 2-.o , .Zof� I� before me, SE) 31144 I �,., 1 before me, Ine,., Saa mtr HA!j 'AL rsonaIIy appeared E-SI FCJ lC�a-zlally appeared !✓CW�InI'G. j�t�L✓ who proved to arlL who proved to me on the basis of satisfactory evidence to be the personl< me on the Ws of satisfactory evidence to be the person(s) whose name(s)is/ar€subscribed to the within instrument and whose name(s)is/are subscribed to the within instmment and acknowledged to me that pe}she/Spey executed the same in acknowledged to me that he/she/they executed the same in his/her/tIbeir authorized capadry(iipej;and that by bWher/tWlr his/her/their authorized capacity(ies), and that by his/her/their signature(s)-on the instrument the person(o, or the entity signature(s) on the instrument the person(s), or the entity upon behalf of which the personal acted, executed the upon behalf of which the person(s) acted, executed the instrument. instrument. I certify under PENALTY OF PERJURY under the laws of the I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and State of California that the foregoing paragraph is true and correct. correct. WITNESS my hand and official seal. WITNESS my hand an ci I se Notary Signature: /D!/ '��� Notary Sign Lure: Notary Seal: Notary Seal: fiHERI6AENZ SnE. >a9NETT Corn ComastiM/2074134 NtRety Public V a t a99407 - California NDtery PuEOC•CNRorme Meefside County RlwreiCe Couny El p,res an 29 2016 OWComm.Expires Aus 7 20101 DaleC/CDBG 14-150AP_SubrecipAgmnl.Jun 4 - 7 - CITY OF PALM SPRINGS EXHIBIT A Scope of Services ProjectlActivity Title: Project Number: Desert AIDS Project 1 0001 Energy-Efficiency Retrofitting Name/Address of Provider: Desert AIDS Project-DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 Objectives/Activities The intent of this program is to provide the most comprehensive direct client services and advocacy to help people living with HIV/AIDS manage their disease, including a state-of-the-art medical center to a nutritionally balanced food voucher program, to case management, legal services, education, prevention, anonymous testing, wellness, dental, transportation, housing assistance and home health services. This will be accomplished through the continuation of the facility renovations to facilitate client services and expand the ability to accommodate the rapidly increasing client base by making energy-efficient upgrades. These upgrades will phase the installation of heat radiated dual-pane windows and doors resulting in energy cost savings and preserving funds for direct client services. DAP service area covers Riverside and San Bernardino Counties, roughly the sized of the state of Massachusetts which this immense area is recognized as the fifth largest concentration of HIV/AIDS population in the United States, serving 2,229 clients Valley-wide and 1,166 Palm Springs'clients. The Provider shall be responsible for the completion of the following objectives/activities in a manner acceptable and satisfactory to the City and consistent with the standards required as a condition of providing these CDBG funds. Objective 1: Assist the City by timely providing any additional information requested. TARGET DATE ACTIVITY#1 On-Going 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 On-Going 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 On-Going Draft a promotional piece and submit to City for approval. Advertise in the Desert Sun's daily general circulation newspaper or its weekly Palm Springs geo-targeted newspaper. Submit final publication to City. Objective 4: Enroll and income qualify at least a total of one thousand one hundred and sixty-six (1,166) extremely low income to moderate-income Palm Springs residents with improved access to the facility. TARGET DATE ACTIVITY#1 On-Going Provide direct client services and advocacy to help Palm Springs residents living with HIV/AIDS manage their disease. Maintain records of names, addresses, demographics and service dates for all assistance. Objective 5: Maintain records for all CDBG activities related to this program. TARGET DATE ACTIVITY#1 On-Going 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 On-Going Submit Semi-Annual reports—referenced Exhibit E. Objective 6: Manage/monitor program activities. TARGET DATE ACTIVITY#1 On-Going 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 7: Make improvements of of heat radiated dual-pane windows and doors resulting in energy cost savings and preserving funds for direct client services. TARGET DATE ACTIVITY#1 On-Going Conduct program activities to improve availability/accessibility in accordance with an 'open competitive' procurement process as stipulated in the proposal and in consultation with the City. Objective 8: Provide an evaluation within fifteen (15) calendar days of the program completion or final reimbursement. TARGET DATE ACTIVITY#1 07/15/14 Provide an evaluation and final report on all programmatic and financial activities. 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 Budget Summary Proiect/Activity Title: Proiect Number: Desert AIDS Project/ 0001 Energy-Efficiency Retrofitting Name/Address of Provider: Desert AIDS Project-DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 COST CATEGORY CDBG OTHER TOTAL SHARE SOURCES COST 1 Personnel -0- $2,472. $2,472. 2 Consultant/Contract Services $27,000. $5,000. $32,000. Architectural Services 3 Travel -0 - -0- -0 - 4 Space Rental -0 - -0 - -0- 5 Consumable Supplies .0 - -0 - -0 - 6 Rental, Lease or Purchase of -0 - -0 - -0- Equipment 7 Insurance -0 - .0 - -0- 8 Other— $63,000. $101,000. $164,000. Construction/Rehabilitation Legal Fees -0 - -0 - -0 - Indirect Project Costs -0 - $19,847. $19,84T TOTALS ,' 490,000. 1 $1�28 319. 1 $218;319, 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. Other funding sources include Riverside County and City of Palm Desert CDBG Award and private donations. Progress payments, approved by the Subrecient and based upon the percentage of completion of the work with a 10% retention, shall be paid by the 3019 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, 2014 through June 30, 2015 with funds allocated from 2014—15 Program Year. CITY OF PALM SPRINGS EXHIBIT C Insurance Inventory Proiect/Activity Title: Proiect Number: Desert AIDS Project/ 0001 Energy-Efficiency Retrofitting Name/Address of Provider: Desert AIDS Project-DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 INSURANCE INVENTORY LIABILITY INSURANCE POLICY Name of Provider's Insurance Company Markel American Insurance Co. Effective Dates of Policy 10/05/13 to 10/05/14 Claims Made Policy / / Per Occurrence Policy Limits of Liability $3,000,000 Deductibles: Per Occurrence Annual Aggregate Additional Insured Endorsement (Certificate Holder) 21 Yes ❑ No Original Certificate of Insurance Attached ❑ Yes IZ No WORKER'S COMPENSATION POLICY Name of Provider's Insurance Company Non Profits' United Workers' Compensation Group Effective Dates 01/01/14 to 01/01/15 Limits of Liability $1 M Per Occurrence Underlying Coverage Limits Original Certificate of Insurance Attached ❑ Yes a No DESEAID-03 SINSAI 'a�o�zo CERTIFICATE OF LIABILITY INSURANCE DATE(M 312 8/2 0 201YYT) 1 4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License#0564249 CONTACT Heffernan Insurance Brokers NAME:PHONE FAX 6 Hutton Centre Drive,Suite 500 ac No,E.t:1 (714 361-7706 ac,N) 1.(714)361.7701 Santa Ana,CA 92707 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC k INSURERA:Markel Insurance Company 38970 INSURED INSURER B:Nonprofits Insurance Alliance of California_ 011845 Desert AIDS Project INSURER C 1695 N Sunrise Way I INSURER D: Palm Springs,CA 92262 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADOL POLICY EFF : POLICY EXP -- - LTR POLICY NUMBER MMIDD/YYYY MMIDD LIMIT$ GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 � RSsA COMMERCIAL GENERA LIABILITY X 8502SS329818-4 1015/2013 10/512014 M Eamnw $ 1,000,00 CLAIMS-MADELX OCCUR I MED EXP(Any one person) $ 10,00 PERSONAL B ADV INJURY i$ 1,000,00 GENERAL AGGREGATE $ 3,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AG_G_ $ 3,000,00 POUCv I PRO- F7 LOG PROFESSIONAL Lill $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 Ea e..dant $ _ _ _ A X ANY AUTO 1002SS329819.4 10/5/2013 1015/2014 BODILY INJURY(Par person) $ ALL OS SCHEDULED BODILY INJURY Per amdent $ AUTOS AUTOS ( ) X HIRED AUTOS X NON-OWNED I PROPERTY DAMAGE $ AUTOS Peraccidenq Is X I UMBRELLALIAB X 'OCCUR EACH OCCURRENCE $ 2,000,00 A EXCESS LIAR .AGGREGATE $ 2,000,00 _ culMs-MADE 460255329821-0 1015/2013 1015/2014 OEO RETENTION$ $ WORKERS COMPENSATION WC STATU- OUR ANY YIN X "RYLIMITS ER_ — B ANY PROPRIETORIPARTNERIEXECUTIVE NPU-WCG 001-2012 1/1/2013 1I1/2014 E.L.EACH ACCIDENT j$ 1,000,00 OFFICER,MEMBER EXCLUDED' ❑ NIA —_ -- If se In NH) yes,describe under E.L.DISEASE EA EMPLOYE $ 1,000,00 Dyes,d DESCRIPTION OF OPERATIONS below E.L.DISEASE POLICYLIMIT $ 1,000,00 q Healthcare Profess, �8502SS329818d 10l5/2013 101512014 'Occurence 1,000,000 A Healthcare Professio 8502SS329818-4 10/512D13 10/5/2014 Aggregate 3,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS(VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Re:Energy-Efficiency Roofing Upgrades. The City of Palm Springs and its officials,employees and agents are Included as additional insureds with regard to liability and defense of all claims, lawsuits, liabilities or damages of whatsoever arising from the operations and uses performed by or on behalf of the named insured.Coverage povided is Primary and Non-Contributory.With respect to the interests of the City of Palm Springs this insurance shall not be cancelled,or materially reduced in follows:City of Palm Springs,Attn:Risk Manager,3200 E.Tahquitz Canyon Way,Palm Springs CA 92262. CERTIFICATE HOLDER CANCELLATION (_� �a SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Palm Springs F/� r -;% THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn:City Clerk �,/ ACCORDANCE WITH THE POLICY PROVISIONS. :~ P.O.Box2743 Sp Palm Springs,CA 92262 AUTHORIZED REPRESENTATIVE �� ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name a d logo are registered marks of ACORD C. When coverage for liability arising out of the "products-completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Per Location or Per Project General Aggregate Limit. D. For the purposes of this section of this endorsement, "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad- E. If the applicable covered construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. F. The provisions of Limits of Insurance (SECTION III) not otherwise modified by this endorsement shall continue to apply as stipulated. XI. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES WHO IS AN INSURED (SECTION II) is amended to include as an additional insured any person or organization who leases to you or manages property you rent or lease, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf in connection with that part of the premises leased or rented to you and shown on the Declarations. The following additional exclusions apply: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person or organization who leases to you or manages property you rent or lease. XII. ADDITIONAL INSUREDS - VENDORS (LIMITED) The following provision applies only if the policy to which this endorsement is attached provides insurance for "bodily injury" and "property damage" included in the "products-completed operations hazard": WHO IS AN INSURED (SECTION II) is amended to include as an additional insured any person or organization (referred to below as vendor) with whom you agree in a written contract or agreement to provide insurance, but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: 1. The insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspections, adjustments, tests or servic' as the vendor has agreed to make or normally undertakes to make in the usual course of s, in connection with the distribution or sale of the products; MGL232 (05/09) Copyright, Markel Insurance Company, 2009 �� Page 6 of 14 Includes copyrighted material of ISO, Inc. with its permis f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; h. Any failure to maintain the product in a merchantable condition; or L "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in subparagraphs d. or f.; or (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2. This insurance does not apply to any insured person or organization from whom you have acquired such products, or any ingredient, part or container entering into, accompanying or containing such products. XIII. ADDITIONAL INSURED - BY WRITTEN CONTRACT, AGREEMENT, PERMIT OR AUTHORIZATION The following paragraph is added to WHO IS AN INSURED (Section II): 4. Any person or organization for whom you are required by written contract, agreement, permit or authorization to provide insurance is an insured, subject to the following additional provisions: a. The contract, agreement, permit or authorization must be in effect during the policy period shown in the Declarations, and must have been executed prior to the "bodily injury", "property damage", or "personal and advertising injury". b. The person or organization is an insured only to the extent you are held liable due to: (1) The ownership, maintenance or use of that part of premises you own, rent, lease or occupy subject to the following additional provisions: (a) This insurance does not apply to any "occurrence" which takes place after you cease to be a tenant in any premises leased to or rented to you; (b) This insurance does not apply to any structural alterations, new construction or demolition operations performed by or on behalf of the person or organization; (2) Your ongoing operations for that insured, whether the work is performed by you or for you; (3) The maintenance, operation or use by you of equipment leased to you by such person or organization, subject to the following additional provisions: (a) The insurance does not apply to any "occurrence" which takes place after the equipment lease expires; (b) This insurance does not apply to "bodily injury" or "property damage" arising out of the sole negligence of such person or organization; (4) Permits or authorizations issued by any state or political subdivision with respect to operations performed by you or on your behalf, subject to the following additional provision: This insurance does not apply to "bodily injury", "property damage", or "personal and advertising injury" arising out of operations performed for that state or muni ality. �� Cr MGL232 (05/09) Includes copyright, Markel Insurance Companyr ghted material of ISO, Inc.with Page 7 of 14 its p 9 ission�C� lj c. The insurance with respect to any architect, engineer, or surveyor, added as an "Insured" by this coverage, does not apply to "bodily injury", "property damage", or "personal and advertising injury" arising out of the rendering or failure to render any professional services by or for you, including: (1) The preparing, approving or failure to prepare or approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; and (2) Supervisory, inspection or engineering services. d. This insurance does not apply to "bodily injury" or "property damage" included within the "products- completed operations hazard". A person's or organization's status as an insured under this endorsement ends when your operations for that insured are completed. No coverage will be provided if, in the absence of this endorsement, no liability will be imposed by law on you. Coverage will be limited to the extent of your negligence or fault according to the applicable principles of comparative fault. This Additional Insured provision does not apply to Managers or Lessors of Premises, Vendors, or Mortgagees, Assignees, or Receivers. For Managers or Lessors of Premises, refer to ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES. For Vendors, refer to ADDITIONAL INSURED - VENDORS. For Mortgagees, Assignees or Receivers, refer to ADDITIONAL INSURED - MORTGAGEE, ASSIGNEE, OR RECEIVER. XIV. ADDITIONAL INSURED - MORTGAGEE, ASSIGNEE, OR RECEIVER WHO IS AN INSURED (Section ll) is amended to include as an insured the person or organization with respect to their liability as mortgagee, assignee, or receiver and arising out of the ownership, maintenance, or use of premises by you. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. XV. EXTENDED "PROPERTY DAMAGE" - EXPECTED OR INTENDED INJURY Exclusion 2.a. of SECTION I - COVERAGES, COVERAGE A is deleted in its entirety and replaced by the following: a. "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. XVI. PROPERTY DAMAGE - BORROWED EQUIPMENT A. Paragraph (4) of Exclusion j. of SECTION I - COVERAGES, COVERAGE A does not apply to "property damage" to borrowed equipment while that equipment is: 1. Not being used to perform operations; and 2. Away from an insured's premises. B. The insurance afforded by this provision is excess over any valid and collectible property insurance (including any deductible) available to the insured whether primary, excess, contingent or on any other basis. C. SECTION III - LIMITS OF INSURANCE is amended to add the following: Subject to the General Aggregate provision, the most we will pa � is provision for "property damage" to borrowed equipment is $10,000 per "occurrence". MGL232 (05/09) Copyright, Markel Insurance Company, 200 Page 8 of 14 Includes copyrighted material of ISO, Inc. with its perm ion CERTIFICATE OF WORKERS' COMPENSATION COVERAGE Decal 2013 PRODUCER Nonprofits'United Workers'Compensation Group THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLY 610 Fulton Avenue,Suite 200 AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. Sacramento,CA 95825 Phone:(916)868-6231 THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE Fax:(916)880-5251 COVERAGE AFFORDED BY THE POLICIES BELOW. Arthur 1.Gallagher&Co Insurance Brokers of California,Inc 1255 Battery Street 9411I 4 San Francisco,CA INSURERS AFFORDING COVERAGE I INSURED wsURERA. NonProfits' United Workers' Compensation Group Desert AIDS Project INSURER B: Safety National Casualty Corp [NAIC a 151051 1695 N Sunrise Way Palm Springs, CA 92262 INSURERC' INSURER D: INSURER E: COVERAGES This Certificate is not intended to specify all endorsements, coverages, terms,conditions and exclusions of the policies shown. THE POLICIES OF COVERAGE LISTED BELOW HAVE BEEN ISSUED TO THE AFFILIATE MEMBER 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 COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY POLICY LTR TYPE OF COVERAGE POLICY NUMBER EFFECTIVE DATE EXPIRATION LIMITS DATE GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ CLAIMS MADE I MED EXPENSE(Any one Person) $ GENERAL AGGREGATE LIMIT APPLIES PER: PERSONAL&ADV INJURY $ POLICY I PROJECT LOC GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Each acdtlenp $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON OWNED AUTOS (Per awidentl $ PROPERTY DAMAGE IS (Per accident) $ WCITS STAT OTHER WORKERS'COMPENSATION IM X A AND NPU-WCG 001-2014 1/1/14 111115 EL EACH ACCIDENT $500.000 EMPLOYERS LIABILITY E.L.DISEASE-EA EMPLOYEE $500,000 E.L.DISEASE—COVERAGE LIMIT $500,000 OTHER B EXCESS Workers'Compensation SP 4050302 1/1/14 111115 $250,000,000 x$500,000 WC $2,000,000 x$500,000 EL DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAUPROVISIONS Evidence of Workers' Compensation Coverage: Re:CDBG Grant for FY 13-14; Waiver of Subrogation provided by Endorsement NPUWCG-DAID- 021 CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION NPUWCG-DAID-021 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED D. I rN �rr-, I,ij f�—I BEFORE THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED City of Palm Springs � )`, L_ IN ACCORDANCE WITH THE POLICY PROVISIONS. Community Dev Admin PG Box 2743 !�I I SEP 2 4 REC'0 Palm Springs,CA 92263 ATTN:Dale G. Conk Based on ACORD 25(2009/09) NoNPROF11'S U N I`I'ED THIS ENDORSEMENT CHANGES THE MEMORANDUM OF COVERAGE PLEASE READ IT CAREFULLY WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 1, I I SEP 2 4 RICO NonProfits' United Workers' Compensation Group Memorandum of Coverage: NPU-WCG 001-2014 This endorsement modifies the coverage provided under the following: Memorandum of Coverage: PART ONE: WORKERS' COMPENSATION COVERAGE Paragraph H. RECOVERY FROM OTHERS is amended with respect to the following: Name and Address of Person or Organization: City of Palm Springs PO Box 2743 Palm Springs, CA 92263 DESCRIPTION OF OPERATIONS/LOCATIONS ADDED BY ENDORSEMENT: - With regard to the City of Palm Springs, its employees and officers. NPU-WCG waives any right of recovery it may have against the person or organization shown above because of payments made by NPU-WCG for injury or damage arising out of the Members' operations done under a contract with that person or organization shown above and included in the coverage provided by the Memorandum of Coverage. This waiver applies only to the person or organization shown on the Schedule Above. This endorsement is part of the Memorandum of Coverage and is effective on the date shown below. All other terms and conditions remain unchanged. Effective Date: January 1. 2014 Expiration Date: January 1 2015 Member: Desert AIDS Project Endorsement No: NPUWCG-DAID- 21 Date Issued: Dec 31 2013 Authorized Representative for NPU-WCG NPU-WCG Page 1 MOC:NPO-WCG 001-2014 CITY OF PALM SPRINGS EXHIBIT D Beneficiary Qualification Statement Proiect/ActivitV Title: Proiect Number Desert AIDS Project/ 0001 Energy-Efficiency Retrofitting Name/Address of Provider: Desert AIDS Project-DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 BENEFICIARY QUALIFICATION STATEMENT This statement must be completed and signed by each person or head of household (legal guardian)receiving benefits form the described projectiactivity. 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—12118113) AREA MEDIAN NUMBER OF PERSONS IN YOUR HOUSEHOLD: INCOME(AMI) 1 2 3 4 5 6 7 8 LEVEL-$60,700 EXTREMELY LO INCOME $12.750 $15,730 $19,790 $23,850 $27,910 $31,970 $36,030 $40,090 0-30%of AMI VERY LOW INCOME $21,250 $24,300 $27.350 $30,350 $32,800 $35,250 $37,650 $40,100 3f-50%of AMI LOW INCOME $34,000 $38,850 $43.700 $48,550 $52,450 $56,350 $60.250 $64,100 51-80%of AMI MODERATE INCOME $50,990 $58,270 $65,560 $72,840 $78,670 $84,500 $90.320 $96,150 81-120% 3. What racelethnicity 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 ❑ NO 5. Do you have a disability? ❑ YES ❑ NO If YES,please describe: ACKNOWLEDGEMENT AND DISCLAIMER I 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 compliance. CITY OF PALM SPRINGS EXHIBIT E Semi-Annual Program Progress Report Proiect/Activity Title: Protect Number: Desert AIDS Project/ 0001 Energy-Efficiency Retrofitting Name/Address of Provider: Desert AIDS Project- DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 PROGRAM PROGRESS REPORT Period: DIRECT BENEFIT REPORT ♦ Number of First-Time Program Beneficiaries Serviced: #of Households #of Persons 0-30% below: 31-50%below: 51-80%below: 81-120% below: • 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 Puerto Rican Cuban Other: • Number of Disabled: ACCOMPLISHMENT NARRATIVE LEVERAGING RESOURCES NARRATIVE Signed Title Date CITY OF PALM SPRINGS EXHIBIT F Request for Reimbursement ProiectlActivity Title: Project Number: Desert AIDS Project/ 0001 Energy-Efficiency Retrofitting Name/Address of Provider: Desert AIDS Project-DAP PO Box 2890, 1695 N Sunrise Way Palm Springs, CA 92263-2890 BENEFICIARY QUALIFICATION STATEMENT nsultanUContrect Services Architectural Services $27,000. ther— Construction/Rehabilitation $63,000 $90,000 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: APPROVED BY: Name, Title, Date 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 G Employment Restrictions 1. Labor Standards The PROVIDER agrees to comply with the requirements of the Secretary of Labor in accordance with the Davis-Bacon Act as amended, the provisions of Contract Work Hours and Safety Standards Act, the Copeland "Anti-Kickback" Act (40 U.S.C. 276a-276a-5: 40 USC 327 and 40 USC 276c)and all other applicable Federal,state and local laws and regulations pertaining to labor standards insofar as those acts apply to the performance of this contract. The PROVIDER shall agree to submit documentation provide by the CITY which demonstrates compliance with hour and wage requirements of this part. The PROVIDER agrees that, all general contractors or subcontractors engaged under contracts in excess of$2,000.00 for construction, renovation or repair work financed in whole or in part with assistance provided under this contract, shall comply with Federal requirements adopted by the CITY pertaining to such contracts and with the applicable requirements of the regulations of the Department of labor, under 29 CFR Parts 1, 3, 5 and 7 governing the payment of wages and ratio of apprentices and trainees to joumeyworkers; provided,that if wage rates higher than those required under the regulations are imposed by state and local law, nothing hereunder is intended to relieve the PROVIDER of its obligation, if any, to require payment of the higher wage. The PROVIDER shall cause or require to be inserted in full,in all such contracts subject to such regulations,provisions meeting the requirements of this paragraph. 2. "Section 3 Clause' a. Compliance Compliance with the provisions of Section 3,the regulations set forth in 24 CFR 135,and all applicable rules and orders issued hereunder prior to the execution of this contract, shall be a condition of the Federal financial assistance provided under this Contract and binding upon the CITY, the PROVIDER and any of the PROVIDER'S subrecipients and subcontractors. Failure to fulfill these requirements shall subject the CITY, the PROVIDER and any of the PROVIDER'S subrecipients and subcontractors, their successors and assigns, to those sanctions specified by the Agreement through which Federal assistance is provided. The PROVIDER certifies and agrees that no contractual or other disability exists which would prevent compliance with these requirements. The PROVIDER further agrees to comply with these "Section 3" requirements and to include the following language in all subcontracts executed under this Agreement: "The work to be performed under this contract is a project assisted under a program providing direct Federal financial assistance from HUD and is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.0 1701. Section 3 requires that to the greatest extent feasible opportunities for training and employment be given to low- and very low-income residents of the project area and contracts for work in connection with the project be awarded to business concems that provide economic opportunities for low-and very low-income persons residing in the metropolitan area in which the project is located." The PROVIDER further agrees to ensure that opportunities for training and employment arising in connection with a housing rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to low-and very low-income persons residing within the metropolitan area in which the CDBG- funded project is located;where feasible, priority should be given to low-and very low-income persons within the service area of the project or the neighborhood in which the project is located, and to low-and very low-income participants in other HUD programs; and award contracts for work undertaken in connection with a housing rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to business concems that provide economic opportunities for low-and very low-income persons residing within the metropolitan area in which the CDBG-funded project is located; where feasible, priority should be given to business concems which provide economic opportunities to low-and very low-income residents within the service area or the neighborhood in which the project is located,and to low-and very low-income participants in other HUD programs. The PROVIDER certifies and agrees that no contractual or other legal incapacity exists which would prevent compliance with these requirements. b. Notifications The PROVIDER agrees to send to each labor organization or representative of workers with which it has a collective bargaining agreement or other contract or understanding, if any, a notice advising said labor organization or workers representative of its commitments under this Section 3 clause and shall post copies of the notice in conspicuous places available to employees and applicants for employment or training.