HomeMy WebLinkAbout05815 - DESERT AIDS PROJECT INC CDBG SUBRECIPIENT AGR SUBRECIPIENT AGREEMENT THIS AGREEMENT(herein "Agreement"), is made and entered into this Alay of 06
2009, 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 semi. ("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-
10 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, 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. 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 2.2, 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 Reporting. Any Provider receiving or due to receive or due to
receiver$20,000.00 or more from the City during the 2009—2010 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.
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 EIGHTY-SEVEN THOUSAND AND NINETY-SIX DOLLARS
($87.096.00) (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.G.
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-
David Brinkman, Executive Director
Peter DeMartino, Public Policy Coordinator
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
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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,
(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,
(1) The restrictions prohibiting use of funds for the benefit of a religious
organization or activity as set forth in 24 CFR 570.200 Q);
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
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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;
(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 ets�Mc.):
(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 (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
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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 Five Hundred Thousand Dollars
($500,000).
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 A ainst 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 parry desires or is required to give to the other parry 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
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3200 East Tahquitz Canyon Way
Palm Springs, CA 92262-6959
Attn: City Attorney
TO PROVIDER.
Desert AIDS Pro ect- DAP
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]
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y CITY OF PALM SPRINGS
ATT a municipal corporation
By: B
ity Clerk /0120 06ri-2 City Manager
APPR'b FD AS TO FOR"
/ APPROVED 81 CITY COUNCIL
By: ��o
City Att may
PRGULDER: 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,
Assists tSecretary, Treasurer, Assistant urer, or Chief Financial Officer .
By: �,w
Notarized Signature of Chair n of Boa 'V2rized Signature'Secret y,Asst Secretary,
j President or`any Vice President reasurer, Asst Treasurer or Chief Financial Officer
Name: l;_�i ks IV. RIVYIAes� S �1% Name: �j -t8 b(ewe�
Title: 6"�l Lcct �.c r�PS Title:
State of Ca i h I rx State of
County�hof t ? i'7 _-ss County of ;�J as
On /Ill ' " ;'7i !�.�I� ///����j before me, On_QG�_ ��j�7� �] Ir before me,
rU,�✓i rjC.P�g//2r N0 1 personally appeared r7�it Ef7 51.r.¢�rro7_ /�Jhsy�Hh�il.personally appeared
4�CtJ"�5 A/, A�—aYiei/1e55 Jr, who proved to Tly VJrLW-09lf who proved to
me on the basis of satisfEfctory evidence to be the personW me on the basis of satisfactory evidence to be the person(gp
whose name,(&) is/afe-subscribed to the within instrument and whose name($)is/are subscribed to the within instrument and
acknowledged to me that he/,ghaltte�rexeeuted the same in acknowledged to me that he/sftelthey executed the same in
his/horitgpa authorized capacity(iW, and that by his/her/their hlslhe(ithor authorized capaeity(i /, and that by hisiheFRhor
signature(s),-on the instrument the person(s1; or the entity signature(p] on the instrument the person(g, or the entity
upon behalf of which the personal acted, executed the upon behalf of which the person�J 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:�iC'
Notary Seal Notary Seal
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NOlary R0o'CdfGnlO i nC aCdI�C11YC
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CITY OF PALM SPRINGS
EXHIBIT A
Scope of Services
Project/Activity 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
O b'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 Depot, 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 replace outdated inefficient small package rooftop air conditioning units
with more economical rooftop air handlers, which will result in energy cost savings. This includes
measures promoting effective maintenance to increase the life and effectiveness of the system by 30%.
DAP covers a 11,250 square mile radius of Palm Springs 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 1,304 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 anV additional information re guested.
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 rocess.
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
.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.
Submit final publication to City.
Objective 4: Enroll and income qualify at least a total of one thousand three hundred and four (1,304)
very 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 MUD 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 mechanical system such as replacement of roof-top air handler
packages and appurtenant work which will result in energy cost savings.
TARGET
DATE ACTIVITY 01
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*I
07/15/07 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 (Le , clerical, monitoring, etc.)
CITY OF PALM SPRINGS
EXHIBIT B
Budget Summary
Project/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
BUDGETSUMMARY
COST CATEGORY CDBG OTHER TOTAL
SHARE SOURCES COST
1 Personnel - 0 - - 0 - - 0 -
2 Consultant/Contract Services - 0 - - 0 - - 0 -
3 Travel - 0 - - 0 - 0 -
4 Space Rental - 0 - - 0 - - 0 -
5 Consumable Supplies - 0 - - 0 - - 0 -
6 Rental, Lease or Purchase of $54,696, $89,500. $144,096,
Equipment
7 Insurance - 0 - - 0 - - 0 -
8 Other $32,500. $1,600, $34,100.
Design & Permit Fees
$87,096. $91,100. $178,196.
TOTALS
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 CDBG Award 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 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 in accordance with the aforementioned cost
categories and line items.
Services are to be performed over a twelve month period of July 1, 2009 through June 30, 2010
with funds allocated from 2009— 10 Program Year.
CITY OF PALM SPRINGS
EXHIBIT C
Insurance Inventory
Project/Activity 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
INSURANCE INVENTORY
LIABILITY INSURANCE POLICY
Name of Provider's Insurance Company Markel Insurance Co.
Effective Dates of Policy 10/05/09 to 10/05/10
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 State Fund
Effective Dates 02/09/09 to 02/09/10
Limits of Liability 1M Per Occurrence
Underlying Coverage Limits
Original Certificate of Insurance Attached 0 Yes 2 No
AcoRO. CERTIFICATE OF LIABILITY INSURANCE OPnsssID RZRlo DATE(MM/GO/1D/o7/09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
(LA) Heffernan insurance Erkrs HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
811 Wilshire Blvd,, Suite 1801 ALTER THE COVERAGE AFFORDED EYTHE POLICIES BELOW.
Los Angeles CA 90017
PJ2one:213-622-6500 Fax:213-623-1388 INSURERS AFFORDING COVERAGE NATO H
INSUR@D INSURER STATE CONPGHSATIGN INS, FUND
INSURER B MARXIEL XNSURANCE CO. --
De5ertA2890Project Inc. INSURER
D Box
Palm Springs CA 92263 INSURER _ _ —
INSURER E
COVERAGES
THE POLICIES OF,INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TI IE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING _
ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRAC f 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 AGGREGATE LIM11 S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR DD' -- FDDCY EFFECTIVE PDLI'CYE%PIRATIGN
LTR INSR TYPEOF INSURANCE POLICY NUMBER DATE MMIDO/YV DATE MMIDDIYY LIMBS
GENERAL LIABILITY EACH OCCURRENCE S 1000000
$ X X COMMF,RCIALGENERALLIABILITY 8502SS329818-0 10/05/09 10/05/10 �P
REMISES OEaEccwence s 1000000
CLAIMS MADE ®OCCUR IMED EXP(Any one person) 510000
8 X Professional Liab 8502SS329818-0 10/05/09 10/05/10 PERSONAL aaOvwduav B 1000000
GENERAL AGGREGATE I33000000
GEN LAGGREGATE LIMIT APPLIES PER PRODUCTS COMP)OPAGG S3000000
X POLICY PRO. -------
JECT LOD _ �•�
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1000000
E $ ANYAUTO 1002SS329819-0 10/05/09 10/05/10 (EEsecidenl)
ALL OWNED AUTOS
BODILY INJURY
E SCHEDULED AUTOS (Paf pnrcon)
X HIREDAUTOS BODILY INJURY '
X_ NON-OWNED AUTOS IF.,ecmdanp S —
__ Comp & collision
PPERTYDAMAGE 5
Deductible $500 � (rrrROecmdrnq
GARAGE LIABILITY AU700NLY-EA ACCIDENT S
ANYAUTO EA ACC IS
-
OTHERTHAN
AUTO ONLY gGG S
EXCESS/uMBR ELLA LIABILITY EACH OCCURRENCE 5100000
E X OCCUR CLAIMS MADE 4602SS329821-0 10/05/09 10/05/10 AGGREGATE s
S
DEDUCTIBLE
FRETENTION S 10000 5
'COMPENSATION AND X TORY LIMITS ER
RS'LIABILITY
1932087-09 O2/09/09 ' 02/09/10 _ELEACH ACCIDENT x1000000
RIETOR)PARTNER/F•XECUTIVE ..___.
MEMBER EXCLUDEDi EL DISEASE-F•AEMPLQYEE 51000000
nCD unda --
ROVISIONS below E 1• DISEASE-POLICY LIMIT 1 5 1000000
Coverage 8502SS329818-0 10/05/09 10/05/10 Emp Dis• 500000
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE:Energy—Efficiency Retrofitting (09/10) .
City of Palm Springs is named as additional insured LS lD] LI
*10 pays Notice of CancQ11at:Lon far Non Payment of PrGmlDm-
OCT 13 2 09
CERTIFICATE HOLDER CANCELLATION
PALMSI5 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELL
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN
City of Palm Springs NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 0050 SHALL
Attn: Dale E COOIL Community Dev Adm. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
P.Q. Sox 2743 REPRESENTATIVEFFFS$$$•EE
Palm Springs, CA 92263-2743 AUTHOR xTATIVE
ACORD 25(2001108) //JY— ®ACORD CORPORATION 1988
ATTACHED TO AND FORMING PART OF COMMERCIAL GENERAL.LIABILITY
POLICY NUMBER:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL GENERAL LIABILITY PLUS EXTENSION
Various provisions in this endorsement modify coverage. Read the entire policy carefully to determine rights, duties
and what is and is not covered.
Throughout this endorsement the words "you" and "your" refer to the Named Insured shown in the declarations. The —
words "we," "us"and"our" refer to the company providing this insurance.
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
Unless specifically stated in this endorsement, all other terms, conditions and exclusions of the policy remain
unchanged.
The following is a summary of the limits, additional coverages and extensions provided by this endorsement. For
complete details on specific coverages, consult the policy contract wording. As respects any coverage provided by this
endorsement, if higher limits are provided on any other schedule, declarations, or endorsement attached to this policy,
then the limits and coverage provided by this endorsement would not apply for that coverage.
SCHEDULE
Medical Payments Increased to$10,000 per person (unless excluded)
Supplementary Payments
Bail Bonds Up to$5000
Loss of Earnings Up to$500 a day
Damage to Premises Rented to You Up to the General Liability Each Occurrence Limit
Non-Owned Watercraft Increased to 51 feet long
Non-Owned Aircraft If rented or loaned with a paid crew
Property Damage from Elevator Use Included
Broadened Definition of Insured Included
Mental Anguish Resulting from Bodily Injury Included
Advertising Injury from Televised or Videotaped Material Included
Broadened Definition of Mobile Equipment Included
Per Location and Per Project Aggregates Included n IrI l St
Additional Insured-Managers or Lessors of Premises Included u y
Additional Insured-Vendors (Limited) Included P
Additional Insured-By Written Contract,Agreement OCT 13 Z009 E
or Permit Included _
Additional Insured-Mortgagee,Assignee, or Receiver Included
Extended "Property Damage" - Expected or Intended ey____
Injury Included
Property Damage to Borrowed Equipment Up to$10,000 per"occurrence"
Property Damage to"Customers'Goods" Up to$10,000 per"occurrence"
Medical Personnel Coverage Up to$100,000 per"occurrence" if no other coverage farm
applies
Limited"Product Withdrawal"Expense Coverage $10,000 per"Product Withdrawal"
Waiver of Transfer of Rights of Recovery Included
Duties in the Event of"Occurrence", Claim or"Suit" Included
Unintentional Failure to Disclose Hazards Included
Liberalization Included
MGL232(04/07) Pago 1 of 14
I. Medical Payments
The following applies only if Medical Payments Coverage is not excluded from the policy to which this endorsement
is attached:
SECTION III- LIMITS OF INSURANCE,paragraph 7„ is deleted in its entirety and replaced by the following:
7. Subject to paragraph 5., Section III -Limits of Insurance,the Medical Expense Limit is equal to the Medical
Expense Limit stated in the Declarations subject to a minimum of$10,000 and is the most we will pay under
Coverage C for all medical expenses because of"bodily injury"sustained by any one person.
II. SUPPLEMENTARY PAYMENTS-BAIL BONDS AND LOSS OF EARNINGS
SUPPLEMENTARY PAYMENTS - COVERAGES A AND B, paragraphs 1.b. and 1.d. are deleted in their entirety
and replaced by the following:
SECTION III-LIMITS OF INSURANCE, paragraph 7.is deleted in its entirety and replaced by the following:
b. Up to$5000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of
any vehicle to which Bodily Injury Liability Coverage applies. We do not have to furnish these bonds;
d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the
claim or"suit", including actual loss of earnings up to$500 a day because of time off from work;
III. DAMAGE TO PREMISES RENTED TO YOU
A. When Damage To Premises Rented To You Limit is shown in the Declarations, Exclusion j. of Coverage A,
Section I is replaced by the following:
j. Damage To Property
"Property damage"to:
(1) Property you own, rent, or occupy, including any casts or expenses incurred by you, or any other
person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of
such property for any reason, including prevention of injury to a person or damage to another's
property;
(2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those
premises;
(3) Property loaned to you;
(4) Personal property in the care, custody or control of the insured;
(5) That particular part of real property on which you or any contractors or subcontractors working directly
or indirectly on your behalf are performing operations, if the "property damage" arises out of those
operations; or
(y) That particular part of any property that must be restored, repaired or replaced because "your work"
was incorrectly performed on it.
Paragraphs(1). (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire)
to premises, including the contents of such premises, rented to you. A separate limit of insurance applies
to Damage To Premises Rented To You as described in Section III -Limits of Insurance.
Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied,
rented or held for rental by you.
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MGL232(04/07) Ey
Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack
agreement.
Paragraph (6) of this exclusion does not apply to "property damage" included in the "products-completed
operations hazard".
B. SECTION I - COVERAGE A.2. Exclusions is amended to delete the last paragraph and is replaced by the
following: —
Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or sprinkler leakage
damage to premises while rented to you or temporarily occupied by you with permission of the owner. A _
separate limit of insurance applies to this coverage as described in Section III- Limits of Insurance.
C. SECTION III- LIMITS OF INSURANCE, Paragraph 6. is replaced by the following:
6. Subject to 5. above,the Damage To Premises Rented To You Limit is the most we will pay under Coverage --
A for damages because of "property damage" to any one premises while rented to you, or, in case of
damage by fire, lightning, explosion, smoke, or sprinkler leakage while rented to you or temporarily
occupied by you with permission of the owner.
The Damage To Premises Rented To You limit is the Each Occurrence Limit shown in the General Liability
Declarations.
D. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4.b.(1)(b) is deleted and
replaced by the fallowing:
(b)That is fire, lightning, explosion, smoke or sprinkler leakage insurance for premises rented to you or
temporarily occupied by you with permission of the owner; or
E. SECTION V-DEFINITIONS, paragraph 9.a. is deleted and replaced by the following:
a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that
indemnifies any person or organization for damage by fire, lightning, explosion, smoke or sprinkler leakage
to premises while rented to you or temporarily occupied by you with permission of the owner is not an
"Insured contract";
IV. NON-OWNED WATERCRAFT AND NON-OWNED AIRCRAFT RENTED OR LOANED TO YOU WITH A CREW
SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Exclusion
g. -Aircraft, Auto or Watercraft, paragraph (2), is deleted in its entirety and replaced with the following:
(2) A watercraft you do not own that is:
(a) Less than 51 feet long; and
(b) Not being used to carry persons or property for a charge.
The following is added to g.
(6) An aircraft not owned by any insured that is rented or loaned to you with a paid crew.
If other insurance applies to a lass because of"property damage"to non-owned watercraft or aircraft as described
in (2)(a) and (b) or (6) above, the insurance provided by this Coverage Form does not apply whether the other
insurance is primary, excess, contingent, or issued on any other basis.
V. PROPERTY DAMAGE COVERAGE ARISING OUT OF ELEVATOR USE
SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Exclusion
j.is amended to include the following: r --�
OC I' 2 3 2009
MGL232(04/07) ByPa f 14
Paragraphs(3), (4) and(6) shall not apply to liability arising out of the use of elevators.
If other valid and collectible insurance applies to a loss because of "property damage" arising out of the use of
elevators,this Coverage Form shall apply excess of the other insurance, whether this other insurance is primary,
excess, contingent, or issued on any other basis.
VI. WHO IS AN INSURED
SECTION II-WHO IS AN INSURED, is amended by the following:A. Paragraph 2.is amended to include the following as insureds: —
e. Any legally incorporated entity of which you own at least 51% of the voting stock on the inception date of
this Coverage Form and on the date of any covered "occurrence",claim or"suit".
This insurance shall not apply to any entity that is already an insured under any other insurance provided by
any company or that would be an insured but for the exhaustion of its limits of insurance.
B. Newly Acquired or Formed Organizations
Paragraph 3.a.is deleted in its entirety and replaced with-
' a. Coverage for your newly acquired or formed organization shall be:
1. Effective on the date of acquisition or affirmation;and
2. Afforded until the end of the policy period of this Coverage Form.
C. The following is added to Paragraph 2.a.:
Paragraph (1) does not apply to executive officers, or to managers at the supervisory level or above.
VII. MENTAL ANGUISH COVERAGE THAT RESULTS FROM BODILY INJURY
SECTION V-DEFINITIONS, Item 3., Bodily Injury, is deleted in its entirety and replaced with the following:
3. "Bodily injury"means:
a. Bodily injury, sickness or disease sustained by a person, and also includes mental anguish or emotional
distress provided such mental anguish or emotional distress results from any of these;and
b. Death resulting from bodily injury,sickness or disease.
VIII. ADVERTISING INJURY
A. SECTION V-DEFINITIONS, Item 14, Personal and Advertising Injury, paragraphs d. and e.are deleted in their
entirety and replaced with the following:
d. Oral, written or professionally produced televised or videotaped publication of material in any manner that
slanders or libels a person or organization, or disparages a person's or organization's goods, products or
services;
e. Oral, written or professionally produced televised or videotaped publication of material in any manner that
violates a person's right to privacy;
B. SECTION I - COVERAGES, COVERAGE B. PERSONAL INJURY AND ADVERTISING INJURY LIABILITY,
Exclusions b.and c.are deleted in their entirety and replaced with the following:
b. "Personal and advertising injury" arising out of oral, written or professionally produced televised or
videotaped publication of material in any manner, if done by you or at your direction with n� �a
falsity; �J
OCT 13 2009
MGL232(04/07) g Page 4 of 14
c. "Personal and advertising injury" arising out of oral, written or professionally produced televised or
videotaped publication of material whose first publication took place before the beginning of the policy
period.
IX. MOBILE EQUIPMENT
SECTION V-DEFINITIONS, Item 12., Mobile Equipment,paragraph f.(1) is amended to add the following;
This shall not apply to self-propelled vehicles of less than 1000 pounds gross vehicle weight.
X PER LOCATION AND PER PROJECT AGGREGATES
SECTION III-LIMITS OF INSURANCE, is amended to add the following:
A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under
COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C
(SECTION 1),which can be attributed only to operations at a covered"location" or covered construction project:
1. A separate Per Location or Per Project General Aggregate Limit applies to each covered "location" or
covered construction project, and that limit is equal to the amount of the General Aggregate Limit shown in
the Declarations.
2. The Per Location or Per Project General Aggregate Limit is the most we will pay for the sum of all
damages under COVERAGE A, except damages because of"bodily injury" or "property damage" included
in the"products-completed operations hazard", and for medical expenses under COVERAGE C regardless
of the number of:
a. Insureds;
b, Claims made or"suits"brought; or
c. Persons or organizations making claims or bringing "suits".
3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses
shall reduce the Per Location or Per Project General Aggregate Limit for each covered "location" or
covered project for which payment is made. Such payments shall not reduce the General Aggregate Limit
shown in the Declarations nor shall they reduce any other covered "location" or covered project's general
aggregate.
4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to
apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such
limits will be subject to the applicable Per Location or Per Project General Aggregate Limit.
B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under
COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C
(SECTION 1),which cannot be attributed only to ongoing operations at a covered "location"or covered project:
1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses
shall reduce the amount available under the General Aggregate Limit or the Products-Completed
Operations Aggregate Limit,whichever is applicable;and
2. Such payments shall not reduce any Per Location or Per Project General Aggregate Limit.
OCT 13 2009
MGL232(04/07) Page 5 of 14
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 an 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 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;
'FOCTV13
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NIGL232 (04/07) Page 6 of 14
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
i. "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, adjustment's, 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 OR PERMIT
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 or permit to provide
insurance is an insured, subject to the following additional provisions:
a. The contract, agreement or permit 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 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 municipality.
FEhT 13 2DD9
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MGL232 (04107) Page 7 of 14
o. 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 II) 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.
S. 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 pay under this provision for "property damage" to
borrowed equipment is$10,000 per"occurrence". O R L � M
OCT 13 2009
MGL292(04107) By M7
XVII. PROPERTY DAMAGE- "CUSTOMERS'GOODS"
A. Paragraphs (3), (4), and (6) of Exclusion j. of SECTION I - COVERAGES, COVERAGE A does not apply to
"property damage"to"Customer's goods"while on your 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 pay under this provision for "property
damage"to customer's goods is 810,000 per"occurrence".
XVIII. MEDICAL PERSONNEL
The following applies only if no other similar coverage is included on or added to the policy to which this —
endorsement is attached:
The following is added to SECTION I - COVERAGES, COVERAGE A - Bodily Injury and Property
Damage Liability-Insuring Agreement:
A, We will pay those sums the insured becomes legally obligated to pay as a result of an "occurrence" arising out
of your employed registered nurse, licensed practical nurse, certified emergency medical technician or certified
paramedic performing professional health care services. This applies only to those professional health care
services arising out of duties related to the conduct of your business. The registered nurse, licensed practical
nurse, certified emergency medical technician or certified paramedic must be your"employee".
B. SECTION 11 - WHO IS AN INSURED is amended to include the above designated "employees" for acts within
the scope of their employment by you while performing duties related to the conduct of your business including
duties arising out of his or her providing or failure to provide professional health services.
C. SECTION III-LIMITS OF INSURANCE is amended to add the following-
Subject to the General Aggregate provision, the most we will pay under Medical Personnel coverage is
$100,000 for all professional health services sustained by any one person.
XIX. LIMITED PRODUCT WITHDRAWAL EXPENSE COVERAGE
THIS COVERAGE ONLY PROVIDES REIMBURSEMENT TO YOU FOR EXPENSES INCURRED BECAUSE OF A
COVERED "PRODUCT WITHDRAWAL". THIS COVERAGE DOES NOT PROVIDE ANY LIABILITY COVERAGE
OR COVERAGE FOR THE COST OR EXPENSE OF DEFENDING ANY CLAIM OR SUIT.
A. The following is added to Section I-Coverages:
SECTION I- LIMITED PRODUCT WITHDRAWAL EXPENSE COVERAGE
1. Insuring Agreement
(a) We will reimburse you for "product withdrawal expense" incurred by you because of a "product
withdrawal"to which this insurance applies.
The amount of such reimbursement is limited as described in Section III - Limits of Insurance. No
other obligation or liability to pay sums or perform acts or services is covered.
(b) This insurance applies to a "product withdrawal" only if the "product withdrawal" is initiated in the
"coverage territory" during the policy period because-
(1) You determine that the "product withdrawal" is necessary: or
(2) An authorized government entity has ordered you to conduct a"product withdrawal
rOCT
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MGL232 (04/07) �Byy, ygy�t
(c) We will reimburse"product withdrawal expenses" only it
(1) The expenses are incurred within one year of the date the"product withdrawal"was initiated;
(2) The expenses are reported to us within one year of the date the expenses were incurred; and
(3) The product that is the subject of the "product withdrawal" was produced after the inception date of
this policy or the date this endorsement was added,whichever is earlier. _
(d) The initiation of a "product withdrawal" will be deemed to have been made only at the earliest of the
following times:
(1) When you first announced, in any manner,to the general public, your vendors, or to your employees
(other than those directly involved in making the determination) your decision to conduct or
participate in a "product withdrawal". This applies regardless of whether the determination to
conduct a"product withdrawal"is made by you or is requested by a third party; or
(2) When you first received, either orally or in writing, notification of an order from an authorized
government entity to conduct a"product withdrawal'.
(e) "Product withdrawal expenses" incurred to withdraw "your products" which contain the same or
substantially similar"defects"will be deemed to have arisen out of the same "product withdrawal".
2. Exclusions
This insurance does not apply to"product withdrawal expenses"arising out of:
(a) Breach Of Warranty And Failure To Conform To Intended Purpose
Any "product withdrawal" initiated due to the failure of "your product" to accomplish their intended
purpose, including any breach of warranty of fitness, whether written or implied. This exclusion does not
apply if such failure is reasonably expected to cause "bodily injury" or physical damage to tangible
property other than "your product".
(b) Infringement Of Copyright,Patent,Trade Secret,Trade Dress Or Trademark
Any "product withdrawal" initiated due to copyright, patent, trade secret, trade dress or trademark
infringements.
(c) Deterioration, Decomposition Or Chemical Transformation
Any "product withdrawal" initiated due to transformation of a chemical nature, deterioration or
decomposition of"your product". This exclusion does not apply if it is caused by:
(1) An error in manufacturing, design or processing;
(2) Transportation of"your product":or
(3) "Product tampering".
(d) Goodwill, Market Share, Revenue, profit Or Redesign
The costs of goodwill, market share, revenue or"profit"or the costs of redesigning "your product".
(e) Expiration Of Shelf Life
Any"product withdrawal"initiated due to expiration of the designated shelf life of"your product".
[� � I
LCT 13 2009
MGL232 (04/07) Pagel 0 of 14
(f) Known Defect
A "product withdrawal" initiated because of a "defect" in "your product" known to exist by the Named
Insured or the Named Insured's "executive officers", prior to the date when this Coverage Part was first
issued to you or prior to the time"your product"leaves your control or possession.
(g) Otherwise Excluded Products
A recall of any specific products for which "bodily injury" or "property damage" is excluded under
Coverage A-Bodily Injury and Property Damage Liability by endorsement.
(h) Governmental Ban
A recall when "your product" or a component contained within"your product"has been:
(1) Banned from the market by an authorized government entity prior to the policy period;or
(2) Distributed or sold by you subsequent to any governmental ban.
(i) Defense Of Claim
The defense of a claim or"suit"against you for liability arising out of a"product withdrawal
(j) Third Party Damages, Fines And Penalties
Any compensatory damages, fines, penalties, punitive or exemplary or other non-compensatory
damages imposed upon the insured.
(k) Pollution-Related Expenses
Any loss, cost, or expense due to any;
(1) Request, demand, order, statutory or regulatory requirement that any insured or others test for,
monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess
the effects of, "pollutants"; or
(2) Claim or suit by or on behalf of a governmental authority for damages because of testing for,
monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way
responding to or assessing the effects of, "pollutants".
B. For purposes of this endorsement, Section III-LIMITS OF INSURANCE is replaced by the following:
SECTION III-LIMITS OF INSURANCE
The most that we will reimburse you for under this coverage is$10,000 regardless of the number of:
(a) Insureds;
(b) "Product withdrawals" initiated; or
(c) Number of"your products"withdrawn.
The $10,000 limit is the most that we will reimburse you for the sum of all "product withdrawal expenses"
incurred for all "product withdrawals" initiated during the policy period.
OCT 3 20G9
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MGL232 (04/07) Page 11 of 14
C. For the purposes of this coverage, the Duties In The Event Of Occurrence, Claim Or Suit Condition under
Section IV-Conditions is replaced by the following:
2. Duties In The Event Of A "Defect" Or A "Product Withdrawal"
a. You must see to it that we are notified as soon as practicable of any actual, suspected or threatened
"defect" in "your product", or any governmental investigation, that may result in a "product withdrawal".
To the extent possible, notice should include: --
(1) How,when and where the"defect"was discovered,-
(2) The names and addresses of any injured persons and witnesses; and
(3) The nature, location and circumstances of any injury or damage arising out of use or consumption of
"your product",
b. If a"product withdrawal" is initiated,you must:
(1) Immediately record the specifics of the"product withdrawal"and the date where it was initiated;and
(2) Notify us as soon as practicable.
You must see to it that we receive written notice of the"product withdrawal"as soon as practicable.
c. You must promptly take all reasonable steps to mitigate the expenses associated with a "product
withdrawal". Any"profit"that you receive from mitigating the expenses will be deducted from the amount
of reimbursement that you will receive for"product withdrawal expenses".
d. You and any other involved insured must:
(1) Immediately send us copies of pertinent correspondence received in connection with the "product
withdrawal";
(2) Authorize us to obtain records and other information; and
(3) Cooperate with us in our investigation of the"product withdrawal".
D, For the purposes of this coverage,the following is added to Section IV-Conditions:
Concealment Or Fraud
We will not provide coverage under Section I to you, or any other insured, who at any time:
1. Engaged in fraudulent conduct; or
2, Intentionally concealed or misrepresented a material fact concerning a "product withdrawal" or "product
withdrawal expenses"incurred by you under Section I of this coverage.
XX. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
Item B., Transfer of Rights of Recovery Against Others to Us of SECTION IV - COMMERCIAL GENERAL
LIABILITY CONDITIONS is amended by the addition of the following:
We agree to waive any right or recovery we may have against any person or organization with whom you have
agreed by contract prior to an "occurrence" to waive such rights because of payments we make for injury or
damage arising Out of your ongoing operations or "your work" done under a contract with that person or
organization and included in the "products-completed operations hazard". The waiver applies only to the person or
organization with whom you have agreed in a contract prior to an"occurrence"to waive such rights. —
OCT 13 2009 (I
C
By--- —
MGL232(04/07) Page 12 of 14
M. DUTIES IN THE EVENT OF OCCURRENCE,OFFENSE,CLAIM OR SUIT
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Item 2., Duties in the Event of
Occurrence, Claim or Suit,is amended to include the following:
e. Your obligation to notify us as soon as practicable of an "occurrence", offense, claim or"suit" is satisfied if you
send us written notice as soon as practicable after any of your "executive officers", directors, partners,
insurance managers or legal representatives becomes aware of or should have become aware of such —
"occurrence", offense, claim or"suit".
XXfI. UNINTENTIONAL FAILURE TO DISCLOSE ALL HAZARDS
SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following:
10. Based on our reliance on your representations as to existing hazards, if you unintentionally fail to disclose all such hazards prior to the beginning of the policy period of the Coverage Part, we shall not deny coverage under
this Coverage Part because of such failure.
XXIII. LIBERALIZATION
SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following:
11. If we revise this Coverage Form to provide more coverage without additional premium charge, your policy will
automatically provide the additional coverage as of the day the revision is effective in your state.
XXIV. DEFINITIONS
The following definitions are added:
1. "Customers' goods" mean tangible personal property belonging to your customers and left with you for storage,
service or repair. "Customers'goods"do not include:
a. Accounts, bills, currency, deeds, food stamps or other evidences of debt, money, notes or securities.
Lottery tickets held for sale are not securities;
b. Animals;
c. Contraband, or property in the course of illegal transportation or trade;
d. Personal property while airborne or waterborne;
e. Property that is covered under another coverage form of this or any other policy in which it is more
specifically described, except for the excess of the amount due (whether you can collect on it or not) from
that other insurance;
f, Vehicles or self-propelled machines (including aircraft or watercraft) that are licensed for use on public
roads.
This paragraph does not apply to:
(1) Vehicles or self-propelled machines, other than "autos", you hold for sale; or
(2) Rowboats or canoes out of water at the described premises; r�
g. The following property while outside of buildings: O C T 13 2009 Y
(i) Grain, hay,straw or other crops;
(2) Fences, radio or television antennas (including satellite dishes) and their lead-in wiring,
44 masts or
towers, signs (other than signs attached to buildings), trees, shrubs or plants (other than trees,
shrubs or plants held for sale).
MGL232(04/07) page 13 of 14
2. "Defect' means a defect,deficiency or inadequacy that creates a dangerous condition.
3. 'Product tampering" is an act of intentional alteration of "your product' which has caused or is reasonably
expected to cause"bodily injury"or physical injury to tangible property other than "your product'.
When "product tampering" is known, suspected or threatened, a "product withdrawal" will be limited to those
batches of"your product'which are known or suspected to have been tampered with.
For purposes of this insurance, electronic data is not tangible property.
As used in this definition, electronic data means information,facts or programs stored as or on, created or used
on, or transmitted to or from Computer software, including systems and application software, hard or floppy —
disks, CD-ROMs, tapes, drives, cells, data processing devices or any other media which are used with —
electronically controlled equipment.
4. "Product withdrawal' means the recall or withdrawal:
a. From the market;or
b. From use by any other person or organization;
of "your products" or products which contain "your products", because of known or suspected "product
tampering', which has caused or is reasonably expected to cause "bodily injury" or physical injury to tangible
property other than"your product'.
For purposes of this insurance, electronic data is not tangible property.
As used in this definition, electronic data means information, facts or programs stored as or on, created or used
on, or transmitted to or from computer software, including systems and applications software, hard or floppy
disks, CD-ROMs, tapes, drives, cells, data processing devices, or any other media which are used with
electronically controlled equipment.
S. "Product withdrawal expenses" means those reasonable and necessary extra expenses, listed below, paid and
directly related to a"product withdrawal':
a. Costs of notification;
b. Costs of stationery, envelopes, production of announcements and postage or facsimiles;
c. Costs of overtime paid to your regular non-salary employees and costs incurred by your employees,
including costs of transportation and accommodations;
d. Costs of computer time;
e. Costs of hiring independent contractors and other temporary employees,
f. Costs of transportation, shipping or packaging;
g. Costs of warehouse or storage space;or
h. Costs of proper disposal of"your products" or products that contain "your products"that can not be reused,
not exceeding your purchase price or your cost to produce the products.
s. 'Profit'means the positive gain from business operation after subtracting for all expenses.
OCT 13 2009
All other terms and conditions remain the same. By
IVIO 232 (04/07) Page 14 of 14
CITY OF PALM SPRINGS
EXHIBIT D
Beneficiary Qualification Statement
PrOlect/ACtiyitV Title: Proiec� t 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 farm the
described prolect/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—03/10109)
AREA MEDIAN NUMBER OF PERSONS IN YOUR HOUSEHOLD,
INCOME(AMI) 1 2 3 4 5 6 7 8
LEVEL
EXTREMELY LO
INCOME $14,000 $16,000 $18,000 $20,000 S21600 S23,200 S24,800 $26,400
0-30°%of AMI
VERY LOW
INCOME $23,300 526,650 S29,950 $33,300 $35,950 538650 $41300 $43,950
37-50V of AMI
LOW INCOME $37,300 $42 650 347,950 553,300 $57,550 $61.850 $66.100 $70,350
51-80%ofAM1
MODERATE
INCOME S54,200 $61,000 $69.650 $77400 S83600 S89,800 1 S9G,000 $102,150
81-120%
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
❑ BlacWAfrican American ❑ Asian AND White
❑ Asian ❑ Black/African American AND White
❑ American Indian or Alaskan Native 0 American IndianlAlaska 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 fomale 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: 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
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
Project/Activity 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
A roved Current Prior Total Grant PP ����
Description Grant Raimbursement Reimbursement Yin Balance
Amount � Period Period(s) Reimbursement (Over)Under
Rental, Lease or
Purchase of Equipment $54,596.
Design & Permit Fees $32,500.
IF-'
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 slate 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 "S�ti�n 3 Clatse"
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 $" 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 C 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