HomeMy WebLinkAbout05459 - MIZELL SENIOR CENTER OF PALM SPRINGS CDBG SUBRECIPIENT AGR CITY OF PALM SPRINGS
CONSOLIDATED PLAN
ANNUAL PLAN UPDATE
2007 - 2008
FUNDING SUMMARY:
The City received Request For Proposals (RFPs) from nineteen (19) funding requests totaling $1,215,727,
compared to 15 proposals received last year, totaling $795,023 in requests. The following chart illustrates the
proposed allocations of CDBG funds expected to be available during the FY 2007 - 2008 period in the City
of Palm Springs, For specific project details, i.e., project description, location, proposed benefits, refer to
attached tables- 'Listing of Proposed Projects'. This coming fiscal year funding consists of$517,881 in new
entitlement funding. The total funds available for the 2007 — 2008 Fiscal Year, by authorized category of
basic eligibility, are:
Public Facilities&Improvements,---- ......................$336,623.'
...................................
Public Services ............. 7$ 7 682.`"
TOTAL PROGRAMMATIC FUNDS.,. ,--- .$414,305.
ADMIN (includes Citizen Participation & Fair Housing) 10$ 3 576."""
TOTAL CDBG 2007--2008 ENTITLEMENT $51�
Public Facilities & Improvements will also be partially funded with program income
and the reprogramming of unexpended activity funds, both from prior years and
current.
Public Service is calculated at 15% of new entitlement funding,
Administration is calculated at 20% of new entitlement funding. `
The following chart indicates the specific strategy (as referenced in the 2005 — 2010 Consolidated Plan'
Strategic Plan Goals), to which the proposed allocation relates: f
�Y YMCA
rlmpr Non-Hsng CD 1 3 $29,744. {
`0 7 �Enlergy ffcQfnCelmSOVements „g --- Non-Hsn CD2& -- �
-----..�� �. cf•- Non-Hsng CD 1 96,879
4 -..
^�rtmeiat.of ^� �� � 115,000.
V� �� Non-HsnCD1 95,000
Ralm-9P�9� -rt e,_,
Jernes(i-7ey^SYp`pE52TC'hiie�Mland Unity Center Energy-Efficiency
Im rovements __ ____ _
Mizell Senior , __.—. ._ ..__ .- 200.
Non-Wsn 1
Meals On wheels&Outreach Hybnd Vehicle,
9 - - 27. .
sng
5 H s 1g ^ ^ 15,000.
Smileepphro ._. _ry ______. Tyr _._ _..._._. .._....N H n 1 --_ _
Court Appointed Special Advocates or Riverside County,Inc, on
_ ml 1 _ _
n"'[ Palm rings SunupRota Foundation- - — Non-Hsng 1 -
Shc s T at Fit Progrdm 16,4B2.
Gj arl Chil hood Oral Healthcare _ Hsng
Facto for the Children of the Desert— Non-Ws g
PE y _ _ re - ---, ----------- 19,000.
Ealr-Wffd ng`GaunciLof Iyer5lde- - 4 15,000
.. ._-
_.._..�. --__
PSpeper;me•tRtgfwmur>Jy�...�,-„any�+-��^nnmic Development- n/a 75,833.
Generet-Progn�m�gdmm}shahvn-BeC-itizen Participation
1�ndi eahPr nra dm A�ekation Economic Development ment p n!d 12,
743.
sts
TOTAL FUNDING(Annual Allocation) $617.881.
Hsng = Housing Goals
Hmis = Homeless Goals
Non-Hsng = Non-Housing Goals
Non-Hsng CD = Nan-Housing Community Development Goals DaleC/CGeG07.08/AnnJPInFndn,Su.,Mayor
SUBRECIPIENT AGREEMENT
THIS AGREEMENT (herein "Agreement"), is made and entered into this day
200�by and between the CITY OF PALM SPRINGS, (herein "City), a municipal Corporation and
charter city, and the Mizell Senior Center of Palm Sprinos. , (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 sec. ("Regulations"), and
WHEREAS, the Act provides that the City may grant the CDBG Funds to nonprofit
organizations for certain purposes allowed underthe 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, 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.
12 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 2.2, 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 2007 — 2008 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.
C ry
20 COMPENSATION,
2.1 Contract Sum. The City shall pay to the Provider on a reimbursable basis for
its services a sum not to exceed TWENTY- SEVEN THOUSAND AND TWO HUNDRED DOLLARS
($27,200.00) (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,
Dean Lockwood, Executive Director
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 Aqainst 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:
(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;
(a) 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);
- 3 -
(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;
(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 atseeqi.);
(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
-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
p p 9 e�'
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 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 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 parry 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 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
- 5 -
WITH COPY TO.
City of Palm Springs
3200 East Tahquitz Canyon Way
Palm Springs, CA 92262-6959
Attn: City Attorney
TO PROVIDER'
Mizell Senior Center
480 South Sunrise WaV
Pelm Springs. CA, 92262-7641
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 as municipal corporation
Krq/Clerk 6 f ��3��b t1 City Manager
APPROV TO FORM:
I / F PPFROVEC BY CITY COUNCIL
By: I�f 1�� a� �•�'a1 Q��1
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,
Assista_nt�Segrettaary, Treasurer, Assistant Treasurer, or Chief Financial Officer).
By: i/// dr r ��� By:le Lv
Notarized SignaVe of Chairman-of 6dard, Notarized Signature Secretary,Asst Secretary,
President or any Vice President Treasurer,Asst Treasurer or Chief Financial Officer
Name: it 1�y 1 /71�{�oc� Name_`_"�^ � S
Title: y I_v N' ea de y y y Title:
State of 640:-On AJi)A State oflJr'�I
County of ktviom 1119 )as Countyof 6�ee6l CJss
On �I�—,t o ' 7 before me, On a9-1�,—7 before me,
�/�IJ ln��e/r ,personally appeared IrAl kr'b141'nr)y G,. t ,personally appeared
!L lz l�l b' ��'� „personally known 9(0,lV &A AC A,5 personally known
to me(or proved to me on the basis oygatisfaCtory evidence) to me (or proved to me on the basis ofsatlsfactory evidence)
to be the personf,6f whose name,(sf s re subscribed to the to be the persen(55 whose names) Is re subscribed to the
within instrument and acknowledged to me that Wshe/tidy within Instrument and acknowledge o me that helst/lthdy
executed the same In AlherltWr authorized capacity(ips), executed the same in his/Vrlt�arr authorized capacity(pS),
and that by jWher/tpcl slgn2ture(,61 on the instrument the and that by hi5/lydr/t44r signaturepf on the Instrument the
person(, or the entity upon behalf of which the person(,¢)' personV, or the entity upon behalf of which the person('
acted,executed the instrument. acted,executed the instrument.
WITNESS my hand and official Seal, nn1 WITNESS my hand and official seal,
Notary Notary
Signature- f1-0 Signature
Notary Seal Notary Seal
•�; 1:.M.9Rof CK E. M. 6R06ERICK
t�9rnrra)salon 0 1736667 Camm4310n $ 1736367
i! Hol®ry Public -California , "r' Notary Public -California
Riverildo County - RNOTSIae County
r M1`Gtlf11M.90195AW5,2017IF 4 A7y Comm Expires Apr 5,2011 '
Mlzell_Subre6pAgrmnt.Julg7
- 7-
CITY OF PALM SPRINGS
EXHIBIT A
Scope of Services
Project/Activity Title. Pro ect Number:
Mizell Senior Center! 0005
Meals on Wheels Delivery
Outreach Hybrid Vehicle
Name/Address of Provider:
Mizell Senior Center
480 S Sunrise Way
Palm Springs, CA 92262-7641
Objectives/Activities
The intent of this program is to provide nutritional assistance to very-low income to moderate income
seniors through daily meals, as well as provides the function of vital human contact, information outreach
and monitors the well being Of isolated homebound elderly. This will be accomplished through the
acquisition of a hybrid technology vehicle. This fuel-efficient vehicle will replace an older gasoline
powered vehicle, which will reduce operational costs. The Mizell Senior Center services 150 clients
providing 64,760 meals annually.
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 rocess,
TARGET
DATE ACTIVITY 41
On-Going Establish and maintain an efficient program process/procedure for proper record keeping-
Set-Up a fling 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 qualifV at least a total of 4,940 low and moderate-income Palm„Sprinas
residents.
TARGET
Objective 4: Enroll and income qualify at least a total of Four Thousand Nine Hundred Fortv (4,040)
very low to moderate income Palm Springs residents with improved access to services.
TARGET
DATE ACTIVITY#1
On-Going Deliver meals to Palm Springs residents. 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
Monthly Submit quarterly 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 Nan-discrimination / EEO requirements.
Objective 7: Acquire a hybrid technology vehicle in accordance with an 'open competitive'
procurement process as outlined in proposal.
TARGET
DATE ACTIVITY#1
05/30/08 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
07/15/08 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
Project/Activity Title: Project Number:
Mizell Senior Center/ OOD5
Meals On Wheels Delivery
Outreach Hybrid Vehicle
Name/Address or Provider:
Mizell Senior Center
480 S Sunrise Way
Palm Springs, CA 92262-7641
BUDGET SUMMARY
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 $ 27,2000 $ 6,000 $ 33,200
Equipment
7 Insurance $ - 0 - $ - 0 - $ - 0 -
8 Other $ - 0 - $ - 0 - $ - 0 -
A/C Contractor Contract
$ - 0 - $ - 0 - $ - 0 -
$ 27,2000 $ 6,000 $ 33,200
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 Center's contribution and the Palm Springs Kiwanis Foundation's private
donation.
The Subrecipient shall submit Request for Reimbursement in accordance with the aforementioned cost
categories. In no quarter shall the Subrecipient submit for reimbursement more than '/< of the total annual
budget. Payments, approved by the Subrecipient, shall be paid by the 30th 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.
Services are to be performed over the twelve-month period of this 2007 - 08 Program Year— July 1, 2007
through June 30, 2007,
CITY OF PALM SPRINGS
EXHIBIT C
Insurance Inventory
Project/Activity Title: Proiect Number:
Mizell Senior Center/ 0005
Meals On Wheels Delivery
Outreach Hybrid Vehicle
Name/Address of Provider:
Mizell Senior Center
480 S Sunrise Way
Palm Springs, CA 92282-7641
INSURANCE INVENTORY
LIABILITY INSURANCE POLICY
Name of Provider's Insurance Philadelphia Insurance Companies
Effective Dates of Policy 10/15/07-10/15/08
Claims Made Policy / / Per Occurrence Policy
Limits of Liability $3,000,000 General Aggregate
Deductibles:
Per Occurrence $1,000,000.00
Annual Aggregate $5,000,000.00
Additional Insured Endorsement (Certificate Holder) m Yes ❑ No
Original Certificate of Insurance Attached ❑ Yes z No
WORKER'S COMPENSATION POLICY
Name of Provider's Insurance Company State Compensation Insurance Fund
Effective Dates 03/01/07 -03101/08
Limits of Liability $1,000,_000 Per Occurrence,
Underlying Coverage Limits Per Statute as set by State Law
Original Certificate of Insurance Attached ❑ Yes z No
ACORD CERTIFICATE OF LIABILITY INSURANCE ZOp ID EL .T °A�V�° 07
MIZEL-1 IO 22 07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Curtis 6 Harris Insurance Sery ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
CA Licenee $ OF30715 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
P.O. Box 1585 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Palm Springa CA 92263
Phono: 760-778-8787 FE :760-700-7676 INSURERS AFFORDING COVERAGE INAI0
IX§UREOY INSUREA A mY
INSURERS
Mizell Senior Canter IUSURFRC -
480 S. S==aa INSURER b.
Palm Springa CA 92262
INSURER E
COVERAa, S
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTINTHSTANDING
ANY RECUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT wTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS EHCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
LTR INSRD TYPE OF INSURANCE PODCYNUMRER D&MI�D yY) IrDAMIMM nONI LIMITS
GE1NERALLIA&L11Y i EACH OCCURRENCE '31000000
A X •X�COMMERCIAL GENERAL LIABILITY PH1?K267135 10/14/071 10/l4/00 IpREMlses fEo vccRroncel I5100000
CLAIMS MADE [](�OCCUP I MFO EXP(Any or,,M
I1 3 S11I
.� PEX�ONnLanpv wJLlRv 13100D 000
! E
^ DDOC
�NLApGREQAM UMfTAPPLIE5 PER UCTS•COMPIOPAGG 111DD0000
POLICY JEo -7 LOC Tf��-
/IUTOMOaILE waluTr
A x ANYAUTC pHPK267135 3-0/14/071 10/14/OB ItEDMB�iaEoSwGLEUMIT Ia1000000
ZZT an
ALL OWNED ALTO$ (BODILY INJURY
I SCHEDULED AUTOS I(Par poau+) S
HIRFDAUTOS
BODILY WJUNT S
NON-OWNED AUTOS (Par-L-Y I
I �
A camp$500 & COLL I PROPERTY Drcl AMAGE
—1 DM - (Per anan0 3
50D DED
GARAGE LIABILITY AUTO ONLY-EA ACCIDENTTS
ANe AU1 O OTHER THAN EA ACC S
AUTO ONLY AGG IF
E%CESSINMUMLLA MIN fTY 1:ACN OCCURRENCE S
�r
OCCUR `J CTAIMS MADE AGGREGATE $
I - i5-
J DEDUCTIBLE I i§
I
RETENTION S I 5
WORXERS COWENSAIION AND I
TORT LIMITS IER
EMPLOnRS'W 61LITY ANY PROPRIETON vAHYNE ELbtlw3 IEL VQHACCIDENT 5
OFFICERIMEMBER EXCLUDEC? EL DISEASE-EA EMPLOYEEI S
SPyeEaC ALPROVISIONS MI.
ROYISION$ nlu E-L a SE•POLICY -- -
LIMIT l S
OTHER
I
I
DE5cRIPTIDN OP OPERATIONS f LOCATIONS 1 VEHICLES I ENCLUSIONS ADDED BY ENOOMEMENT I SPEOML PROVISIONS
THE CITY OF PALM SPRINGS ITS OFFICIALS EMPLOYEES AND AGENTS ARE ADDITIONAL
INSURFT] PER FORM CG2026. COVERAGE IS PRIMARY AND NON CONTRIBUTORY. 10 DAY
NOTICE OF CANCELLATION FOR NON PAYMENT OF PREMIUM.
REFERENCE CDBGRAS459/MEALS ON WHEELS AND OUTREACH HYBRID VEHICLE.
CERTIFICATE HOLDER CANCELLATION
CITYOFP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED III THE E)UNRATION
DATE THEREOF,THE ISSUING INSURER WILL EMAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TC THE
THE CITY OF PALM SPRINGS 1lhNR4NR91PJd1}TR9dR �1H.TR9[3C9t ]P1PR1k7l�l5Effht�l7L9Pk
DALE COOK
palm BOX 2743 k9t7E�
Palm SpruLga CA 92263r
AGORD 25(20011031 0 ACORD CORPORATION 788E
POLICY NUMBER PHPI(267135 COMMERCIAL.GENERAL LIABILITY
CG 20 26 07 04
THIS ENDORSEMENT CHANGES THE POLICY,PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the rollnwing_
COMMERCIAL GENERAL LIABILITY COVERAGE. PART
SCHEDULE
Name of Additional Insured Person(s)or Organication(s)
THE CITY OF PALM SPRINGS,ITS OFFICIALS,EMPLOYEES AND AGENTS
P.O. 13OX 2743
PALM SPRINGS,CA 92263
ATTN:DALE COOK
Information required to complete this Schedule,if not shown above,will be shown in the Declarations.
Section 11—Who Is An Insured is amended to include
as an 'additional insured the person(s)or organizatian(s)
shown in the Schedule,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 an your behalf:
A. In the performance of your ongoing operations:
or
B. In connection witb your premises owned by ar
rented to you.
CG 20 26 07 04 Copyright, ISO Properties,Inc.,2004 Page I of I
CERT710LDER COPY SK
STATE
P.0 BOX 420807. SAN FRANCISCO,CA 941 A2,^0807
COMPRINISAVON
iNtURANCia
FUND OMMCATS OF WORMW MMPMSATION IN$WRANCE
;SSUE DATE; 07-00-No7 GROVP.
POLICY NUWtFa 14e2$14-2007
CERTIFICATE ID: 1
GRATIFICATR E7tPIRES:W-01-200e
0341-007/03-01-20011
CITY OF PALM SPRZNSS SK
ATTH- CITY CLEAK
pO IWK 2742
PAIN SPR%NCS CA 02280-27411
This 0 t0 AMIN that wa hevo Issued a valid Wofke�v` Compo"WHon Insurance policy in A form Appraved by Ilia
Cdlfornlo Insurance Commldtfener to the employer named below for the policy period Indicated
Tmis policy 0 not cuhjset to concallatlon by ma Fund except uponl0 days ndvanco WWII noddd to the dMi5layar.
Wb will aloe give You 10days advance heeled should this policy be cancelled print to Its normal explrelbn.
This oartifie to of 10urmm is met in iriturMyoe policy and does not ameryd, extand or alter the
erepovorago afftxdad
by the policyspec o W fIAPr,1 is cwUtic"s of INstl Ima rely hbee Imt. uod v t or o wINFh It�PartshC the Imm�lnoo tMRM
With respect to which th
Alfefdpe ay Thp tmlldf described heroln le subject to all the term&, dxeluslorw, And oondlgom, of such policy,
IZED gCPAESFNTA PRESIDENT
ERPIDYF,TtrS L%ARILITY UNIT INCLUDING DEFENSE COSTS' S1,000,000 PER OCCURRENCE.
EMPLOYER
WILL SENIOR CWCR SK
480 S SUNRISE NAY
PALM SPRINGS CA 1R7ett �p O�4,qJj
IAPY.S•edl PRZWED : 0T=�2007
CITY OF PALM SPRINGS
EXHIBIT D
Beneficiary Qualification Statement
Project/Activity Title: Proleot Number:
Mizell Senior Center/ 0005
Meals On Wheels Delivery
Outreach Hybrid Vehicle
Name/Address of Provider
Mizell Senior Center
480 S Sunrise Way
Palm Springs, CA 92262-7641
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. Haw 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(Riversld"an Bernardino-Ontario,CA MSA—03/08/06)
MEDIAN NUMBER OF PERSONS IN YOUR HOUSEHOLD:
INCOME 1 2 3 4 5 6 7 8
LEVEL.
VERY LOW
INCOME $20150 $23000 $25,900 S28,750 $31,050 $33,350 $35.660 "7.300
Below 50
LOW INCOME $32200 $35,800 $41400 $46000 S40,700 $53.350 $57,050 $60.700
51 -80%
MODERATE
INCOME S48,300 $55,200 S62 100 $69,000 $74 500 $80 000 $85 600 $91 100
20%
3. What race/ethnicity do you identify yourself as;Please note that this self-identification is voluntary in accordance with
equal opportunity laws
❑ While ❑ American Indian or Alaska Native AND White
❑ Black/African American ❑ Asian AND White
❑ Asian ❑ Blaek/African American AND White
❑ American Indian or Alaskan Native ❑ American Indian/Alaska Native AND Black/African American
❑ Native Hawaiian or Other Paafic Islander ❑ Other:
HISPANIC/LATINO ETHNICITY ❑ Yes ❑ No If yes,check one. 0 Mexican/Chlcano
LJ Puerto Rican
❑ Cuban
❑ Other.
4. Please check, ves or_no if you are a female Head of Household? ❑ YES ❑ NO
ACKNOWLEDGEMENT AND DISCLAIMER
I CERTIFY UNDER PENALTY OF PERJURY THAT INCOME AND HOUSHOLD STATEMENT$MADE ON THIS FORM ARE TRUE.
NAME: DATE:
ADDRESS: PHONE NO:
SIGNATURE:
The information you provide on this form is conFdential and is only utilized for Community Development Block Grant(CDBG)program purposes a
Fedeially4unded program,governmental reporting purposes to monitor compliance
CITY OF PALM SPRINGS
EXHIBIT E
Semi-Annual Program Progress Report
Project/Activity Title: Project Number:
Mizell Senior Center/ 0005
Meals On Wheels Delivery
Outreach Hybrid Vehicle
Name/Address of Provider:
Mizell Senior Center
480 S Sunrise Way
Palm Springs, CA 92262-7641
PROGRAM PROGRESS REPORT Period.2007-2008
DIRECT BENEFIT REPORT
♦ Number of First-Time Program Beneficiaries Serviced
#of Households #of Persons 4,520
0-50%below 51-80%below 120% below
♦ Number of First-Time Female Headed Households:
♦ Counts by Race/Ethnicity:
White 3500 American Indian or Alaska Native AND White
Black/African American 900 Asian AND White
Asian 20 Black/African American AND White_
American Indian or Alaskan Native American Indiar/Alaska Native AND Black/African American
Native Hawaiian or Other PBCIfC Islander Other,
HISPANIC/I_ATINO ETHNICITY: Mexican/Chicano 120 Puerto Rican
Cuban Other
ACCOMPLISHMENT NARRATIVE
LEVERAGING RESOURCES NARRATIVE
The Kiwanis Club of Palm Springs Foundation saw the immediate benefit in partnering with the City of Palm Springs
and the Mizell Senior Center in assisting to fund this project A greener, more efficient delivery and Outreach vehicle
enables the Center to provide the quality services at a lower overhead, enabling us to keep the cosl of the program
as affordab as possible to the users.
1
1.
Signed ` Title Executive Director Date June, 20, 2007
J
CITY OF PALM SPRINGS
EXHIBIT F
Request for Reimbursement
Proiect/Achvity Title: Project Number
Mizell Senior Center/ 0005
Meals On Wheels Delivery
Outreach Hybrid Vehicle
Name/Address of Provider:
Mizell Senior Center
480 S Sunrise Way
Palm Springs, CA 92262-7641
BENEFICIARY QUALIFICATION STATEMENT
Approved Current Prior Total Grant
Descriptlon, Grant Reimbursamant Ratmbursemant YTD Balance
Amount - - Porlad Perlod(s) Relmbursoment (Over/under)'
Rental, Lease or $27,200.00
Purchase of
Equipment
TOTAL ,
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 Lax laws and hereby affix original signatures.
PREPARED BY: APPROVED BY:
Dean Lockwood, Executive Director October 18, 2007
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 Davl5-2acon 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 S2,000.00 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 financlal 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 PROVIDERS
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 requirement's of Section 3 of the Housing and Urban Development Act of
1g5a, 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 glven 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 protect 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 rehabllllatlon (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 ncapaaty 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 sectlon 3 clause and shall post copies of the notice in conspicuous places
available to employees and applicants for employment or training