HomeMy WebLinkAbout05463 - FAIR HOUSING COUNCIL OF RIVERSIDE COUNTY INC CDBG SUBRECIPIENT Page 1 of 1
Kathie Hart
From: Dale Cook
Sent: April 03, 2009 1:10 PM
To: Kathie Hart
Subject: RE: a5463 Fair Housing Program for FY 2007-08
Yes, completed and can be closed.
From: Kathie Hart
Sent: Thursday, April 02, 2D09 6:01 PM
To: Dale Cook
Subject: a5463 Fair Housing Program for FY 2007-08
COMPLETED?
Ok TO CLOSE?
Kathie Hart, CMC
Chief Deputy City Clerk
City of Palm Springs
3200 E.Tehqutz Canyon Way
Palm Springs,CA 92262
(760) 323-8206 1 LQ� (760) 322-8332
2 Kathie.Hart@Palm5pringeCA.gov
04/03/09
SUBRECIPIENT AGREEMENT p
THIS AGREEMENT (herein "Agreement"), is made and entered into this / day of r
200A, by and between the CITY OF PALM SPRINGS, (herein "City), a municipal corporation nd
charter city, and the Fair Housing Council of Riverside County, lnc. , (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 at seq.), 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 under the Act; and
WHEREAS, the Provider is a nonprofit organization which operates a program which is eligible
for a grant of CDBG funds and the City desires to assist in the operation of the program by granting
CDBG Funds to the Provider to pay for all or a portion of those costs incurred in operating the program
permitted by the Act and the Regulations on terms and conditions more particularly set forth herein;
NOW, THEREFORE, the parties hereto agree as follows:
1.0 SERVICES OF PROVIDER,
1.1 Scope of Services. Provider agrees to provide to City all of the services
specified and detailed in its application for funding and Exhibit A, 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 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
® 4 @N°AL E i D
�J , pti, I ups
information satisfactory to City's Finance Director. The financial information provided for in this
paragraph shall be furnished not later than January 31"t 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 FIFTEEN THOUSAND DOLLARS ($15.000.00) (the "Contract
Sum") in accordance with the Budget attached hereto in Exhibit B and incorporated herein by this
reference; and as herein provided. The budget cost categories set out in Exhibit B are general
guidelines and if mutually agreed by both parties, may be amended administratively by no more than
10%, without the requirement of a formal amendment to this Agreement, but in no event shall such
adjustments increase the Contract Sum. The Provider shall submit to the City monthly statements on
reimbursable expenditures pursuant to the attached Budget along with pertinent supporting
documentation. The City shall promptly review the monthly expenditure statements and, upon
approval, reimburse the Provider its authorized operating costs.
2.2 Payroll Records. In cases where the contract sum will reimburse payroll
expenses as part of operations, the Provider will establish a system of maintaining accurate payroll
records which will track daily hours charged to the project by the Provider's respective employees, as
set forth in OMB Circular A-122 Attachment B.6.
2.3 Draw Downs. Failure by Provider to request reimbursement or encumbrance
of at least 25% of the total grant by the end of each fiscal year quarter (September 30, December 30,
March 31, and June 30) shall result in the immediate forfeiture of 25% of the total grant.
3.0 COORDINATION OF WORK.
3.1 Representative of Provider. The following principals of Providers are hereby
designated as being the principals and representatives of Provider authorized to act in its behalf with
respect to the work specified herein and make all decisions in connection therewith:
Board of Directors of the Fair Housing Council of Riverside County, Inc.
P.O. Box 1068 3933 Mission Inn Avenue
Riverside CA 92502-1068
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.
-2 -
4.1 The Provider shall maintain records of its operations and financial activities in
accordance with the requirements of the Housing and Community Development Act and the
regulations promulgated thereunder, which records shall be open to inspection and audit by the
authorized representatives of the City, the Department of Housing and Urban Development and the
Comptroller General during regular working hours. Said records shall be maintained for such time as
may be required by the regulations of the Housing and Community Development Act, but in no case for
less than FIVE years after the close of the program.
4.2 The Provider certifies it shall adhere to and comply with the following as they
may be applicable
(a) Submit to City through its Community and Economic Development
Department semi-annual reports on program status;
(b) Section 109 of the Housing and Community Development Act of 1974,
as amended and the regulations issued pursuant thereto;
(c) Section 3 of the Housing and Urban Development Act of 1968, as
amended;
(d) Executive Order 11246, as amended by Executive Orders 11375 and
12086, and implementing regulations at 41 CFR Chapter 60;
(e) Executive Order 11063, as amended by Executive Order 12259, and
implementing regulations at 24 CFR Part 107;
(f) Section 504 of the Rehabilitation Act of 1973 (P.L. 93-112), as
amended, and implementing regulations;
(g) The Age Discrimination Act of 1975 (P.L. 94-135, as amended, and
implementing regulations;
(h) The relocation requirements of Title II and the acquisition requirements
of Title III of the Uniform Relocation Assistance and Real Property
Acquisition at 24 CFR Part 42;
(i) The restrictions prohibiting use of funds for the benefit of a religious
organization or activity as set forth in 24 CFR 570.200 0);
Q) The labor standard requirements as set forth in 24 CFR Part 570,
Subpart K and HUD regulations issued to implement and
requirements,
(k) The Program Income requirements as set forth in 24 C.F.R.
570.504(c) and 570.503(b)(8);
(1) The Provider is to carry out each activity in compliance with all
Federal laws and regulations described in 24 C.F.R. 570, Subpart K,
except that the Provider does not assume the City's environmental
responsibilities described at 24 C.F.R. 570.604; nor does the
Provider assume the City's responsibility for initiating the review
process under the provisions of 24 C.F.R. Part 52;
- 3 -
(m) Executive Order 11988 relating to the evaluation of flood hazards
and Executive Order 11288 relating to the prevention, control and
abatement of water pollution;
(n) The flood insurance purchase requirements of Section 102(a) of the
Flood Disaster Protection Act of 1973 (P.L. 93-234);
(o) The regulations, policies, guidelines and requirements of 24 CFR
570; the "Common Rule", 24 CFR Part 85 and subpart J; OMB
Circular Nos, A-102, Revised, A-87, A-110 and A-122 as they relate
to the acceptance and use of federal funds under the federally-
assisted program;
(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 Vill of the Civil Rights Act of 1968 (P.L. 90-284) as amended;
(r) The lead-based paint requirements of 24 CFR Part 35 issued
pursuant to the Lead-Based Paint Poisoning Prevention Act (42
U.S.C. 4801 et seq.):
(s) Maintain property inventory system to numerically identify HUD
purchased property and document its acquisition date as is set forth
in OMB Circular A-110 Attachment N Property Management
Standard 6d; and
(t) Reversion of asset. Upon the Expiration of the agreement, the
subrecipient shall transfer to the City any CDBG funds on hand at the
time of expiration and any accounts receivable attributable to the use of
CDBG funds. Additionally, any real property under the subrecipierfs
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
570208 (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.
-4 -
5.0 INSURANCE AND INDEMNIFICATION.
5.1 Insurance. The Provider shall procure and maintain, at its cost, and submit
concurrently with its execution of this Agreement, public liability and property damage insurance
against claims for injuries against persons or damages to property resulting from Provider's acts or
omissions arising out of or related to Provider's performance under this Agreement. Provider shall also
carry Workers' Compensation Insurance in accordance with State Workers' Compensation laws. Such
insurance shall be kept in effect during the term of this Agreement and shall not be cancelable without
thirty (30) days' prior written notice of the proposed cancellation to City. A certificate evidencing the
foregoing and naming the City as an additional insured shall be delivered to and approved by the City
prior to commencement of the services hereunder, The procuring of such insurance or the delivery of
policies or certificates evidencing the same shall not be construed as a limitation of Provider's
obligation to indemnify the City, its officers, or employees. The amount of insurance required
hereunder shall be as required by the Contract Officer not exceeding 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 farce 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 parry.
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 party shall be in writing and either
served personally or sent by prepaid, first-class mail to the address set forth below, or such other
addresses as may from time to time be designated by mail.
- 5 -
TO CITY:
City of Palm Springs
3200 East Tahquitz Canyon Way
Palm Springs, CA 92262-6959
Attn: City Manager
WITH COPY TO:
City of Palm Springs
3200 East Tahquitz Canyon Way
Palm Springs, CA 92262-6959
Attn: City Attorney
TO PROVIDER:
Fair Housing Council of Riverside County, Inc.
P. O. Box 1068
Riverside, CA 92502
7.2 Amendment. This Agreement may be amended at any time by the mutual
consent of the parties by an instrument in writing.
IN WITNESS WHEREOF, the parties have executed and entered into this Agreement as of the date
first written above.
[ End —Signatures on Next Page ]
- 6-
CITY OF PALM SPRINGS
- ATTEST- a municipal corporation
By-, r By .�
It lerk dq f�'L City Manager r
APPRO S TO FORM:,
{�� A�P1PRaOOV1ED By C{I7Y COUNCIL
City
y /. g 1If�/ 0►r7�/I� U.I 1 I�i
City Attor ey �
PROVIDER: Check one `Individual _ Partnership x Corporation
(Corporations require two notarized signatures: One signature must be from the Chairman of
Board, President, or any Vice President. The second signature must be from the Secretary,
Assistant Secretary, Treasurer, Assistant Treasurer, or Chief Financial Officer).
By: By: L�
Not gnature of Chairman of Board, Notarized Signature Secretary,Asst Secretary,
resident or any Vice President Treasurer, Asst Treasurer or Chief Financial Officer
Name: John Stevens Name: Ella Uli
Title: President Title: Secretary
StateoF State of CaV br0t'cl
County ofA.,f ,,�,'i� Is County of\ 9i L,n'A 55
On J✓ DOS before me, On�1` 1(.y�.. fZ_-_before,,.
A- 00uSz.r ,personally appeared �tA1 +�— A, •I�r LlSe/" personally appeared
personally known— F- pemrntattgRndvvR
tome(or proved to me on the basis satisfactory evidence) to me(or proved to me on the basis of satisfactory evidence)
e to be the personX whose nam '�S afe Subscribed to the to be the person(whose nameO is subscribed to the
within instrument and acknowledged to me that ho/she/they- within instrument and ackno ledge to me that F /hgltiiey-
exeeuted the same in is'/} 44eir authorized capaeity(iao, executed the sa in I i their authorized capani
and that by(Rhedtheir signature,(sr on the instrument the and that by h !thw slgnature'f on the instrument the
persogX or the entity upon behalf of which the person!`aj" person( or the entity upon behalf of which the person
acted,executed the Instrument. acted,executed the instrument.
WITNESS my hand and official seal. WITNESS my hand and official Seal
Notary Notary n I
Signature ��dam& Signature: JOA,
Notary Seal: Notary Seal:
A.i EIt JULIE A. HOUSER
V�r # 1716476 Cornrnlulon# 1716476
nblatlf NMC CCNlfafrlla tlgfory EubllC -California
R"fill dl County f vibill a County
rpprEliElpUINM1312-o, pltrplrRlrt6pI16 im13,2011
- 7-
CITY OF PALM SPRINGS
EXHIBIT A
Scope of Services
Project/ActivityTitle: Project Number:
Fair Housing Council of Riverside/Fair Housing 0009
Name/Address of Provider.
Fair Housing Council of Riverside County, Inc.
PO Box 1068; 3933 Mission Inn Avenue 655 N Palm Canyon Dr, Ste 201
Riverside, CA 92502-1068 Palm Springs, CA 92262-5512
Objectives/Activities
The intent of this program is to provide a full menu of fair housing services for Palm Springs residents that
promotes fair housing rights and obligations as defined and articulated in the Federal Fair Housing Act
and the California State Law Enactments under the Rumford & Unruh Civil Rights Acts which affirmatively
furthers fair housing. This will be accomplished through the staffing of a Palm Springs' office facilitating
three components, as it relates to Anti-Discrimination and Landlord/Tenant services, such as education
(i.e., outreach, public awareness); training / technical assistance (i.e., pro-active workshops preventing
complaints and violations), and enforcement (i.e., compliant intake and investigation) for one thousand
and five hundred (1,500) Palm Springs residents.
The Provider shall be responsible for the completion of the following objectives/activities in a manner
acceptable and satisfactory to the City and consistent with the standards required as a condition of
providing these CDBG funds.
Objective 1: Assist the City by timely providing any additional information requested.
TARGET
DATE ACTIVITY#1
On-Going Make readily available any information relative to the successful implementation of the
activity.
Objective 2: Establish and maintain a programmatic and financial record keeping process.
TARGET
DATE ACTIVITY#1
On-Going Establish and maintain an efficient program process/procedure for proper record keeping-
Set-Up a filing system for CDBG files only. Document and maintain all records related to
this program In a stable and secure location.
Objective 3: Advertise, market and publicize the program to facilitate positive promotion for all,parties
(Le_, 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 qualifies at least an approximately one thousand and five hundred
(1,500) Palm Springs residents with new access to this service.
TARGET
DATE ACTIVITY#1
On-Going Provide fair housing services to clients. 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 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: Provide fair housing services, including_Fair Housing Practice and Landlord/Tenant
workshops, as outlined in proposal.
TARGET
DATE ACTIVITY#1
On-Going Conduct program activities for 1,500 clients and offer two workshops for property owners,
managers, Realtors and lenders to improve availability/accessibility, as stipulated in the
proposal.
Objective S: Provide an evaluation within fifteen (15) calendar days of the program completion or final
reimbursement.
TARGET
DATE ACTIVITY#1
07/15/02 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-
Fair Housing Council of Riverside/ Fair Housing 0009
Name/Address of Provider--
Fair Housing Council of Riverside County, Inc.
PO Box 1068; 3933 Mission Inn Avenue 665 N Palm Canyon Dr, Ste 201
Riverside, CA 92502-1068 Palm Springs, CA 92262-5512
BUDGET SUMMARY
COST CQBG OTHER TOTAL
CATEGORY SHARE SOURCES 'COST
1 Personnel $10,549. $19,491. $30,040.
2 Cons ultant/Contract Services $305. $566. $871.
3 Travel $125. $231. $356.
4 Space Rental $2,399. $4,456. $6,855.
5 Consumable Office Supplies $198. $369. $567,
6 Office Equipment/Purchase, $373. $692. $1,065.
Lease or Maintenance
7 Insurance - D - 0 - - 0 -
8 Other $554. $1,030. $1,584.
Telephone
$497. $922. $1,419.
Other Operational Costs"
TOTALS $15,000. $27,757. $42,757.
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.
EXHIBIT B—Budget Summary
Page 2 of 2 Pages
DETAIL BUDGET
DESCRIPTION OF ACTIVITY/ CDBG OTHER TOTAL
PAY ITEMS SHARE SOURCES COST
Wages $8,147. $15,053. $23,200.
Fringe Benefits $2,402. $4,438. $6,840.
Consultant/Contract Services $305, $566. $871.
Travel $125. $231. $356.
Space Costs $2,399. $4,456. $6,855.
Consumable Supplies $198. $369. $567,
Equipment— $373. $692, $1,065.
Purchase, Lease or Maintenance
Telephone $554. $1,030. $1,584.
Other Operational Costs $497. $922. $1,419,
Total $15,000, $27,757. $42,757.
The Subrecipient shall submit monthly reimbursement based on prorated and actual costs in
accordance with the aforementioned cost categories and pay items. In no month shall the
Subrecipient submit for reimbursement more than of the total annual budget. The reimbursement
shall be split between the Community Redevelopment Agency's Tahquitz Andreas Low/Mod and
CDBG's General Administration with the respective allocation of$27,757 (65%) and $15,000 (35%),
totaling$42,757.
Services are to be performed over the twelve-month period of this 2007 - 08 Program Year—July 1,
2007 through June 30, 2008.
CITY OF PALM SPRINGS
EXHIBIT C
Insurance Inventory
Proiect/Activity Title: Proiect Number:
Fair Housing Council of Riverside/Fair Housing 0009
Name/Address of Provider:
Fair Housing Council of Riverside County, Inc.
PO Box 1068; 3933 Mission Inn Avenue 655 N Palm Canyon Dr, Ste 201
Riverside, CA 92502-1068 Palm Springs, CA 92262-5512
INSURANCE INVENTORY
LIABILITY INSURANCE POLICY
Name of Provider's Insurance Company Nonprofits Insurance Alliance
Effective Dates of Policy 04/28/07 to 04/28/08
Claims Made Policy / / Per Occurrence Policy
Limits of Liability $2,000 000 aggregate&1 000,000 per occurrence
Deductibles:
Per Occurrence none
Annual Aggregate
Additional Insured Endorsement (Certificate Holder) Q Yes ❑ No
Original Certificate of Insurance Attached ❑ Yes IZ No
WORKER'S COMPENSATION POLICY
Name of Provider's Insurance Company State Compensation Insurance Fund
Effective Dates 07/01/08to 07/01/08
Limits of Liability $1 000.000 per occurrence
Underlying Coverage Limits n/a
Original Certificate of Insurance Attached D Yes 21 No
ACORD CERTIFICATE OF LIABILITY INSURANCE izizoo'7""
PRODUCER (909)476-0600 FAX: (909)476-0601 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
The arc Co an ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
mP X HOLDER, THIS CERTIFICATE AGES NOT AMEND, EXTEND OR
10201 Trademark St. , Suite D ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 5400
Ranoho Cucamonga - CA 91729 INSURERS AFFORDING COVERAGE NAIC#
INSURED I NSURERA Nonprofits Ins. Alliance
Fair Housang Council of Riverside County, Inc- trNSURPRR
F.O. Box 1068 INSURER »_
WSURER U
Riverside CA 92502-1068 INSURERS
OVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY
REQUIREMENT,TERM OR CQNDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN
THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH PC4gES,
F, TP SS FAIDCL
INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION
N TYPE OF INSURANCE POLICYNUMBER DATE MM/DD DATE MMJDDNYV LIMITS
GENERAL LIABILITY E,9,C-DCC ENCE 1,000,000
X COMMERCIAL GENERAL LIABILITY PRE.SF5 Pa a iED 300,000
+� ^ CLAIMS MADE [T OCCUR 2 0 0 7-0 4 221-N O 4/28/2007 4/28/2008 MED EIfP nnv ono ooron S 10,000
PERSONAL&ADV INJURY s 1,000,000
ERAL AGGREGATE 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS- . GG a 2,000,000
JEO X POLICY Y LOC
AUTOMOBILE LIADILITY COMBINED SINGLE LIMB
ANY AUTO 2007-04221-NPO 4/2B/2007 4/28/200$ (Enxod,.nq S 1,000,000
ALL OVAED AFROS BODILY INJURY
X SCHEDULED AUTOS
(Per Peron) 5
X HIRED AUTOS BODILY INJURY
X NON.OWTIED AUTOS (Prr aredant7
PRCPC•RTY DAMAGE
(Peramldenp 9
GARAOCU01LITY AUTO ONLY-EA ACCIDENT 6
ANY AUTO OTHER THAN A A./•
AUTO ONLY qGG S
EXPESSNMBRELLALIABILITY EACH OCCURRFNCF 5
OCCUR F7CI,AIMS MA➢E AGGREGATF
DEDUCTIBLE 5
RETENTION S
WORKERS COMPENSATION AND 4CSTATU- OTH
EMPLOYERS'LIABILITY T Rv I.
ER
ANY PROPMETOR/PARTNERIEXECUTNIT EL EACH ACCIDENT S
OFFICER/rnEMBER EXCLUDED? EL DISEASE-F,AP FLOYEE 5
IT yr eccrlye under ^
SPECIAL PROVIBIONR enlow El DlaE- E.POUCYLIMIT 5
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES[EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PRONSIONS
Cane Noti1CC 10 daym for non pnymcnt of Premium. The City of Palm springs, its officers, oEfieials, enployccs and
volunteers are named as addltlonal insut= dS.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Palm Springs EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
Attn: City Clerk 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT
PO Box 2743 FAILURE TO DO SO SI IALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UFON THE
Palm Spring„ CA 92262
INSURER,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED RRPRESQNTATNE _
Selina Ramos/SELINA
ACORD 25(2001/03) ®ACORD CORPORATION 1985
INS025(mcgD, Pageld2
POLICY NUMBER: . 2007-04221-NPO COMMERCIAL GENERAL LIABILITY
CC,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 following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Persons Or Organization(s)
The City of Palm Springs its officers, officials, employees and volunteers
Information required to complete this Schedule,if not shown above will be shown in the Declarations.
Section II — Who Is An Insured is amended to in-
clude as an additional insured the person(s) or organi-
zation(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 omis-
sions of those acting on your behalf:
A. In the performance of your ongoing operations; or
B. In connection with your premises awned by or
rented to you.
C. The insurance afforded by this endorsement shall
be primary and non-contributory as respects
any insurance available to the Additional In-
sured(s),
CG 20 26 07 04 O 180 Properties, Inc.,2004 Page 1 of 1 ❑
STATE
C.I. '�Y 7GO,
Q 1 ATE PO-gCX 420$07,SANEFRANC[SOO,CA 04142-0607
OOMPanaA-rlgN
INSLIFAr+OC
FUND CERTIFICATE OF WORKERV COMPENSATION INSURANCE
JULY 9, 2007 POLIOYNUMeER, I34174S O7
CEATIFIaATE 'EXPIRES: 7-1-03
Cm OF PALM SPRINCS
CITY CLERK
p O BOX 2745
PALM SPRIWS rA 92263
ThiS is to certlly that we have issubd a valid WOrX r CgmpeneatlOn inru2hce poiipy in a form apprOVed by the Calrfdrnia
Incurando Commwoioner to the employer named belowtdr the policy penal Indicated _
This policy is not wbjcct W cancellation by the Fund except upon tenys'advance written notice to the employer.
PYe will also give you TE liays'advance notice should this policy bs cancelled Prior to rtA norms!expEration.
This eerWioate Of inrumnoo Is not an insurance policy and does not amend,Wend Cr alter the eomrage afforded by the
polibiva Wed herein. Notwiftlandin9 filly requiremant, TiRM, W tondillon Gf any COgtl'flat Or other dOCPmeht With
respect to which this Certificate of misurnnce may be iavgad or may pertain:tho insurehec Aifordod by tho pCfiti**
dascribad herein is suhiectto all the terrw.,s,excluslons and conditions of such policies.
M1UTM i..0 ri..neaENTAT Ivq v •RIESIDENT
EMPLOYER'S 1-10%ITY LIMIT INCLUDING DEFENSE COSTSt $1,000,000 PER OCCURRENCE.
EMORSEMENT ti2065 ENTITLED SERTIAICATE HOLDERS'NoTICE EFFECTIVE
07/0I/07 IS ATTACHED T3 ANE FORMS A PART OF THIS POLICY.
EMPLOYER
THE FAIR HZU5ING COUNCIL aF BIBERSIDR COUNTY qNC
P n sox INSS
RIVERSIDE CA 92502
L FILE 00 r1l
Ed WdBT:ET LOW 90 'inf 'ON 3N0Hd WEIISAS XUA oluo52u2d WOJ-�
CITY OF PALM SPRINGS
EXHIBIT D
Beneficiary Qualification Statement
ro ec�ctivlty It e: rolec um er
Fair Housing Council of Riverside/ Fair Housing 0009
Name/Address of Provider. Date:
Fair Housing Council of Riverside County, Inc.
PO Box 1068, 3933 Mission Inn Avenue 655 N Palm Canyon Dr, Ste 201
Riverside, CA 92502-1068 Palm Springs, CA 92262-5512
BENEFICIARY QUALIFICATION STATEMENT
This statement must be completed and signed by each person or head of household (legal guardian) receiving benefits form the
described project/activity. Please answer each of the following questions.
1. How many persons are in your household? _
For this question a household is a group of related or unrelated persons occupying the same house with at least one member
being the head of the household. Renters, roomers,or borders cannot be included as household members.
2. Circle your combined gross annual income(Riverside-San Bernardino,CA—03120107)
MEDIAN NUMBER OF PERSONS IN YOUR HOUSEHOLD:
INCOME 1 2 3 4 6 6 7 8
LEVEL
VERY LOW
INCOME S20,700 S23700 S26,650 $29,600 $31,950 S34,350 $36,700 S$9,050
Below 50%
LOW INCOME $33,150 S37,900 S42,600 $47,350 $51,150 $54,950 $58,700 $62,500
51 -80%
MODERATE
INCOME S49,700 S56,800 S63,900 $71,000 $76,700 S82,400 S88000 $93,700
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
0 Black/African American D Asian AND White
❑ Asian ❑ Black/Afncan Artlerlc8n AND White
• American Indian or Alaskan Native ❑ American Indian/Alaska Native AND Black/African American
❑ Native Hawaiian or Other Pacific Islander ❑ Other
HISPANIC/LATINO ETHNICITY ❑ Yes ❑ No If yes,check one. ❑ Mexican/Chicano
❑ Puerto Rican
❑ Cuban
❑ Other
4. Are you female Head of Household? ❑ YES ❑ NO
5. Do you have a disability? ❑ YES ❑ NO If YES,please describe:
ACKNOWLEDGEMENT AND DISCLAIMER
I CERTIFY UNDER PENALTY OF PERJURY THAT INCOME AND HOUSHOLD STATEMENTS MADE ON THIS FORM ARE TRUE.
NAME: DATE:
ADDRESS: PHONE NO:
SIGNATURE!
The information you provide on this farm is confidential and is only utilized for Communily Development Block Grant(COSG) program purposes, a
Federally-funded program governmental reporting purposes to monitor compliance
CITY OF PALM SPRINGS
EXHIBIT E
Semi-Annual Program Progress Report
rolec ctivlty it Title, ro ect Number:
Fair Housing Council of Riverside/ Fair Housing 0009
Name/Address of Provider. Date:
Fair Housing Council of Riverside County, Inc.
PO Box 1068; 3933 Mission Inn Avenue 655 N Palm Canyon Dr, Ste 201
Riverside, CA 92502-1058 Palm Springs, CA 92262-5512
PROGRAM PROGRESS REPORT Period
DIRECT BENEFIT REPORT
♦ Number of First-Time Program Beneficiaries Serviced
#of Households_ _ #of Persons
0-50°/abelow 51-80%below 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 Indiar/Alaska Native AND Black/African American
Native Hawaiian or Other Pacific Islander Other.
HISPANIC/LATINO ETHNICITY Mexican/Chicano _ Puerto Rican
Cuban Other:
ACCOMPLISHMENT NARRATIVE
LEVERAGING RESOURCES NARRATIVE
Signed ____„� Title Date.
CITY OF PALM SPRINGS
EXHIBIT F
Request for Reimbursement
Project/Activity Title, Project Number:,
Fair Housing Council of Riverside/ Fair Housing 0009
Name/Address of Provider: Date:
Fair Housing Council R Riverside County, Inc.
PO Box 1068, 3933 Mission Inn Avenue 665 N Palm Canyon Dr, Ste 201
Riverside, CA 92502-1068 Palm Springs, CA 92262-5512
11 1[Approved ' 'Current Prior' Total Grant
Description pGrant IReimbursemen! R_etmdursoment YTD ' Balance
Amount Period' .Porlod(s) Reimbursement (Overl Under)
Personnel 510,549.
consultant/Contract services $305
Travel $125
space Rental $2,399
Consumable Office Supplies S198
Office Equipment/Purchase $373.
Lease or Maintenance
Other E554
Telephone
$497
Other Operational Costs'
TOTAL = I[E===
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.0
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 62 000 00 for
construction, renovation or repair work financed in whole or in part with assistance provided under this contract, shall comply
with Federal requirements adopted by the CITY pertaining to such contracts and with the applicable requirements of the
regulations of the Department of labor, under 29 CFR Parts 1, 3, 5 and 7 governing the payment of wages and ratio of
apprentices and trainees to journeyworkers, provided,that if wage rates higher than those required under the regulations are
imposed by state and local law, nothing hereunder is intended to relieve the PROVIDER of its obligation, if any, to require
payment of the higher wage. The PROVIDER shall cause or require to be inserted in full, in all such contracts subject to such
regulations provisions meeting the requirements of this paragraph
2. "Section 3 Clause
a. Compliance
Compliance with the provisions of Section 3,the regulations set forth in 24 CFR 135, and all applicable rules and orders
issued hereunder prior to the execution of this contract, shall be a condition of the Federal financial assistance provided
under this Contract and binding upon the CITY the PROVIDER and any of the PROVIDER'S subrecipients and
subcontractors. Failure to fulfill these requirements shall subject the CITY, the PROVIDER and any of the PROVIDER'S
subreeipients and subcontractors,their successors and assigns, to those sanctions specified by the Agreement through
which Federal assistance is provided. The PROVIDER certifies and agrees that no contractual or other disability exists
which would prevent compliance with these requirements.
The PROVIDER further agrees to comply with these Section 3" requirements and to Include the following language in all
subcontracts executed under this Agreement.
"The work to be performed under this contract is a project assisted under a program providing direct Federal financial
assistance from HUD and is subject to the requirements of Section 3 of the Housing and Urban Development Act of
1968, as amended, 12 U.S.0 1701 Section 3 requires that to the greatest extent feasible opportunities for training
and employment be given to low- and very low-income residents of the project area and contracts for work In
connection with the project be awarded to business concerns that provide economic opportunities for low-and very
low-income persons residing In the metropolitan area in which the project is located."
The PROVIDER further agrees to ensure that opportunities for training and employment arising in connection with a housing
rehabilitation (including reduction and abatement of lead-based paint hazards) housing construction, or other public
construction project are given to Iew-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 law- 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 opponunities 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