HomeMy WebLinkAbout05269 - FAIR HOUSING COUNCIL OF RIVERSIDE COUNTY INC CDBG SUBRECIPIENT AGR DOCUMENT TRACKING Page: 9
Report: Expired Documents Summary March 4, 2008
Condition: Oldest Date= 1 1, Groups=COMMUNITY&ECONOMIC,ALL Services,ALL XREFs
Document# Description Approval Date Ex irattion Date Closed Date
A5186 v/;�V/ operational expenses CEDG 04/07/2004 06/30/2005
Company Name: Fair Housing Council of Riverside County
Address:
Group: COMMUNITY& ECONOMIC
Service: In Process
xRef: COMMUNITY& ECONOMIC
Ins. Status: No Certificate on file.
A5220 Exclusive agreement to negotiate for city-owned property for up-scale... 01/18/2006 .�p 07/01/2007
Company Name: Oasi Group LLC
Address: 100 S Sunrise Way, No 498, Palm Springs, CA 92262
Phone: (310) 877-3110 Fax: (310) 476-9216
Group: COMMUNITY& ECONOMIC
Service: In File
xRef: JOHN RAYMOND 760 323-8228
Ins. Status: Certificate and Policies are OK
A5269 Fair Housing Program 04/12/2006 06/30/2007
v
Company Name: Fair Housing Council of Riverside
Address: P O Box 1068, Riverside, CA 92502
Group: COMMUNITY& ECONOMIC
Service: In File
xRef: DALE COOK 760 323-8198
Ins. Status: Certificate and Policies are OK
x x x x x x
END OF REPORT * - * * ' *
v
SUBRECIPIENT AGREEMENT
THIS AGREEMENT (herein "Agreement"), is made and entered into this 2 day of April
200 7 by and between the CITY OF PALM SPRINGS, (herein "City), a municipal corporation and
charter city, and the Fair Housing Council of Riverside County, 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 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 2006 — 2007 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
AND/OR A GI(iL!'f EJ''1T
information satisfactory to City's Finance Director. The financial information provided for in this
paragraph shall be furnished not later than January 31 st of the current fiscal year-
2-0 COMPENSATION.
2.1 Contract Sum. The City shall pay to the Provider on a reimbursable basis for
its services a sum not to exceed TWENTY-FIVE THOUSAND DOLLARS ($25.000.00) (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 casts.
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 6.6.
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 Subcontractinq 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.
- 2-
4.0 COMPLIANCE WITH FEDERAL REGULATIONS.
4.1 The Provider shall maintain records of its operations and financial activities in
accordance with the requirements of the Housing and Community Development Act and the
regulations promulgated thereunder, which records shall be open to inspection and audit by the
authorized representatives of the City, the Department of Housing and Urban Development and the
Comptroller General during regular working hours. Said records shall be maintained for such time as
may be required by the regulations of the Housing and Community Development Act, but in no case for
less than three years after the close of the program.
42 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 monthly 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 VIII of the Civil Rights Act of 1968 (P.L. 90-284) as amended;
(r) The lead-based paint requirements of 24 CFR Part 35 issued
pursuant to the Lead-Based Paint Poisoning Prevention Act (42
U.S.C. 4801 et semi.);
(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.
-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 force and effect until completion of the services, but
not exceeding one (1) year from the date hereof.
6.3 Termination Prior to Expiration of Term. Either party may terminate this
Agreement at any time, with or without cause, upon thirty (30) days' written notice to the other party.
Upon receipt of the notice of termination the Provider shall immediately cease all services hereunder
except as may be specifically approved by the Contract Officer. Provider shall be entitled to
compensation for all services rendered prior to receipt of the notice of termination and City shall be
entitled to reimbursement for any services which have been paid for but not rendered.
7.0 MISCELLANEOUS PROVISIONS.
7.1 Notice. Any notice, demand, request, document, consent, approval, or
communication either party desires or is required to give to the other party shall be in writing and either
served personally or sent by prepaid, first-class mail to the address set forth below, or such other
addresses as may from time to time be designated by mail.
- 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
Riveside, CA 92502 T
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
_- PTT Tr a municipal corporation
y Clerk zD" t 20d 7 City Manager of C c)tcead �=
Without The Exp e�S?l�:ti teu7
Authorization pr iV ' City
APPROV A TpFpRM. APPROVED BY CITY COUV`�IEnagew••
Iv
City Attorney (� qjo
PROVIDER: Check one: _Individual Partnership _Corporation
(Corporations require two notarized signatures: One signature must be from the Chairman of
Board, President, or any Vice President. The second signature must be from the Secretary,
Assistant Secretary, Treasurer, Assistant Treasurer, or Chief
Financial Officer).
By:. By:
i o arized Signature of Chairman of Board, Notarized Signature Secretary, Assf Secretary,
President or any Vice President Treasurer,Asst Treasurer or Chief Financial Officer
Name: John Stevens Name: Mildred Tyler
Title. President Title: Secretary
/��Air/'�n!l/Y
S. of/ f' •—� State of L' Z l=orn:car �ll
County of o- ss County of{Z_,/t. ;t&- Iss
0 before me, on q�_fj n'7 before me.
7W- OV personally appeared d.\.dj' . P,- wl1"4" ,personally appeared
�Drhn�f���1c S a�newa ice; c��91� C-,'y-.bd r� -persc�rarlytctT�wrl—
Soaae-(sr proved to me on the basis of satisfactory evidence) 4-me-(,or proved to a on the basis of satisfactory evidence)
to be the person>rwhose nameLs�`slaresubscribed to the to be the person(sj whose name(gj is/eoe-subscnbed to the
within instrument and acknowledged to me that heA&4e4hey within instrument and acknowledged to me thaljWoh they
executed the same in hisgw;;Ap authorized eapaatygea executed the same in pKLQeyi:Wr authorized capacityjie ,,
and that by his{hoNthe signature,aron the instrument the and that by Js{s'(dt k4err signature(( 'on the instrument the
personX, or the entity upon behalf of which the persDgksT- personal, or the entity upon behalf of which the personw
acted,executed the instrument. acted,executed the instrument
WITNESS my hand and official seal WITNESS my hand and official seal.
Notary Notary \ g
Signature: Signature:
Notary Seal: Notary Seal:
JUUIE .NOU
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CommIl lon 0 1512771 Nmw ftmic-CaliforMa
Nolory Public-Cgliromlo avill Counly
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MV Comm.Expires Oct 9,on
- 7-
CITY OF PALM SPRINGS
EXHIBIT A
Scope of Services
rolec ctivity Titlei Project Number
Fair Housing Council of Riverside/Fair Housing 0009 and 0011
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
O biectives/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
(Le., outreach, public awareness); training / technical assistance (i.e., pro-active workshops preventing
complaints and violations); and enforcement (Le., 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 providingany 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#1
On-Going Establish and maintain an efficient program process/procedure for proper record keeping.
Set-up a filing system for CDBG files only. Document and maintain all records related to
this program in a stable and secure location.
Objective 3: Advertise market and publicize the program to facilitate positive promotion for all parties
i.e. Provider CV, 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.
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 ro osal.
TARGET
DATE ACTIVITY#1
On-Going Conduct program activities for 1,500 clients and offer two workshops for property owners,
managers, Realtors and lenders, as stipulated in the proposal.
Objective 8: 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
Proiect/Activity Title. Project Number:
Fair Housing Council of Riverside/ Fair Housing 0009 and 0011
Name/Address of Prcvider:
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
BUDGETS UMMARY "
COST CATEGORY, CDBG OTHER TOTAL
SHARE SOURCES COST
1 Personnel $17,317. $11,088 $28,405.
2 Consultant/Contract Services 636, 407. 1,043.
3 Travel 120. 76. 196.
4 Space Rental 3,444. 2,201, 5,645,
5 Consumable Office Supplies 709. 454. 1,163.
6 Office Equipment/Purchase, 932, 596. 1,528.
Lease or Maintenance
7 Insurance - 0 - - 0 - - 0 -
8 Other 1,124. 719. 1,843.
Telephone
718. 459. 1,177.
Other Operational Costs*
$25,000. $16,000. $41,000.
TOTALS
If costs are to be shared by other sources of funding, including CDBG funds from otherjurisdictions,
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/ CDHG OTHER TOTAL
PAY ITEMS SHARE SOURCES COST
Wages $13,865. $8,864. $22,729.
Fringe Benefits 3,452, 2,224, 5,676,
Consultant/Contract Services 636. 407. 1,043.
Space Casts 3,444. 2,201. 5,645.
Equipment— 932. 596. 1,52B.
Purchase, Lease or Maintenance
Consumable Supplies 709. 454. 1,163.
Travel 120, 76. 196,
Telephone 1,124. 719. 1,843.
Other Operational Costs 718. 459. 1,177.
Total $25,000. $16 OOO. $41,000.
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 Y4 of the total annual budget. The
reimbursement shall be split between the Community Redevelopment Agency's Tahquitz
Andreas Low/Mod, CDBG's Public Services and CDBG's General Administration with the
respective allocation of $16,000 (39%), $15,000 (37%) and $10,000 (24%), totaling
$41,000.
Services are to be performed over the twelve-month period of this 2006-07 Program Year—
July 1, 2006 through June 30, 2007.
CITY OF PALM SPRINGS
EXHIBIT C
Insurance Inventory
roles ctivityTitle: rolect um er:
Fair Housing Council of Riverside/Fair Housing 0009 and 0011
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 Non-Profits Insurance Alliance of CA
Effective Dates of Policy 04/28/06 to 04/28/07
Claims Made Policy / I Per Occurrence Policy / I
Limits of Liability 12,000,0000 a re ate/S1 000 0DD Per occurrence General Liabili —no
deductible
$1,000,000 combined single limit ea accident—Automobile $500 deductible
Deductibles:
Per Occurrence
Annual Aggregate
Additional Insured Endorsement (Certificate Holder) • Yes ❑ No
Original Certificate of Insurance Attached 0 Yes r No (copy enclosed)
WORKER'S COMPENSATION POLICY
Name of Provider's Insurance Company STATE Compensation Insurance FUND
Effective Dates 07/01/06 to 07/01/07
Limits of liability $1,000,000 per occurrence
Underlying Coverage Limits
Original Certificate of Insurance Attached 0 Yes « No (copy enclosed)
,4CORD DATE(MM DDNYYlr)
TM. CERTIFICATE OF LIABILITY INSURANCE 04/2512006
PRODUCER Pac 99-0&'i11 9 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
$LAVIN S ASSOC-INS,BROKERS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P O BOX 2249 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR yA
RANCHO CUCAMONGA CA 91729 AI,TER THE COVERA95 AFFORDED BY THE PQLICIE$
INSURERS AFFORDING COVERAGE NAIC P
A LrGF OC35!<55
INSURED INSURER A- NONPROFITS INSURANCE ALLIANCE OF CA. p
FAIR HOUSING COUNCIL OF RIVERSIDE COUNTY,INC. INSURER 0: _
PO BOX 1064 INSURER C:
RIVERSIDE CA 52502-1068 -
INSURER O:
INSURER E
COVERAGES
THE POUCIES OF INSURANCE U= BE1(YW I-AVE B8EN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD MDICATED, NOMIITHSTANOING
ANY RCQME RENT,TERM OR CONDITION OF ANY CONTRACT MOTHER DOCUMENT WRN RESRECT TO WHICH THIS CERnRICATE MAY BE ISSUED OR
MAY PERTAIN THE INSURANCE hFFORDEII BY THE POLICIES DESCRIBES] HEREIN IS SUBJECT To ALLTHE TERMS, E)CCLUSIONS AND CONOMONS OF SUCH
POLICIES. AGME-GATEUMns SHOV MAY HAVE BEEN RT3/IICEO BY PAID CLAIMS
'Lml="Jj
TY OF INSURANCE POLICY NUMBER .TE � YG EOwwARorl LIMITS
PE
GENE"L LIABILITY 2006-04221-NPO 04!LBI06 WMW EACH Dcra/RRvrcE z 1,000,000
X OOMMERaALGENERALUABIUTY � --) 5 100,000
CUUMS MADE OCCUR MED.EXP(MYwc person) $ 10,000
A ES X COMM07N PuisoNu-s AOVIWURY s 1.000,000
GENERAL AGGREGATE s 2,000,000
GENL AGGREGATE UM IT APPLIES PER PROOUL95-CCMPe7P AGG- S 7,000,BOB
PRICY JE�CT X LOC
AUTOMOBILE LIABILITY 2006-04221-NPO 0412810i 04128107 COMBINED SINGLE LIMB a 1,000,000
ANY AUTO (EA )
AU.OWNED AUTOS BCPLYIWUURY
(Per fe+".en) S
x SCHEDULED nuros
A X NRm Auras BODILY INJURY S
X NON-0 ED AUTOS (F�u
PRaP6DYDAMAGE S
IPw AccidcPtl
GARAGE UABIUTY AuTOONLY•EAAOGDENT s
ANYAUTO OTRERTHAN EAACC S
hOB]ONLY; qGG 5
EXCESS I UMEIRSUA LIABILITY EACH OCCURRENCE s
OIXUR CLANS MADE AGGREGATE s
S
DEDUCnBLE 5 .
RETENTIONS s
we sYn'Iif �. A
wvRlcrns coM�shnaN AND Tour uArt:
BAPLOY UABILTTY EI EACH ACROENT $
Axr nmNETamARTxEA W Tlyq
ATl�� EL DGFASEFA EMPLOYEE S
xE.r'A.eea�r,.l.r EL DIBEAsE�uMrr S
OTHER
DESCRIPTION OF OPERATIBNSILOCATIONSArEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
ALL OPERATIONS.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESMSED POLLUTES BE CANCELLED BCf-0RETIIE
E)"RAT oN DATE THEREOF.THE ISSUING INST/RER WILL MAIL 30 DAYS WRITTEN
NDnCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
CITY OF PALM SPRINGS
OFFICE OF THE CITY CLERK AUTHO DED REPRESENTATIVE
PO 13OX 2743
PALM SPRINGS,CA 92263
POLICY NUMBER:2006-04221-NPO COMMERCIAL GENERAL LIABILITY
Fair Housing Council of Riverside County, Inc. 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 following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Persons Or Organization(s)
City of Palm Springs, its officials, officers, employees and agents
Office of The City Clerk
PO Box 2743
Palm Springs,CA 92263
Infgrnrationrequired to complete this Schedule, it 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 or-
ganization(s) shown in the Schedule, but only with
respect to liability for 'bodily injury", "property dam-
age" 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:
A. In the performance of your ongoing operations;or
B. In connection with your premises owned by or
rented to you.
CG 20 26 07 04 0 ISO Properties, Inc.,2004 Page 11 of 1 Q
POLICY NUMBER: 200"4221-NPO
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED-OWNERS, LESSEES OR
CONTRACTORS (Form B)
This endorsement modifies insurance provided under the following:
COMMERCIAL AUTOMOBILE LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization(s):
ANY PERSON OR ORGANIZATION
WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT
Of no entry appears above,information required to complete this endorsement will be shown in the
Declarations as applicable to this endorsement)
WHO IS AN INSURED (Section 11) is amended to include as an insured the person or organization
shown in the Schedule,but only with respect to liability arising out of'your ongoing operations'
performed for that insured by or for you.
It is further agreed that insurance provided by this policy for the benefit of the additional insured(s)with
respect to liability arising out of the named insured(s operations shall be primary insurance.Any other
insurance maintained by the additional insured(s)shall be excess and non-contributory.
It is further agreed that this policy provides no insurance for the benefit of any additional insured(s)as
respects the sole negligence of any additional insured(s)
CG 2010 10 93 Copyright, Insurance Services Office, Inc., 1992
ACORD CERTIFICATE OF LIABILITY INSURANCE, 7/ 2007YYY'
PRODUCER (909)476-0600 FAX: (909)476-0601 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
The Empire Company HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
10201 Trademark St. , Suite D ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Sox 5400
Rancho_ Cucamonga CA 91729 INSURERS AFFORDING COVERAGE NAIL 9
INSURED INSUHEHANOn roots Ins. Alliance
Fair Housing Council of Riverside County, Inc. INSURERS
P.O. Box 106E INSURER
NSURER❑
Riverside CA 92502-1068 INS)RERE
CD
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY
REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN
THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
(; SHOWN MAY HAVE BP• AID CLAIMS
INSR A00 L POLICY EFFECTIVE POLICY EXPIRATION
q TYPE OF INSURANCE POLICY NUMBER DATE MM/DO DATE(MWDDNYI LIMITS
GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGETO RENTED no,000
A CLAIMS MADE EMISGS Ea o urrenw s'
OCCUR 2007-04221-NPO 4/28/2007 4/28/2008 MEOFx, P(An„.n arson s 10,000
f VINJURY 1,000,000
..E�SLACG. EGATE 2,000,000
CEN L AGGREGATE LIMIT APPLIES PER PROD S - /Op AGG 9 2rD00,O00
X PC PR
LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
ANY AUTO 2007-04221-NPO 4/28/2007 4/26/2008 (Ea aceldenB 1,000,000
ALL OWNED ALTOS
BODILY INJURY
X =HEOULED AUTOS (Pcr Person) 9
X HIRED AUTOS BODILY INJURY
X NON OWNED AUTOS (Peramcenp 9
PROPERTY DAMAGE
(POr aCCdCnn
h6ARAOELIABILITY
AUTO ONLY-F_A AOCIOEM 9
ANY AUTO OTHERTHAN -ELACL-•5
AUTO ONLY.
ACC e
EXCESSIUMERELLA LIABILITY A nC - 9
OCCUR CLAIMS MADE AGGREGATE 5
B
_ DEDUCTIBLE
6
RFTFNTION T
WORKERS ON AND WOSTATq- OTH•
EMPLOYERS'LIABILITY TGHv I IMI I A FN
ANY RROPRIETORYPARTNOWE]ECU I'IVE EL EACH ACCIDENT
OFFIGERMEMBER EXCLUDED?
If yea tle9nribe under EL DISEASE-EAEMPLOYEE
SPECIAL PROVISIONS b I.
EL DISEASE•POLICY LIMIT 5
OTHER
DESCRIPTION OF CPBRATIONSILOCATIONSNEHICLEUI c4u510NS ADDED BY ENDORSEMENTISPBCIAL PROM51ONS
Cane Notice 10 days for non payment of Premum. The City of Palm Springs, its officers, OTSiclals, employees end
� Iuntccrs arc named as aedutirdval insureds.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES aE CANCELLED BEFORE THE
City Of Pall{{ Springs EIRATION 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
Palm Springs, CA 92262 FAILURE TO Do 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY of ANY FIND UPON THE
INSURER,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE _
Selina Ramos/SELTNA
ACORD 25(2001108) ®ACORD CORPORATION 198Y
INS025(moa)oea P,e e i of 2
POLICY NUMBER:: 2007-04221-NPO 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 fallowing:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured persons Or Or anization s
The City of Palm Springs ils officers,officials, employees and volunteers
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 in-
clude as an additional insured the person{s) or organi-
zations) 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 owned 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 0 ISO Properties, Inc., 2004 Page 1 of 1
POLICYHOLDER COPY SK
STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807
COMPENSATION
INSURANCE
FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 07-01-2008 GROUP:
POLICY NUMBER: 1344748-2006
CERTIFICATE 10: 60
CERTIFICATE EXPIRES: 07-01-2007
07-01-2005/07-01-2007
CITY OF PALM SPRINGS SK
3200 TAH4UITZ CANYON WAY
PALM SPRINGS CA 92262
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer.
We will also give you i0 days advance notice should this policy be cancelled prior to its normal expiration-
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms((.exclusions, and conditions, of such policy.
�TMORIZEMREPRESENTATI PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
EMPLOYER
THE FAIR HOUSING COUNCIL OF RIVERSIDE COUNTY
INC. 613
PO BOX 1068
RIVERSIDE CA 92502 -
140410
PRINTED : 06-19-2006
(REv.7-05)
CITY OF PALM SPRINGS
EXHIBIT D
Beneficiary Qualification Statement
rolec ctiv¢y Title. Prolect Number:
Fair Housing Council of Riverside/ Fair Housing 0009 and 0011
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
BENEFICIARY QUALIFICATION STATEMENT
This statement must be completed and signed by each person or head of household (legal guardian) receiving benefits form the
described projectfactivlty. 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-03108106)
MEDIAN NUMBER OF PERSONS IN YOUR HOUSEHOLD:
INCOME 1 2 3 4 5 6 7 8
LEVEL
VERY LOW
INCOME $20,150 $23,000 $25.900 $28,750 $31,050 $33.350 S35,650 $37,350
Below 50
LOW INCOME $32,200 $36,800 $41A00 $46,000 $49.700 $53,350 $57,050 $60,700
51-80/
M ODERATE
INCOME S48,300 355,200 $62.100 $69,000 $74,500 $80,000 $85,600 $91,100
120%
3. What racakthnicity 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
Cl Black/Afdcan American ❑ Asian AND White
❑ Asian ❑ Slack/Afdcan Amerimn AND White
❑ American Indian or Alaskan Native ❑ American Indian/Alaska Native AND Black/African American
❑ Native Hawaiian or Other Pacific Islander ❑ Other:
HISPANICILATINO ETHNICTY ❑ Yes D No If yes,check one: 0 Mexican/Chicano
❑ Puerto Rican
❑ Cuban
❑ Other.
4. Are you female Head of Household? ❑ YES ❑ NO
S. 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 informatim you provide On this force is confidential and is only utilized for Community Development Block Grant(CDBG)program purposes,a
Federally-funded program,govemmenral reporting purposes to monitor compliance.
CITY OF PALM SPRINGS
EXHIBIT E
Semi-Annual Program Progress Report
roles ctNltYTitle-, Project Number:
Fair Housing Council of Riverside/ Fair Housing 0009 and 0011
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
PROGRAM PROGRESS REPORT Period:
DIRECT BENEFIT REPORT
♦ Number of First-Time Program Beneficiaries Serviced:
#of Households #of Persons
0-50%below 51-80%below 120%below
a Number of First-Time Female Headed Households:
♦ Counts by Race/Ethnicity:
White American Indian or Alaska Native AND White
Black/African American Asian AND White
Asian Black/African American AND White
American Indian or Alaskan Native American Indian/Alaska Native AND Black/African American
Native Hawaiian or Other Pacific Islander Other:
HISPANICILATINO ETHNICITY: Mexican/Chian Puerto Rican
Cuban Other:
ACCOMPLISHMENT NARRATIVE
LEVERAGING RESOURCES NARRATIVE
Signed Title Date
CITY OF PALM SPRINGS
EXHIBIT F
Request for Reimbursement
—ProleC ctivity I ite: Project Number:
Fair Housing Council of Riverside/ Fair Housing 0009 and 0011
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
.Appravad Current Prlor:-' Total. Grant
neser !pn ` Grant j �MReimdursement Roimbursement YTU Balance .
-'i�monnt ,v� ^Poriod ' ;Perlod(aJ. Reimbursumenf (pverl Under)
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-Baoon 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$2 000.00 for
construction, renovation or repair work financed in whole or in part with assistance provided under this contract, shall comply
with Federal requirements adopted by the CITY pertaining to such contracts and with the applicable requirements of the
regulations of the Department of labor, under 29 CFR Parts 1, 3, 5 and 7 governing the payment of wages and ratio of
apprentices and trainees to joumeyworkers; provided,that if wage rates higher than those required under the regulations are
imposed by state and local law, nothing hereunder is intended to relieve the PROVIDER of its obligation, ff any, to require
payment of the higher wage. The PROVIDER shall cause or require to be inserted in full,in all such contracts subject to such
regulations,provisions meeting the requirements of this paragraph,
2. "Section 3 Clause"
a. compliance
Compliance with the provisions of Section 3,the regulations set forth in 24 CFR 135, and all applicable rules and orders
issued hereunder prior to the execution of this contract, shall be a condition of the Federal financial assistance provided
under this Contract and binding upon the CITY, the PROVIDER and any of the PROVIDER's subrecipients and
subcontractors. Failure to fulfill these requirements shall subject the CITY,the PROVIDER and any of the PROVIDER'S
subrecipients and subcontractors,their successors and assigns, to those sanctions specked by the Agreement through
which Federal assistance is provided. The PROVIDER certifies and agrees that no contractual or other disability exists
whirl[would prevent compliance with these requirements,
The PROVIDER further agrees to comply with these "Section 3" requirements and to include the following language in all
subcontracts executed under this Agreement:
"The work to be performed under this contract is a project assisted under a program providing direct Federal financial
assistance from HUD and is subject to the requirements of Section 3 of the Housing and Urban Development Act of
1968,as amended, 12 U.S.0 1701. Section 3 requires that to the greatest extent feasible opportunities for training
and employment be given to low- and very low-income residents of the project area and contracts for work in
connection with the project be awarded to business concerns that provide economic opportunities for low-and very
low-income persons residing in the metropolitan area in which the project is located,"
The PROVIDER further agrees to ensure that opportunities for training and employment arising in connection with a housing
rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public
construction project are given to low-and very low-income persons residing within the metropolitan area in which the CDBG-
funded project is located;where feasible, priority should be given to low-and very low-income persons within the service area
of the project or the neighborhood in which the project is located,and to low-and very low-income participants in other HUD
programs; and award contracts for work undertaken in connection with a housing rehabilitation (including reduction and
abatement of lead-based paint hazards), housing construction, or other public construction project are given to business
concerns that provide economic opportunities for low- and very low-income persons residing within the metropolitan area in
which the CDBG-funded project is located; where feasible, priority should be given to business concerns which provide
economic opportunities to low-and very low-income residents within the service area or the neighborhood in which the project
is located,and to low-and very low-income participants in other HUD programs
The PROVIDER certifies and agrees that no contractual or other legal incapacity exists which would prevent compliance with
these requirements.
b. Notifications
The PROVIDER agrees to send to each labor organization or representative of workers with which it has a collective
bargaining agreement or other contract or understanding, if any, a notice advising said labor organization or workers
representative of Its commitments under this section 3 clause and shall post copies of the notice in conspicuous places
available to employees and applicants for employment or training.