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HomeMy WebLinkAbout05065 - MIZELL SENIOR CENTER OF PALM SPRINGS EXTERIOR ENERGY-EFFICIENT LIGHTING IMPROVEMENTS • Pabe 1 of 1 • Kathie Hart From: Kathie Hart Sent: March 10, 2008 3:18 PM To: John Raymond Cc: Dale Cook Subject: CDBG Agreements Tracking: Recipient Delivery John Raymond Delivered: 03/10/08 3'18 PM Dale Cook Delivered: 03/10/083t18PIA JR Per our conversation of Friday, March 7, 2008, I will close all CDBG Agreements through FY 2005-06, except for the YMCA agreement which I just sent you email on earlier today. 491, Kathie Hart, CMC Chief Deputy City Clerk City of Palm Springs 3800 lanym[r Canyon Way Pzdro Springs, CA 9226.2 Kathie.Nurt@palmsprmgs-cogov Office (760)323-8200 03/10/08 SUBRECIPIENT AGREEMENT THIS AGREEMENT (herein "Agreement"), is made and entered into this A day of 1-I 200�, by and between the CITY OF PALM SPRINGS, (herein "City), a municipal corporation end charter city, and the Mizell Senior Center of Palm Springs. , (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 seq. ("Regulations"), and WHEREAS, the Act provides that the City may grant the CDBG Funds to nonprofit organizations for certain purposes allowed under the Act, and WHEREAS, the Provider is a nonprofit organization which operates a program which is eligible for a grant of CDBG funds and the City desires to assist in the operation of the program by granting CDBG Funds to the Provider to pay for all or a portion of those costs incurred in operating the program permitted by the Act and the Regulations on terms and conditions more particularly set forth herein; NOW, THEREFORE, the parties hereto agree as follows: 1.0 SERVICES OF PROVIDER, 1.1 Scope_ of Services. Provider agrees to provide to City all of the services specified and detailed in its application for funding and Exhibit A, 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 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 2005 - 2006 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"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 SEVENTEEN THOUSAND DOLLARS ($17,000.00) (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: 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 Against Subcontracting or Assignment. Provider shall not contract with any other entity to perform in whole or in part the services required hereunder without the express written approval of the City. Neither this Agreement nor any interest herein may be assigned or transferred, voluntarily or by operation of law, without the prior written approval of the City. 3.4 Independent Contractor. Neither the City nor any of its employees shall have any control over the manner, mode or means by which Provider, its agents or employees, perform the services required herein, except as otherwise set forth herein. Provider shall perform all services required herein as an independent contractor of City and shall remain at all times as to City a wholly independent contractor with only such obligations as are consistent with that role. Provider shall not at any time or in any manner represent that it or any of its agents or employees are agents or employees of City. 4.0 COMPLIANCE WITH FEDERAL REGULATIONS, 4.1 The Provider shall maintain records of its operations and financial activities in accordance with the requirements of the Housing and Community Development Act and the regulations promulgated thereunder, which records shall be open to inspection and audit by the authorized representatives of the City, the Department of Housing and Urban Development and the Comptroller General during regular working hours. Said records shall be maintained for such time as - 2 - may be required by the regulations of the Housing and Community Development Act, but in no case for less than three 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 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); () 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 et sea.); (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 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. 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 S Sunrise Way Palm Springs, CA 92262 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 _ a mumci all corporation Al r y it Clerk � 7 7 1 1 2�p City Manager APPROV F RM: APPROVED BY CITY CO'UKIL City Attorne \ 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). n BY /<-7'_�',4 ^I Notarized Signature of Chairman of Board, Notarized Signature Secretary, Asst Secretary, Presi ennt/or any Vice President Treasurer,Asst Treasurer or Chief Financial Officer Name 1 !-!�/,� W7i // C- Name- k` ZI ✓�4✓ "(Z- k 5 Title: l�c ✓2GS�C�4 i 7 Title. of p f Stateof Stateof ��414 `'n,n p County of 1IU/PE';.�iI.D"$ County of 1� �trj Y')f �ss On L —d 'I/ — 0 :Z before me, On fp"I_`'^ I g before me, Personal YaAAeared r ' . , onally appeared s personally known ,���'i ��_J �,�.�,�r n.�/1� personally known to me(or proved to me on the basis of satisfactory evidence) to me(or proved to me o the basis of satisfactory evidence) to be the person(o whose name(sfis(aW subscribed to the to be the person('whose nameX is/aX subscribed to the within instrument and acknowledged to me that Wshe/Pw? within instrument and acknowledged to me that helswl jiey' executed the same in tj1t/her/tbKr authorized capaclty�K, executed the same In his/t&/t er authorized capacityQW, and that by 4W/her/tf elf signature(s) on the instrument the and that by his/harltDe�fir signature( )-on the instrument the personK,, or the entity upon behalf of which the personX person(W or the entity upon behalf of which the person(d5)` acted,executed the instrument acted.Oxeouted the instrument. WITNESS mg har}d and official se,/I, WITNESS my h pd and official s al. e Notary 7 q 7 1V - Notary 1� Signature• ��I. ✓ /�-I%/-/!�/ Signature Notary Seal. 1V �V/��� Notary Seal E.M.BRODERICK E. M. BROpERICK Commission 0 173N67 Corn a E- M. R all RICK 7 a NOfary VubNC-COIIfOn11a + Notary pu411c -Cgl[fornla RlwnldR County Riverside County MNCrntrI1,R{rMn/IPrdr�i 1 MyCamm.ExpuesApr5,2t711 Mizell_SubmelpAgrmnt-Enrgy-Eficnt juIQ$ - 7- CITY OF PALM SPRINGS EXHIBIT A Scope of Services Proiect/Activity Title: Proiect Number: Mizell Senior Center/ 0007 Exterior Energy-Efficient Lighting Improvements Name/Address of Provider. Mizell Senior Center 480 S Sunrise Way Palm Springs, CA 92262-7641 Obiectives/Activities The intent of this program is to provide programming and services for very-low income to moderate income seniors and frail elderly. This will be accomplished through the upgrade exterior light fixtures connecting to a centralized photoelectric switching system for improved energy-efficiencies and wider illuminated coverage. These improvements would provide the building's exterior perimeter better nighttime security lighting, promote expanded after-hour usage, showcase the building's evening architectural beauty, and reduce operational costs. Those operational savings can in turn be redirected allowing for increased programming and services. The Center also serves as one of the City's emergency shelters under the Fire Department's Emergency Preparedness Plan and Riverside County Summer Crisis Cooling Center. The Mizell Senior Center primarily covers the City of Palm Springs and the adjacent community of Cathedral City, serving 5,200 clients of which 4,940 are 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 oesitive 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 qualifV at least a total of 4,940 low and moderate-income Palm Springs residents. TARGET DATE ACTIVITY#1 On-Going Provide direct client programming for 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 92 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: Upgrade and improve the building's exterior lighting system for greater energy-efficiency in accordance with an 'open competitive' procurement process as outlined in proposal TARGET DATE ACTIVITY#1 On-Going Conduct program activities, 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 07/15/07 Provide an evaluation and final report on all programmatic and financial activities. General Administration Provide the management oversight and leadership to address specific operational tasks in meeting the established performance levels, as well as perform supportive activities (i e , clerical, monitoring, etc.) CITY OF PALM SPRINGS EXHIBIT B Budget Summary Prolect/Activity Title: P_reiect Number; Mizell Senior Center/ 0007 Exterior Energy-Efficient Lighting Improvements Name/Address of Provider: Mizell Senior Center 480 S Sunrise Way Palm Springs, CA 92262-7641 Ll BUDGET,SUMMARY COST CATEGORY CDBG OTHER TOTAL SHARE SOURCES COST 1 Personnel $ - 0 - $ - 0 - $ - 0 - 2 Consultant/Contract Services $ - 0 - $5,000, $5,000. 3 Travel $ - 0 - $ - 0 - $ - 0 - 4 Space Rental $ - 0 - $ - 0 - $ - 0 - 5 Consumable Supplies $ - 0 - $ - 0 - $ - 0 - 6 Rental, Lease or Purchase of $ - 0 - $ - 0 - $ - 0 - Equipment 7 Insurance $ - 0 - $ - 0 - $ - 0 - 8 Other $17,000. _ $1,750. $18,750. A/C Contractor Contract $ - D - $ - 0 - $ - 0 - $1T,DDO $1,750. $18,75Ll 0. TOTALS *If costs are to be shared by other sources of funding, including CDSG funds from other jurisdictions, identify the source of funding, grantor/lending agency, and cost category information. Other funding source includes Mizell's cash match. 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 2005-06 Program Year — July 1, 2005 through June 30, 2006. CITY OF PALM SPRINGS EXHIBIT C Insurance Inventory Proiect/Activity Title: Proiect Number: Mizell Senior Center/ 0007 Exterior Energy-Efficient Lighting Improvements Name/Address of Provider: Mizell Senior Center 480 S Sunrise Way Palm Springs, CA 92262-7641 INSURANCE INVENTORY LIABILITY INSURANCE POLICY Name of Provider's Insurance Philadelphia Insurance Co Effective Dates of Policy 10/14/04 to 10/14/05 and 10/14/05 to 10/14/05 Claims Made Policy / / Per Occurrence Policy ! / Limits of Liability $2,000,000 General Aggregate Deductibles: Per Occurrence_ $1,000.00 Annual Aggregate $5,000.00 Additional Insured Endorsement (Certificate Holder) 0 Yes ❑ No Original Certificate of Insurance Attached 0 Yes O No WORKER'S COMPENSATION POLICY Name of Provider's Insurance Company State Compensation Insurance Fund Effective Dates 08/06/04 to 08/06/05 and 08/06/05 to 08/06/06 Limits of Liability_ $1 000 000 Per Occurrence Underlying Coverage Limits Per Statute as set by State Law Original Certificate of Insurance Attached 0 Yes 121 No ACORD D6/ CERTIFICATE OF LIABILITY INSURANCE DATE 28/20D$ PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Weingarten & X3ough (`I RECEIVED ` ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P 0 Box 1866 22�QQ55 nIIF P.hLf1 aPRIi'�iG.. ALTERRTHECOVERAGE CERTIFICATE AFFORDEDBYTHEPOL.ICIESBELOW.EXTEND OR Pal% S rungs CA 922063 JUL _ I AM 8, 16 INSURERS AFFORDING COVERAGE INSURED INSURERA PHILADEL$HIA INSURANCE CO Mizell Senior Center +1 CITY CLER/., INSURER B: {"^ 480 S. Sunrise r 5col f � INSURERC V'AY " / f 1 f�;'f INSURER❑ Palm S rin s CA92262- ** [ ,•*d,� 6'�, INSURERS COVERAGES (' THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OPINSURANCE POLICY NUMBER POLICYEFFEC POLICY EXPIRATION _ LIMIT$ LTR DATE M TNE M/DD DATE MMIDDr A GENERAL LIABILITY / / EACH OCCURRENCE 5 1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Anyone fire) $ 100,000 CLAIMS MADE OCCUR BRPi,057282 10/14/2004 10/14/2005 MEO EXP(Anj ego parson) S 5,000 PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN L AGGREGATE 4IMIT APPLIES PER PRODUCTS-COMP/OP AGO $ 1,000,000 POLICY PR X LOC A `AUTOMOBILE LIABILITY / / / / COMBINED ANY AUTO (Ea accidemINGLE LIMIT ) 5 1,000,000 ALL OWNED AUTOS PHPK097282 10/14/2004 10/14/2005 BODILY INJURY X SCHEDULED AUTOS (Per person) S HIRED AUTOS / / / / BODILY INJURY NON-OWNED AUTOS (Peracadpw) S PROPERTY DAMAGE (Pcraccldent) S GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO / / / / OTHERTHAN EAACC S AUTO ONLY AGO $ EXCESS LIABILITY / / / / EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S 5 DEDUCTIBLE / / / / S RETENTION 5 S WORKERS C' MPENSA ION ANDOTH- TORT LIMI I'S ER E.L EACH ACCIDENT $ EL DISEASE-EA EMPLOYEES EL DISEASE.POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS OPERATIONS OF THE INSURED FOR THE CIERTIFICATE HOLDER RE: AGREEMENT N2621 AND LEASE OF PREMISES AT 480 S, SUNRISE WAY, PALM SPRINGS, CA. THE CITY OF PALM SPRINGS IS NAMED AS ADDITIONAL INSTJRED. 10 DAY NOTICE OF CANCELLATION FOR NONPAYMENT OF PREMIUM. CERTIFICATE HOLDER X I ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT THE CITY OF PALM SPRINGS FAILURE TO DO SO SHALL IMPOSE NO BLIGATION OR LIABILITY OF ANY RIND UPON THE INSURANCE DEPT. INSURER,ITS AGENTS OR REPRESENTA IVE P. 0. BOX 2743 AUTHORIZED REPRESENTATIV ti PALM SPRINGS CA 92263- 01 AACORD 25-S(7197) ©ACORD CORPORATION 1988 L'Lrm"INS025S(9910).02 ELECTRONIC LASER FORMS INC.-(a00)227-0945 Page 1 of2 11/30/2004 17:44 760320a373 MIZELL SENIOR rt7NTER PAGE 02 CERTHOWER COPY �I w P:Q. f �Cr l r SAN FRANCISCO-CA '04142-6907 w lu V146 CEATIPICAft bFt 1NgRIKERV COMPENSATION`INkLIAmes 1 uE OATS Pi-O-20CV a GROUP; g •. .. POLICY NUMBER G"6023-I00i CERTIFICATE IM 12 r " CERTIPICATE'EXPI�yyIF�S: 00-00-4004 � ': N 0a-{s►*20oi(0�/YtMI-><oW i a V OF ?ALA 4PRIMGs S8, ATt'M PICd.E''CA K P 0 80X 2743 PALM SPRINVIS CA ` 9226) 'Th is to cardfY llyirt VM hVVI I99UW a wiid Workirs' Co"ensetion Insurawo policy in a forin approbad by the C ornia Irmurance Commissioner to the amploy r named below for the pollgy parlod Indicsted. Th policy is not swiect to cancellation by the Fund except upon 3o days' advance written Milos to the ercaployw. i r : W Will, also {five yott.riry diyi`sdvaricai r4lice should this policy be cancelled prior to its nomrnar expiration Ttir Ciro!cafe c} insWarme Is feet sh in wine Policy end does not amend, extend or alter the covA7a3e afforded by P711Ccj�es lied tiireln„,",w&hsWd� any,rAquiremenk term. or condition of any contract or other dbculttent wi rsspbct•to which Ws certificate of idsuradoe,may bF.issued or may parpin, the insurance afforded:by the Po 1*6 dwferibed herein it subject to all the tprms, FxiWalQns and Conditions of Fuck Policies, i frMA, PRESIDI:WT_�RIVLIA91Il3TY L114T INCLUDING WrlilSL' 6�TS: 000,DGDOo F'ER°DCCll11.RtNCEw.Xr'/C0'i6 EMTST4kp AWITI NAt. INSURED EMPLOYER EFFECTIVtr69-00-20PO 19 ATTAOIf4D'Tp AM PART DF THIS IDL`?sCY.q § xAWITI0MA1, INSLREDt CI;TY OF •p"I SpItING5 SK MEMT 020H EWITLED C�RTIPICATfr FOLDERS• MTICE FFFtCTIVE 0{-00-2003 IS ATTACNEDTO AND PART DF TRY; AOLtcT., ^ EMPLOYER LEM "W .. . . , MIZCLLr ,SENi0R, 'IC TER �► k.1f 1PRIM ivili pown, 480 $ SUNRISE r.NAK'Y �' "•M"`' rA FLGM-PRar T GDIRP.) : PALM SPRINGS CA �g2242i I u DOCUMENT HASA BLUE PATTERNED BACKGROUND CITY OF PALM SPRINGS EXHIBIT D Beneficiary Qualification Statement Project/ActivityTitle: Proiect Number: Mizell Senior Center/ 0007 Exterior Energy-Efficient Lighting Improvements 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 pro)ectlactivily. Please answer each of the following questions. 1. How many persons are in your household? For this question a household Is a group of related or unrelated persons occupying the same house with at least one member being the head of the household, Renters,roomers,or borders cannot be included as household members. 2. Circle your combined gross annual income(Riverside-San Bernardino-Ontario,CA MSA—02/11/05) MEDIAN NUMBER OF PERSONS IN YOUR HOUSEHOLD: INCOME 1 2 3 4 5 6 7 8 LEVEL VERY LOW INCOME $19,500 $22.250 S25,050 $27,850 $30,050 $32,300 $34,500 $36,750 Below 50% LOW INCOME $31,200 S35,650 $40,100 $44,550 S48,100 $51 700 S55,250 $58,800 51—80% MODERATE INCOME $46,750 $53,450 $60100 S66,800 $72.150 577,500 $82,850 $88,200 120% 3. What racelethnicity do you identify yourself as; please note that this self-identification is voluntary in accordance with equal opportunity laws? ❑ White ❑ American Indian or Alaska Native AND White ❑ Black/African American ❑ Asian AND White ❑ Asian ❑ Block/African American AND White 0 American Indian or Alaskan Native ❑ American Indian/Alaska Native AND SlackfAfrican American ❑ Native Hawaiian or Other Pacific Islander EI Other: HISPANICILATINO ETHNICITY ❑ Yes ❑ No If yes,check one. 0 Mexican/Chicano ❑ Puerto Rican 0 Cuban ❑ Other: 4. Please check,for n�rf you are a female Head of Household? ❑ YES 0 NO ACKNOWLEDGEMENT AND DISCLAIMER I CERTIFY UNDER PENALTY OF PERJURY THAT INCOME AND HOUSHOLD STATEMENTS MADE ON THIS FORM ARE TRUE, NAME: DATE: ADDRESS: PHONE NO: SIGNATURE: The information you provide on this form Is confidential and is only utilized for Community Development Block Grant(CDBG)program purposes a Federally-funded program,govemmental reporting purposes to monitor compliance, CITY OF PALM SPRINGS EXHIBIT E Semi-Annual Program Progress Report ProtectlActivity Title: Project Number: Mizell Senior Center/ 0007 Exterior Energy-Efficient Lighting Improvements Name/Address of Provider: Mizell Senior Center 480 S Sunrise Way Palm Springs, CA 92262-7641 PROGRAM PROGRESS REPORT Period: 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 Nahve AND White Slack/Afriean American 900 Asian AND White_ Asian 20_ Black/African American AND White American Indian or Alaskan Native American Indian/Alaska Native AND Black/African American Native Hawaiian or Other Pacific Islander Other: HISPANIC/LATINO ETHNICITY. Mexican/Chicano 120 Puerto Rican Cuban Other, ACCOMPLISHMENT NARRATIVE The lighting project for the Mizell Senior Center has been a benefit for the Center and those who use the facility. Replacing older exterior lighting has had an unknown dollar saving, as many of the lights replaced were not in good working order, however, we have been able to utilize the facility in a manner that better accommodates those with sight or ambulatory issues. By providing better lighting, we have eliminated dark spots by entrances and walk ways, creating a safer environment. �1 LEVERAGING RESOURCES NARRATIVE I i Signed 11� Title Executive Director Date V �V�©� CITY OF PALM SPRINGS EXHIBIT F Request for Reimbursement Project/Activity Title: Proiect Number Mizell Senior Center/ 0007 Exterior Energy-Efficient Lighting Improvements Name/Address of Provider: Mizell Senior Center 480 S Sunrise Way Palm Springs, CA 92262-7641 BENEFICIARY QUALIFICATION STATEMENT Approved �� curranb, '• Prior .,.T. Total•—--- Grant" . Oascripkion ',Grant Reiplbu5eemenk" ',Reimborsement" YTO '- Balance 'A'mqunt' ;L Period , o.Feriod(s) )Reimbursement (Oved'lJnder),, LTDTAL I CERTIFY THAT, (a) the City of PALM SPRINGS, as grantee of the CDBG, has not previously been billed for the costs covered by this Invoice, (b) funds have not been received from the Federal Government or expended for such costs under the terms of the Agreement or grant pursuant to FMC-74-4 & 24 CFR Part 58;(c) this agency is in full compliance with all applicable provisions under the terms of the Contractor grant; and (d) this agency is in full compliance with all applicable tax laws and hereby affix original signatures. PREPARED BY: APPROVED BY: Name, Title, Date Name, Title, Date City of PALM SPRINGS Use Only Audited by Examined by' Approved by: If necessary,additional sheet(s) must be attached detailing cost breakdowns, and verified by original signatures CITY OF PALM SPRINGS EXHIBIT G Employment Restrictions 1, Labor Standards The PROVIDER agrees to comply with the requirements of the Secretary of Labor in accordance with the Davis-Bacon Act as amended, the provisions of Contract Work Hours and Safety Standards Act, the Copeland "Anti-Kickback" Act (40 U S C. 276a-276a-5;40 USC 327 and 40 USC 276c)and all other applicable Federal, state and local laws and regulations pertaining to labor standards insofar as those acts apply to the performance of this contract. The PROVIDER shall agree to submit documentation provide by the CITY which demonstrates Compliance with hour and wage requirements of this part. The PROVIDER agrees that, all general contractors or subcontractors engaged under contracts in excess of$2,000,00 for construction, renovation or repair work financed in whole or in part with assistance provided under this contract, shall comply with Federal requirements adopted by the CITY pertaining to such contracts and with the applicable requirements of the regulations of the Department of labor, under 29 CFR Parts 1, 3, 5 and 7 governing the payment of wages and ratio of apprentices and trainees to journeyworkers provided, that if wage rates higher than those required under the regulations are imposed by state and local law, nothing hereunder is intended to relieve the PROVIDER of its obligation, if any, to require payment of the higher wage. The PROVIDER shall cause or require to be inserted in full, in all such contracts subject to such regulations,provisions meeting the requirements of this paragraph. 2. "Section 3 Clause" a Compliance Compliance with the provisions of Section 3,the regulations set forth in 24 CFR 135, and all applicable rules and orders issued hereunder prior to the execution of this contract, shall be a condition of the Federal financial assistance provided under this Contract and binding upon the CITY, the PROVIDER and any of the PROVIDER'S subrecipients and subcontractors. Failure to fulfill these requirements shall subject the CITY, the PROVIDER and any of the PROVIDER'S subrecipients and subcontractors, their successors and assigns, to those sanctions specified by the Agreement through which Federal assistance is provided. The PROVIDER certifies and agrees that no contractual or other disability exists which would prevent compliance with these requirements. The PROVIDER further agrees to comply with these "Section 3" requirements and to include the following language in all subcontracts executed under this Agreement. 'The work to be performed under this contract is a project assisted under a program providing direct Federal financial assistance from HUD and is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.0 1701. Section 3 requires that to the greatest extent feasible opportunities for training and employment be given to low- and very low-income residents of the project area and contracts for work in connection with the project be awarded to business concerns that provide economic opportunities for low-and very low-income persons residing in the metropolitan area in which the project Is located.' The PROVIDER further agrees to ensure that opportunities for training and employment arising in connection with a housing rehabilitation (including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to low-and very low-income persons residing within the metropolitan area In which the CDBG- funded project is located;where feasible, priority should be given to low-and very low-income persons within the service area of the project or the neighborhood in which the project is located, and to low-and very low-income participants in other HUD programs; and award contracts for work undertaken In connection with a housing rehabilitation (Including reduction and abatement of lead-based paint hazards), housing construction, or other public construction project are given to business concerns that provide economic Opportunities for low- and very low-Income persons residing within the metropolitan area In which the CDBO-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, Notifcetlons 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.