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HomeMy WebLinkAbout05066 - BOYS' CLUB OF PALM SPRINGS PARKING LOT SAFETY IMPROVEMENTS CDBG GRANT DOCUMENT TRACKING Page: 8 Report: Expired Documents Summary March 4, 2008 Condition: Oldest Date= / /, Groups=COMMUNITY& ECONOMIC, ALL Services, ALL XREFs Document# Description Apg%v_al_Date Expiration Date Closed Date A5062 . /' CDBG Grant#B-05-MC-06.0561 FY 05- 6 $623,843 04/06/2005 06/30/2005 Company Name: US Dept of HUD Address: Group; COMMUNITY& ECONOMIC 1` `,r ` Service: In File xRef: COMMUNITY & ECONOMIC Ins. Status: No Certificate on file. A5064 CDBG sub-recipient FY 05-06 (Food Sery area ADA repovation) 7 04/06/2005 06/30/2006 Company Name: Family YMCA of the Desert /'AX\� \ ` `C7 Address: Group: COMMUNITY& ECONOMIC Service: In File xRef: COMMUNITY& ECONOMIC Ins. Status: A policy has Expired A5066 CDBG sub-recipient FY 05-06 (parking lot safety imp ovements) $50.000 04/07/2005 06/30/2006 Company Name: Boys' Club of Palm Springs Inc ` \_ Address: U` li I Group: COMMUNITY& ECONOMIC L' Service: In File \\ xRef: COMMUNITY& ECONOMIC Ins. Status: A policy has Expired �✓_: I Boys' Club of Palm Springs Parking lot safety improvements A5066 SUBRECIPIENT AGREEMENT Res 21236 04-06-05 THIS AGREEMENT (herein "Agreement"), is made and entered into this lstday of February 2000 6 by and between the CITY OF PALM SPRINGS, (herein "City), a municipal corporation and charter city, and the Boys' Club of Palm Springs, 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 seq.), 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 Ciiy 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 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 31sr of the current fiscal year. FU� , �. FIN r C!r'tVh:gSa\I��IA � DJC0R s!",ask"r"i?Pi,' � ��V�9h..P 04 �..d`6L'�a,..�m1 V-V�f 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 FIFTY THOUSAND DOLLARS ($50.000.00) (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: James C. Coston L. Dean Moore 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); Q) The labor standard requirements as set forth in 24 CFR Part 570, Subpart K and HUD regulations issued to implement and requirements; (k) The Program Income requirements as set forth in 24 C.F.R. 570.504(c) and 570.503(b)(8); (1) The Provider is to carry out each activity in compliance with all Federal laws and regulations described in 24 C.F.R. 570, Subpart K, except that the Provider does not assume the City's environmental responsibilities described at 24 C.F.R. 570.604; nor does the Provider assume the City's responsibility for initiating the review process under the provisions of 24 C.F.R. Part 52; (m) Executive Order 11988 relating to the evaluation of flood hazards and Executive Order 11288 relating to the prevention, control and abatement of water pollution; (n) The flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234); -3- (o) The regulations, policies, guidelines and requirements of 24 CFR 570; the "Common Rule", 24 CFR Part 85 and subpart J; OMB Circular Nos. A-102, Revised, A-87, A-110 and A-122 as they relate to the acceptance and use of federal funds under the federally- assisted program; (p) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) and implementing regulations issued at 24 CFR Part 1; (q) Title VIII of the Civil Rights Act of 1968 (P.L. 90-284) as amended; (r) The lead-based paint requirements of 24 CFR Part 35 issued pursuant to the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4801 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 ornissions 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 parry desires or is required to give to the other party shall be in writing and either sewed 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: Boys Club of Palm Springs Inc. 450 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 ATTEmST of a municipal corporation '�:a Clerk �` City Manager APPROVE© BY I COUNCIL APPROA, S TO ORM: By: City Attorne) 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 Fi l Officer). By: _r'-i,.(�Jt�.�� 's>1 gy. � JI"''t Notarized Signature/of Chairman of Board, Notarized Signature Secretary,Asst Secretary, President or any Vice President Treasurer, Asst Treasurer or Chief Financial Officer Name: Arthur Block Name: James C . Coston Title: President Title:_ Executive Vice President �/7� State of �,:Y"`` = State of �-�- County of: 6I:L- 5�'I?-=sss County of z ss P / On A before me, On before me, =. r peksonSy��rGliv G{G-- i� �rpe�sonally appeared ,_.�.�1/�i!'fa-ll�i,;zp✓ �i�"•'- '' Y P � , personal) appeared i personally-known 61l �=� ��-''>../� personally-known tome,(or proved to me on the basis of satisfactory evidence) to-mes(or proved to me on the basis of satisfactory evidence) to be the person(S) whose name(s) is/aF subscribed to the to be the person(s) whose name,(s) is/arc subscribed to the within instrument and acknowledged to me that he/she/they- within instrument and acknowledged to me that he/she/they- executed the same in his/herdtheir—authorized capacity(ies), executed the same in his/hadtheir,authorized capacity(ies), and that by his/herRhetr-signature(s) on the instrument the and that by his/herltheiF signature(b) on the instrument the person(s), or the entity upon behalf of which the person(sf person($), or the entity upon behalf of which the person(s) acted,executed the instrument. acted,executed the instrument. WITNESS m hand a d official seal. /- WITNESS my-hand anlofficial seal. Notary i, / Notary Signature: -- f L,e f�.c�! Signatu�� Notary Seal: Notary Seal: Commisillw#11595256 # 56 Notary Pub9C-CONtomla Nolary 1hrbNc•CO NXM RNertlde County klveglde Courtly L01161MV Comm.EXPifet Jul 15,2 pity Comm.FxpltMJr/i5, e&G_SubrecipAgnnnt_RO A05 - 7- CITY OF PALM SPRINGS EXHIBIT A Scope of Services Project/Activity Title: Project Number Palm Springs Boys &Girls Club 0009 Parking Lot Safety Improvements Name/Address of Provider: Palm Springs Boys & Girls Club 450 S Sunrise Way Palm Springs, CA 92262-7641 O biectives/Activities The intent of this program is to remain the largest provider of after-school childcare and youth development activities in the City by offering education, computer education, arts and craft, recreation, and leadership development. This will be accomplished through the continued renovation of their facility that will reconfigure and enlarge their parking lot for separately improved vehicular ingress and egress on one of the City's heavily trafficked primary streets. These improvements would reduce vehicular congestion, establish a circular drop-off and pick-up traffic flow allowing maximum movement, and most importantly, prevent pedestrian injury. The Club serves 985 members in the western part of the Valley of which 934 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 (i.e., Provider. City CDBG, etc.). TARGET DATE ACTIVITY#1 On-Going Draft a promotional piece and submit to City for approval. Advertise in the Desert Sun. Submit final publication to City. Objective 4: Enroll and income qualify at least a total of nine hundred thirty-four (934) low and moderate-income Palm Springs residents. TARGET DATE ACTIVITY#1 On-Going Provide after-school childcare and youth development activities 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 On-Going Submit Semi-Annual reports— referenced Exhibit E. Objective 6: Manage/monitor program activities. TARGET (DATE ACTIVITY#1 On-Going Perform monitoring activities necessary to ensure that the program is being conducted in compliance with the CDBG policies, federal regulations, and local statues, including Davis-Bacon Act, Copeland Act, and Non-discrimination/ EEO requirements. Objective 7: Reconfigure and enlarge the parking lot for separately improved vehicular ingress and egress on one of the City's heavily trafficked primary streets which will reduce vehicular congestion establish a circular drop-off and pick-up traffic flow allowing maximum movement and most importantly, prevent pedestrian injury 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 07/15/06 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: Palm Springs Boys &Girls Club 0009 Parking Lot Safety Improvements Name/Address of Provider: Palm Springs Boys & Girls Club 450 S Sunrise Way Palm Springs, CA 92262-7641 BUDGETSUMMARY _ COST CATEGORY CDBG OTHER TOTAL SHARE SOURCES COST 1 Personnel $ - 0 - $ - 0 - $ - 0 - 2 Consultant/Contract Services $ - 0 - $ - 0 - $ - 0 - 3 Travel $ - 0 - $ - 0 - $ - 0 - 4 Space Rental $ - 0 - $ - 0 - $ - 0 - 5 Consumable Supplies $ - 0 - $ - 0 - $ - 0 - 6 Rental, Lease or Purchase of $ - 0 - $ - 0 - $ - 0 - Equi ment 7 Insurance $ - 0 - $ - 0 - $ - 0 - 8 Other $50,000. $15,000. $65,000 Construction Contract $ - 0 - $ - 0 - $ - 0 - $50,000. $15,000. $65,000: TOTALS If costs are to be shared by other sources of funding, including CDBG funds from other jurisdictions, identify the source of funding, grantor/lending agency, and cost category information. Other funding sources include private donations. Progress payments, approved by the Subrecipient and based upon the percentage of completion of the work with a 10% retention, shall be paid by the 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. The Subrecipient shall receive reimbursements in accordance with the aforementioned cost categories and line items. Services are to be performed over a twelve month period of July 1, 2005 through June 30, 2006 with funds allocated from 2005—06 Program Year. CITY OF PALM SPRINGS EXHIBIT C Insurance Inventory Project/Activity Title: Project Number. Palm Springs Boys &Girls Club 0009 Parking Lot Safety Improvements Name/Address of Provider: Palm Springs Boys &Girls Club 450 S Sunrise Way Palm Springs, CA 92262-7641 INSURANCE INVENTORY LIABILITY INSURANCE POLICY Name of Provider's Insurance Company Markel Insurance Company Effective Dates of Policy 5/29/2005 - 5/29/2006 Claims Made Policy / / Per Occurrence Policy Limits of Liability $10 , 000, 000 Deductibles: Per Occurrence $1 ,000 Annual Aggregate Additional Insured Endorsement (Certificate Holder) ❑ `(as g No Original Certificate of Insurance Attached ❑Yes 4 No WORKER'S COMPENSATION POLICY Name of Providers Insurance Company Alea North America Insurance Co. Effective Dates 6/1/2005 - 6/1/2006 Limits of Liability $10 , 000 , 000 Underlying Coverage Limits $1 ,000 , 000 Original Certificate of Insurance Attached ❑Yes d No 'ACORQR ] CERTIFICATE OF INSURANCE SSUE GATE(MM/DDNY) 05-25-2005 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Markel Insurance Company NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, P.O. Box 3870 EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Glen Allen, VA 23058-3870 COMPANIES AFFORDING COVERAGE COMPANY CODE SUB-CODE LETTER A MARKEL INSURANCE COMPANY COMPANY B INSURED LETTER Boys Club of Palm Springs, Inc. & COMPANY O Pathfinder Ranch, Inc. I. ER 450 S. Sunrise Way COMPANY D Palm Springs, CA 92262 LETTER COMPANY E LETTER THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID r.1 AIMS O POLICY EFFECTIVE POLICY EXPIRATION TA TYPE OF INSURANCE POLICY NUMBER LIMITS PATE IMM/DDNVI DATE IMM/DDlVV) A GENERAL LIABILITY GENERAL AGGREGATE $ 51000,000 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OPS AGGREGATE $ 1,000,000 CLAIMS MADE El OCCUR. 8502CY077170-7 05-29-2005 05-29-2006 PERSONAL&ADVERTISING INJURY $ 1,000,000 OWNERS&CONTRACTOR'S PROT. EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE(Anyone fire) $ 100,000 MEDICAL EXPENSE(Any one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE ANY AUTO LIMIT $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) 5 HIRED AUTOS BODILY INJURY NON OWNEDAUTOS (Pereccident) $ GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM - STATUTORY LIMITS WORKER'S COMPENSATION AND EACH ACCIDENT 5 DISEASE POLICY LIMIT $ EMPLOYERS'LIABILITY DISEASE EACH EMPLOYEE $ A OTHER Inland Marine Property 8502CY077170-7 05-29-2005 05-29-2006 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Certificate holder is included as additional insured as lessor of premises. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO City of Palm Springs MAIL In DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION Department of Recreation OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR Post Office Box 2743 REPRESENTATIVES. 19 Palm Springs, CA 92263 AUTHORIZED REPRESENTATIVE ,''�^ !( Bruce A. Kay AB I ACORD 25-S(7/90) (c) ACORD CORPORATION 1990 CITY OF PALM SPRINGS EXHIBIT D Beneficiary Qualification Statement Project/Activity Title: Project Number: Palm Springs Boys & Girls Club 0009 Parking Lot Safety Improvements Name/Address of Provider: Palm Springs Boys & Girls Club 450 S Sunrise Way Palm Springs, CA 92262-7641 BENEFICIARY QUALIFICATION STATEMENT This statement must be completed and signed by each person or head or 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—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 $25,050 $27,850 $30,050 $32,300 $34,500 $36,750 Below 50% LOW INCOME $31,200 $35,650 $40,100 $44,550 $48,100 $51,700 $55,250 $58,800 51 —80% MODERATE INCOME $46,750 $53,450 $60,100 $66,800 $72,150 $77,500 $82,850 $88,200 20% 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 ❑ 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 ❑ Yes ❑ No If yes, check one. O 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 form is confidential and is only utilized for Community Development Block Grant(CDBG) program purposes, a Federally-funded program,governmental reporting purposes to monitor compliance. CITY OF PALM SPRINGS EXHIBIT E Semi-Annual Program Progress Report Project/Activity Title Project Number: Palm Springs Boys & Girls Club 0009 Parking Lot Safety Improvements Name/Address of Provider: Palm Springs Boys & Girls Club 450 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 0-50%below 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 Indian/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 Proiect/Activity Title: Project Number: Palm Springs Boys & Girls Club 0009 Parking Lot Safety Improvements Name/Address of Provider: Palm Springs Boys & Girls Club 450 S Sunrise Way Palm Springs, CA 92262-7641 BENEFICIARY QUALIFICATION STATEMENT A roved Current ' 'Prior Total Grant, C PF _ Description Grant Reimbursement Reiioiiursement YTD "' Balance Amount Period Period(s) .Reimbursement (Overt Under) [ , TOTAL. I CERTIFY THAT, (a) the City of PALM SPRINGS, as grantee of the CDBG, has not previously been billed for the costs covered by this invoice, (b) funds have not been received from the Federal Government or expended for such costs under the terms of the Agreement or grant pursuant to FMC-74-4 & 24 CFR Part 58;(c) this agency is in full compliance with all applicable provisions under the terms of the Contractor grant; and (d) this agency is in full compliance with all applicable 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 1965, 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 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 Best's Rating Center- Search Results Page I Page I of I rid see I � �. WI r ' w rr nrer View Ratings: Financial Strength Issuer Credit Securities Advanced Search Other Web Centers: Select One 11 Search Results Page 1 of 1 2 Rated and non-Rated companies found, results sorted by Company Name Criteria Used: Company Name: Company names starting with markel ins To refine your search, please use our Advanced Search or view our Online Help for more information. New search' I Imarke!ins i View results starting with: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Re Company Information Financial Strength Ratings Issuer Credit Ratings Outlook/ � Outlook/ * AMB# Company Name Rating Implication Long-Term * Implication Short-Term- Domicile 02699 Markel Insurance Company A Stable a Stable US: Illinois (Property/Casualty-Insurance Company) 85767 Markel Insurance Company of A.* Negative a-* Negative CA: Ontaric Canada (Property/Casualty-Insurance Company) Note: Financial Strength Ratings as of 0410312006 02:46 PM E.S.T. Financial Strength Ratings (FSR) are sometimes assigned to Property/Casualty-A.M. Best Consolidated Groups. Please nc $Life/Health -A.M. Best Consolidated Groups and Company Consolidated Financial Statements are not assigned FSR rating; * Denotes Under Review Best's Ratings Visit Best's Rating Center for a complete overview of our rating process and methodologies. Important Notice:Best's Ratings reflect our independent opinion,based on a comprehensive quantitative and qualitative evaluation of a company's balance sheet stren operating performance and business profile.These ratings are neither a warranty of a company's financial strength nor its ability to meet its financial obligations,includin policyholders.View our entire notice for complete details. Customer Service I Product Support I Member Center I Contact Info I Careers About A.M. Best I Site Map I Privacy Policy I Secur y I Terms of Use I Legal & Licensing Copyright©2006 A.M.Best Company, Inc.All rights reserved. A.M.Best Worldwide Headquarters,Ambest Road,Oldwick,New Jersey,08858, U.S.A. http://www3.ambest.coin/ratings/RatingsSearch.asp?AltSrc=9 04/03/06 Best's Rating Center- Search Results Page 1 Page 1 of 1 ;I View Ratings:Financial Siren th Issuer Credit Securities Advanced Search Select O Other Web Centers: ne Search Results Page 1 of 1 2 Rated and non-Rated companies found, results sorted by Company Name Criteria Used: Company Name: Company names starting with alea north amer To refine your search, please use our Advanced Search or view our Online Help for more information. New Search oleo nodn amer View results starting with: A B C D E F G H I J K L M N O P O R S T U V W X Y Z RE Company Information Financial Strength Ratings Issuer Credit Ratings Outlook/ . Outlook/ AMB# Company Name Rating Implication Long-Term Implication Short-Term Domicile 12467 Alea North America Insurance NR-4 Not nr US: New Y, Comps Applicable (Property/Casualty-Insurance Company) 11432 Alea North America Specia� NR-4 Not nr US: Delam (Property/Casualty-Insurance Company) Applicable Note;Financial Strength Ratings as of 0410312006 02:46 PM E.S.T. Financial Strength Ratings(FSR) are sometimes assigned to Property/Casualty-A.M. Best Consolidated Groups. Please me $Life/Health -A.M. Best Consolidated Groups and Company Consolidated Financial Statements are not assigned FSR rating, * Denotes Under Review Best's Ratinps Visit Best's Rating Center for a complete overview of our rating process and methodologies. Important Notice:Best's Ratings reflect our independent opinion,based on a comprehensive quantitative and qualitative evaluation of a company's balance sheet siren operating performance and business profile.These ratings are neither a warranty of a company's financial strength nor its ability to meet its financial obligations,includin policyholders.View our entire notice for complete details. Customer Service I Product Support I Member Center I Contact Info I Careers About A.M. Best I Site Map I Privacy Policy I Securit I Terms of Use I Legal & Licensing Copyright©2006 A.M.Best Company, Inc.All rights reserved. A.M.Best Worldwide Headquarters,Ambest Road,Oldwick, New Jersey,08858, U.S.A. http://www3.ambest.corn/ratings/RatingsSearch.asp 04/03/06 From Chapman Cert Request At:Chapman Insurance Fa%ID Chapman Assocs E26- To CRY of Palm Springs Date.4/52006 02:56 AM Page 2 of 2 a�20RD. CERTIFICATE OF LIABILITY INSURANCE 0PID p DATE(MWDDrvvry BOYS-40 04 05/06 PRODUCER THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION Chapman 6 Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License #0522024 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P. 0. Box 5455 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Pasadena CA 91117-0455 Phone: 626-405-8031 Fax:626-405-0585 INSURERS AFFORDING COVERAGE NAIL If INSURED tMURERA Alea North America Ins Co INSURER O Boys 6 Girls Club of Palm wsuRERc Springs .450 S Sunrise Wayy INSURERD Palm Springs CA 92262 NSURER E COVERAGES THE POUCIES 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 LTR MR TYPEOFINSURANCE POLICY NUMBER DATE(MWDDIYY) DATE(MWDDIYY) LIMITS GENERALLIAmLITY EACH OCCURRENCE $ MA COMMERCIAL GENERAL LIABILITY PREMISES Eaacurence $ CLAIMSMADE OCCUR MED EXP(Ary.Ta,son) $ PERSONAL A ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGGRO $ POLICY1-1 J T LOD AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALLOWNEDAUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (PcraaldenQ PROPERTYDAMAGE $ (Pat=deal) GA AGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHERTHAN EA ACC $ 7 AUTOONLY: AGO $ EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ b DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TORY LIMITS ER A EMPLOYERS'LIABILRY WC1003329 06/01/05 06/Ol/06 E.L.EACH ACCIDENT $1O0o000 ANY OFFICE PEMBERIEXCLUDEIE%ECUTIVE EL.DISEASE-EA EMPLOYEE $1000000 OPFICEOPRIETEREACLUDEDP SPECIAL PROVISIONS below EL DISEASE-POLICY LIMIT $1000000 OTHER DESCRIPTION of OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Evidence of Workers' Compensation coverage. 10 days notice of cancellation for non-Lpayment of premium. CERTIFICATE HOLDER CANCELLATION CITYPAI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATETHEREOF,THE ISSUING INSURER WALL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL City of Palm Springs IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR ,PO Box 2743 REPRESENTATIVES. Palm Springs, CA 92263 AUT DREPRE ATI ACORD 25(2001108) ©ACORD CORPORATION 1988 CONTRACT ABSTRACT Contract Company Name: Boys' Club of Palm Springs, Inc. Company Contact: James C. Coston, Executive Vice-President Summary of Services: Parking Lot Safety Improvements Contract Price: $50,000.00 Funding Source: CDBG 137-4806-63553 ($50,000) Contract Term: July 1, 2005 - June 30, 2006 Contract Administration Lead Department: Community & Economic Development Contract Administrator: Dale Cook Contract Approvals Council/ Community Redevelopment Agency Approval Date: April 6, 2005 Minute Order/ Resolution Number: 21236 Agreement No: A5066 Contract Compliance Exhibits: Yes Signatures: Yes Insurance: Yes Bonds: N/A Contract prepared by: Dale Cook, Community Devel 1pment Administrator Submitted on: March 31, 2006 By: ������ )f ?A LM S k M E M O R A N D U M � ��IGA.vYi.V vs4 �TO: Dale Cook Community Development Administrator FROM: Kathie Hart, CMC Chief Deputy City Clerk DATE: April 11, 2006 SUBJECT: Boys' Club of Palm Springs, Inc. —A5066 (parking lot safety improvements) cc: File Attached are four duplicate originals relating to the subject agreement. We have retained the original for our files. Please feel free to contact me if there are any questions, ext. 8206. /kdh attach.