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HomeMy WebLinkAbout04728 - PSUSD CDBG SUBRECIPIENT ADULT EDUATION ?ALAI City of Palm Springs 'ti Community Redevelopment Agency ' MEMORANDUM tglffOgN�� Date: August 14, 2003 To: Barbara White, Assistant City Clerk From: John Raymond, Director of Community& Economic Develo Subject: Closing/termination of expired contracts Yesterday I sent over a long list of expired contracts that had been reviewed by Dale Cook, the Community Development Administrator, with instructions to close the ones indicated. These were mostly CDBG contracts that have expired, the services provided, and the funds paid out. The purpose of this memo is to inform you that I reviewed the list and concur with the recommendation to close those indicated. Please keep a copy of this memo in the file of each of the ide4ified closed contracts. PSUSD Subrecipient Agr Adult Ed AGREEMENT #4728 CM signed 7-31-03 p/R20021 SUBRECIPIENT AGREEMENT THIS AGREEMENT(herein "Agreement"), is made and entered into this 16 day of June 200 1 by and between the CITY OF PALM SPRINGS, (herein "City), a municipal corporation, and the Palm Springs Unified School District-Adult Education , (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 sue.), as amended from time to time (the "Act'), and the regulations promulgated thereunder(24 C.F.R. Section 570 et seg. ('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 CONTRACTOR. 1.1 Scope of Services. In compliance with all terms and conditions of this Agreement, the Provider shall provide those services specified in the "Scope of Services" attached hereto as Exhibit "A" and incorporated herein by this reference. Provider warrants that all services will be performed in a competent, professional and satisfactory manner. 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. 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 TWELVE THOUSAND DOLLARS ($12,000.00) (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: Virginia D. Eberhard:; ,PhD, PRINCIPAL 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 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: -2 - (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 to promote religious interests 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); (o) The regulations, policies, guidelines and requirements of 24 CFR 570; the "Common Rule", 24 CFR Part 85 and subpart J; OMB - 3 - 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 Vlll of the Civil Rights Act of 1968 (P.L. 90-284) as amended; (r) The lead-based paint requirements of 24 CFR Part 35 issued pursuant to the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.); (s) Maintain property inventory system to numerically identify HUD purchased property and document its acquisition date as is set forth in OMB Circular A-110 Attachment N Property Management Standard 6d; and (t) Reversion of asset. Upon the Expiration of the agreement, the subrecipient shall transfer to the City any CDBG funds on hand at the time of expiration and any accounts receivable attributable to the use of CDBG funds. Additionally, any real property under the 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.) (i) 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 -4- 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, color, creed, religion, sex, marital status, physical or mental disability, national origin, or ancestry 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, or ancestry. 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 Attn: City Manager - 5- WITH COPY TO: Aleshire&Wynder, LLP 18881 Von Karman Avenue, Suite 400 Irvine, CA 92612-1500 TO PROVIDER: PALM SPRINGS ADULT SCHOOL 333 S. FARRELL DRIVE 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 this Agreement on the date first above written. _CITY OF PALM SPRINGS, CALIFORNIA f C Dated: City City Manager ATTES City Clerk ra'>`s icb°,' 1,.In/:;: h J"r -Pt,�G-"a'tll;'r; L e APPROVED AS TO FORM: Aleshire &Wynder, LLP City ey PROVIDER: PALM SPRINGS UNIFIED SCHOOL DISTRICT ADULT EDUCATION Dated: 06/16/03 Name: William E. Diedrich, PhD Title: Superintendent Naive: Virginia D. Eberhard, PhD Title: Principal (Corporations require two NOTARIZED signatures; one from each of the following categories: A. Chairman of Board, President or any Vice President,AND B. Secretary,Assistant Secretary, Treasurer,Assistant Treasurer, or Chief Financial Officer.) - 6 - ` L;1IIa��I1 QTI�Il�Qll�� �1CCII;ir�T®�PJILIId»C�l'�d�i f>d�`J°� �\S State of California �_�„ - County of �' �( Je On O61/ /"//"'�9.-.? before lue, 1 A5F1 f _ (NGIARY) i personally appeared � �CJJ✓�.;� -� Z.f L-"AfK4,��, d� SIGNER(S) / �) personally known to me OR - ❑ proved to me on the basis of satisfactory �) evidence to be the person,(s) whose named is/ale subscribed to the within instrument and U acknowledged to me that he/she/they executed l� the same in his/her/their authorized capacity(ies), and that by his/her/their �) signatures(s) on the instrument the person(s), ) ( or the entity upon behalf of which the )) person(s) acted, executed the instrument. () r+ '.-: ANA M. TAPIR �p CmUNTA 1297660 N ) U� 'A 4 NOTARY PUBLIC CAUFOANIA Los Angeles County My Cemm,bpyee Mereh18,2005 WITNESS t hand and official seal. ( NOTARY'S SIG ATURE ) The information below is not required by law. However, it could prevent fraudulent attachment of this acknowl- edgement to an unauthorized document. QIt ACC I'llly ICHAYIi ED NY MCKEH' QPRIP`WTIPPQ DI33MRIIT"1PHOH 0P A77AECHHED D®CC[UP�K-mv ❑ INDIVIDUAL /i D ��Gf'C' Sf cii J S of CORPORATE OFFICER TITLE OR TYPE OF DOCUMENT I rI'1,E(s) . 0 s " ❑ PARTNER(S) ❑ ATTORNEY-IN-FACT NUMBER OF PAGES ( ❑ TRUSTEE(S) GZ ( ❑ GUARDIAN/CONSERVATOR l DATE OF DOCUMENT ®'OTHER: S () (> OTHER SIGNER IS REPRESENTIINIC: RIGHT THUMBPRINT O NAME OF PERSON(S)OR NTITY(IES) OF E (� V _ SIGNER o ) L^.�.J�CCCe��.:�^.�J::�.�� APA5/99 VALLEY-SIERRA, 800-362-3369 CITY OF PALM SPRING'S EXHIBIT A Scope of Services Project/Activity Title: Project Number: Palm Springs Unified School District 0013 Adult Vocational Education -Operations Name/Address of Provider: Date: PSUSD Adult Vocational Education 333 South Farrell Dr Palm Springs, CA 92262 Objectives/Activities The intent of this program is to provide hands-on educational and training in the field of television operations (i.e., filming, editing, broadcasting) through the City's local government cable access channel. The program will enroll twenty-six (26) low-to-moderate individuals of which fifteen (15) individuals are Palm Spring 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 qualifies at least an approximately fourteen (14) individuals. TARGET DATE ACTIVITY#1 On-Going Distribute motel vouchers to clients. Maintain records of names, addresses, demographics and service dates for all assistance. Objective 6: Maintain records for all CDBG activities related to this program. TARGET DATE ACTIVITY#1 On-Going Document and maintain all records related to this program, including those required, in accordance with HUD Regulations, in a stable and secure location. ACTIVITY#2 Monthly Submit quarterly reports—referenced Exhibit E. Objective 6: Manage/monitor program activities. TARGET DATE ACTIVITY#1 On-Going Perform monitoring activities necessary to ensure that the program is being conducted in compliance with the CDBG policies, federal regulations, and local statues, including Davis-Bacon Act, Copeland Act, and Non-discrimination/EEO requirements. Objective 7: Provide emergency housing services, including motel vouchers to homeless individuals as outlined in proposal. TARGET DATE ACTIVITY#1 On-Going Conduct program activities, 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 Project/Activity Title: Project Number: Palm Springs Unified School District 0013 Adult Vocational Education -Operations Name/Address of Provider: Date: PSUSD Adult Vocational Education 333 South Farrell Dr Palm Springs, CA 92262 BUDGOT,SUMNIARY COST CATEGORY CDBG OTHER TOTAL SHARE SOURCES COST 1 Personnel $12,000. $33,500. $45,500. 2 Consultant/Contract Services $ $ $ 3 Travel $ $ $ 4 Space Rental $ $ $ 5 Consumable Supplies $ $ $ 6 Rental, Lease or Purchase of $ $ $ Equipment 7 Insurance $ $ $ 8 Other $ $2,000. $2,000. Book and upplies $ $2,500. $2,500. Other Outgo $12,000. $38,000. $50,000. 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 primarily are Community-Based English Tutoring Grant and Carl Perkins Vocational &Technical Education. EXHIBIT B—Budget Summary Page 2 of 2 Pages DETAIL BUDGET DESCRIPTION OF ACTIVITY/ CDBG OTHER TOTAL PAY ITEMS SHARE SOURCES COST Personnel - $12,000. $33.500. $45,500. Salaries/Benefits—Instructor Other Costs- -0 - $4,500. $4,500. Operations & Overhead Expenses Total $92;000. $38,000. $501000: The Subrecipient shall submit monthly reimbursement of Personnel Salaries/Benefits for the Instructor costs based on the District's $50.00 Contractual Hourly rate, including Health & Welfare Benefits 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 301h 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 2001-02 Program Year—July 1, 2001 through June 30, 2002. CITY OF PALM SPRINGS EXHIBIT C Insurance Inventory Proiect/Activity Title: Project Number: Palm Springs Unified School District 0013 Adult Vocational Education -Operations Name/Address of Provider: Date: PSUSD Adult Vocational Education 333 South Farrell Dr Palm Springs, CA 92262 INSURANCEINVENTORY LIABILITY INSURANCE POLICY Name of Provider's Insurance Company RSIA/ACE USA-Pacific Employer Effective Dates of Policy 07/01/01 through 06/30/02 Claims Made Policy / / Per Occurrence Policy Limits of Liability $1 000 000.00 Deductibles: NONE Per Occurrence Annual Aggregate Additional Insured Endorsement (Certificate Holder) wYes ❑ No Original Certificate of Insurance Attached ❑ Yes AN WORKER'S COMPENSATION POLICY Name of Provider's Insurance Company ACE USA-Pacific Employer Effective Dates 07/01/01 through 06/30/02 Limits of Liability $1,000 000.00 Underlying Coverage Limits N/A Original Certificate of Insurance Attached ❑Yes I/No CITY OF PALM SPRINGS EXHIBIT D Beneficiary Qualification Statement Proiect/ActivitV Title: Proiect Number: Palm Springs,Unified School District 0013 Adult Vocational Education -Operations Name/Address of Provider: Date: PSUSD Adult Vocational Education 333 South Farrell Dr Palm Springs, CA 92262 BENEFICIARY QUALIFICATION STATEMENT This statement must be completed and signed by each person or head of household (legal guardian) receiving benefits form the described project/activity. Please answer each of the following questions. 1. How many persons are in your household? For this question a household is a group of related or unrelated persons occupying the same house with at least one member being the head of the household. Renters,roomers,or borders cannot be included as household members. 2. Circle your combined gross annual income(Riverside-San Bernardino,CA—03129101) MEDIAN INCOME NUMBER OF PERSONS IN YOUR HOUSEHOLD: LEVEL 1 2 3 4 5F$28,950 7 8 VERY LOW INCOME $17,450 $19,950 $22,450 $24,950 $26,950 $30,950 $32,950 Below 50% LOWINCOME $27,950 $31,950 $35,950 $39,900 $43,100 $49,500 $52,700 51—80% MODERATE INCOME $41,950 $47.900 $53,900 $59,900 $64,700 $74,300 $79,100 120% 3. Do you identify yourself as: ❑ White ❑ Black ❑ Hispanic ❑ Asian Pacific Islander ❑ American Indian/Alaskan Native 4. Please circle, ves or n�if you are a female Head of Household? ❑ YES ❑ NO ACKNOWLEDGEMENT AND DISCLAIMER 1 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 for Community Development Block Grant(CDBG)program purposes only and will be kept confidential. CITY OF PALM SPRINGS EXHIBIT E Quarterly Program Progress Report Proiect/Activity Title: Project Number: Palm Springs Unified School District 0013 Adult Vocational Education -Operations Name/Address of Provider: Date: PSUSD Adult Vocational Education 333 South Farrell Dr Palm Springs, CA 92262 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, not Hispanic Origin Black, not Hispanic Origin Hispanic American Indian/Alaskan Native Asian Pacific Islander Multi-ethnic ACCOMPLISHMENT NARRATIVE LEVERAGING RESOURCES NARRATIVE Signed Title Date r. CITY ©F PALM SPRINGS EXHIBIT F Request for Reimbursement Project/Activity Title: Project Number: Palm Springs Unified School District 0013 Adult Vocational Education -Operations Name/Address of Provider: Date: PSUSD Adult Vocational Education 333 South Farrell Dr Palm Springs, CA 92262 ?PRroved Current: ,Prlor Total `. Grant Desod'pflon "Grant ReimbUnsemant Reimbursement; 1TD" Balance Amount Period ! Period(a) Reimbursement .(dverl 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-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 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. r F al ReLiEF CERTIFICATE OF COVERAGE ISSUEDATE 04/10/03 TRATOR: LICENSE#0451271 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION NAN & ASSOCIATES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 0 Central Avenue #400 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR R].VETSide, CA 92506 ALTER THE COVERAGES AFFORDED BY THE COVERAGE DOCUMENTS BELOW, COVERED PARTY: ENTITIES AFFORDING COVERAGE RIVERSIDE SCHOOLS INSURANCE AUTHORITY ENTITYA Southern California Palm Springs Unified School District ReLiEF 980 E . Tahquitz Canyon Way, Suite 200 Palm Springs, CA 92262 ATTN: Mr. Curtis Stephan THIS IS TO CERTIFY THAT THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE COVERED PART(NAMED ABOVE FORTHE PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, NCOVFRAG[I,, AFFORDED HEREIN IS SUBJECT TO ALL THE TERMS,AND CONDITIONS OF SUCH COVERAGE DOCUMENTS. TYPE OF COVERAGE COVERAGE EFFECTIVE/ MEMBER DOCUMENTS XPIRATION DATE ETAINED LIMIT LIMITS DEDUCTIBLE GENERAL LIABILITYy]GENERAL LIABILITY SCR0010116 07/O1/02 COMBINED SINGLE LIMIT ]CLAIMS MADE[,NOCCURRENCE EACH OCCURRENCE )QGOVERNMENTCODES 07/01/03 $50, 000 $ 5, 000 , 000 QERRORS&OMISSIONS ] AUTOMOBILE LIABILITY yJANY AUTO COMBINED SINGLE LIMIT A [yJHIRED AUTO SCROO10116 07/01/02 EACH OCCURRENCE [y]NON-OWNED AUTO 07/01/03 $50, 000 $ 5, 000, 000 [y]GARAGE LIABILITY [A]AUTO PHYSICAL DAMAGE PROPERTY SCROO10116 07/01/02 A ALL RISK $25, 000 $ 100, 000, 000 EXCLUDES EARTHQUAKE&FLOOD 07/01/03 EACH OCCURRENCE A STUDENT PROFESSIONAL LIABILITY SCROO10116 07/01/02 07/01/03 $50, 000 $ Included EACH OCCURRENCE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL PROVISIONS: Subrecipient Agreement for Community Development Block Grant funds . CERTIFICATE HOLDER: CANCELLATION..... SHOULD ANY OF THE ABOVE DESCRIBED COVERAGES BE CANCELED BEFORE THE EXPIRATIQN DATE THEREOF,THE ISSUING ENT"JPA City Of Palm Springs WILL PPIWAVdW515MAIL 30 DAYSWRITENNOTGETOTHECERTIRCATE 3200 Tahquitz Canyon Way HOLDER NAMED TO THE LEFT, Palm Springs, CA 92262 KR kkwy-RAFR IXKx (%?C—��� �� �Ga--'- ATTN: Mr. Dale Cook Jr. AUTHORIZED REPRESENTATIVE [ K&A..P/L..06/20001 of 1 #S25605/M14372 BKO T ^ A.C.# 25605 SOUTHERN CALIFORNIA ReLiEF ENDORSEMENT ADDITIONAL COVERED PARTY COVERED PARTY COVERAGE DOCUMENT ADMINISTRATOR Palm Springs Unified School SCR0010116 KEENAN &ASSOCIATES District Subject to all its terms, conditions, exclusions and endorsements, such additional covered party as is afforded by the coverage document shall also apply to the following entity but only as respects to liability arising directly from the actions and activities of the covered party described under"as respects" below. Additional Covered Party: City of Palm Springs 3200 Tahquitz Canyon Way Palm Springs, CA 92262 As Respects: Subrecipient Agreement for Community Development Block Grant funds . Authorized Representative Client#: 641 PALMSPRU AAaC D„ CERTIFICATE OF LIABILITY INSURANCE 0DATE 4/10/030 v) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keenan &Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3610 Central Avenue, Suite 400 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Riverside, CA 92506 INSURERS AFFORDING COVERAGE INSURED INSURER A: ACE USA1Pacific Employers Ins. Co. Palm Springs Unified School District INSURERB: 980 E. Tahquitz Canyon Way, Suite 200 INSURER C: Palm Springs, CA 92262 INSURER D: Attn: Mr. Curtis Stephan INSURERE: 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 NSR TYPE OFINSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE MM/OOlYY DATE MM/DD/YY GENERAL LIABILITY EACH OCCURRENCE $ COMM ERCIAL GENERAL LIAR ILITY FIRE DAMAGE(Any one fire) S CLAIMS MADE D OCCUR MED EXP(Any one person) $ PERSONAL&AOV INJURY $ GENERAL AGGREGATE $ GEN'L AGGRE7LIMITAPPLIES PER: PRODUCTS -COMP/OPAGG $ POLICY PEa LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGO $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR F-11 CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION AND WLRC43506110 07/01/02 67/01/03 X TOOSTAY LI Tl OTR EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $1,000,000 E.L.DISEASE-EA EMPLOYEE $1,000,000 E.L DISEASE-POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSfVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS *10 Days notice of cancellation for non-payment of premium applies. Subrecipient Agreement for Community Development Block Grant funds. CERTIFICATE HOLDER ADDPRONALINSURED;INSURERLETTER: CANCELLATION SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Palm Springs DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYSWRITTEN 3200 Tahquitz Canyon Way NOTICETOTHE CERTIFICATE HOLD ERNAM ED TOTHE LEFT,BUTFAJLURE TODOSOSHALL Palm Springs, CA 92262 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURERJTS AGENTS On REPRESENTATIVES. AUTHORIZED R Attn: Mr. Dale Cook Jr. �� ACORD 25-S(7/97)1 of 2 #S2639/M1786 BKO © ACORD CORPORATION 1988 y k IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD25-S(7/97)2 of 2 #S2639/M1786 0 0 So Cal ReLIEF CERTIFICATE OF COVERAGE ISSUEDATE 08/19/03 ADMINISTRATOR: LICENSE#0451271 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keenan & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3610 Central Avenue, Suite 400 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Riverside, CA 92506 ALTER THE COVERAGES AFFORDED BY THE COVERAGE DOCUMENTS BELOW. COVERED PARTY: ENTITIES AFFORDING COVERAGE _ RIVERSIDE SCHOOLS INSURANCE AUTHORITY ENTITYA Southern Californi-a',',;m,?w/, „ Palm Springs Unified School District ReLiFF 980 EtCa9226Way, Suite 200 Palm Springs, CA 2 ATTN: Mr. Curtis Stephan THIS IS TO CERTIFY THAT THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE COVERED PARTY NAMED ABOVE FOR THE 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 COVERAGE AFFORDED HEREIN IS SUBJECT TO ALL THE TERMS,AND CONDITIONS OF SUCH COVERAGE DOCUMENTS. ENT TYPE OF COVERAGE COVERAGE EFFECTIVE/ MEMBER LTR DOCUMENTS EXPIRATION DATE RETAINED LIMIT LIMITS DEDUCTIBLE GENERAL LIABILITY A [X]GENERAL LIABILITY SCR0010117 07/O1/03 COMBINED SINGLE LIMIT [ ]CLAIMS MADE[XOCCURRENCE EACH OCCURRENCE [X]GOVERNMENT CODES 07/01/04 $50 , 000 $ 5, 000, 000 [X]ERRORS&OMISSIONS I AUTOMOBILE LIABILITY [}{]ANY AUTO COMBINED SINGLE LIMIT A' [X]HIRED AUTO SCROO10117 07/01/03 EACH OCCURRENCE [y,]NON-OWNED AUTO 07/01/04 $50, 000 $ 5, 000 , 000 [X]GARAGE LIABILITY [ ]AUTO PHYSICAL DAMAGE PROPERTY SCR0010117 07/01/03 A ALL RISK $25 , 000 $ 150 , 000, 000 EXCLUDES EARTHQUAKE&FLOOD 07/01/04 EACH OCCURRENCE A STUDENT PROFESSIONAL LIABILITY SCR0010117 07/01/03 07/01/04 $50, 000 $ Included EACH OCCURRENCE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL PROVISIONS: Hanger Lease Agreement 44729 for a portion of Lot 2 in Section 13 of Palm Valley Colony Lands for warehouse space. CERTIFICATE HOLDER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED COVERAGES BE CANCELED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING ENTITY/JPA City of Palm Springs WILL MVAVWt-6 30 DAYS WRITTEN NOTICETOTHE CERIIHCATE 3400 East TahqultZ Canyon Way HOLDER NAMED TO THE LEFT,Q Suite-OFC � � � � �� Palm Springs, CA 92262-6966 � ATTN: AUTHORIZED REPRESENTATIVE K&A..P/L..06/20001 of 1 4S34909/M26329 BKO ATE(MM PIPS CERTI&ATE OF COVERAGE * /DD/YY) ISSUE DATE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ADMINISTRATOR ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Keenan & Associates License#0461271 ALTER THE COVERAGE AFFORDED BY THE COVERAGE 3610 Central Ave.,Suite 400 DOCUMENTS OF COVERAGE BELOW. Riverside, CA 92506 ENTITIES AFFORDING COVERAGE COVERED PARTY ENTITY A: Protected Insurance Program for Schools Palm Springs Unified School District ENTITY B' 980 East Tahquitz Canyon Way,Suite 200 Palm Springs, CA 92262 ENTITY C' ENTITY D: Attn: Mr. Curtis Stephan ENTITY e COVERAGES L' THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE COVERED PARTY NAMED ABOVE FOR THE PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE COVERAGE AFFORDED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH COVERAGE DOCUMENTS. EFFECTIVE EXPIRATION ENT COVERAGE DATE DATE LTR TYPE OF COVERAGE DOCUMENTS MM/DDIYY MM/DD/YY LIMITS oTH- 'See Special WC STATUTORY LIMITS X ER Provisions Below WORKERS 07/01/03 06/30/04 E.L.EACH ACCIDENT $ 1,000,000.00 A COMPENSATION AND PIPS 00129 12:00 AM 11:69 PM EMPLOYERS'LIABILITY E.L.DISEASE—EA EMPLOYEE 1,000,000.00 E.L.DISEASE—COVERAGE LIMIT $ 1,000,000.00 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/RESTRICTIONS/SPECIAL PROVISIONS Hanger Lease Agreement#4729 for a portion of Lot 2 in Section 13 of Palm Valley Colony Lands for warehouse space. Subject to terms and conditions of the Memorandum of Coverage CERTIFICATE HOLDER ADDITIONAL COVERED PARTY;ENTITY LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED COVERAGES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING ENTITY WILL ENDEAVER TO MAIL 30` DAYS WRITTEN NOTICE TO THE CERTIFICATE City of Palm Springs HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO 3400 East Tahquitz Canyon Way, Suite-OFC OBLIGATION OR LIABILITY OF ANY KIND UPON THE ENTITY,ITS AGENTS OR Palm Springs, CA 92262-6966 REPRESENTATIVES. Attn: AUTHORIZED REPRESENTATIVE Certificate No, 57 Keenan&Associates Rev.6/24/03 Lic#0451271 Confidential Client Use Only Page 1 of 2 l A.C.# 34909 SOUTHERN CALIFORNIA ReLiEF ENDORSEMENT ADDITIONAL COVERED PARTY COVERED PARTY COVERAGE DOCUMENT ADMINISTRATOR Palm Springs Unified School SCR0010117 KEENAN &ASSOCIATES District Subject to all its terms, conditions, exclusions and endorsements, such additional covered party as is afforded by the coverage document shall also apply to the following entity but only as respects to liability arising directly from the actions and activities of the covered party described under "as respects" below. Additional Covered Party: City of Palm Springs, its officers, employees and agents 3400 East Tahquitz Canyon Way Suite-OFC Palm Springs, CA 92262-6966 As Respects: Hanger Lease Agreement #4729 for a portion of Lot 2 in Section 13 of Palm Valley Colony Lands for warehouse space . This coverage shall be primary to the certificate holders coverage as respects the actions and activities of the Covered Party due to their sole negligence . Authorized Representative