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HomeMy WebLinkAbout04683 - HUD FAIR HOUSING COUNCIL SUBRECIPIENT Page: 1 Deport: Documents to Expire Within 30 days. and XREF=COMMUNITY& ECO and service= IN FILE -Summary March 16, 2004 Document Number Document Description Approval Date Expiration Date Closed Date A4677 Domestic Violence Outreach 04/02/2003 04/01/2004 Company Name: Shelter From The Storm �.�c�[BYO V Insurance Status: Certificate and Policies are OK XREF: COMMUNITY& ECONOMIC DEVELOPMENT ,d o3 Service: In File / A4683 SubrecipientAgr Housing Services 04/11/2003 04/01/2004 Company Name: Fair Housing Council Of Riverside County Insurance Status: Certificate and Policies are OK XREF: COMMUNITY& ECONOMIC DEVELOPMENT IV, p Service: In File * * ' * * ' END OF REPORT * * * * * * Fair Housing Council Subrecipient Agr AGREEMENT #4683 R20302, 4-14-03 SUBRECIPIENT AGREEMENT -- - -THIS AGREEMENT (herein "Agreement"), is made and entered into this '7 day of - , 2003, by and between the CITY OF PALM SPRINGS, (herein "City), a municipal corporation, and the Fair Housing Council of Riverside County, Inc. , (herein "Provider"). WHEREAS, the City has entered into various funding agreements with the United States Department of Housing and Urban Development ("HUD"), which agreements provide funds ("CDBG Funds") to the City under the Federal Housing and Community Development Act of 1974 (42 U.S.C. Section 5301 et sec.), as amended from time to time (the "Act"), and the regulations promulgated thereunder(24 C.F.R. Section 570 et 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 TWENTY-NINE THOUSAND DOLLARS ($29,000.00) (the "Contract Sum") in accordance with the Budget attached hereto in Exhibit B and incorporated herein by this reference; and as herein provided. The budget cost categories set out in Exhibit B are general guidelines and if mutually agreed by both parties, may be amended administratively by no more than 10%, without the requirement of a formal amendment to this Agreement, but in no event shall such adjustments increase the Contract Sum. The Provider shall submit to the City monthly statements on reimbursable expenditures pursuant to the attached Budget along with pertinent supporting documentation. The City shall promptly review the monthly expenditure statements and, upon approval, reimburse the Provider its authorized operating costs. 2.2 Payroll Records. In cases where the contract sum will reimburse payroll expenses as part of operations, the Provider will establish a system of maintaining accurate payroll records which will track daily hours charged to the project by the Provider's respective employees, as set forth in OMB Circular A-122 Attachment B.6. 2.3 Draw Downs. Failure by Provider to request reimbursement or encumbrance of at least 25% of the total grant by the end of each fiscal year quarter (September 30, December 30, March 31, and June 30) shall result in the immediate forfeiture of 25% of the total grant. 3.0 COORDINATION OF WORK. 3.1 Representative of Provider. The following principals of Providers are hereby designated as being the principals and representatives of Provider authorized to act in its behalf with respect to the work specified herein and make all decisions in connection therewith: Board of Directors FAIR HOUSING COUNCIL OF RIVERSIDE COUNTY INC P: ` 0. Box 1056, Riverside, CA 92502 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); (j) 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 sue.); (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: Board of Directors FAIR HOUSING COUNCIL OF RIVERSIDE COUNTY- INC P. 0. Box 1068, Riverside, CA 92502 7.2 Amendment. This Agreement may be amended at any time by the mutual consent of the parties by an instrument in writing. IN WITNESS WHEREOF, the parties have executed this Agreement on the date first above written. CITY OF PALM SPRINGS, CALIFORNIA Dated: 2-3 �•By �' City Manager ATTEST: Agreement over/uof3er $25,000 City Clerk Reviewed and approved by j Procurement & Contracting APPROVED AS TO FORM: Aleshire&Wynder, LLP Initials- Date tcL P.O. Number City ey PROVIDER: Dated: �� ` BjName: Jack Stevensitle: President ---- - - / c BY Name: Mildred Tyle Title: Secretary (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 Cy'bi'.4 e'; SS i��' 't rc= yti 18 4 C?,�/1 ✓�.j.� dye. c�„� ..A 1."> :.. �'7 E4,:", �� 'J` CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California i'd, J�.J�� �1 C'1� ss. Ip? County of I ICI it(((1`' A y-i W lr� �/ , ��+-r fis' d E "4JIL• d'�y"F,r./ t G 71 On h D before me, Date Name antl Tillo of OOlce 1; (e g "Jane Doo,Notary Pvbpc") ;p �✓�/!� Y l/V C/Y 4K—/personally appeared C� < <Qi� Name;a;eisl9nega; .'personally known to me > <; ❑ proved to me on the basis of satisfactory e evidence to be the persons) whose name(s)Lf'i J; subscribed to the within instrument and JI SHERRi iNIMN acknowledged to me that�s,re/i executed JJ r Commission N 1218.533 3 (;I_ •6� 4 the same in �s7hetr/thtir authorized I1; f(g• R-1 Notary Pubic—Colitomio caoacitv(ies , and that by h) hentbeir ICI v •r Riverside County Expires Jun A.2fb3 signature(epon the instrument the person(*,, or ,p my Comm the entity upon behalf of which the persons) (� acted, exec to the instrument. G t% WIZT S In off I I a 1. 2{ SlgnaWre of Notary Pohlm 7 Ir j OPTIONAL Though the information below is not required bylaw,rt may prove valuable to persons relying on the document and could prevent lj S' fraudulent removal and reattachment of this form to another document. )� ai P n c Description of Attached Document 10 �ti i Title or Type of Documen '"'�` �'g "`11�� ll? Document Date: `V9" Number of Pages: °✓� )I C Signer(s)Other Than Named Above: is fai 'j Capacity(ies) Claimed by Signer it' Signer's Name: K )1 t' ❑ Individual f� , Top of thumb here �,i XCorporate Officer—Title(s): i`�• ��- ;� I� f ❑ Partner—❑ Limited ❑General a ❑ Attorney-in-Fact I"r ti' ❑ Trustee io] ❑ Guardian or Conservator j i� [I Other: .05 Signer Is Represenring: in L1 P—i yev,id e UbI _ )1 m 1999 National Notary Association•9350 De Solo Ave,on Box 2402•CFatswoM.CA9Y313-24o2•www naLonalnolaryorg need No 5907 Feordei Call Toll-Free 1-800 876 6827 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT �' State of California&�2A ve� 1 ?I � J} County of On G /1 '� Z � toefore me, Data Name gand Thro of O mar(aa l 1"Jana Data,NiPgv71 i�l personally appeared _ �1v1 G l II '�� �I A Nai or Signer(s) > S, 0_persranafly-kaownrtoTme >I fN,proved to me on the basis of satisfactory SI evidence fl < N to be the pprs in whose name,FS)�s arg 3 °i subscribed to the within instrument and �) m acknowledged to me tha e hey executed JI i( il the same in yrls/ er/her authorized 71 ,> SHERRI D,INWN capaci�(i.es), and that by h+g9l e tfaelr' al 1„ t Commission a IZI si nature )on the instrument the perso ), or °i Notary Public— the entityupon behalf of which the arson Califomla P P.,= )I M Rfvbe Coun y Co ty - acted, ax/eS�t d th instrument. �)) Comm.Expi Jun 4, vyITNE�� SignaWre DI Nolary Pobbc If; OPTIONAL01 (QI Though the information below is not required by law,R may prove valuable to persons relying on the document and could prevent .)1 j„ fraudulent removal and reattachment of this form to another document ;)'I Description of AttachedeDgcument � i Title or Type of Document: IN Document Date: Number of Pages: )r I� !Q1 Signer(s)Other Than Named Above: Capacity(ies) Claimed by Signer ra3 Signer's Name: IA i> CI; El Individual ON of thumb P6reli $Z Corporate Officer—Title(s): ✓'���� ���� r)I ❑ Partner—❑ Limited El General ql ❑ Attorney-in-Fact )7 ((, ❑ Trustee I �� ❑ Guardian or Conservator <. ((; ❑ Other. ( I' -�`� Signer Is Representing:l`Ci i it t 1 I l o;-�; fi N'aii �L. <<�����.:.:=emu•.�-=� ,-,- - � '----;- `'�-.��—�p_�_s,.��).7:--;_�_�; ��J��_v!�/ti1r��e`./�` �•._--'�93 A,1999 National Nola,Association-9350 De Solo Ave,PO Box 2402•ohalswonh,CA 91313-2402•wwlv.nalionalnolaryorg .. Pmd No 5907 Reorder Call Toll-Free 1-800-876-6827 CITY OF PALM SPRINGS EXHIBIT A Scope of Services Proiect/ActivitV Title: Proiect Number: Fair Housing Council of Riverside/Fair Housing Name/Address of Provider: Fair Housing Council of Riverside County, Inc. PO Box 1068, 3600 Lime Street, Ste 613 PO Box 1871; 655 N Palm Canyon Dr Riverside, CA 92502-1068 Palm Springs, CA 92263-1871 O b iectives/Activities The intent of this program is to provide a full menu of fair housing services for Palm Springs residents that promotes fair housing rights and obligations as defined and articulated in the Federal Fair Housing Act and the California State Law Enactments under the Rumford & Unruh Civil Rights Acts which affirmatively furthers fair housing. This will be accomplished through the staffing of a Palm Springs' office facilitating three components, as it relates to Anti-Discrimination and Landlord/Tenant services, such as education (i.e., outreach, public awareness); training / technical assistance (i.e., pro-active workshops preventing complaints and violations); and enforcement (i.e., compliant intake and investigation) for one thousand eight hundred and twenty-two (1,822) 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 CitV bV timely providing anV 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 one thousand eight hundred and twenty two (1,822) residents. TARGET DATE ACTIVITY#1 On-Going Provide fair housing services to clients. Maintain records of names, addresses, demographics and service dates for all assistance. Objective 5: - Maintain records for all CDBG activities related to this program. TARGET DATE ACTIVITY#1 On-Going Document and maintain all records related to this program, including those required, in accordance with HUD Regulations, in a stable and secure location. ACTIVITY#2 Monthly Submit 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 fair housing services including Fair Housing Practice and Landlord/Tenant workshops as outlined in proposal. TARGET DATE ACTIVITY#1 On-Going Conduct program activities for 1,822 clients and offer two workshops for property owners, managers, Realtors and lenders, as stipulated in the proposal. Objective 8: Provide an evaluation within fifteen (15) calendar days of the program completion or final reimbursement. TARGET DATE ACTIVITY#1 07/15/02 Provide an evaluation and final report on all programmatic and financial activities. General Administration Provide the management oversight and leadership to address specific operational tasks in meeting the established performance levels, as well as perform supportive activities (i.e., clerical, monitoring, etc.) CITY OF PALM SPRINGS EXHIBIT B Budget Summary Proiect/Activit Title: Project Number: Fair Housing Council of Riverside/Fair Housing Name/Address of Provider: Fair Housing Council of Riverside County, Inc. PO Box 1068; 3600 Lime Street, Ste 613 PO Box 1871; 655 N Palm Canyon Dr Riverside, CA 92502-1068 Palm Springs, CA 92263-1871 � BUDGET,UM MARY . . . COSTCATEGORY CDBGi' OTHER `,TOTAL: SHARE : J SOURCES COST 1 Personnel $18,487. - 0 - $18,487. 2 Consultant/Contract Services $500. - 0 - $500. 3 Travel $970. - 0 - $970. 4 Space Rental $1,575. - 0 - $1,575. 5 Consumable Office Supplies $1,200. - 0 - $1,200. 6 Office Equipment/Purchase, $1,172. - 0 - $1,172. Lease or Maintenance 7 Insurance 8 Other $2,000. - 0 - $2,000. Telephone $3,096. - 0 - $3,096. Other Operational Costs* $29,000. - 0 - $29,000. 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. EXHIBIT B— Budget Summary Page 2 of 2 Pages � �"IIDETAIEB.UD;GET' DESCRIPTION OF ACTIVITY/ CDBG OTHER TOTAL PAY ITEMS SHARE SOURCES COST Wages $15,690.00 - 0 - $15,690.00 Fringe Benefits $2,797.00 - 0 - $2,797.00 Consultant/Contract Services $500.00 - 0 - $500.00 Space Costs $1,575.00 - 0 - $1,575.00 Equipment— $1,172.00 - 0 - $1,172.00 Purchase, Lease or Maintenance Consumable Supplies $1,200.00 - 0 - $1,200.00 Travel $970.00 - 0 - $970.00 Telephone $2,000.00 - 0 - $2,000.00 Other Operational Costs $3,096.00 - 0 - $3,096.00 Total ' _." � " .: r .:),.',!$29;'000'.DQ�,' b,`= $29',000.00 The Subrecipient shall submit monthly reimbursement based on prorated and actual costs in accordance with the aforementioned cost categories and pay items. In no month shall the Subrecipient submit for reimbursement more than %of the total annual budget. Services are to be performed over the twelve-month period of this 2002-03 Program Year— July 1, 2002 through June 30, 2003. CITY OF PALM SPRINGS EXHIBIT C Insurance Inventory Project/Activity Title: Project Number: Fair Housing Council of Riverside/ Fair Housing Name/Address of Provider: Fair Housing Council of Riverside County, Inc. PO Box 1068; 3600 Lime Street, Ste 613 PO Box 1871; 655 N Palm Canyon Dr Riverside, CA 92502-1068 Palm Springs, CA 92263-1871 INSURANCE INVENTORY LIABILITY INSURANCE POLICY Name of Provider's Insurance Company NONPROFITS ' INSURANCE ALLIANCE OF CALIFORNIA Effective Dates of Policy 4/28/02 to 4/28/03 Claims Made Policy / / Per Occurrence Policy Limits of Liability Each occurrence 11 ,000,000 -- Personal & Adv Injury $1 ,00,000 -- Deductibles: General Agg $2,O0n,000-- Products Comm/Op Agg $2,000,000 -- Auto $1 ,000,000 Per Occurrence Annual Aggregate Additional Insured Endorsement (Certificate Holder) ®Yes ❑ No Original Certificate of Insurance Attached (copy) a Yes ❑ No WORKER'S COMPENSATION POLICY Name of Provider's Insurance Company State Compensation Insurance Fund Effective Dates 7/1 /02 to 7/1 /03 Limits of Liability $1 ,000,000 each occurrence Underlying Coverage Limits Original Certificate of Insurance Attached iR Yes ❑ No copy enclosed CITY OF PALM SPRINGS EXHIBIT D Beneficiary Qualification Statement Project/Activity Title: Project Number: Fair Housing Council of Riverside/ Fair Housing Name/Address of Provider: Date: Fair Housing Council of Riverside County, Inc. PO Box 1068; 3600 Lime Street, Ste 613 PO Box 1871; 655 N Palm Canyon Dr Riverside, CA 92502-1068 Palm Springs, CA 92263-1871 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 6 6 7 8 VERY LOW INCOME $17,450 $19,950 $22,450 $24,950 $26,950 $28,950 $30.950 $32,950 Below 50% LOW INCOME $27.950 $31,950 $35,950 $39,900 $43,100 $46,300 $49,500 $52,700 51 —80% MODERATE INCOME $41,950 $47,900 $53,900 $59,900 $64,700 $69,500 $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 no, if you are a female Head of Household? ❑ YES ❑ 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 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: Proiect Number: Fair Housing Council of Riverside/ Fair Housing Name/Address of Provider: Date: Fair Housing Council of Riverside County, Inc. PO Box 1068; 3600 Lime Street, Ste 613 PO Box 1871; 655 N Palm Canyon Dr Riverside, CA 92502-1068 Palm Springs, CA 92263-1871 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 CITY OF PALM SPRINGS EXHIBIT F Request for Reimbursement Proiect/Activity Title: Proiect Number: Fair Housing Council of Riverside/Fair Housing Name/Address of Provider: Date: Fair Housing Council of Riverside County, Inc. PO Box 1068; 3600 Lime Street, Ste 613 PO Box 1871; 655 N Palm Canyon Dr Riverside, CA 92502-1068 Palm Springs, CA 92263-1871 " AO{ r �. sReTmbIurse 'h7 isemeBaWnce,n o t'". , fa __ ' ; ..jlnt s`� Pnridd :Irerlod(s) kRetmf urseineht {iSvarl Unde __j 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 C 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. CERTIFICAT ` OF LIABILITY INSURANCr DATEA(PR 902 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND SLAVIN&ASSOCIATES INSURANCE BROKERS CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE 10261C TRADEMARK ST I P O BOX 2249 DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE RANCHO CUCAMONGA CA 91729 POLICIES BELOW. PHONE: 909.483-1010 FAX: 909.483-1080 Agency LiG#:OC38855 COMPANIES AFFORDING COVERAGE INSURED COMPANYA: NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA FAIR HOUSING COUNCIL OF RIVERSIDE COUNTY,INC. COMPANY B: PO BOX 1068 RIVERSIDE CA 92502-1068 COMPANY C: COMPANY D: COMPANY E: 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 CLAIMS. INS R TYPE OF INSURANCE POLICY NUMBER POUCYEFFECTIVE POLICY EXPIRATION LIMITS DATE R,IMRRI�j DATE IMMMONY) GENERAL LIABILITY 2002.04221-NPO APR 28 02 APR 28 03 EACH OCCURRENCE $ 1,000,000 _ X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any One Fire) $ 100,000 CLAIMS MADE OCCUR MED.EXP(Any One Person) $ 10,000 A _ PERSONAL&ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GEN-L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOPAGG. $ 2,000,000 X r POLICY PRoJEeT ]LOC AUTOMOBILE LIABILITY 2002.04221-NPO APR 28 02 APR 28 03 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Par person) $ A X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per xcident) $ PROPERTY DAMAGE $ GARAGE LIABILITY I AUTO ONLY-EA ACCIDENT Is IANY AUTO OTHER THAN EAACC.$ AUTO ONLY: AGGs _ EXCESS LIABILITY EACH OCCURRENCE $ LlOCCUR ❑ CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ § WORKERS COMPENSATION AND WC STATU- OTHER EMPLOYERS'LIABILITY RYIIMn^ E.L.EACH ACCIDENT $ E.L.DISEAS&FA EMPLOYEE $ E.L.DISEAS&POUCY LIMIT $ OTHER: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED PERFORM CG 20 26 11-85 ATTACHED. 10 DAYS NOTICE FOR NON-PAYMENT OF PREMIUM. CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: _ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE CITY OF PALM SPRINGS EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL MAIL 30 DAYS WRITTEN P 0 BOX 2743 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, PALM SPRINGS CA 92263-2743 AUTHORIZED REPRESENTATIVE Attention: CITY CLERK ccz�)Cw��' ACORD 25-S(7197) Certificate# 10499 LYN SLAVIN 0007646 POLICY NUMBER: 2002-04221-NPO COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: CITY OF PALM SPRINGS P O BOX 2743 PALM SPRINGS CA 92263-2742 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement). WHO IS AN INSURED (Section ll) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or rented to you. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. CG 2026 (11/85) Copyright, Insurance Services Office, Inc., 1984 ? 'l d S I�XT'� : PIJffo x, p ; Aly Fxcnlc�scq,cA ��©�`Aaz 1 COMP'9NSAT 0-W IN $ UaR fi,lq CTE .. .ia: � i + 4¢ Itt 'JUN 2Sn 2002 'g FUI�Q CERTII'cgTE OF WdRKERS COM{� 1VATIQN II�SURI�NCF 'POLICY NUMBER. 1344748 02� ISSUE DATE: 07-01 02 i _ -, ..CER7lPICA"rE E'XFIFjES _07-Or1=O3 �.. 4 CITY OF PALM "J' NGS PATR�I CI A• SANDIER$- �� $ r, 3200 TAHQUITL CIANXON WAX PALM SPRINGS GA„922b2r;• This is to certify that we have Jssued a•.vagd Workers' Cornp�'n'sptiq,n, msuran'ce polwy"m a form'approved by the California Insurance Commissioner to the eemployer hai'rlp�.,bAlnvJ forv'the policy, period indicated. - This policy is not subject to ca„nce'llstion'by_the Fund exidept'upon'3�o days" advance,written notice to the employer. ' We will also give you 3o days`b6v nce.'notice should this policy be cancelled prior to"its normal expiration. This certificate;of,,insurance,is_not an insurance policy and does not amehe,. extend or after�the coverage afforded by the pohcles listed herein.,Notwithstanding any,r„equrlement, term, or condition of any contract or other document., , - with respect to.which this certificate ofiinsuranee may beissuedpr may`pertains-the insurance afforded;by the,,, policies described herein is subject to all the terriis, exclusions and conditions of such.policies. " PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS' $1 OOd.,OOO:00 PER?OCCURRENCE, LDERS NO'Y,I CE GFFECSIYE 07/C51/02, I•S ATTACbIEp•T,O AND FORMS A PART �OF�THIS POLICY t„u. - ', "• ENDORSEMENTa'4085 ENTITLED CERTIFICATE HO EMPLOYER 'LEGAL NAME ' THE,FATR,•H04IN SG',C,DUNCYL OF - THE :FAIR HOUSING,COUNCI'lit,OF RIVERSIDE RIVERSIDE COUNTY ANC :5.19 COUNTY INC PO BOX loss NON-PROFITi,CORP.') , RIVERSIDE CA 92b'0 " - ` "'is'017, Q2- pi" TFn�, erj�Ano-