HomeMy WebLinkAbout04524 - MIZELL SENIOR CENTER SUBRECIPIENT AGR • • Mizell Senior -Center
Subrecipient Agreement
AGREEMENT #4524
R20021, 4-4-01
SLIBRECIPIENT AGREEMENT
THIS AGREEMENT (herein "Agreement'), is made and entered into this 9'" day of May ,
2002, by and betweeq,the CITY OF PALM SPRINGS, (herein"City), a municipal corporation, and the
As<<z c/l5'?n rs✓ v (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 sea.), 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 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 THOUSAND DOLLARS ($20,000.00) (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
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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 [east 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
all`d�ecisions in connection therewith:
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3.2 Contract Officer. The Contract Officer shall be such person as may be
designated by the chief administrative officer of City,
3.3 Prohibition Against Subcontractinq or Assignment. Provider shall not contract
with any other entity to perform in whole or in part the services required hereunder without the express
written approval of the City. Neither this Agreement nor any interest herein may be assigned or
transferred, voluntarily or by operation of law, without the prior written approval of the City.
3.4 Independent Contractor. Neither the City nor any of its employees shall have
any control over the manner, mode or means by which Provider, its agents or employees, perform the
services required herein, except as otherwise set forth herein. Provider shall perform all services
required herein as an independent contractor of City and shall remain at all times as to City a wholly
independent contractor with only such obligations as are consistent with that role. Provider shall not at
any time or in any manner represent that it or any of its agents or employees are agents or employees
of City.
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:
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(a) Submit to City through its Economic Development Division 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 labor standard requirements as set forth in 24 CFR Part 570,
Subpart K and HUD regulations issued to implement and
requirements;
(j) The Program Income requirements asset forth in 24 C.F.R. 570.504(c)
and 570.503(b)(8);
(k) 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;
(1) Executive Order 11988 relating to the evaluation of flood hazards and
Executive Order 11288 relating to the prevention, control and
abatement of water pollution;
(m) The flood insurance purchase requirements of Section 102(a) of the
Flood Disaster Protection Act of 1973 (P.L. 93-234);
(n) 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.
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(o) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) and implementing
regulations issued at 24 CFR Part 1;
(p) Title VIII of the Civil Rights Act of 1968 (P.L. 90-284) as amended; and
(q) 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.);
(r) 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.
(s) 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.)
(t) Such other City, County, State, or Federal laws, rules, and regulations,
executive orders or similar requirements which might be applicable.
4.3 The City shall have the right to periodically monitor the program operations of
the provider under this Agreement.
5.0 INSURANCE AND INDEMNIFICATION.
5.1 Insurance. The Provider shall procure and maintain, at its cost, and submit
concurrently with its execution of this Agreement, public liability and property damage insurance
against claims for injuries against persons or damages to property resulting from Provider's acts or
omissions arising out of or related to Provider's performance under this Agreement. Provider shall also
carry Workers' Compensation Insurance in accordance with State Workers' Compensation laws. Such
insurance shall be kept in effect during the term of this Agreement and shall not be cancelable without
thirty (30) days' prior written notice of the proposed cancellation to City. A certificate evidencing the
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
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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
WITH COPY TO:
Burke, Williams & Sorensen, LLP
18301 Von Karman Avenue, Suite 1050
Irvine, CA 92612-1009
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TO PROVIDER: �y
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: By:
City Manag✓er
ATTEST p
q�
City Clerk
APPROVED AS TO FORM:
Burke, Williams &Sorensen, LLP
City Att
PROVIDER:
Dated: By: .8 Gl v Cu d�z
Name: Q A,L, I E �t7 �-r),"'J
Title:
Title: 6,rca—Ca r- ;b-
(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.)
A VER By � 07v 'L� �f
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CALIFORNIA ALL-PURP040 ACKNOWLEDGMENT
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'I State of California
`; County of Riverside
On June 25, 2002 ELAINE L. WEDEKIND Notary before me, , y Public �
Dole Name and Title of Officer(a.g,'Uene Doe,Notary Pubho") s�>
If'Ij CARRIE DAO ALLAN and VIRGINIA D. EBERHARD ------
personally appeared
��� Name(s)cr 61gner(s)
f 2 ersonally known to me-N r€3b Yi�€� � P$ s g §#t € c� McMWto be the persons} ?i
whose name(s)_Ware subscribed to the within instrument 91
l and acknowledged to me that huNAIWthey executed the
y same in FM*Ntheir authorized capacity ies , and that by '
NNW/their signatures on the instrument the erson s �;
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oero NOT PUELIC-CALIFORNIA� ?
C� `y ` i` + ' P.IVERSIQE COUNTY n �>
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,2Q03 WITNESS m hand and official seal
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Signature of Notary Public -
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent
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Description of Attached Document
Title or Type of Document:
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Document Date:
Number of Pages:
Signer(s) Other Than Named Above:
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Capacity(ies) Claimed by Signer(s) 3�
Signer's Name: Signer's Name: 3
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Title(s): Title(s):
❑ Partner—❑ Limited ❑ General ❑ Partner—❑ Limited ❑ General
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❑ Trustee ❑ Trustee
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Notary 6236 Remmet Ave,PO box •Canoga Park CA 91309]184 Prod No 8907 Reorder.Call Toll-Free 1 800 8]6 682]
CITY OF PALM SPRINGS
EXHIBIT A
Scope of Services
Proiect/Activity Title: Project Number:
Mizell Senior Center
Meals-On-Wheels Delivery Van
Name/Address of Provider:
Mizell Senior Center
480 South Sunrise Way
Palm Springs, CA 92262
Obiectives/Activities
The intent of this program is to provide nutritional assistance to low-income seniors through daily meals,
as well as provides the function of vital human contact, information outreach and monitors the well being
Of isolated homebound elderly. This will be accomplished through the acquisition of a new van and
replacement of an existing a high mileage costly later model van. Riverside County Office On Aging is
contacting with Mizell for congregate and home delivered meals, serving 40,000 meals Valley-wide and
150 Palm Springs' clients.
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 one hundred and fifty (150) very low to
moderate income Palm Springs residents.
TARGET
DATE ACTIVITY#1
On-Going Deliver meals to Palm Springs residents. Maintain records of names, addresses,
demographics and service dates for all assistance.
Objective 5: Maintain records for all CDBG activities related to this program.
TARGET
DATE ACTIVITY#1
On-Going Document and maintain all records related to this program, including those required, in
accordance with HUD Regulations, in a stable and secure location.
ACTIVITY#2
Monthly Submit quarterly reports—referenced Exhibit E.
Objective 6: Manacle/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: Acquire a cargo van 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
07/15/02 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: Proiect Number:
Mizell Senior Center
Meals-On-Wheels Delivery Van
Name/Address of Provider:
Mizell Senior Center
480 South Sunrise Way
Palm Springs, CA 92262
BUDGET SUMMARY
COST CATEGORY CDBG OTHER TOTAL
SHARE SOURCES COST
1 Personnel $ $ $
2 Consultant/Contract Services $ $ $
3 Travel $ $ $
4 Space Rental $ $ $
5 Consumable Supplies $ $ $
6 Rental, Lease or Purchase of $20,000. $ $20,000.
Equipment
7 Insurance $ $ $
8 Other $ $ $
$20,000. - 0 - $20,000.
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
r •
EXHIBIT B— Budget Summary
Page 2 of 2 Pages
DETAIL BUDGET
DESCRIPTION OF ACTIVITY/ CDBG SHARE OTHER TOTAL
PAY ITEMS SOURCES COST
Caro Van (including Trade-In & Rebates $18,000. -0- $18,000.
Fees &Taxes (Prep, License, Tire& Sales) $2,000. -0- $2,000.
Total $20;000.
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 30 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 the twelve-month period of this 2001 — 02 Program Year— July
1, 2001 through June 30, 2002.
i •
CITY OF PALM SPRINGS
EXHIBIT C
Insurance Inventory
Project/Activity Title: Project Number:
Mizell Senior Center
Meals-On-Wheels Delivery Van
Name/Address of Provider:
Mizell Senior Center
480 South Sunrise Way
Palm Springs, CA 92262
INSURANCE INVENTORY
LIABILITY INSURANCE POLICY
Name of Provider's Insurance Company �� ��u3��wc -.
Effective Dates of Policy /0/1,F�a/
Claims Made Policy / / Per Occurrence Policy
Limits of Liability
Deductibles:
Per Occurrence
Annual Aggregate /
Additional Insured Endorsement (Certificate Holder) ha Yes ❑ No
Original Certificate of Insurance Attached ❑\Yes K/No
WORKER'S COMPENSATION POLICY /y
Name of Provider's Insurance Company 5'�� ��-d%3q�C'cLsa�ie�a� -L��f�«
Effective Datesf��I t t/ � �G. ,/c, /
Limits of Liability
Underlying Coverage Limits
Original Certificate of Insurance Attached ❑Yes )<No
CITY OF PALM SPRINGS
EXHIBIT D
Beneficiary Qualification Statement
Project/ACtiyitV Title: Project Number:
Mizell Senior Center
Meals-On-Wheels Delivery Van
Name/Address of Provider: Date:
Mizell Senior Center
480 South Sunrise Way
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—03129/01)
MEDIAN INCOME NUMBER OF PERSONS IN YOUR HOUSEHOLD:
LEVEL 1 2 3 4 5 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,yes or n� 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:
Mizell Senior Center
Meals-On-Wheels Delivery Van
Name/Address of Provider: Date:
Mizell Senior Center
480 South Sunrise Way
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
CITY OF PALM SPRINGS
EXHIBIT F
Request for Reimbursement
Proiect/Activity Title: Project Number:
Mizell Senior Center
Meals-On-Wheels Delivery Van
Name/Address of Provider: Date:
Mizell Senior Center
480 South Sunrise Way
Palm Springs, CA 92262
BENEFICIARY QUALIFICATION STATEMENT
'. Approved, Current Prior Total Grant
Description Grant '. Reimburs6menf Reimbursement. VTD. Balance
Amount Period Perlod)s) RelmbUrsemerit '(Over/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
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
STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142.0807
COMPENSATION
INSURANCE
FUND ,CERTIFICATE OF WORKERS' COMPENSATION,INSURANCE
SEPTEMBER 11, 2401 POLICY:WUMseR,`„ 061,9923 - 01
'CERTIFICATE EXPIRES: 9;-6-' 02?
CITY OF PALM SPRINGS
ATTN DALE COOK ,
P 0 BOX 2743
PALM SPRINGS CA 922"63
L
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California
Insurance Commissioner to the employer named below for the policy period indicated. _
This policy is not subject to cancellation bythe Fund except upon ten days'advance written notice to the employer.
We will also give you TEN days'advance notice should this policy be cancelled priorto its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the
policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with
respect to which.this`certificate of insurance may be issued'or may pertdipthe insurahob affor8eq, by the policies
described herein is subject to all the`terms,`excl Mons andirconditions,of such,ppliGles.
AUTHORIZED REPRESENTATIVE PELSIDENT
EMPLOYER'S LIABILITY .LIMIT' INCLUDINGrDEFENSE COSTS $1 0OO,0Q0, PER OGcORRENCE.
EMPLOYER
$EP15 2001
PALM SPRINGS SENIOR CENTER (A NON PROFIT 'CORP)
DBA MIZELL SENIOR CENTER
480 S SUNRISE WAY
PALM SPRINGS CA 92262
L °
DOCUMENTTHIS
JUL-01-2002 MON 11 :50 AM W GARTEN & HOUGH FAX NO, 7A-591P
M11401 P. 02
7�
MMIDONY)
till.
07/01/02
PRODUCER Weingarten & Hough-Lic#0086542 ^ THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION
P 0 Box 1866 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
ALTER THE COVERAGE AFFORDED By THE POLICIES BELOW.
Palm Springs CA 92263 COMPANIES AFFORDING COVERAGE
(760) 325-2526 COMPANY
INSURED A Philadelphia Insurance Company
COMPANY
Mizell Senior Center B
480 S . Sunrise Way COMPANY
C
Palm Springs CA 92262 COMPANY
(7-60) 323-5689 D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED
INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM STED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INS OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
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,
CO TYPE OF INSURANCE POLICY POLICY EFFECTIVE POLICY EXPIRATION UNITS
LTR NUMBER DATE(MM/00/YV) DATE(MWbOrM
A GENERAL LIABILITY GENERAL AGGREGATE s2, 000 000
GENERALLIADILMY PHPK013566 10/14/01 10/14/02 PRODUCTS m COMPIOP AGG 11, 000, 000
CLAIMS, MADE
ry OCCUR PERSONAL&ADVINJUAY E1, 0 0-0 , 000
i�l
OWNER'S
&CONTRACTORS PROT EACH OCCURRENCE -5-1—, 0 Q 0, 0 0 0
FIRE DAMAGE(Any ms fire) s 100 , 000
one mwn) $ 5, 000
A AUTOMOBILE UABILITY — MED F-V(Any
ANY AUTO PHPK013566 10/14/01 10/1.4/02 COMBINED SNGLE LIMIT $1
ALL OWNED AUTOS 10001000
X SCHEDULEDAUTOS BOOLYINJURY
(Per w5m) $
X HIRED AUTOS
NONLOWNED AUTOS BODILYINJURY
(Per mwideno $
PROPERTY DAMAGE
GARAGE LIABILITY
AUTO ONLY-EA ACCIDENT
ANYAUTO
OTHER THAN AUTO ONLY'
EACHACCIDENT s
EXCESS LIABILITY AGGREGATE *
UMBRELLAPORM EACHOCCURRENCE 9
OTHER THAN UMBRELLA FORM AGGREGATE s
WORKERS COMPENSATION AND $
EMPLOYERS'UABILITY :1iTATUFrORy umRs
THE PBOPRIETOR/ EACH ACCIDENT $
PARTNERSAD(ECUTtVE INCL DISEASE-POLICY LIMIT $
OFFICERS ARE' EXCL
.1"em DISEASE-EACH EMPLOYEE $
DESCRIPTION Of OP9RATION9/LOCA1DDN,MWMw*,,,,,ITEMS I
Operations of the insured for the certificate holder regarding CDBG.
City of Palm Springs is named as an additional insured per the attached
endorsement.
...........
U R
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
City Of Palm Springs 3 0 DAYS WFUTTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFF,
P 0 Box 2743 BUT FAILU' TO MAIL BUCH NOTICE SHALLIMPOSE no ojjLI,,jjoN OR LIABILITY
Palm Springs CA 92263 :F ANY NO UPON r COMPARA ITS ADENTS OR REPRESENTATIVES.
AUTHORIZE EP
,n
--- 1
JUL-01-2002 MOM 11 :bl AM WGHKIEN & ttuuan rnA 11U. ivu.,�,,, "
CCOERCIAL 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 PALA"_
(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 II) 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.
CG 20 26 1185 Copyright,Insurance Services Office,Inc.,1984