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04332 - CATHOLIC CHARITIES CDBG SUBRECIPIENT
PALM s City of Palm Springs Community Redevelopment Agency t MEMORANDUM 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 propose of this memo is to inform you that I reviewed the list and concur with the reconu-nendation to close those indicated. Please keep a copy of this memo in the file of each of the ide4ified closed contracts. Page: 6 Report: Expired Contracts: Oldest Date= / / and XREF= COMMUNITY& ECONOMIC DEV-Summary July 24, 2003 Approval Date Expiration Date_ Closed Date Contract tuber Description a 08/23/2000 OS/01/2001 A426� Food Vouchers, Cdbg Subrecip.2000-01 Certificate and Policies are OK Contractor:Aids Assistance Program Insurance Status: + XREF: COMMUNITY &ECONOMIC DEVELOPMENT S ice: In File ;15 f j> 12/01/2000 12101/2001 A4296' CDBG Subrecipient Agr., RefriglFreezer, 12-1-00 A policy will expire soon. Insurance Status: P Y P Contractor :Desert Aids Project .4 f XREF: COMMUNITY &ECONOMIC DEVELOPMENT / Service: In File 06/27/2001 06/01/2002 �1 A4297 C D B G Subrecipient 2001-02 Domestic Violence Outreach Insurance Status:A policy has Expired. _ S C./ Contractor:Shelter From The Storm 7— XREF: COMMUNITY& ECONOMIC DEVELOPMENT 0fi jam. eS Service: In File 12/01/2000 12/01/20012%j� A429 Status:C D B G Subrecipient 2000-01 Nightengale Manor Certificate and Policies are OK Contractor:Riverside County-Housing Authority j XREF: COMMUNITY & ECONOMIC DEVELOPMENT �10a/p> Service: In File 12/01/2001 12l13/2000 A4299 C D B G Subrecipient 2000-01 Fair Housing Program Certificate and Policies are OK Contractor:Fair Housing Council Insurance Status: XREF:COMMUNITY& ECONOMIC DEVELOPMENT � f� Service: In File �i A430 2000-01 CDBG Subrecipient Agreement 11/20/2000 11/01 i2001 � 7 Contractor :Food In Need Of Distribution Insurance Status:A policy has Expired. �� XREF:COMMUNITY &ECONOMIC DEVELOPMENT Service: In File A4332 CDBG 2000101 Homeless Outreach 04/05/2000 04/01/2001 t a Contractor:Catholic Charities Insurance Status: Certificate and Policies are OK XREF: COMMUNITY & ECONOMIC DEVELOPMENT f�/�/3� Service: In File Catholic Charities CDBG Subrecipient Agr AGREEMENT #4332 R19771, 4-5-00 SUBRECIPIENT AGREEMENT pp THIS AGREEMENT (herein "Agreement") , is made and entered into this (s+ day of -Te1y , 2000, by and between the CITY OF PALM SPRINGS, (herein "City) , a municipal corporation, and the CATHOLIC CHARITIES, (herein "Provider") . WHEREAS, the City has entered into various funding agreements with the United States Department of Housing and Urban Development ("HUD") , which agreements provide funds ("CDBG Funds") to the City under the Federal Housing and Community Development Act of 1974 (42 U. S.C. Section 5301 et seq. ) , as amended from time to time (the "Act") , and the regulations promulgated thereunder (24 C.F.R. Section 570 et seq. ("Regulations") ; and WHEREAS, the Act provides that the City may grant the CDBG Funds to nonprofit organizations for certain purposes allowed under the Act; and WHEREAS, the Provider is a nonprofit organization which operates a program which is eligible for a grant of CDBG funds and the City desires to assist in the operation of the program by granting CDBG Funds to the Provider to pay for all or a portion of those costs incurred in operating the program permitted by the Act and the Regulations on terms and conditions more particularly set forth herein; NOW, THEREFORE, the parties hereto agree as follows: 1. 0 SERVICES OF 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 FIVE THOUSAND THREE HUNDRED DOLLARS ($25, 300) (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. G. 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`0 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: Louis Coloia Regional Director Catholic Charities-Coachella Valley Regional Center 35-325 Date Palm Dr Suite 153-A Cathedral City, CA 92234 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 2 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: (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; 3 (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 as set 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. (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 4 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. 3. 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 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 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, California 92263 Attn: City Manager 6 WITH COPY TO: Rutan & Tucker 611 Anton Blvd. , Suite 1400 Costa Mesa, California 92626-1998 TOO CONTRACTOR: /p q6�O C!A'qwe;..t ' 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,S, CALIFORNIA Dated: By: �— City Manage (:I;y Clerk APPROVED AS TO FORM: �KER '�� ,bV�d�@fin B 51f 'THE CA�J 1( �;C)U'I.S:L'L- _tea City t rney 14 �6 CONTRACTOR: CATHOLIC CHARITIES SAN BERNARDINO/RIVERSIDE Dated: By; N e: e rgiann ahill Title: First Vice President By A*4t a MaryRose Wallace rtle: Chief Financial Officer/Treasurer (Corporations require two NOTARIZED signatures; one from each of the following: A. Chairman of Board, any Vice President; AND B. Secretary, Assistant Secretary, Treasurer, Assistant Treasurer, or Chief Financial Officer. ) 7 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California ss. LC County of fi �On 1 I o o�c , before me, V"yuxrc�o_c¢�1 A. �s she r Dale Name antl Tllle of O firer e( g,"Jane Doe,Notary Public"� > personally appeared fiNall of Signers) impersonally known to me 31 ❑ proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument andI acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the persorl or )I the entity upon behalf of which the person(s) =j& N,0TARY ETA. KOSTER acted, executed the instrument. 167990OOLICCALIFORNIA V7 WITNESS my hand and official seal. ndmoCuntyExpires Jen.R'2002 d /1no ird 1 ova.-[ Place Notary Seal Above U Signature of Notary Publlc I OPTIONALII 11 Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document �) Description of Attached Document ) `1 Title or Type of Document: Document Date: Number of Pages: Irk �I Signer(s) Other Than Named Above: Capacity(ies) Claimed by SignerI Signer's Name: ❑ Individual ' I' Top of thumb here ❑ Corporate Officer—Title(s): �I ❑ Partner—❑ Limited ❑ General r�l ❑ Attorney In Fact r�r ❑ Trustee ❑ Guardian or ConservatorI ❑ Other: I I� Signer Is Representing: �I ©1999 Nallonal Nolary Assooll-9350 De Solo Ave,PO Box 2402•Chatsworth,CA 91313-2402-wwnalionalnolary.or9 Prod No 5907 NeOltlar Call Toll Free 1-8005766827 CITY OF PALM SPRINGS EXHIBIT A Scope of Services Proiect/Activity Title: Project Number: Homeless Outreach — Palm Springs B-25-8 Name/Address of Provider: Catholic Charities, Coachella Valley Regional Center 35-325 Date Palm Drive, Suite 153 Cathedral City, CA 92234 PROJECT/ACTIVITY DESCRIPTION The Homeless Outreach Worker visits soup kitchens and other places where the homeless congregate in Palm Springs. The worker helps access services that are locally available to clients and offers referrals regarding medical accommodations and employment, etc. If homeless clients have dependent children, the worker refers them to Nightengale Manor Homeless Shelter or provides motel vouchers to local motels/hotels for temporary housing, if available. The length of temporary housing varies depending on the needs of the client, usually the stay ranges from four (4) to thirty-seven (37) days and costing $17 to $44 per night. The voucher services are estimated to serve forty (40) persons/households. Estimated Number of City of PALM SPRINGS Persons/Households to be served 240. CITY OF PALM SPRINGS EXHIBIT B Budget Summary Project/Activity Title: Project Number: Catholic Charities Homeless Outreach B-25-8 Name/Address of Provider: Catholic Charities, San Bernardino/Riverside 35-325 Date Palm Drive, #153-A Cathedral City, CA 92234 BUDGET SUMMARY COST CATEGORY CDBG SHARE OTHER TOTAL SOURCES COST 1 Personnel $6,083.00 - 0 - $6,083.00 2 Consultant/Contract Services - 0 - - 0 - - 0 - 3 Travel - 0 - - 0 - - 0 - 4 Space Rental - 0 - - 0 - - 0 - 5 Consumable Supplies - 0 - - 0 - - 0 - 6 Rental, Lease or Purchase of - 0 - - 0 - - 0 - Equipment 7 Insurance - 0 - - 0 - - 0 - 8 Other $2,640.00 - 0 - $2,640.00 Administrative Support $16,577.00 - 0 - $16,577.00 Client Services $25,300.00 - 0 - $25,300.00 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 DETAIL BUDGET DESCRIPTION OF ACTIVITY/ CDBG OTHER TOTAL PAY ITEMS SHARE SOURCES COST Personnel - $6,083.00 - 0 - $6,083.00 Salaries/Benefits — Outreach Advocate Administrative Support - $2,640.00 - 0 - $2,640.00 Supplies &Accounting Services Client Services - $15,459.00 - 0 - $15,459.00 Motel/Hotel Vouchers $1,118.00 - 0 - $1,118.00 Transportation Costs Total . ,.;,, ; ,$25;3000.00 - 0 - �$25;300.00 The Subrecipient shall receive monthly reimbursement in accordance with the aforementioned cost categories and line items. Services are to be performed within this 2000-01 Program Year — July 1, 2000 through June 30, 2001. CITY OF PALM SPRINGS EXHIBIT C Insurance Inventory Protect/Activity Title: Proiect Number: COMMUNITY DEVELOPMENT BLOCK GRANT FISCAL YEAR 2000-2001 Name/Address of Contractor Agency: Date: CATHOLIC CHARITIES SAN BERNARDINO/RIVERSIDE September 22, 2000 1450 NORTH D STREET SAN BERNADINO, CA 92405 INSURANCE INVENTORY LIABILITY INSURANCE POLICY Name of Contractor's Insurance Company THE CATHOLIC MUTUAL RELIEF SOCIETY Effective Dates of Policy 7/1/2000-7/l /2001 Claims Made Policy / / Per Occurrence Policy Limits of Liability $1 ,000,000 Deductibles: Per Occurrence Annual Aggregate Additional Insured Endorsement Yes ❑ No Certified Copy of Policy Attached ❑ Yes 'XNo Certificate of Insurance Attached y(Yes ❑ No WORKER'S COMPENSATION POLICY Name of Contractor's Insurance Company SAME AS ABOVE Effective Dates 7/l /2000-7/1 /2001 Limits of Liability $1 000 000 Underlying Coverage Limits Additional Insured Endorsement Attached ) 'Yes ❑ No Certified Policy (copy of) Attached ❑ Yes NINo Certificate of Insurance Attached Yes ❑ No CITY OF PALM SPRINGS EXHIBIT D Beneficiary Qualification Statement Prolect/Activity Title: Protect Number: Name/Address of Contractor Agency: Date: BENEFICIARY QUALIFICATION STATEMENT This statement must be completed and signed by each person or head of household(legal guardian)receiving benefits form the described projectlactivity. 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 NUMBER OF PERSONS IN YOUR HOUSEHOLD: 1 ___21 3 4 5 6 7 8 VERY LOW INCOME Below 50% $16,600 $18,950 $21,350 $23,700 $25,600 $27,500 $29,400 $31,300 LOW INCOME $26,550 $30,350 $34,150 $37,900 $40,950 $44,000 $47,000 $50,050 51 —80% 3. Do you identify yourself as: ❑ White ❑ Black ❑ Hispanic ❑ American Indian ❑ Asian ❑ Multi-ethnic 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 Prolect/Activlty Title Project Number: Palm Springs Homeless Outreach Name/Address of Contractor Agency: Date: 9/11/00 Catholic Charities 35325 Date Palm Dr., Suits 153A Cathedral City, CA 92234 PROGRAM PROGRESS REPORT For the Period Ending: DIRECT BENEFIT REPORT -Number of First-Time Program Beneficiaries Serviced#of Households #of Persons 240 0-50%below X 51-80%below -Number of First-Time Female Headed Households: 7% -Counts by Race/Ethnicity: White, Not Hispanic Origin 20% Black, not Hispanic Origin 15% Hispanic 55% American Indian/Alaskan Native--_W—.Asian Pacific Islander 1% Multi-ethnic 6% Signed Title Hcuieless Shelter Date 9/1'I/on Coordinator • s CITY OF PALM SPRINGS EXHIBIT F Request for Reimbursement Protect/Activity Title: Protect Number: Name/Address of Contractor Agencv: Date: BENEFICIARY QUALIFICATION STATEMENT Column 1 Column 2 Column 3 Column 4 Column 5 Total Grant Amount Current Prior Total Cumulative Grant Balance Reimbursement Reimbursement Reimbursement 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 Contract 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. PREPARED BY: Phone: APPROVED BY: Date: Name, Title Name, Title (must be an original signature) City of PALM SPRINGS Use Only Audited by: Examined by: Approved by: A detailed breakdown of costs expended must be attached to each Request for Reimbursement and verified by original signature. CITY OF PALM SPRINGS EXHIBIT G Employment Restrictions 1. Labor Standards The PARTICIPANT 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 PARTICIPANT shall agree to submit documentation provide by the CITY which demonstrates compliance with hour and wage requirements of this part. The PARTICIPANT 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 PARTICIPANT of its obligation, if any,to require payment of the higher wage. The PARTICIPANT 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 PARTICIPANT and any of the PARTICIPANT'S subrecipients and subcontractors. Failure to fulfill these requirements shall subject the CITY,the PARTICIPANT and any of the PARTICIPANT'S subrecipients and subcontractors,their successors and assigns,to those sanctions specified by the Agreement through which Federal assistance is provided. The PARTICIPANT certifies and agrees that no contractual or other disability exists which would prevent compliance with these requirements. 0 The PARTICIPANT 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 PARTICIPANT 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 PARTICIPANT certifies and agrees that no contractual or other legal incapacity exists which would prevent compliance with these requirements. b Notifications The PARTICIPANT 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. AMiD CERTIFICATE OF LIABILITY INSURANCE 1/23/00arcr) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR C.N.G, Agency, InC. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 4223 center Street Cmaha, NE 66105 INSURERS AFFORDING COVERAGE INSURED -- i INSURER A Virginia urety Companyr Inc. The.'Roman Catholic Bishop of San Bernardino ;,INSUnen5 al Corporation Sole INSURER C. 12t1 E Highland Avenue INSURER D: man Bernardino, CA 92404 INSURERS, :OVERAGES THE POLICISS OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,-HE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS EUBJECTTO ALLTHE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ILTF TYPE OF INSURANCE POLICY NUMBER ' POLICY E�PGCTIVE FOLTCY EAPIRALION LIMITS i' GENARALLIMILfTV ! EACH CCC.IHAENCE S COMMERCIALGENERALUABIUTY PIRE DAMAGE(Aar Anaira) S CLAIMSMADE ❑OCCUR MEDEX'IAnycm Person) IS PEHSONRLS ADV INJURY �S ' GENEP.AL AGGPEGATE .E GEN'L AGGREGATE LIMIT APPLIES PER PROCUCTS CO+APAP AGG E F'JLICT PRD LOU AuronwSaE upswTY COMBINED SINGLE uMc I ANY AUTO (Ea.=dw) S ALL UWNED AJ70S 1 BODILY IPIJURY E SChEDLLEOAUTOE (P=t Penan'1 '—I HIRED AUTOS BODILY INJURY J NON.OWNEC AUTOS ,(Pu,a,idw) I E -- PROPERTY DAMAGE :i 1 OARAGELIABILITY AU700F_Y-EA ACCIDENT S ANI\AUTO OTHER THAN EA ACC 1 S I� AUTO O9-Y. ACG,S EXCEEN Umum I�EACH OCCUPRENCE } _ CI CUR CLAIMGMADE AGORr ESATE iS C'EOUCTIBLE NETEMTON S S OTHI WORKBAG COMPBNSATON ANO VIC STATU•TRY MI- I AiIEMF'OYERS'DAQILRY O1000S21O2-pO I ]'-1-01 1-1�2 ,E,LEACHACCIDENT S �QD,QDQ ' E.L.DISEASE la EMPLOYEE E l�.CX)O E.L.DIEEA9� E POUC O,YMER i DG.CNIATRIN OF OnEMTS)N5(LOCATION3NZHIGLE3I JLUSION5 ADDED BY ENOURBEM EH WECIAL PROVISIONS Coverage verified for Catholic Charities, 1450 North D Street, San Bernardino, CA 92405. CERTIFICATE HOLDER I I ADDITIONAL I14809901 mSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EQPIRATION DATE THEREOF,THE ISSUING INSURER'MILL ENDiAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CENTIFICA7E HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMRORE NO OBLIGATION OR LIABILITY OF ANY KIND UPON 111E INSURER.IT3 AGENTS OR REPRESENTATIVES. /y AUTHORIZED t ACORD 25•S(7/97) } O ACO D PORATION 198E Sep 25 00 10106a Catholic MUtU81 I9091475-5144 p. 2 ACORD. CERTIFICATE OF LIABILITY INSURANCE a-21---00 DATE—ORD. ATS Y) o0 PRODUCER THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION C.M.G. Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4223 Center Street HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Cmaha, NE 68105 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INsuRED INSURERA _ Virginia Surety Company, Inc. The Roman Catholic Bishop of San Bernardino INSURERS a Corporation Sole INSUREflG --- - -- 120 E Highland Ave N"RERD San Be nardino, CA 92404 INSURERS —^ J COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTVJITHSTAND:NG ANY REQUIREMENT,TERM CR 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 15 SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. k@R TYPE OF INSURANCE I POLICY EFFECTIVE PCLICY EXPIRATION POLICY NUMBER TATE lMMIDDKV 11MrtG GENERAL LIABILITY EACH OCCUNRE!JCE .S COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one ire) $ CLAIMS MADE Ej OCCUR MED EXP IAL'Y PnP P..On) PERSONAL d ADY INJURY S GENERAL AGGREGATE Y GEWL AGGREGATE LIMIT AP'PPLIEIS PER: PRODUCTS-COMPAIP AGG S PIXJCY PRO- IE ILOC AUTOMOBILE LIAOILID Y COMBINED SINGLE LIMIT Z ANY AUTO (Ea ealdent) S PAU.OWNED AUTOS BODILY NJUFY SCHEDULED AUTOS {Per Per9Pn) $ HIRED AUTOS BODILY INJURY $ NON4WNE0 AUTOS (Pel accidanl)PRO — PERTY DAMAGE ' (Pera=IdEI11) GARAGE LIABILITY AUTO ONLY_EYACCIDENT I_S ANY AUTO OTHER THAN EA ACC S _ AUTO ONLY AGO E EXCESS LIASILRY ! EACH OCCURRENCE b OCCUR CLJVMS MADE AGGREGATE — 5 DEDUCTIBLE I r— I S RETENTION S WORKOTB COMPENSATION ON AND tVC STAMU OTRH o EMPLOYERS'LIABILr '— E L EACH ACCIDENT 5 A 0100049941-00 7-1-00 7-1-01 ELCISEASE-EAEMPLOY $ 10M01000 EL OICEASE-PCLICY LIMIT S 5W,000 OTHER OESCRIPtiON OF OPERATICNS OCATiONG'VEHICLEOIEXCLUSIONE ADDED BY ENOORSEMENTISPECIAL PROVISIONS Coverage verified for Catholic Charities, 1,450 North D St, San Bernardino, CA 92405, CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION ENOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL. 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TC DO SO SHALL IMPOSE NO OBLIGATION OP LIAFILRY OF ANY KIND UPON Y'ME INSVREP,ITS AGENTS CR ROPREOGNTATIVES. AUTHORIZED REPRESENTATIVE ACORD 29-S(7197) o ACORD CORP T1ON 1SAS Sep 22 00 09iola Catholic Mutual (9091475-5144 p. 2 SE?.22.2000 9.11RM OLIC MUTURL GRP NO,969 P12 Certificate of Covera e ate7 Cerrifuate}]older This Certificate It Issued at a matter of information only and The Roman Catholic Bishop of Son Bernar&Q.CA, cantors no rights upon the holder of this certificate.This certificate a Corporation Sole dose not amend,extend or alter the coverage afforded below, 1201 East Highland Avenue Con as ARording Caren c San Demardino,CA 92404 p y li THE CATHOLIC MUTUAL RELIEF SOCIETY COvrred LCeatlaa 4223 CENTER fir Cadiont:Charities,Coachella Valley OMAHA, NE 68105 67-625 E Palm Canyoa A 5 Cathedral City,CA 92234 ovemacr This is to certify that the coverages listed bwd4w-)Cav*boon issued tote Certificate holder nomad above for the certificate indicated,notwithstanding any requirement,term or condition of any contract or other document with respect to which this certificate may be[sued or may pertain,wife coverage afforded described harein is subject to all the terms,exclusions and conditions otsuch coverage.Limits shown may slave been reduced by paid claims. Typo orCeroaec CerdOcato Nambor Cmvernao Gthetin Coveutge l4piration Llmla Dote Dare Praperry ea enoaaiProperty General 1.14111ty Gcecrel A,arKah rra uen.Comwo Age ® 9caurrertea 8571 7/12000 7/V2001 1'erawraldrnartN+uy Claima Made Eith occurroto n Dhawler(Any omc re ra(Any an poram) &retar Liability Each Decarrence Other aeh()WU"anCC Dutrlpriea or OpeneonalLaeuianWnMdor/dpedsl items Coverage only extends to claims directly arising cut of CDBG/Housing and Job Plecemont for Homolsts Persons art Pain Springs,CA fe tho worm of the carrificate. oleera[ errfecnte as u{oa Additional Protect rson(a) 81rould any of the above described eovaragat be canedled City of Palm Springs before the expiration date thereof,the issuing company will mall 30 days written uotia to the Holder of certificate named to the left. I li And orled neprumtative 0309000008 � t Sep 22 00 ❑S: 01a Catholic Mutual (9091475-5144 p- 3 SEP,22.2000 9:11RM &00C MUTURL GRP 10 NO,369 P.3 ENDORSEMENT (TO BE ATTACHED TO CERTIFICATE) Effective Drru of Endorsement 7/1=0 Charge Credit Cancellation Data of Endorsement=II Cort)fioate Holder The Roman Catholic Bishop of San Bernardino,CA, a Corporation Sole 1201 East Highland Avenue San Bernardino,CA 92404 Certificate No.xa71 of he Catholic Mutual Relief Society is amended as fo)lows: SECTION II-ADDITIONAL PROTECTED PERSON($) It Is understood and agreed that Section 11-Liability(only with respect to Coverage D-General Liability,Coverage F-Medical Payments to Others and Coverage H-Counseling Errata and Omissions)is amended to include as an Additional Protacted Porson(s)members ofthe organizations shown in the schedule,but only with respect to their liability for the Protected Persons)activities or activities they perform on behalf of the Protected Persen(s). It is limper understood end agreed that coverage extended underthb endorsement is limited to and applies only with respect to liability assumed by contract or agreement;and this oxtmsion of coverage shall not ealuse the scope of coverage provided under this certificate or increase the limit of liability thereunder, Unless otherwise agreed by contract or agreement,coverage"tended under this endorsement to the Additional Protected Person(a)will not procedo the effective data of this certificate of coverage endorsement or extend beyond the cancellation date. Schedule-ADDITIONAL PROTECTED PERSONS) City of Palm Springs Remarks; Coverage only extends to claims directly arising out of CDBGIEIousiag and Job Placement for Homeless Persons in Palm Springs,CA for the rent of the certificate. Au ad ed Repr antanve rics-122(1.99) 909 34B 1130; Feb-5� 4:14PM; Page 2/3 Sent By: Catholic Charities; 13C �g95 .5144 F. 3 ; _ — .5' e6 ❑3 03 O9=,,,,3a Ca' � 1ic Mutua N0. 1041 F. 3/4 tE6. 3: 2 9 WL_CMG 402 971 2943 CERTIFICATE OF LIABILITY INSURANCE 2-03 .. ; 03 1III3 CERNMATE IB WBUEO As A ATATTRH OF FORMATION C.M.G. AGE Ally, INC. ONLY ANoD CONFER$ NO RIGTITS UPON THE CWTMH:ATe ' HOLDER. THIS GERTIMCA7E DOER NOT AMEND. !)(TEND OR 10843 OLD -ALL ROAD, 5UITE 300 ALDER THE COYiRRAAOOEE AI1ffOROEO 8Y THLr POLOE9-IIELOW. OMAHA, NE8l54-2b00 IN5URERSAFF011DWOGOVENAGE NAWA/— !COMBINED S� THE %OMAN HOLIC BISHOP OY SAN HERNARDINO N}VpCP0. r! /• � _ A CO A ATION SOLE 1201 E Hi D 4VE . SAN BERnA CA 92404 1 �Z;Ad, ww, ✓ "T 11f THEE W,ICILSD 5URINCE LISTED BELOW HAVE BEEN ISSUfP To THE INSVREDNAMED A9Duf FOR THE POLICY PdR100INOlCATEO,NOhir:�.NS,Lw,LNQING F-x,, ANY REgU1RFN TERM OA CONDITION OF ANY L:ONTRACY OR orHFiR ggou]Ee1+T WLTR RESPECT lq WHICH THIS CFRTIFICATE MAY RE,i381Ieb OR lMDLIC STADOR r DJ LRAWAIWT�APFOR00 BY THE OL10000EOSCRIGIED HER IN a PAID CWM51$SVWEGT TO ALL THE TERMS,FXGLUS(ONS AND COND111061 OF SuG11 `- POUCY NVMAER WL Yi F l' GLNFRKI 14lP! EAOHOCC4WIENOE _ [ _ I� I �WAA!iC1µGENENAL L1AtlILiTY !!1 MI FT�T} � �_� 1 C?y fua MACE OOGVN I DLO!%P(nnxp�04nw 14 F FERSONAL L AOV"AY I JI- _�'�� GENEPALAODNLGATQ E ;'�,9: 1^OENl AGO, i11LEM AP0.i➢TER MODUCTSCOMP:OLAGO.�_ Pout S/ +.:! ANOMON q.1Tr tiI Gff...We.ANYA SINCAL LIMT A I �KLG AV1q} BODILY INJURY V�DAUTO$ (✓.'Pub") �,t I ;„�� e wRED4Ps�D9 b09pY NLURY NON 01{ 04lITD$ � ( _, tee m rvoAtAGE r I cPU Iwamll ' GANAOF W yO,��1' 1 AVTppMYEAwCC10ENT �_ _ ANYAUI I OTf�{R THAN LAALG' AYTOOM4Y, ADQ i I'n I : .. _ E%CFAwNAi, L EACN OCGV 7E OCCUR k:4��CLAIMS MADE SEE ATTACHED I A6CpP0ATF __ f 1 _ _. �.. (DEDUCT @ f IYFTFNiI 'kW w'ORK ftwldpllw ` NAMO x3 yEAMlia l.R. I .. • AMlWriEE'IMFA —. 0l :EL GLN AOCID6NT Et 180,000 OMEOTICEA ANMryEN 00063245-00 1-01-03 1-01-04 A L D7FASEFA EMOLOYOE aT f JQQ,(JQQ `, I:' �$� MOrn IDH '�1Lr _ E.L.DI}LAEE-IWCYLIMR 1 , ... '' OlNlM P ?�,{ 0!'kGR1Y110EADTOIIER� TLOCATgRF1YENEL{}I FACLWIONtl ADDED 0YLkegA1{EYFMItlAFCIALMOYHIbNA COVERAGE VER • .A" ED tOR CATHOLIC CHARITIES, 1450 NORTH ➢ STREXT, SAN BERNARDINO, CA 92405, FOR THE TERM I THE CERTIPICATF. CENTIFlCAT HOLD�It CANCELLATION FNOULDANY OF TR4 MOVE OCECIMEO MUCIAA RECANCFLM AFIORE TNF EI{AAIATIM, 5 6n r%[ DATE TMRIEOE,THE M"NO Ari M WILL EHOEAYOR TO NAL-UL OAT} MARTEN ]yt' }1011GR TO THE CYRTIIICAYENOL"N MAMED TO THE I.E We F"M11E TO 00 FO IAALL MITOA!NO 0A1JOAnpN M t1AFLLRT OF ANT NWD IlAON THE MADIIER,n5 AQENTS 011 r '. 31�' RArREFENM1nVEtl. I� AUTHONRADNFAFAtA � .,. >fj, uw7. ACORD25�20ovoq ;aet' *AOCIRD U43MFIATIONTDEe 909 348 1130; Feb-5 4:15PM; Page 3/3 p, 4 Sent By: Catholic Charities; 19 ¢75-5144 '�liC Mutual . _ eb �13tos f 54` 44 53AM Ca\ }402 531 DO NO lOa7 P 4,'4 ° a } 1 Irv:ri ,,,r•c Y. -' elf vzypr µdi t t B M13 APNyrta{I R f F Vste 21312 ,,5�!', ,,.1:..�'I4IyQi.�I 141�.oR' `Y`f::�',!f;: Cy µfl�y,�4•RR�tITrMlY ..; fV • RA6,T,Tfj I,ilNM . ff`v`v IWIV rl.7l 1 v�ni l'i'; Wit..,.lvii,1. + ell"ant■tc lNlJdrqD� .• This CertlGcale it issued ar a matter of itiformahoa only anU 1 '? he Raman Ca 1C HaChap of 6ea Bernardino, CA, confers so rights upon the holler of this ceMlilcate.TMir cenincate : € A Corporation •e Allies not es.codt NOW Or 111W Me eevcr4ge afforded below. 1201 East Hight Avenue 1 Q,N}■p Artnriltnr CuY•Hrt Sou Hrrnazdure ` THE CATHOLIC MUTUAL.RELIEF SOCIM m'S CoverN Geeneap `r 10843 OLD MILL RD M 300 �„z °3. CadtolicChatitfiy�,{.? OMAIiA, NE68154 'k, ttl50 Natlh ll S San Scrtaatdian, I 92405 Y 1'. , � Y'r, �Hlt 1, 5 d�((�a� S/¢ �±xt� 1 ""1jY'f` Y � :� >lq 7� •\}"1 This Is to mrAfy at the coverages listed brow have beta issued to the cortiGcatr balder named above fur the cel'til'icate indicated,notwi 'landing my requirhmT{,serial or condition of any contract or other document with respect to whl It thiy cettiftcrte may aeued or tray pertaht,the coverage althrdcd described berein as whid:t to all the terms,tulusiont Kind conditions of su aversUc.Limits shorn may have been redueed by paid claims. COvelnsv!Y:tRNYe CPVMur.RN}Srallal .-- TYst nfCl� n+li Cq*Lk■tR Numb" a■1. n.ve L4nto ct+urut YAsbi Cew+l Aepit-ft ---'� Aw4f pCC.Mlaa ld Ads 1■I■r) �'n"' L'UNnr I4te " ''' n(a'.c Fite Wainer(Any one fist) ,..—, NW Up(A"nnc VM* "t{i F.I(Ca'IR LI■bA1tY;�;%'aT kF. t ig ,4 Tother ' }". Gxcess'Enpla s 8571 7/1/2002 7/1/2003 Eachotcunraw St50,000 -,? Lisbili[y °era' +5', De.tttpt[va oropemo f',,,otlttlpw/VeWdtwd}NN 14m, Covaags verified ad)olic Glorifies for the[rnm of the cGatiflcele. Total coverage is$250,000 each accident,S250,0110 each c. ! employee„$500, `erase•goHey liadt CMRS Excess SI50�H O XS S100,000. I,C�k a . ) : "i) v v k; Iyr tx 'Y l'• 1 f+' SD"'�A p d(",'. ,\r V �i ,` M '�' d v t I':",. ¢. ,' Sx+il211 S .JtoM.r rfwJa`Fh, 4 N h off M1t?.^.. ",.tit 11.�y.,(+!,;, t 1 lV'C■utd6tkurt", F.IiA 1` .,.k>si,...., t.-j .,r .•i•X' , a t ;} +'a.:r: ,Should any of the above described coveratel be conceited before the expiration date thereof,the iseaing company-W ° e a endeavor to mail 30 days wriKrn tweico to the holder Of p +,� reriif3tate named to the sett,but failure to tnad such aoTlcr elan i.. a t:av obit ation or of an Idad upon the cum part , V f Y Y P I Y its agem or morctewsOves, ;'i�{s j,;lyyf,; AulavriteJ Repraenl a;4fY;. Y�}Sf t o 6 2V Date: 8/21/2002 Ortif Cate of Coverage g Certificate Holder This Certificate is issued as a matter of information only and The Roman Catholic Bishop of San Bernardino, CA, confers no rights upon the holder of this certificate. This certificate a Corporation Sale does not amend,extend or alter the coverage afforded below. 1201 East Highland Avenue Company Affording Coverage San Bernardino, CA 92404 THE CATHOLIC MUTUAL RELIEF SOCIETY Covered Location 10843 OLD MILL RD STE 300 OMAHA, NE 68154 Catholic Charities, Coachella Valley 67-625 E Palm Canyon A-5 Cathedral City, CA 92234 coverages This is to certify that the coverages listed below have been issued to the certificate holder named above for the certificate 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 described herein is subject to all the terms,exclusions and conditions of such coverage.Limits shown may have been reduced by paid claims. Coverage Effective Coverage Expiration Type of Coverage Certificate Number Date Date LunrtS Property Real&Personal Property General Liability General Aggregate Products-Comp/OP Agg Occurrence 8571 7/1/2002 7/1/2003 Personal.@ Adv Injury Claims Made Each Occurrence $500,000 hire Damage(Any one tire) Med Lip(Any one person) Excess Liability Each Occurrence Other Each Occurrence Description of Operations/LocationsNehicles/Speciai Items Coverage only extends to claims directly arising out of CDBO/Housing and Job Placement for Homeless Persons in Palm Springs, CA for the term of the certificate. '..Holder of Certificate '... ` -' ,Cancellation Additional Protected Person(s) Should any of the above described coverages be cancelled City of Palm Springs before the expiration date thereof,the issuing company will mail 30 days written notice to the holder of certificate named to the left. Authorized Representa s 0309000008 ENDORSEMENT (TO BE ATTACHED TO CERTIFICATE) Effective Date of Endorsement 7/1/2002 Charge Credit Cancellation Date of Endorsement 7/1/2003 Certificate Holder The Roman Catholic Bishop of San Bernardino, CA, a Corporation Sole 1201 East Highland Avenue San Bernardino, CA 92404 Certificate No. 8571 of The Catholic Mutual Relief Society is amended as follows' SECTION II-ADDITIONAL PROTECTED PERSON(S) It is understood and agreed that Section II-Liability (only with respect to Coverage D-General Liability, Coverage F-Medical Payments to Others and Coverage H- Counseling Errors and Omissions)is amended to include as an Additional Protected Person(s)members of the organizations shown in the schedule,but only with respect to their liability for the Protected Person(s)activities or activities they perform on behalf of the Protected Person(s). It is further understood and agreed that coverage extended corder this endorsement is limited to and applies only with respect to liability assumed by contract or agreement;and this extension of coverage shall not enlarge the scope of coverage provided under this certificate or increase the limit of liability thereunder. Unless otherwise agreed by contract or agreement, coverage extended under this endorsement to the Additional Protected Person(s)will not precede the effective date of this certificate of coverage endorsement or extend beyond the cancellation date. Schedule-ADDITIONAL PROTECTED PERSON(S) City of Palm Springs Remarks: Coverage only extends to claims directly arising out of CDBG/Housmg and Job Placement for Homeless Persons in Palm Springs, CA for the term of the certificate. Aut onzed Representative PKS-122(1-99)