Loading...
HomeMy WebLinkAbout04299 - FAIR HOUSING CDBG SUBRECIPIENT 4 PALM s City of Palm Springs G Jk'i� 'O,o ,' � Community Redevelopment Agency u 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 pwpose of this memo is to inform you that I reviewed the list and concur with the recommendation to close those indicated. Please keep a copy of this memo in the file of each of the ideillfied closed contracts. Page: 6 Report: Expired Contracts: Oldest Date= I 1 and XREF = COMMUNITY&ECONOMIC DEV-Summary July 24, 2003 C—ontract�mber Description Approval Date Expiration Date Closed Date '/ A4269y Food Vouchers, Cdbg Subrecip. 2000-01 08/23/2000 08/01/2001 �r ,i of Contractor:Aids Assistance Program Insurance Status: Certificate and Policies are OK XREF: COMMUNITY&ECONOMIC DEVELOPMENT S ice: In File �13 A429 CDBG SubrecipientAgr., Refrig/Freezer, 12-1-00 12/01/2000 12/01/2001 Contractor:Desert Aids Project Insurance Status:A policy will expire soon. _ XREF: COMMUNITY& ECONOMIC DEVELOPMENT Service: In File A4297 C D B G Subrecipient 2001-02 Domestic Violence Outreach 06/27/2001 06/01/2002 Contractor:Shelter From The Storm Insurance Status:A policy has Expired. XREF: COMMUNITY& ECONOMIC DEVELOPMENT Service: In File A429V C D B G Subrecipient 2000-01 Nightengale Manor 12/01/2000 12/0112001 Contractor:Riverside County-Housing Authority Insurance Status: Certificate and Policies are OKy� XREF: COMMUNITY& ECONOMIC DEVELOPMENT Service: In File A4299 C D B G Subrecipient 2000-01 Fair Housing Program 12/13/2000 12/01/2001 Contractor:Fair Housing Council Insurance Status: Certificate and Policies are OK ( XREF:COMMUNITY& ECONOMIC DEVELOPMENT Service: In File' A430 2000-01 CDBG Subrecipient Agreement 11/20/2000 11/01/2001 / Contractor:Food In Need Of Distribution Insurance Status:A policy has Expired. XREF: COMMUNITY& ECONOMIC DEVELOPMENT Service: In File A4332 C D B G 2000/01 Homeless Outreach 04/05/2000 04/01/2001 L �e Contractor:Catholic Charities Insurance Status: Certificate and Policies are OKe� XREF: COMMUNITY& ECONOMIC DEVELOPMENT Service: In File v� . • Fair Housing Council Fair Housing Services AGREEMENT #4299 R19771, C14 Signed 12-13-00 SUBRECIPIENT AGREEMENT THIS AGREEMENT (herein "Agreement") , is made and entered into this A day of 'Joey , 2000, by and between the CITY OF PALM SPRINGS, (herein "City) , a municipal corporation, and the FAIR HOUSING COUNCIL, (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. i • 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-EIGHT THOUSAND DOLLARS ($28, 000) (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 OF THE FAIR HOUSING COUNCIL OF RIVERSIDE COUNTY, INC. 3600 LIME ST. #613 RIVERSIDE, CA 92501 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 he 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.E.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 sego . ) ; (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. 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 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 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT h cl �. State of C� County of ////�/ ��� j n r �` On �C ' f .,'�U before me, G L C Del ✓ Name a Tithe of Officer(a g.,"Jane Doe,Nolary Publ' ') (1 <S� personally appeared - �"I Namo(s)ol Signers) �)� J 1 personally known to me—OR—❑proved to me on the basis of satisfactory evidence to be the person 9) f> whose name(4'ls/subscribed to the within instrument A and acknowledged to me that *she/" executed the same in hVher/tR*authorized capacity(is�, and that by hlf*ther/thh�i6ignatureW on the instrument the person q� SHE GALL commlxlon k 113243E or the entity upon behalf of which the persori acted {� •� Notary Public—Calfomla executed the instrument. ° I,C� Riverslde County of My Comm.Explre3 Apr 3,2001 j7 t" WITNESS my hand and official seal. X Z 6ignaWre of Notary Pubha y OPTI NAL 4 1< 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. ;3 G,� `a ®escripti®n Of Attached ®®caomecot n Title or Type of Document: �S it Document Date: 5 it Number of Pages: a; n Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) -' try Signer's Name: Signer's Name_ i � ❑ Individual ❑ Individual �I ❑ Corporate Officer ❑ Corporate Officer Title(s): Title(s); lip I ❑ Partner—❑ Limited ❑ General ❑ Partner—❑ Limited ❑ General )I ❑ Attorney-in-Fact ❑ Attorney-in-Fact )S ❑ Trustee ❑ Trustee ❑ Guardian or Conservator ❑ Guardian or Conservator ); ❑ Other: Top of thumb here ❑ Other: Top of thumb heir-al�)I iJ r (i IoJl 0 IIS IS�I Signer Is Representing: Signer Is Representing: >I qTI 'i2 a/ �hV` - - .1.�'/J✓,`.,✓✓�J�`"`�6�':=):T- ✓;��-- L�.- .+`J'�R`✓J�:S.Jr9 -.._v vse--S�FJ���������,�„- - Nv�y�Y j ©1995 National Notary Association•8236 Remmet Ave PO.Box 7184 Canoga Parr,CA 91309 7184 Prod No.5907 Reorder.Call Toll Free 1-800-876 6827 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT Q _ - "— —'-- .=r="-On('�'?-Ft-'"'z='4'�•C� _�9�?.' .,r__„ {`-L3 _�_.-�.�z��.^'_'""•>' �^;3 yI i �r State of County of /1 //�}�.'���1/2& �/� n before me, ,cJ�,; }vi Data ���j7 q l Noma and Tj(le of ORioar(a g,'xJano Ooe,Notary Publlo") ,>;)� Si personally pp /7���//l' -(JCS i, ersonall appeared Namev)of Signer(s) > ;i ❑personally known to me-OR-1 dtproved to me on the basis of satisfactory evidence to be the personal n whose name(`is/a`r�subscribed to the within instrument �I and acknowledged to me that Nj&he/fhid executed the �I same in /her/their authorized ca acit ies and that b (,- hKIher/11I signature(�`on the instrument the personO, SHERRY GALL or the entity upon behalf of which the persorl acted, l� conger n a 1132438 x executed the instrument. NctcryPuCllc—ccuornb '7J RNorsldoCrouny WITNESS my hand and official seal, Nry corr.n.F.nnires Apr 3,2(X)1IQ I ignalu`re or Notary Publlo SDI I(. OPTI NAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent •>I fraudulent removal and reattachment of this form to another document Il Description of-A tached Document - -- - �il- c - Title or Type of Document: wC Document Date: Number of Pages: ;11 jSigner(s) Other Than Named Above: Ca acit tes Claimed b Signer(s) s? P Y�• ) Y al fi Signer's Name: Signer's Name: s� ia3 ❑ Individual ❑ Individual ❑ Corporate Officer ❑ Corporate Officer ] G Title(s): Title(s): 3 ❑ Partner—❑ Limited ❑ General ❑ Partner—❑ Limited ❑ General ❑ Attorne -in-Fact t Y El Attorney-in-Fact on ❑ Trustee ❑ Trustee n w' ❑ Guardian or Conservator ❑ Guardian or Conservator it ❑ Other: Top of thumb here ❑ Other: Top of thumb here i(b a)S ,- Signer Is Representing: Signer Is Representing: » >I I� `>rl s,l 71 �, sp t�" a 1f5, I�z iC%' - - �`�✓Cq%Tp?rjg, - - �--' p-1T%C,bC. ✓'_�..v�,�r >o�•�-v—�•^d✓.'.�c.�-%4 - � _L.- -- r - _ ?�_- �_—.1� ©1995 National Notary Associnkmn•8236 Remmet Ave. PO Box 7184 Canoga Park,CA 91309-7184 P.d No 5907 Reorder Call Toll Free 1-800-876�6827 WITH COPY TO: Rutan & Tucker 611 Anton Blvd. , Suite 1400 Costa Mesa, California 92626-1998 TO CONTRACTOR: 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, CALIF NIA Dated: City Manager THE r.-'ffV G City Clerk Jun APPROVED AS TO FORM: RUTAN & TU KER s City_,Attorney _- CONTRACTOR: FAIR HOUSING COUNCIL OF RIVERSIDE COUNTY INC Dated: BY: _- Name: LULAMAE CLNS _ ism+u;L�,•1" By: Y� > /� fS �J ,_ me: Judith D riffith Title: 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 CITY OF PALM SPRINGS EXHIBIT A Scope of Services Proiect/Activity Title: Protect Number: Fair Housing Program B-25-19 Name/Address of Provider: Fair Housing Council of Riverside County, Inc. PO Box 1068 3600 Lime Street, Ste 613 Riverside, CA 92501-1068 Riverside, CA 92501 PROJECT/ACTIVITY DESCRIPTION The Fair Housing Council of Riverside County, Inc. (Council) will provide a full menu of fair housing services via the Palm Springs' office that promote fair housing rights and obligations as outlined in the Federal Fair Housing Act and the California State Law Enactments under the Rumford and Unruh Civil Rights Acts. The fair housing services will consist of three (3) components, as it relates to Anti-Discrimination and Landlord/Tenant services. They include • Education (i.e., educating the public); • Training and Technical Assistance (i.e., assisting the public with achieving compliant housing practices); and • Enforcement (i.e., ensuring enforcement activities appropriate to non-compliant housing practices). Estimated Number of City of PALM SPRINGS Persons/Households to be served 1,800 CITY OF PALM SPRINGS EXHIBIT B Budget Summary Prolect/Activity Title: Protect Number: Fair Housing Program B-25-19 Name/Address of Provider: Fair Housing Council of Riverside County, Inc. PO Box 1068 3600 Lime Street, Ste 613 Riverside, CA 92501-1068 Riverside, CA 92501 BUDGET SUMMARY -�j COST CATEGORY CDBG SHARE OTHER TOTAL SOURCES COST 1 Personnel $17,980.00 - 0 - $17,980.00 2 Consultant/Contract Services $629. 0 — 0 - $629.00 3 Travel $465.00 0 - $465.00 4 Space Rental $3,262.00 - 0 - $3,262.00 5 Consumable Supplies $727.00 - 0 - $727.00 6 Rental, Lease or Purchase of $1,732.00 - 0 - $1,732.00 Equipment 7 Insurance $646.00 0 - $646.00 8 Other $2,559.00 - 0 - $2,559.00 Operational Costs —r-- $28,000.00 - 0 - $28,000.00 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 Salaries $15,605.00 - 0 - $15,605.00 Benefits $2,375.00 - 0 - $2,375.00 Administration $629.00 - 0 - $629.00 Advertise $144.00 - 0 - $144.00 E ui ment/Ca ital $818.00 - 0 - $818.00 Equipment/Non-Capital $180.00 - 0 - $180.00 Equipment/Lease $510.00 - 0 - $510.00 Equipment/Maintenance $224.00 - 0 - $224.00 Insurance $646.00 - 0 - $646.00 Membership/Dues $90.00 - 0 - $90.00 Office Supply $259.00 - 0 - $259.00 Postage $305.00 - 0 - $305.00 Printing/Reproduction $163.00 - 0 - $163.00 Publications/Subscriptions $90.00 - 0 - $90.00 Rent/Utility $3,262.00 - 0 - $3,262.00 Sundry $809.00 - 0 - $809.00 Telephone $1,176.00 - 0 - $1,176.00 Training $90.00 - 0 - $90.00 Travel/Conference $269.00 - 0 - $269.00 Travel/Mileage $196.00 - 0 - $196.00 Vehicle/Maintenance $78.00 - 0 - $78.00 Vehicle/Operation $82.00 - 0 - $82.00 T,otal $28;00,000 0: $28;000.00 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 Prolect/ActivitV Title: Proiect Number: FAIR HOUSING PROGRAM Name/Address of Provider: Date: FAIR HOUSING COUNCIL OF RIVERSIDE COUNTY, INC. P. 0. Rox 1065, Riverside, CA 92502 3600 Lime Street, Suite 613, Riverside, CA 92502 INSURANCE INVENTORY LIABILITY INSURANCE POLICY Name of Provider's Insurance Company NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA Effective Dates of Policy. APR 2R o0 to APR 2R D1 Claims Made Policy / /2000-04221 NIPO Per Occurrence Policy / / 000-04221 NP0 Limits of Liability Deductibles: Per Occurrence $1 .000,000 Annual Aggregate $2 000,000 Additional Insured Endorsement xi Yes ❑ No Certified Copy of Policy Attached ❑Yes )c No Certificate of Insurance Attached r Yes ❑ No WORKER'S COMPENSATION POLICY Name of Provider's Insurance Company STATE COMPENSATION INSURANCE FUND Effective Dates 7/1 /00 to 7/1/01 Limits of Liability $1 ,00,000 oer occurrence Underlying Coverage Limits Additional Insured Endorsement Attached ❑ Yes xq(No Certified Policy (copy of)Attached ❑Yes xxNo Certificate of Insurance Attached )CYes ❑ No CITY OF PALM SPRINGS EXHIBIT D Beneficiary Qualification Statement Project/Activity Title: Project Number: Name/Address of Provider: 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 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 NUMBER OF PERSONS IN YOUR HOUSEHOLD: 1 2 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, yes 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 wAl be kept confidential CITY OF PALM SPRINGS EXHIBIT E Quarterly Program Progress Report Project/Activity Title: Project Number: Name/Address of Provider: Date: PROGRAM PROGRESS REPORT For the Period Ending: DIRECT BENEFIT REPORT -Number of First-Time Program Beneficiaries Serviced#of Households #of Persons 0-50%below 51-80%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 Signed Title Date CITY OF PALM SPRINGS EXHIBIT F Request for Reimbursement Project/Activity Title: Project Number: Name/Address of Provider: 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. - f � 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. r, r 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. CERTIFIC! T&F LIABILITY INSURAN DATE(MM/DD/YY) APR 27 00 SLAVIN&ASSOCIATES INSURANCE BROKERS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE 10261C TRADEMARK ST I P O BOX 2249 RANCHO CUCAMONGA CA 91729 POLICIES BELOW. ' EXTEND OR ALTER THE COVERAGE AFFORDED BY THE PHONE: 909483.1010 FAX: 909-483.1080 Agency Lic#: OC38855 COMPANIES AFFORDING COVERAGE INSURED 'COMPANY A: NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA -- FAIR HOUSING COUNCIL OF RIVERSIDE COUNTY, INC. COMPANY B ------ - - - ---------------- PO BOX 1018 ------"- RIVERSIDE CA 92502 ---------- - COMPANYD - _--"- -- COMPANY E._— COVERAGES 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 AE 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 NSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION - ------ - DATEIMM/pp/1'YI PATE IMMI00", LIMITS GENERAL LIABILITY 2000-04221-NPO APR 28 00 APR 28 01 EACH OCCURRENCE S 70 ro,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any One Fire) S 100,000 CLAIMS MADE X OCCUR MED EXP(Any One Person) S 10,000 A .— - - _ --_._ PERSONALBADV INJURY S 1,000,000 GENERAL AGGREGATE 5 2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER. ._ — _ PRODUCTS-COMP/OPAGG S 2,000,000 POLICY PROJECT BLOC - - -- -----_ --- AUTOMOBILE LIABILITY 2000-04221-NPO APR 28 00 APR 28 Ot COMBINED SINGLE LIMIT ANY AUTO C.am,d.nt) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY A X SCHEDULED AUTOS (Per Person) S X HIRED AUTOS X NON-OWNED AUTOS BODILY INJURY S (P.,..Cdenp PROPERTY DAMAGE S GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANYAUTO OTHERTHAN EAACC $ AUTO ONLY qGG $ EXCESS LIABILITY _ EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE S S DEDUCTIBLE S _ RETENTION S WORKERS COMPENSATION ANO EMPLOVERS'LIABILIN WC OTHER TORY LIMITS TORT LIMITITATU.S I EL EACH ACCIDENT S EL DISEASE-EA EMPLOYEE $ EL DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS ALL OPERATIONS OF THE NAMED INSURED. CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED AS RESPECTS FUNDING-SEE FORM CG 20 26 11 85 ATTACHED. CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION CITY OF PALM SPRINGS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY CLERK EXPIRANOTICETION DATE THEREOF.TO THE CERTIFICATE7HE HOLDER ISSUING NAMEDMPANY TO THE LEFT 30 DAYS WRITTEN P O BOX 2743 PALM SPRINGS CA 92263-2743 AUTHORIZED REPRESENTATIVE Attention: PATRICIA A SANDERS,CITY CLERK 0�-�(n/ L& ('—) 1, ACORD 25-S (7197) Certificate# 757 LYN SLAVIN 0007646 POLICY NUMBER: 2000-04221-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: 9 COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: CITY OF PALM SPRINGS ATTN: CITY CLERK P O BOX 2743 PALM SPRINGS CA 92263-2743 (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. The additional insured status is not afforded with respect to liability arising out of or related to your activities as a real estate manager for the above designated person or organization. CG 20 26 11 85 Copyright, Insurance Services Office, Inc., 1984 STATE P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 CO WI PEN SATI ON INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION•INSU.RANCE JULY 1.2, 2L 0, POLICY NUMBER: 34A i�45 '- 00 'CERTIFICATE EXPIRESr - 01 - C`Tf OF PAU1 SPRINGS, 1IR1. LIT; C12 'K RECEIVED ra„0. BOX 2743 R,%LN EP8ING'S CAL.17ORNIA 922F,3, U 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 em to YIK named below for the policy period indicated. -This policy is not subject to cancellation by the 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 prior to 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 maybe issued'or may pertajn,lthe insurance affordedby the policies described herein issubject to all the terms,:-exclusions a06cbndttions of such poficjes. AUTHORIZED REPRESENTATIVE PRESIDENT "L^i.J uit'N 7 I,1311iIT INC kIDIi+T>x DEFENSE' COSTS: $1,OCX),000 ? ,0 1.;F12 N"Ir,. EMPLOYER THE F R HIXTSINI 1:01`C'IT, Or IsIYER' OCUNTY frith;. ?C DOX liioN RIVER,SIDI CA 3?:EC2 L_ THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND . a 'C'i ;gLCEA'S CG ACORD CE`RTIFIC E OF LIABILITY INSURANCE, DATE 2103 ) TM. PROODUCE3 ASSOCIATES INSURANCE BRL S THIS CERTIFICATE SUED AS A MATTER OF INFORMATION ONLY AND CONFE -d0 RIGHTS UPON THE CERTIFICATE 10261C TRADEMARK ST/P O BOX 2249 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR RANCHO CUCAMONGA CA 91729 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PHONE: 909483-1010 FAX: 909.483.1080 Agency Lic#:OC38855 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: NONPROFITS INSURANCE ALLIANC —V—F 71LIF0 80922 FAIR HOUSING COUNCIL OF RIVERSIDE COUNTY,INC. "� °'�I;' INSURER B: PO BOX 1068 RIVERSIDE CA 92502.1068 INSURER C: INSURER D: j 21 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTAdDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE-ISSUED;,:ORA MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LT DATE MMIDD DATE MMOD GENERAL LIABILITY 2003-04221-NPO APR 2803 APR 2804 EACH OCCURRENCE $ 1,000,OOD X COMMERCIAL GENERAL LIABILITY OPMAGETORENTED $ 100,000 -71 n PREMISE Ea occuranm CLAIMS MADE IJ OCCUR MED.EXP(Any One Person) $ 10,000 A PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE IS 2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS-COMPIOPAGG. $ 2,000,000 X POLICY AUTOMOBILE LIABILITY 2003-04221-NPO APR 2803 APR 2804 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULEDAUTOS (Per person) $ A X HIREDAUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ GARAGELIABILITY AUTO ONLY-EA ACCIDENT S ANYAUTO OTHERTHAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBERELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION g Is WORKERS COMPENSATION AND TO ST WC STATL'T TAU-S OTHER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ ANYPROPRIETORIPARTNERIE%ECUTIVE OFFICE RIMAmBEREXCLUDEDa E.L.DISEASE-EA EMPLOYEE $ Ity a,dnedb.bndx SPECIAL PROVISIONS b.Iaw E.L.DISEASE-POLICY LIMIT $ OTHER: DESCRIPTION OF OPERATIONS/LOCATIONIVEHICLES/EXCLUSIONS ADDED ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED PER FORM CG 20 26 11.85 ATTACHED. CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: _ CANCELLATION CITY OF PALM SPRINGS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE P O BOX 2743 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. PALM SPRINGS CA 92263-2743 AUTHORIZED REPRESENTATIVE ^ Attention: CITY CLERK (1 �cuo— �~ ACORD 25(2001/08) Certificate# 11093 LYN SLAVIN 0007646 SK THOLDER'.,COPY STATE' P.O. BOX '807, SAN'FRANCISCO;CA !�,?1,42 0807,� ,6< ' •COMPeN5ATIQNrtf INSUFIAN'CH _. FUND CERTIFICATE OF WORKERS' COMPENSATION, INSURANCE ' ISSUE DATE: 07-61-2003 - GROUP: - .POLICY NUMBER: .1344748-2003 ' CERTIFICATE, ID." '37 CERTIFICATE ,EXPIRES: 07-01-2004 .' 07-01-200.3/07-01-200,4 , - CITY ,OF PALM'SPRI'NGS SK PATRICIA SANDERS 3200 TAHQUITZ CANYON WAY PALM SPRINGS CA 9,2262 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 by the Fund except upon 30 days' advance written notice to the employer. We will also give you 30 days' advance notice should this policy be cancelled prior to 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 pertain, the insurance afforded,by,the policies described herein is subject to all, the terms, exclusions and conditions of such policies. AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S`LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER'�OCCURRENCE. ENDORSEMENT H2O65 ENTITLED CERTIFICATE. HOLDERS' NOTICE EFFECTIVE' 07-01-2003 'IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER LEGAL NAME - THE FAIR" HOUSING' COUNCIL 'OF , THE FAIR HOUSNQ-60UNCIL, OF RIVERSIDE RIVERSIDE COUNTY INC. 613 COUNTY INc. PO BOX 1068 . - - (A'NON^.PROFIT- CORP. ) RIVERSIDE CA 92502 06'-18-2003 REv.3-031 "-''. _ _ , PRINTED. _ P0408 • i -'►K-V—V.iRM7r"r-r.T a--1 ^Tit