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HomeMy WebLinkAboutC-4295 WAIVER OF CONTRACTUAL TERM
TO
AGREEMENT FOR PROFESSIONAL SERVICES
CONTRACT No. 100119ARCSP-01
This document shall serve as Union Station Homeless Services' ("Sub-Recipient") decision to waive its
right("Waiver)to pursue benefit of Section IV. Compensation and Method of Payment, item number 2, titled
Working Capital Advance, on Contract No. 100119ARCSP-01 (the"Agreement").
RECITALS
WHEREAS, the City of Arcadia and the Sub-Recipient executed Agreement No. 100119ARCSP-01,
effective November 1, 2019, for homeless outreach, case management, and interim housing services; and
WHEREAS, the Agreement included terms that provided the Sub-Recipient with the benefit of a Working
Capital Advance; and
WHEREAS, the receipt of such Advance would subsequently task the City of Arcadia with recoupment
procedures throughout the term of the Agreement;
NOW, THEREFORE, Sub-Recipient agrees to forego its contractual right to pursue the benefit of the
following terms, and thus, relieves the City of Arcadia of subsequent recoupment procedures, as noted in
Section IV. Compensation and Method of Payment:
2. Working Capital Advance: To facilitate Sub-Recipient's working capital requirements of the
Statement of Work, Sub-Recipient may request an initial advance equivalent of two (2) months'
expenses upon the execution of the Agreement. If Sub-Recipient requests an advance, the
following recoupment conditions shall apply.
A. City of Arcadia shall recoup the advance payment to Sub-Recipient in twelve (12)
equal payments effective January 2020 with Sub-Recipient's reimbursement
request for the month of December 2019.
B. Final recoupment of advance will be processed against Sub-Recipient's
reimbursement request for the month of November 2020.
All other terms and conditions of the Agreement shall remain in full force and effect.
This Waiver is made effective on this 10th day of February 2020 upon the authorizing signature of Sub-
Recipient's Chief Executive Officer.
SUB-RECIPIENT
UNION STATION HOMELESS SERVICES
By: ( AA/AWL .'�:. C
Anne Miskey
Chief Executive Officer#
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AGREEMENT FOR PROFESSIONAL SERVICES
CONTRACT No. 100119ARCSP-01
This Agreement for the Provision of Measure H Funding for homeless outreach, case management, and
interim housing services (herein referred to as the "Agreement"), is made and entered into this 1st day of
November 2019, between the City of Arcadia and the City of South Pasadena, hereinafter referred to as the
"Cities", and Union Station Homeless Services, a California non-profit public benefit corporation organized
under the laws of the State of California, hereinafter referred to as the "Sub-Recipient", with the Cities and
the Sub-Recipient collectively referred to as the"Parties",with reference to the following:
RECITALS
WHEREAS, in response to the growing crisis of homelessness in Los Angeles County, its Board of
Supervisors launched the Homeless Initiative (HI) in 2015 to prevent and address homelessness in its
communities. In 2017, the Board of Supervisors approved funding for cities to develop their own
homelessness plans, and in September 2018, approved Measure H funding for multi jurisdictional partners to
implement such initiatives; and
WHEREAS, the Cities jointly applied, and was approved to receive Measure H funding to implement their
homeless plans within their city jurisdictions; and
WHEREAS, the Cities require professional services for homeless outreach, case management, and
interim housing services for individuals and families who are homeless or would be homeless but for this
assistance; and the Sub-Recipient is qualified by virtue of its experience and facilities to execute the
Homeless Outreach Program consistent with the requirements of the Cities' Homelessness Implementation
Plan.
WHEREAS, the Cities desire to allocate to the Sub-Recipient a portion of the Cities' Measure H funding to
enable the Sub-Recipient to provide certain homeless outreach, case management, and interim housing
services; and,
WHEREAS, the City of Arcadia shall be the main entity to administer the Measure H Funding on behalf of
the Cities,
NOW, THEREFORE, the Cities and Sub-Recipient agree as follows:
I. SCOPE OF SERVICES
1. Service Area: The service areas shall extend throughout the municipalities of Arcadia and
South Pasadena.
2. Statement of Work: Sub-Recipient shall perform all the services ("Services") described in
the Statement of Work set forth as Exhibit"A"to this Agreement, a copy of which is attached
hereto and incorporated herein by reference.
II. BUDGET
The Cities agree to allocate Homeless Initiatives Measure H funding, which originate from the County
of Los Angeles, to reimburse the Sub-Recipient subject to the conditions set forth in this Agreement.
The Sub-Recipient shall comply with the Pricing Schedule specified in Exhibit "B" ("to this
Agreement, a copy of which is attached hereto and incorporated herein by reference.
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III. TIME OF PERFORMANCE
The Services of the Sub-Recipient shall commence as of November 1, 2019 and shall continue until
the program completion date of February 28,2021.
The Parties hereto understand that Cities have authorized the performance of the Statement of Work
described in Exhibit"A"attached hereto, commencing on November 1, 2019. Sub-Recipient hereby
agrees to commence said Services as of that date and to complete said Services on or before
February 28, 2021 in accordance with all the terms and provisions of this Agreement.
The total amount of compensation set forth in Section IV of this Agreement may be amended,
modified or supplemented by the Cities in their sole and absolute discretion to reflect such amount as
Cities deem necessary and appropriate, which determination shall be based on such factors as, but
not limited to, the amount of Measure H funding available for the Cities to allocate for homeless
outreach, case management, and interim housing services for this program.
IV. COMPENSATION AND METHOD OF PAYMENT
1. Partner agreement Between Cites: Cities will execute a partner agreement to define terms
of the procedural administration to collectively fund this Agreement. The partner agreement
shall be between the City of Arcadia and the City of South Pasadena, and the Sub-Recipient
shall not be party to such agreement. Cities collectively agree that failure of the Cities to
execute the partner agreement shall not negatively impact the compensation terms outlined
in this Section IV of this Agreement.
2. Working Capital Advance: To facilitate Sub-Recipient's working capital requirements of the
Statement of Work, Sub-Recipient may request an initial advance equivalent of two (2)
months' expenses upon the execution of the Agreement. If Sub-Recipient requests an
advance,the following recoupment conditions shall apply.
A. City of Arcadia shall recoup the advance payment to Sub-Recipient in twelve (12)
equal payments effective January 2020 with Sub-Recipient's reimbursement
request for the month of December 2019.
B. Final recoupment of advance will be processed against Sub-Recipient's
reimbursement request for the month of November 2020.
3. Reimbursement of Sub-Recipient Cost: City of Arcadia shall reimburse Sub-Recipient for
allowable costs incurred under the scope of this Agreement which have not been paid for or
reimbursed in any other manner by any other Agency or private source of funding.
Subject to the conditions set forth in this Agreement, City of Arcadia will reimbursement Sub-
Recipient a maximum of Two Hundred Ninety Two Thousand Dollars ($292,200)to support
the scope of Services. Payment of eligible expenses shall be made against the program
budget specified in Exhibit "B", attached hereto and by this reference incorporated herein
("Budget").
Disbursement of payment to Sub-Recipient shall be made by monthly reimbursements,
contingent upon City of Arcadia's receipt of a Sub-Recipient's monthly invoice. Monthly
invoice shall include expenditure reports and "Audit Ready" supportive evidence of
expenditures, in accordance with Federal regulations.
Sub-Recipient will submit its monthly invoice by the fifteen (15th) day of the calendar month
following the month of in which the Sub-Recipient provided the services. Within 30 days of
receipt Sub-Recipient's invoice, City of Arcadia will draw a warrant in favor of Sub-Recipient
for approved expenditure amounts. In the event that Sub-Recipient submits its monthly
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invoice after the fifteenth (15th)day of the month, City of Arcadia will provide payment within
thirty(30)calendar days of the submission date.
V. NOTICES
All notices, Certificates of Insurance, and other communications must be in writing and will be
deemed to have been duly given only if delivered personally or mailed (certified or registered,
postage prepaid, return receipt requested) to the Parties at the addresses that follow. Such
notification and communications will be deemed received when delivered if by personal delivery, or
two (2) business days from the date of mailing (postmark date) when delivered by U.S. Postal
Service.
CITIES:
City of Arcadia
Attn: Dominic Lazzaretto, City Manager
240 W. Huntington Drive
Arcadia, CA 91007
Telephone: (626)574-5401
Fax: (626)446-5729
Email: domlazzarcadiaca.qov
City of South Pasadena
Attn: Stephanie DeWolfe, City Manager
1414 Mission Street
South Pasadena, CA 91030
SUB-RECIPIENT:
Union Station Homeless Services
Attn:Anne Miskey, Chief Executive Officer
825 E. Orange Grove Blvd.
Pasadena, CA 91104
Telephone: (626)240-4550
Email:amiskey@unionstationhs.org
VI. GENERAL CONDITIONS
A. City Review: The Cities reserve the right to review and approve actions and decisions taken by
Sub-Recipient regarding operation of Homeless Outreach Services for compliance with all
applicable regulations.
B. Sub-Recipient Status:
1. The Cities recognize Sub-Recipient as an independent non-profit organization and agree to
reasonably cooperate in protecting its image as a politically neutral organization.
2. Sub-Recipient shall act as an independent contractor in the performance of the services
provided for in this Agreement and shall furnish such services in Sub-Recipient's own
manner and method and in no respect shall Sub-Recipient be considered an agent or
employee of the Cities.
3. Sub-Recipient warrants and agrees that it is not a party listed on the General Service
Administration's List of Parties Excluded from Federal Procurement or Nonprocurement
Programs in accordance with Executive Orders 12549 and 12689, "Debarment and
Suspension." If the amount of this Agreement exceeds the small purchase threshold as
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established by 41 U.S.C. 403(11) (currently$25,000), Sub-Recipient agrees to provide the
required certification regarding its exclusion status.
C. Indemnification: Sub-Recipient hereby agrees to the following:
1. Indemnification for Professional Services. Sub-Recipient will save harmless and
indemnify Cities and, at Cities' request, reimburse defense costs for Cities and all their
officials, officers, volunteers, employees and agents from and against any and all suits,
actions, or claims, of any character whatever, brought for, or on account of, any injuries,
including death or damages sustained by any person or property resulting or arising from
any negligent or wrongful act, error or omission by Sub-Recipient or any of Sub-
Recipient's officials, officers, volunteers, employees and agents, in the performance of
this Agreement.
2. Indemnification for other Damages. Sub-Recipient shall indemnify and hold Cities and
their officials, officers, volunteers, employees and agents harmless from and against any
claim, action, damages, costs (including, without limitation, attorney's fees), injuries, or
liability, arising out of this Agreement, or its performance. Should Cities be named in any
suit, or should any claim be brought against them by suit or otherwise, whether the same
be groundless or not, arising out of this Agreement, or its performance, Sub-Recipient will
defend Cities (at Cities' request and with counsel satisfactory to Cities)and will indemnify
Cities for any judgment rendered against them or any sums paid out in settlement or
otherwise.
a. For purposes of this section "Cities" include Cities' officers, officials, employees,
agents, and representatives.
b. It is expressly understood and agreed that the foregoing provisions will survive
termination of this Agreement.
c. Cities do not, and shall not, waive any rights against Sub-Recipient which it may have
by reason of the aforesaid hold-harmless Agreement because of the acceptance by
Cities or the deposit with Cities by Sub-Recipient, of any of the insurance policies
hereinafter described in this Agreement.
d. The aforesaid hold-harmless Agreement by Sub-Recipient shall apply to all damages
and claims for damages of every kind suffered, or alleged to have been suffered, by
reason of any of the aforesaid operations of Sub-Recipient, or any subcontractor of
Sub-Recipient, regardless of whether such insurance policies shall have been
determined to be applicable to any of such damages or claims for damages.
e. The provisions of this section do not apply to claims occurring as a result of the
Cities' sole negligence or willful acts or omissions.
D. Compliance with Laws and Assurances: Sub-Recipient hereby assures and certifies that it has
complied and will continue to comply with all applicable Federal, State, and local laws,
ordinances, regulations, policies, guidelines, and requirements as they relate to acceptance and
use of funds for this assisted program. This Agreement is subject to all such laws, ordinances,
regulations, policies,and guidelines.
Notwithstanding any other provision of this Agreement, Cities may elect not to make a particular
payment on account of this Agreement if:
1. Misrepresentation: Sub-Recipient,with or without knowledge, shall have made any
misrepresentation of a substantial and material nature with respect to any information
furnished to Cities.
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2. Litigation: There is then pending litigation with respect to the performance by Sub-Recipient
of any of its duties or obligations hereunder which may jeopardize or adversely affect
carrying out its scope of services including any court action or proceeding involving the
Federal Bankruptcy Act.
3. Default: Sub-Recipient is in default under any provision of this Agreement.
4. Reduction in Funds: Cities' Measure H funding source is reduced.
E. Disputes and Remedies: Claims, disputes, and other matters in question between the
Parties arising out of or relating to this Agreement or the breach thereof, must be resolved by
the following procedure:
1. Cities and Sub-Recipient will exercise their best efforts to resolve disputes through the
development of a consensus. A meeting may be requested by Cities or Sub-Recipient at
any time for the purpose of resolving a dispute. A determination by City Managers will be
made within two(2)weeks after a meeting to resolve the dispute;
2. If unresolved within thirty(30) days, then City Manager, or his designee, will make a final
determination;
3. Following the City Manager's final determination, the Parties may submit any unresolved
matters to non-binding mediation. The Parties may, but are not required to be,
represented by counsel in mediation;
4. If the Parties do not agree to mediation, or if mediation does not resolve the Parties'
dispute, the matter may be pursued in Los Angeles County Superior Court, or the United
States District Court, Central District of California, if federal jurisdiction exists.
5. The Parties' rights and remedies under this Agreement are in addition to any other rights
and remedies provided by law.
F. Non-Assignment: This Agreement is not assignable either in whole or in part by Sub-
Recipient without the written consent of Cities.
G. Termination of Agreement: The Cities may terminate this Agreement upon giving a
thirty(30) day advance written notice of such termination to Sub-Recipient. In that event,
the City Manager, or his designee, based upon work accomplished by Sub-Recipient prior
to notice of such termination, shall determine the amount of fees to be paid to Sub-
Recipient for such services based upon accepted accounting practices. This finding by
the City Manager, or his designee, shall be considered by the City Council and the
Council's determination shall be final and conclusive as to the amount of such fee.
H. Insurance: Sub-Recipient shall not commence work under this contract until Sub-
Recipient shall have obtained all insurance required by this Agreement and such
insurance shall have been approved by Cities as to form, amount and carrier, nor shall
Sub-Recipient allow any subcontractor of Sub-Recipient to commence work on any
subcontract until all similar insurance required of the subcontractor of Sub-Recipient shall
have been so obtained and approved.
1. COMPENSATION INSURANCE. Sub-Recipient shall take out and maintain, during
the life of this contract, Worker's Compensation Insurance for all of Sub-Recipient's
employees employed to perform the Services as described section 2 of the
Agreement; and, if any work is sublet, Sub-Recipient shall require the subcontractor
of Sub-Recipient similarly to provide Worker's Compensation Insurance for all of the
latter's employees, unless such employees are covered by the protection afforded by
Sub-Recipient. If any class of employees engaged in work under this Agreement is
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not protected under any Workers' Compensation law, Sub-Recipient shall provide and
shall cause each subcontractor of Sub-Recipient to provide adequate insurance for
the protection of employees not otherwise protected. Sub-Recipient shall indemnify
Cities for any damage resulting to it from failure of either Sub-Recipient or any
subcontractor of Sub-Recipient to take out or maintain such insurance.
2. COMPREHENSIVE GENERAL LIABILITY, PROFESSIONAL LIABILITY,
COMPREHENSIVE AUTOMOBILE LIABILITY AND CONTRACTUAL GENERAL
LIABILITY INSURANCE. Sub-Recipient shall take out and maintain during the life of
this contract comprehensive general liability, products/completed operations hazard,
comprehensive automobile liability and contractual general liability insurance and
shall protect Cities, their elective and appointive boards, officers, agents and
employees, Sub-Recipient, and any subcontractor of Sub-Recipient performing work
covered by this contract, from claims for damage for personal injury, including
death, as well as from claims for property damage which may arise from Sub-
Recipient or any subcontractor of Sub-Recipient's operations under this contract,
whether such operations be by Sub-Recipient or by any subcontractor of Sub-
Recipient, or by anyone directly or indirectly employed by either Sub-Recipient or
any subcontractor of Sub-Recipient, and the amounts of such insurance shall be as
follows:
a. Commercial General Liability Insurance in an amount of not less than ONE
MILLION DOLLARS($1,000,000);
b. Professional Liability Insurance in an amount of not less than ONE MILLION
DOLLARS ($1,000,000);
c. Comprehensive Automobile Liability Insurance in an amount of not less amount
of not less than ONE MILLION DOLLARS ($1,000,000).
A combined single limit policy with aggregate limits in an amount of not less than
TWO MILLION DOLLARS ($2,000,000) shall be considered equivalent to the
said required minimum limits set forth in subsections(i),(ii), and (iii)above.
PROOF OF INSURANCE. The insurance required by this Agreement shall be with
insurers which are A.M. Best A rating not less than A:VII, and California-Admitted, or
better. The Cities, their officials, officers, volunteers, employees and agents shall be
named as "additional insured" on all policies required hereunder, except for Professional
Liability Insurance, and Sub-Recipient shall furnish the Cities' Clerk, concurrently with the
execution hereof, with satisfactory proof of carriage of the insurance required, and
adequate legal assurance that each carrier will give Cities at least thirty (30) days' prior
notice of the cancellation of any policy during the effective period of the contract.
ADDITIONAL INSURSED STATUS. The Cities, their directors, officials, officers,
employees, agents and volunteers shall be provided additional insured status under Sub-
Recipient's General Liability policy with respect to liability for bodily injury, property
damage, personal injury, or advertising injury cause in whole or in part, by Sub-
Recipient's acts or omissions or the acts or omissions of those acting on behalf of the
Sub-Recipient in performance of its Services.
NOTICE TO COMMENCE WORK. The Cities will not issue any notice authorizing Sub-
Recipient or any subcontractor to commence work under this Agreement until Sub-
Recipient has provided to the Cities' Clerk the proof of insurance as required by
subparagraph (C)of this article.
I. Amendments; Variations: The Cities or Sub-Recipient may amend this Agreement at any
time provided that such amendments make specific reference to this Agreement, and are
executed in writing, signed by a duly authorized representative of both organizations, and
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approved by the Cities'governing body. Such amendments shall not invalidate this Agreement,
nor relieve or release the Cities or Sub-Recipient from their obligations under this Agreement.
The Cities may, in their discretion, amend this Agreement to conform with Federal, State, or
local governmental guidelines, policies, and available funding amounts, budget modifications or
for other reasons. If such amendments result in a change in the funding, scope of services, or
schedule of the activities to be undertaken as part of this Agreement, such modifications will be
incorporated only by written amendment signed by both Cities and Sub-Recipient.
The City Manager of Arcadia, or designee, is authorized to modify the budget of this Agreement
in the form of a written amendment or written document hereto for the movement of funds within
the budget categories identified in Exhibit"B"on behalf of the Cities,when such modifications:
1. Do not alter the total amount of compensation under this Agreement;
2. Will not change the project goals or scope of services;and
3. Are in the best interests of the Cities, the County and the Sub-Recipient in performing the
scope of services under this Agreement.
J. Changes in Grant Allocation: Cities reserve the right to reduce the grant allocation when
Cities' fiscal monitoring indicates that Sub-Recipient's rate of expenditure will result in unspent
funds at the end of the Agreement term. Changes in the grant allocation will be done only after
prior consultation with the Sub-Recipient, and such changes shall be incorporated into this
Agreement by written amendments.
K. Program Monitoring: The Cities will conduct periodic program monitoring reviews. These
reviews will focus on the extent to which the planned program has been implemented and
measurable objectives achieved, effectiveness of program management, and impact of the
program. Authorized representatives of Cities and the County of Los Angeles shall have the
right of access to all activities and facilities operated by the Sub-Recipient under this Agreement.
Facilities include all files, records, and other documents related to the performance of this
Agreement. Activities include attendance at staff, board of directors, advisory committee, and
advisory board meetings and inspection by Cities' and Los Angeles County representatives,and
ensure that its employees and board members furnish such information, as in the judgment of
Cities and County of Los Angeles representatives, may be relevant to the question of
compliance with contractual conditions and County directives, or the effectiveness, legality, and
achievements of the program.
VII. ADMINISTRATIVE REQUIREMENTS
A. Financial Management
1. Accounting Standards: The Sub-Recipient agrees to comply with Title 2 U.S. Code of
Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost
Principles and Audit Requirements for Federal Awards, and agrees to adhere to the
accounting principles and procedures required therein, utilize adequate internal controls,
and maintain necessary source documentation for all costs incurred.
2. Cost Principles: The Sub-Recipient shall administer its program in conformance with
Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative
Requirements, Cost Principles and Audit Requirements for Federal Awards." These
principles shall be applied for all costs whether charged on a direct or indirect basis.
3. Joint Funding: For programs in which there are sources of funds in addition to Measure
H funds, the Sub-Recipient shall provide proof of such funding. The Cities shall not pay
for any services provided by the Sub-Recipient which are funded by other sources. All
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restrictions and/or requirements provided in this Agreement relative to accounting,
budgeting, and reporting applies to the total program regardless of funding sources.
B. Documentation & Record Keeping
1. Records to be Maintained: Sub-Recipient shall maintain all records required by the
Federal Regulations specified in 24 CFR Part 570.506,that are pertinent to the activities to
be funded under this Agreement. Such records shall include, but not be limited to:
a. Records providing a full description of each activity undertaken;
b. Records demonstrating that each activity undertaken meets the requirements of;
c. Records required to determine the eligibility of activities;
d. Financial records as required by 24 CFR Part 570.502, and 2 U.S. Code of Federal
Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles
and Audit Requirements for Federal Awards(2 CFR 200.333-337);and
e. Other records necessary to document compliance with Subpart K of 24 CFR 570.
2. Records Retention: Sub-Recipient shall maintain all records required by the Federal
regulations specified in 24 CFR, Part 570.506, that are pertinent to the activities funded
under this Agreement, and as further described in Exhibit"A."
Financial records, supporting documents, statistical records, and all other records
pertaining to the use of the funds provided under this Agreement shall be retained by the
Sub-Recipient for a period of five (5) years, at a minimum, and in the event of litigation,
claim, or audit, the records shall be retained until all litigation, claims, and audit findings
involving the records have been fully resolved. Records for non-expendable property
acquired with funds provided under this Agreement shall be retained for three (3) years
after the final disposition of such property.
3. Reversion of Assets: Upon the expiration or termination of this Agreement, for any
reason whatsoever, Sub-Recipient shall forthwith transfer to Cities, any funds on hand at
the time of such expiration or termination and any accounts receivable attributable to the
use of funds including,without limitation, program income.
4. Close Outs: Sub-Recipient 's obligation to the Cities shall not end until all close-out
requirements are completed. Activities during this close-out period shall include, but are
not limited to: making final payments, disposing of program assets(including the return of
all unused materials, equipment, unspent cash advances, program income balances, and
accounts receivable to Cities), and determining the custodianship of records.
5. Audits: Sub-Recipient is required to arrange for an independent financial and compliance
audit annually for each fiscal year funds are received under this Contract. Audits must be
in compliance with Single Audit Act Amendments of 1996 and Title 2 U.S. Code of Federal
Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles and
Audit Requirements for Federal Awards. An audit may be conducted by Federal, State, or
local funding source agencies as part of the Cities'audit responsibilities. The results of the
independent audit must be submitted to the Cities within thirty (30) days of completion.
Within thirty(30)days of the submittal of the audit report,the Sub-Recipient shall provide a
written response to all conditions of findings reported in the audit report. The response
must examine each condition or finding and explain a proposed resolution, including a
schedule for correcting any deficiency. All conditions or finding correction actions shall
take place within six(6)months after receipt of the audit report. Cities and their authorized
representatives shall at all times, have access for the purpose of audit or inspection, to
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any and all books, documents, papers, records, property, and premises of the Sub-
Recipient. The Sub-Recipient s staff will cooperate fully with authorized auditors when
they conduct audits and examinations of the Sub-Recipient's program. If indications of
misappropriation or misapplication of the funds of this Contract cause Cities to require a
special audit, the cost of the audit will be encumbered and deducted from this Contract
budget. Should Cities subsequently determine that the special audit was not warranted,
the amount encumbered will be restored to the Contract budget. Should the special audit
confirm misappropriation or misapplication of funds, the Sub-Recipient shall reimburse
Cities the amount of misappropriate or misapplication. In the event Cities use the judicial
system to recover misappropriated or misapplied funds,the Sub-Recipient shall reimburse
Cities' legal fees and court costs in addition to awards.
C. Reporting
1. Program Reporting: The Sub-Recipient agrees to prepare and submit to the City
Manager monthly program progress/activity reports, evaluations, and other reports as
required by the County of Los Angeles or Cities. The Sub-Recipient shall maintain such
property, personnel, financial, and other records and accounts as are considered
necessary by the County of Los Angeles or Cities to assure proper accounting for all
Contract funds, as specified in Exhibit "A." All the Sub-Recipient's records, with the
exception of confidential client information, shall be made available to representatives of
Cities and the appropriate agencies. Sub-Recipient is required to submit data necessary
to complete the Housing Element Annual Performance Report in accordance with State
regulations in the format and at the time designated by the Cities.
D. Procurement
1. Administrative Standards: The Sub-Recipient shall procure all materials, property, or
services in accordance with the requirements of Title 2 U.S. Code of Federal Regulations
(CFR) Part 200, Uniform Administrative Requirements, Cost Principles and Audit
Requirements for Federal Awards(2 CFR 200.67, and 2 CFR 200.318-326).
2. Purchase and Invoice Deadlines: Purchase of equipment or property must be
completed before the last three (3) months of the initial performance period and all
equipment bills are to be paid before the last two (2) months of this period. No
expendable or non-expendable property or equipment is to be purchased during the final
three (3) months of the initial performance period unless approved by Cities in writing.
Invoices for all obligations incurred under this Contract must be submitted to City Manager
within sixty(60)days after the initial performance period termination date or they may not
be honored. Exceptions to the preceding limitations require prior written approval by the
Cities.
3. Non-Expendable Property: A record shall be maintained by Sub-Recipient for each
item of non-expendable property acquired for this program. This record shall be provided
to Cities as well as being available for inspection and audit upon reasonable notice by the
Cities at the request of the Cities. Non-expendable property means tangible personal
property having a useful life of more than one (1) year and an acquisition cost of Three
Thousand Dollars ($3000.00) or more per unit. The Sub-Recipient shall not purchase or
agree to purchase non-expendable property without the prior written approval from the
Cities. Upon completion or early termination of this Agreement, Cities reserves the right to
determine the final disposition of the non-expendable property acquired for this program
and Measure H funds in compliance with applicable laws and regulations. The disposition
may include, but is not limited to, Cities taking possession of the non-expendable property.
4. Expendable Personal Property: Expendable personal property refers to all tangible
personal property other than non-expendable personal property. The Sub-Recipient shall
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not purchase or agree to purchase expendable personal property with a unit value of
Three Thousand Dollars ($3000.00) or more per unit without the prior written approval of
the Cities.
5. Purchase or Lease of Non-Expendable Property or Equipment: Sub-Recipient shall
purchase or lease from the lowest responsive and responsible bidder. All equipment that
has a purchase or lease price of Three Thousand Dollars($3000.00) in unit value and life
expectancy of more than one(1)year shall be properly identified and inventoried and shall
be charged at its actual price. This inventory shall be provided to Cities as well as being
available for inspection and audit upon reasonable notice by the Cities at the request of
Cities.
6. Travel and Conference Restrictions: The Sub-Recipient certifies and agrees that prior
approval for travel and conference expenses will be obtained from the City of Arcadia's
City Manager for travel outside of Los Angeles County. These expenses must be
specifically provided for in Exhibit"A" hereto.
7. Procurement and Construction Contracts: All procurement and construction contracts
shall comply with all relevant portions of OMB Circular A-110, including, but not limited to,
the provisions required by Appendix A of OMB Circular A-110 as described below:
a. Provisions or conditions that allow for administrative, contractual, or legal remedies
for breach of contract, and sanctions and penalties for the breach; this condition
applies only to procurement contracts in excess of the small purchase threshold
fixed at 41 U.S.C.403(11)(currently$25,000);
b. Provisions for termination for cause and for convenience by Sub-Recipient, the
manner that such termination will be effected, and the basis for settlement; this
condition applies only to procurement contracts in excess of the small purchase
threshold fixed at 41 U.S.C.403(11)(currently$25,000);
c. Provisions requiring compliance with Executive Order 11246, entitled "Equal
Employment Opportunity" as amended by Executive Order 11375, "Amending
Executive Order 11246 Relating to Equal Employment Opportunity" and as
supplemented in Department of Labor Regulations (41 CFR Part 60). (This Order
provides, in part, that no person shall be discriminated against on the basis of race,
color, religion, sex, or national origin in all phases of employment during the
performance of federally assisted construction contracts);
d. Provisions evidencing compliance with the Copeland "Anti-Kickback"Act(18 U.S.C.
74 as supplemented in Department of Labor regulations 29 CFR Part 3). (This Act
makes it a criminal offense for any person to induce, by any manner whatsoever,
any person employed in the construction, prosecution, completion, or repair of any
public building, public work, or building or work financed in whole or in part by loans
or grants from the United States, to give up any part of the compensation to which
he is entitled under his contract of employment.); this condition is required of all
contracts and subgrants in excess of two thousand dollars($2,000)for construction
or repair.
e. Provisions evidencing compliance with the Davis-Bacon Act(40 U.S.C. 276 a to a-
7) as supplemented by Department of Labor regulations 29 CFR Part 6, (this Act
requires provisions regarding minimum wages, fringe benefits, payments with
deductions or rebates,withholding funds from contractors to ensure compliance with
the wage provision, and termination of the contract or debarment for failure to
adhere to the required priority); this condition is required only for construction
contracts in excess of two thousand dollars($2,000);
10
f. Notice of any Cities' requirements and regulations pertaining to reporting copyrights
in accordance with 29 CFR 8534;and patents in accordance with 37 CFR Part 401;
g. Access by Sub-Recipient, the Cities, the County grantor agency, the Comptroller
General of the United States, or documents, papers, and records of the contractor
which are directly pertinent to that specific contract for the purpose of making audit,
examination, excerpts, and transcriptions;
h. Provisions requiring retention of all required records for five years after Cities makes
final payments and all other pending matters are closed;
i. For contracts in excess of one hundred thousand dollars ($100,000), provisions
requiring compliance with all applicable standards, orders, or requirements of the
Clear Air Act (42 U.S.C. 7401 et. seq. and the Federal Water Pollution Control Act
as amended(33 U.S.C. 1251 et. seq.); and provisions requiring that violations of the
Clean Air Act and the Federal Water Pollution Control Act be reported to the Federal
grant awarding agency and the Regional Office of the U.S. Environmental
Protection Agency(EPA);
j. Mandatory standards and policies relating to energy efficiency which are contained
in the State Energy Conservation Plan issued in compliance with the Energy Police
and Conservation Act(P.L.94-163).
k. Where applicable, all contracts in excess of$2,000 for construction contracts and in
excess of$25,000 for other contracts that involve the employment of mechanics or
laborers shall include a provision for compliance with Sections 102 and 107 of the
Contract Work Hours and Safety Standards Act (40 U.S.C. 327-333). as
supplemented by Department of Labor regulations(29 CFR part 5).
I. Contracts or agreements for the performance of experimental, development, or
research work shall provide for the rights of the Federal Government and the
recipient in a resulting invention in accordance with 37 CFR part 401, "Rights to
Inventions Made by Nonprofit Organizations and Small Business Firms Under
Government Grants, Contracts and Cooperative Agreements."
m. Contractors who apply or bid for an award of $100,000 or more shall file the
required certification in compliance with 31 U.S.C. 1352, "Byrd Anti-Lobbying
Amendment."
n. No contract shall be made to Parties listed on the General Services Administration's
List of Parties Excluded from Federal Procurement or Nonprocurement Programs in
accordance with Executive Orders 12549 and 12689, "Debarment and
Suspension." Contractors with awards in excess of the small purchase threshold
shall provide the required certification regarding exclusion status.
VIII. PERSONNEL AND PARTICIPANT CONDITIONS
A. Equal Employment Opportunities Practices: Sub-Recipient shall make every effort to
ensure that all projects funded wholly or in part by Measure H funds shall provide equal
employment and career advancement opportunities for minorities and women. In addition, Sub-
Recipient shall make every effort to employ residents of the area and shall keep a record of the
positions that have been created directly or as a result of this program.
11
1. Provision of Program Services
a. Sub-Recipient shall not on the ground of race, color, religion, national origin, sex,
handicap or familial status exclude any person from participation in, deny any
person the benefits of, or subject any person to discrimination under any program or
activity funded in whole or in part with Measure H funds.
b. Sub-Recipient shall not under any program or activity funded in whole or in part
with Measure H funds, on the ground of race, color, religion, national origin, sex,
handicap or familial status:
(1) Deny any facilities, services,financial aid or other benefits provided under the
program or activity.
(2) Provide any facilities, services, financial aid or other benefits which are
different or are provided in a different form from that provided to others under
the program or activity.
(3) Subject a client to segregated or separate treatment in any facility in,or in any
manner of process related to receipt of any service or benefit under the
program or activity.
(4) Restrict in any way access to, or in the enjoyment of any advantage or
privilege enjoyed by others in connection with facilities, services, financial aid,
or other benefits under the program or activity.
(5) Treat an individual differently from others in determining whether the
individual satisfies any admission, enrollment, eligibility, membership, or other
requirement or condition which the individual must meet in order to be
provided any facilities, services, or other benefit provided under the program
or activity.
(6) Deny a client an opportunity to participate in a program or activity as an
employee.
c. Sub-Recipient may not utilize criteria or methods of administration which have the
effect of subjecting individuals to discrimination on the basis of race, color, religion,
national origin, sex, handicap, or familial status or have the effect of defeating or
substantially impairing accomplishment of the objectives of the program or activity
for individuals of a particular race, color, religion, national origin, sex, handicap or
familial status.
d. Sub-Recipient, in determining the site or location of housing or facilities provided in
whole or in part with Measure H funds, may not make selections of such site or
location which have the effect of excluding individuals from, denying them the
benefits of, or subjecting them to discrimination on the grounds of race, color,
religion, national origin, sex, handicap, or familial status or which have the purpose
or effect of defeating or substantially impairing the accomplishment of the objectives
of the Civil Rights Act of 1964 and amendments thereto.
e. (1) In administering a program or activity funded in whole or in part with Measure
H funds regarding which Sub-Recipient has previously discriminated against
persons on the grounds of race, color, religion, national origin, sex, handicap,
or familial status, Sub-Recipient must take affirmative action to overcome the
effects of prior discrimination.
12
(2) Even in the absence of such prior discrimination, Sub-Recipient, in
administering a program or activity funded in whole or in part with Measure H
funds, should take affirmative action to overcome the effects of conditions
which would otherwise result in limiting participation by persons of a particular
race, color, religion, national origin, sex, handicap, or familial status. Where
previous discriminatory practice or usage tends, on the grounds of race,color,
national origin, sex, handicap, or familial status, to exclude individuals from
participation in, to deny them the benefits of, or to subject them to
discrimination under any program or activity to which Measure H funding
applies, Sub-Recipient has an obligation to take reasonable action to remove
or overcome the consequences of the prior discriminatory practice or usage,
and to accomplish the purpose of the Civil Rights Act of 1964.
(3) Sub-Recipient shall not be prohibited by this part from taking any eligible
action to ameliorate an imbalance in services or facilities provided to any
geographic area or specific group of persons within its jurisdiction where the
purpose of such action is to overcome prior discriminatory practice or usage.
f. Notwithstanding anything to the contrary in the provisions under Section
VIII.A.(1)(b)(1)-(5), nothing contained herein shall be construed to prohibit the Sub-
Recipient from maintaining or constructing separate living facilities or rest room
facilities for the different sexes. Furthermore, selectivity on the basis of sex is not
prohibited when institutional or custodial services can properly be performed only by
a member of the same sex as the recipients of the services.
2. Employment Discrimination
a. Sub-Recipient shall not discriminate against any employee or applicant for
employment because of race, color, religion, sex, national origin, age, handicap, or
familial status. Sub-Recipient shall take affirmative action to ensure that applicants
are employed, and that employees are treated, during employment, without regard
to their race, color, religion, sex, national origin, age, handicap, or familial status.
Such action shall include, but not be limited to, the following: employment,
upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or
termination, rate of pay or other forms of compensation and selection for training
including apprenticeship. Sub-Recipient agrees to post in conspicuous place
available to employees and applicants for employment, notices setting forth the
provisions of this non-discrimination clause.
b. Sub-Recipient shall, in all solicitations or advertisements for employees placed by or
on behalf of the Sub-Recipient, state that all qualified applicants will receive
consideration for employment without regards to race, color, religion, sex, national
origin, age, handicap, or familial status.
c. Sub-Recipient shall send to each labor union or representative of workers with
which it has a collective bargaining agreement or other contract or understanding, a
notice to be provided by Cites' contracting officers advising the labor union or
workers' representative of the Sub-Recipient 's commitments under Section 202 of
Executive Order No. 11246 of September 24, 1965, and shall post copies of the
notices in conspicuous places available to employees and applicants for
employment.
d. Sub-Recipient shall comply with all provisions of Executive Order 11246 of
September 24, 1965, and of the rules, regulations, and relevant orders of the
Secretary of Labor.
13
e. Sub-Recipient shall furnish to the Cities all information and reports required by
Executive Order No. 11246 of September 24, 1965, and by the related rules,
regulations, and orders.
f. In the event of Sub-Recipient's failure to comply with any rules, regulations, or
orders required to be complied with pursuant to this Agreement, the Cities may
cancel, terminate, or suspend in whole or in part its performance and the Sub-
Recipient may be declared ineligible for further government contracts in accordance
with procedures authorized in Executive Order No. 11246 of September 24, 1965,
and such other sanctions as may be imposed and remedies invoked as provided in
Executive Order No. 11246 of September 24, 1965, or by rule, regulation, or order
of the Secretary of Labor, or as otherwise provided by law.
g. Sub-Recipient shall include the provisions of the "Equal Employment Opportunities
Practices," Section VIII.A. and all relevant subsections, in every sub-contract or
purchase order unless exempted by rules, regulations, or order of the Secretary of
Labor issued pursuant to Section 204 of Executive Order No. 11246 of September
24, 1965, so that such provisions will be binding upon each sub-contractor or
vendor. Sub-Recipient shall take such action for any sub-contract or purchase
order as the Cities may direct as a means of enforcing such provisions including
sanctions for non-compliance; provided, however, that, in the event the Sub-
Recipient becomes involved in, or is threatened with, litigation with a sub-contractor
or vendor as a result of such direction by the Cities, the Sub-Recipient may request
the United States to enter into such litigation to protect the interests of the United
States.
h. Sub-Recipient shall not discriminate on the basis of age in violation of any provision
of the Age Discrimination Act of 1975 (42 U.S.C. 6101 et seq.) or regarding any
otherwise qualified handicapped individual as provided in Section 504 of the
Rehabilitation Act of 1973(29 U.S.C. 794).
i. Sub-Recipient shall also provide ready access to and use of all Measure H funded
assisted buildings to physically handicapped persons in compliance with the
standards established in the Architectural Barriers Act of 1968 (42 U.S.C. 4151 et
seq.)and the Americans with Disabilities Act(42 U.S.C.§12101 et.seq.).
(1) Remedies: In the event of Sub-Recipient's failure to comply with any rules,
regulations, or orders required to be complied with pursuant to this
Agreement, the Cities may cancel, terminate, or suspend in whole or in part
its performance and Sub-Recipient may be declared ineligible for further
Government contracts and any such other sanctions as may be imposed and
remedies invoked as provided by law.
B. Personnel Policies: Cities may review Sub-Recipient's personnel policies and may make
available to Sub-Recipient personnel policies developed by Cities. Cities' personnel policies are
optional with Sub-Recipient, unless (a) at the time of negotiations of this Agreement, Cities
mandate Sub-Recipient to use the Cities-developed personnel policies, in which case the
requirement is attached hereto under special provisions, or (b) Cities verify personnel
management problems during the program year, in which instance the Cities' Manager may
require use of the Cities-developed personnel practices, including use of Cities' Personnel
Policies Manual, as a condition of continued funding of future contract awards. Personnel
policies include, but are not limited to, staff size and levels, salaries, supervisory-subordinate
ratios,consultant fees,fringe benefits and other related matters.
C. Nepotism: Sub-Recipient hereby agrees not to hire or permit the hiring of any person to fill a
position funded through this Agreement if a member of that person's immediate family is
employed in an administrative capacity by Sub-Recipient. For the purposes of this section, the
14
term "immediate family" means spouse, child, mother, father, brother, sister, brother-in-law,
sister-in-law, father-in-law, mother-in-law, son-in-law, daughter-in-law, aunt, uncle, niece,
nephew, stepparent and stepchild. The term "administrative capacity" means having selection,
hiring, supervisory or management responsibilities including serving on the governing body of
Sub-Recipient.
D. Outside Employment: In its written personnel policies, Sub-Recipient shall include the
following provisions governing outside employment of its employees:
1. Such employment shall not interfere with the efficient performance of the employee's
duties in the implementation of this Agreement.
2. Such employment shall not involve a conflict of interest or an appearance of
impropriety with the employee's duties in the implementation of this Agreement.
3. Such employment shall not involve the performance of duties which the employee
should perform as part of his or her employment in the implementation of this Agreement;
and
4. Such employment shall not occur during the employee's regular or assigned working
hours in the implementation of this Agreement, unless, during the entire day on which
such employment occurs, the employee is on vacation, compensatory leave or leave
without pay.
5. Sub-Recipient shall establish effective procedures to enforce these provisions and
must provide specific procedures regarding outside employment of its full-time personnel
whose duties are not readily confined to a standard work-day or work-week. This
personnel includes, but is not limited to, Executive Directors, neighborhood workers and
other employees whose responsibilities may require them to be available for duty during
evenings or on weekends.
E. Conduct
1. Subcontracts
a. Approvals: The Sub-Recipient shall not enter into any subcontracts with any
agency or individual in the performance of this contract without the written consent
of the Cities, prior to the execution of such agreement.
b. Monitoring: Sub-Recipient will monitor all subcontracted services on a regular
basis to assure contract compliance. Results of monitoring efforts shall be
summarized in written reports and supported with documented evidence of follow-
up actions taken to correct areas of non-compliance.
c. Content: Sub-Recipient shall cause all of the provisions of this contract, in its
entirety, to be included in and made a part of any subcontract executed in the
performance of this Agreement.
d. Selection Process: Sub-Recipient shall undertake to ensure that all subcontracts
let in the performance of this AGREEMENT shall be awarded on a fair and open
competition basis. Executed copies of all subcontracts shall be forwarded to the
Cities along with documentation concerning the selection process.
2. Conflict of Interest: Sub-Recipient agrees to abide by the provisions of 24 CFR, Part
570.611 regarding conflicts of interest. Sub-Recipient certifies that no member, officer, or
employee of the Sub-Recipient is an officer or employee of the
15
Cities, or a member of any of their boards, commissions, or committees or entities that
have any interest or holding which could be affected by any actions taken in execution of
this Agreement.
3. Lobbying & Lobbying Certification: Sub-Recipient certifies, to the best of its knowledge
and belief, that no State appropriated funds have been paid or will be paid, by or on behalf
of the undersigned, to any person for influencing or attempting to influence an officer or
employee of any agency, any government official, an officer or employee of the State
Legislature in connection with the awarding of any State contract, the making of any
cooperative agreement, and the extension, continuation, renewal, amendment, or
modification of any State contract, grant, loan, or cooperative agreement.
4. No Benefit to Arise to Local Employee: No member,officer, or employee of the Cities,
or its designees or agents, no member of the governing body of Cities, and no other public
official who exercises any functions or responsibilities regarding the program during his
tenure or for one year thereafter, shall have any interest, direct or indirect, in this
Agreement or in any contract or subcontract, or the proceeds thereof, for work to be
performed in connection with the program assisted under this Agreement.
5. Use of Funds for Entertainment or Gifts: Sub-Recipient certifies and agrees that it will
not use funds provided through this Agreement to pay Sub-Recipient for entertainment or
gifts.
6. Copyright: If this contract results in any copyrightable material or inventions, the Cities
and/or grantor agency reserves the right to royalty-free, non-exclusive and irrevocable
license to reproduce, publish, or otherwise use and to authorize others to use, the work or
materials for government purposes. Sub-Recipient agrees to comply with 37 CFR part
401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms
Under Government Grants, Contract and Cooperative Agreements," and any
implementing regulations issued by the awarding agency.
7. Religious Proselytizing or Political Activities: Sub-Recipient agrees that it will not
perform or permit any religious proselytizing or political activities in connection with the
performance of this AGREEMENT. Funds under this AGREEMENT will be used
exclusively for performance of the services required under this AGREEMENT and no
funds shall be used to promote any religious or political activities.
8. Equal Employment Opportunity: In addition to the Equal Employment Opportunities
Practices described in Section VIII.A. of this Agreement, Sub-Recipient agrees to comply
with all applicable provisions of Executive Order 11246, "Equal Employment Opportunity,"
as amended by Executive Order 11375, "Amending Executive Order 11246 Relating to
Equal Employment Opportunity," and as supplemented by regulations at 41 CFR part 60,
"Office of Federal Contract Compliance Programs, Equal Employment Opportunity,
Department of Labor."
9. Clean Air Act and Federal Water Pollution Control Act Compliance as amended(33
U.S.C. 1251 et. seq.). Violations shall be reported to the Federal awarding agency and
the Regional Office of the U.S. Environmental Protection Agency.
10. Copeland "Anti-Kickback" Act Compliance: Sub-Recipient agrees to comply with all
relevant portions of the Copeland"Anti-Kickback"Act(18 U.S.C. 874 and 40 U.S.C. 276c),
which prohibits contractors and Sub-Recipient from inducing, by any means, any person
employed in construction, completion, or repair of public work, to give up any part of the
compensation to which he or she is otherwise entitled. Sub-Recipient agrees to report
any and all suspected or reported violations to the Federal awarding agency.
16
11. Contract Work Hours and Safety Standards Act Compliance: Sub-Recipient agrees
to comply with Sections 102 and 107 of the Contract Work Hours and Safety Standards
Act (40 U.S.C. 327-333), as supplemented by Department of Labor regulations (29 CFR
part 5),which governs the standard work week and overtime provisions.
IX. SEVERABILITY
If any provision of this AGREEMENT is found to be invalid, void, or unenforceable, the remaining
provisions shall, insofar as reasonably possible, continue in full force in effect without being impaired or
invalidated in any way.
X. COUNTERPARTS
This Agreement may be executed in counterparts. When executed, each counterpart shall be deemed
an original, irrespective of date of execution. The counterparts shall together constitute one and the
same Agreement.
XI. WAIVER
Cities' waiver of one term or condition of this Agreement is not a waiver or breach of any other term or
condition, nor of a subsequent breach of the term or condition waived.
XII. INTERPRETATION
A. Order of Precedence. In the event there are inconsistencies or conflicts in this Agreement or
any exhibits or attachments hereto, unless otherwise provided herein, the inconsistencies shall
be resolved by giving precedence in the following order:
1. County regulations for the use of Measure H Program funds.
2. The provisions of this Agreement and exhibits and attachments thereto.
3. In case of conflict between the terms of this Agreement and the terms contained in any
document attached as an exhibit, the terms of the Agreement will strictly prevail unless
said terms are in conflict with federal, state or local law, in which case said law shall strictly
prevail.
B. Applicable Law: This Agreement, and the rights and duties of the Parties hereunder (both
procedural and substantive), shall be governed by the laws of the State of California, except
where superseded by federal law.
C. Entire Agreement: This Agreement constitutes the entire agreement and understanding
between the Parties regarding its subject matter and supersedes all prior or contemporaneous
negotiations, representations, understandings and agreements,written or oral.
XIII. EXHIBITS
The Exhibits to this Agreement are an integral part of this Agreement and have each been incorporated
herein.
17
IN WITNESS WHEREOF,the Parties have caused this Agreement to be executed as of the day and year
first written above.
CITY OF ARCADIA CITY OF 9OUTH PA I NA
/41(
BY r
otninic Lazzaretto St r- anie flreWoff;
City Manager City Manager
Date: CC,...VbsEs4,2-31
SUB-RECIPIENT
UNION STATION HOMELESS SERVICES
TAXPAYER ID# 95-3958741
ATTEST
Byt ' 44,44 f By:
City jerk Anne Miskey
Chief Executive Officer
APPROVED AS TO FORM:
r
By: V . 2,
Stephen `.Deitsch
City Attorney
Date: ii/ 4q
CONCUR:
(7\ e 55.
By
Sara Somogyi
Recreation Community Services Director
18
EXHIBIT A
STATEMENT OF WORK
Cities of Arcadia and South Pasadena Multi-Jurisdictional Proposal
City Homelessness Plan Implementation Grant
Section I. Overview
On August 17, 2015, in response to the growing crisis of homelessness, the Los
Angeles County Board of Supervisors launched the Homeless Initiative (HI) to
prevent and combat homelessness which continues to pervade our communities. An
unprecedented collaborative planning process resulted in a comprehensive plan
consisting of 47 strategies, with four more strategies subsequently added.
Recognizing the need to sustain the HI strategies, the Board of Supervisors approved
the Measure H ordinance that identifies 21 of the 51 HI strategies as eligible for
funding through Measure H. On March 7, 2017, the voters approved Measure H.
Since the inception of the HI in 2015, collaboration and engagement with the 88 cities
in the County has been a major priority for the County. Cities play a critical role in
ensuring that the impact of these strategies is maximized. Cities have jurisdiction
over housing and land use for about 90% of the countywide population, and thus play
a vital role in developing affordable housing and interim housing.
In 2017, the Board of Supervisors approved funding to cities to develop their own
homelessness plans. In 2018, participating cities submitted their homelessness
plans. In September 2018, the Board of Supervisors approved $9 million in Measure
H funding for the HI and United Way Home for Good Funders Collaborative to issue a
Request for Proposals (RFP) for the cities to implement their homelessness plans,
either as individual cities or multi-jurisdictional partners.
Based on the 2019 Point-in-Time Homeless Count (PIT Count) conducted by the Los
Angeles Homeless Services Authority (LAHSA), the cities of Arcadia and South
Pasadena have a combined homeless count of 91 individuals and family members.
Since completing their Plans to Combat and Prevent Homelessness in 2018, both
cities have been working to implement the action items in their respective plans.
South Pasadena has identified a Homeless Coordinator and has undergone
extensive training on homeless outreach, increased collaboration with LAHSA,
enhanced existing partnerships with service providers and faith groups, increased
collaboration across city departments with regard to homelessness, and participated
in various other activities and forums. Arcadia has identified a city homeless contact,
established a local team of key stakeholders has been established, new community
resources have been created, and office space has been designated for a homeless
case manager.
Section II. Objectives and Program Description
Ex Priority Area 1 - Increase the supply of supportive and interim housing for people
experiencing homelessness.
1
EXHIBIT A
STATEMENT OF WORK
© Priority Area 2 - Enhance the effectiveness of County service systems for those
experiencing and/or at-risk of homelessness.
Priority Area 1
The Cities of Arcadia and South Pasadena Funds will implement a new interim housing
(Motel Voucher) program, which will fund on average, four rooms per week. Two motel
vouchers per week will be designated for Arcadia and two motel vouchers will be
designated for South Pasadena. If one of the cities does not utilize all of the vouchers,
the other multijurisdictional partner will have the opportunity to use them in order to get
more people off the streets regionally.
In addition, the Cities of Arcadia and South Pasadena will implement a Rapid Re-
Housing (RRH) program that will support up to four households at any given time, with a
goal of serving 6-9 households during the contract term. As appropriate, clients
provided interim housing would be linked to and served through the RRH Program to
ensure access to permanent housing resources. The Cities of Arcadia and South
Pasadena will partner with Union Station Homeless Services & LAHSA housing locators
to recruit a minimum of four landlords/property owners interested in participating in
RRH. These will be newly designated units or rooms available for RRH within the local
city limits and the San Gabriel Valley region.
These programs support County Homeless Initiative Strategies B3 (Partner with Cities
to Expand Rapid Re-Housing) and E8 (Enhance the Emergency Shelter System).
Priority Area 2
The Cities of Arcadia and South Pasadena will utilize County Funding for a dedicated
Case Manager who will provide services in safe and highly accessible and visible
locations. The Case Manager with have strong knowledge of available resources to link
people experiencing homelessness with needed programs, services, and housing
options. The Case Manager will assess the specific needs of each client and arrange,
coordinate, monitor, and advocate for housing and other services to meet the
individual's needs.
This program supports County Homeless Initiative Strategies D5 (Support for Homeless
Case Managers) and E7 (Strengthen the Coordinated Entry System).
Section III. Tasks
Task I: Cities of Arcadia and South Pasadena Enter into Agreement
ACTIVITIES TARGET DUE DATE
OUTCOME (IF APPLICABLE)
Arcadia and South Pasadena will Executed MOA November 5, 2019
enter into a memorandum of
agreement (MOA) or other type of
agreement establishing the terms
of their collaboration on this
2
EXHIBIT A
STATEMENT OF WORK
project.
Task II: Execute Subcontractor Agreement
ACTIVITIES TARGET DUE DATE
OUTCOME (IF APPLICABLE)
1. Contract with Union Station Executed subcontractor agreement November 5, 2019
Homeless Services (or other approved in advance by the
provider) to provide Case County.
Management services to
people experiencing
homelessness.
Task III: Establish and Implement the Interim Housing, Rapid Re-Housing, and
Homeless Case Management Services programs.
Activities Metrics Combined Target
Outcome (Arcadia &
South Pasadena)
Interim Housing (motel Number of individuals and family 17 (18 months)
vouchers) members newly enrolled
Number of individuals and family 4 (per quarter)
members active in the program
within the report date range
Number of individuals and family N/A
members who exited to any
destination within the report date
range
Number of individuals and family 3 (18 months)
members who exited to
permanent housing destination
within the report date range
Number of individuals and family 5 (18 months)
members who exited to other
interim housing destinations
Percentage of individuals and 15%
family members who exited the
program to permanent housing
Rapid Re-Housing Number of individuals and family 6 (18 months)
members newly enrolled in the
program within the report date
range
Number of individuals and family 4 (per quarter)
members active in the program
3
EXHIBIT A
STATEMENT OF WORK
within the report date range
Number of housing plans 6 (18 months)
established for individuals and
families
Number of individuals and family 4 (18 months)
members that move-in to
permanent housing destination
within the report date range
Number of individuals and family N/A
members that exited to
permanent housing destination
within the report date range
Number of individuals and family N/A
members with move-in dates that
exited the program to any
destination
Number of individuals and family 4 (18 months)
members who obtained
employment
Number of individuals and family 4 (18 months)
members who obtained benefits
Number of individuals and family 4
members who retained
permanent housing (reached the
6-month retention milestone from
date of placement)
Number of individuals and family 4
members placed in permanent
housing who were eligible to meet
the 6-month retention milestone
(DENOMINATOR FOR ABOVE
METRIC)
Number of individuals and family 4
members who retained
permanent housing (reached the
12-month retention milestone
from date of placement)
Number of individuals and family 4
members placed in permanent
housing who were eligible to meet
the 12-month retention milestone
Homeless Case Number of individuals and family 40 (18 months)
Management Services members newly enrolled in the
program within the report date
range
Number of individuals and family 25 (18months)
members active in the program
4
EXHIBIT A
STATEMENT OF WORK
within the report date range
Number of households assessed 85%
using the VI-SPDAT and relevant
sub-surveys
Number of individuals and family 50%
members connected to services
Number of housing plans 20(18 months)
established for individuals and
families.
Number of individuals and family 50 %
members matched to a
permanent housing resources
including RRH and PSH
Number of individuals and family 10 (18 months)
members that move-in to
permanent housing destination
Number of individuals and family 17 (18 months)
members who attained referrals to
the interim housing, including
motel vouchers funded by Arcadia
and South Pasadena
Number of individuals and family 4-6 ( 18 months)
members referred to the rapid re-
housing program funded by
Arcadia and South Pasadena
Section V. Staffing
Provide description of staff roles that directly support the successful implementation of
the funded program.
Cities of Arcadia and South Pasadena Homeless Services Programs
Agency Title Role
City of Director of Recreation and The Director will provide administrative oversight
Arcadia Community Services and coordination of housing and homelessness
services for the City. The Director will coordinate
the City's response to homelessness with other
City Departments, LA County, and the
community. Coordinate the annual Homeless
(PIT) Count.
City of Police Department Staff The Police Department's Homeless Education
Arcadia and Liaison Team will respond to calls for
services, provide proactive outreach, and partner
with Case Manager to conduct joint outreach.
City of South Homeless The Sergeant will coordinate project
Pasadena Coordinator/Sergeant implementation with USHS and the City of
5
EXHIBIT A
STATEMENT OF WORK
Arcadia to provide support and oversee direct
service components and to provide updates to
city management.
City of South City Management Staff The position will help accomplish the goals of the
Pasadena grant award, including reporting support and
coordination with the City of Arcadia to ensure
effective project implementation.
Section VII. Deliverables
Report Schedule
Deliverable Due Date
I. Provide copy of any Within 60 days of contract execution.
subcontracted
agreements necessary to
implement the funded
program and evidence of
completed hiring of staff
needed to implement
funded program.
II. Submit Quarterly Within 30 days after each quarter of program
Reports and supporting implementation
documents.
Reporting Period Submit Report
November 1, 2019 - January 31, February 29, 2020
2020
February 1, 2020 — April 30, 2020 May 31, 2020
May 1, 2020 - July 31, 2020 August 31, 2020
August 1 , 2020 — October 31, 2020 November 30, 2020
November 1, 2020 — January February 28, 2021
31,2021
February 1, 2021 — February 28, March 31, 2021
2021
III. Submit Final March 31,2021
Report
Quarterly Reports and Invoices shall be submitted to County Chief Executive Office -
Homeless Initiative at the following email address: HomeiesslnitiativeCities(a lacountv.gov
6
EXHIBIT B
PRICING SCHEDULE
Total Agreement amount of Two Hundred Ninety Two Thousand Dollars ($292,200) to be paid
by County of Los Angeles. The County will pay up to 1/4 of the total contract sum amount upon
execution of the subcontracts necessary to perform contract services. The remaining contract
sum shall be paid out based on reimbursable charges over the term of the agreement.
Arcadia and South Pasadena Homeless Services Programs
NON - PERSONNEL COSTS
Sub-Contract/Consultant Costs (Priority Area 1) Total Cost not
to exceed
Cities shall submit any subcontract agreements to the County for review
and approval before payment may be issued for this cost. $180,900
1. Interim Housing (Motel Vouchers)
2. Rapid Re-Housing
Sub-Contract/Consultant Costs (Priority Area 2)1
Cities shall submit any subcontract agreements to the County for review $82,080
and approval before payment may be issued for this cost.
1. Homeless Case Management Services
Administrative Costs (no more than 10% of the total contract sum and Total Cost not
costs approved by the County are reimbursable upon proof of expenditure) to exceed
Examples of admin costs: $29,220
Office Supplies
Printing/Mailing
Mileage/Parking
Materials
Etc.
SUBTOTAL (NON- PERSONNEL COSTS) $292,200
TOTAL SUB-RECIPIENT AGREEMENT AMOUNT $292,200
*Changes within line items and/or categories require written authorization from the County
Project Manager. Written authorization may be defined to include letter, email, and fax. A
contract amendment is not required for changes within line items and/or categories.
1 Priority Area 2 programs require a City match. City match information is provided in Exhibit B1.
7
EXHIBIT B1
CITY MATCH COMMITMENT:
Priority Area 2 programs require city matching funds to ensure that the entire program is
implemented. Below is an itemized list of contributions that the Cities committed to
provide for the awarded program. This section does not include the County's funding
commitment.
Arcadia and South Pasadena Homeless Services Programs
PERSONNEL COSTS
Position Title Number of Hours to be worked Total Cost to the
over the life of contract/hourly City
rate/FTE $
South Pasadena 312 hours/ FTE 0.10
Homeless Coordinator $25,000
South Pasadena City 40 hours
Management Staff $1,125
Arcadia Director of 312 hours*$120/hour
Recreation & $37,000
Community Services
Arcadia Police Department Staff $20,000
SUBTOTAL (PERSONNEL COSTS) $83,125
NON-PERSONNEL COSTS
Arcadia Office Space
$4,500
SUBTOTAL (NON- PERSONNEL COSTS) $4,500
TOTAL CITY COMMITMENT $87,625.00
TOTAL PROJECT AMOUNT $379,825
8
AC�® DATE(MM/DD/YYYY)
`� CERTIFICATE OF LIABILITY INSURANCE 10/7/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME: Evett Lam
Arthur J. Gallagher&Co. PHONE FAX
Insurance Brokers of CA. Inc., LIC#0726293 Wc.No.Ext):818-638-4835 tAic.No):818-638-0835
505 N. Brand Boulevard, Suite 600 A DRESS:
Glendale CA 91203 INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:Great American Insurance Company of NY 22136
INSURED UNIOSTA-05 INSURER B:
Union Station Homeless Services
825 E. Orange Grove Blvd. INSURER C:
Pasadena CA 91104 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:1189683612 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILTS
R TYPE OF INSURANCE JNSW
D VD POLICY NUMBER (MUBR M/D/YYYY) (MMIDDIYYYY)
LIMITS
A X COMMERCIAL GENERAL LIABILITY Y PAC4160341 1/1/2019 1/1/2020 EACH OCCURRENCE $1,000,000
CLAIMS-MADE X OCCUR DAMAGE TO RENTED
PREMISES(Ea occurrence) $1,000,000
MED EXP(Any one person) $20,000
PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000
PRO XPOLICY JECT LOC PRODUCTS-COMP/OP AGG $3,000,000
I
OTHER: Employee Benefits $3,000,000
A AUTOMOBILE LIABILITY CAP4160342 1/1/2019 1/1/2020 COMaBiNdEDINGLELIMIT $1,000,000
X ANY AUTO BODILY INJURY(Per person) $
X OWNED AUTOS
SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY
X HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
Medical $5,000
A UMBRELLA LIAB X OCCUR UMB4160343 1/1/2019 1/1/2020 EACH OCCURRENCE $5,000,000
X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000
DED X RETENTION$in/Inn $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILITY YIN STATUTE ER
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
OFFICER/MEMBEREXCLUDED? NIA
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
A Crime Coverage PAC4160341 1/1/2019 1/1/2020 Employee Dishonesty 1,000,000
Professional Liability Each Occurrence 1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Certificate holder is named as an additional insured as defined in the policy form if required in a written agreement.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Arcadia ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Dominic Lazzaretto, City Manager
240 W. Huntington Drive AUTHORIZED REPRESENTATIVE
Arcadia CA 91007 j �\
©1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(201 6/03) The ACORD name and logo are registered marks of ACORD
DATE(MM/DD/YYYY)
ACGRL) CERTIFICATE OF LIABILITY INSURANCE
9/17/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME: Natalia Dionela
Arthur J. Gallagher& Co. PHONE FAX
Insurance Brokers of CA. Inc., LIC#0726293 (A/C.No.Ext): 818.539.8633 ,No):818.539.8733
505 N Brand Blvd, Suite 600 ADDRESS: Natalia_Dionela@ajg.com
Glendale CA 91203 INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:Quality Comp Inc 4515
INSURED UNIOSTA-02 INSURER B:
Union Station Homeless Services
825 E. Orange Grove Blvd. INSURERC:
Pasadena, CA 91104 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:1052166629 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP WLIMITS
LTR INSD VD POLICY NUMBER (MMIDDIYYYY) (MM/DD/YYYY)
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE RETED
$
CLAIMS-MADE OCCUR PREM SESO(Ea occurrence) $
MED EXP(Any one person) $
PERSONAL&ADV INJURY $
GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
POLICY PRO-
JECT LOC PRODUCTS-COMP/OP AGG $
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Ea accident)
ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident)
UMBRELLA LIAB OCCUR EACH OCCURRENCE _$
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
A WORKERS COMPENSATION 0150700416 1/1/2019 1/1/2020 PER ERH-
AND EMPLOYERS'LIABILITY STATUTE ER
YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
OFFICER/MEMBEREXCLUDED? NIA
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Evidence of Coverage
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Arcadia ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Dominic Lazzaretto, City Manager
240 W. Huntington Drive AUTHORIZED REP ESENTATIVE
Arcadia CA 91007 tom , __
©1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
QUALITYCOMF'
111r�rl i'r:'; Compensation Solution,
DATE:
TO:
ACCOUNT:
RE: Quality Comp, Inc.—Self-Insured Workers' Compensation Group
To Whom It May Concern:
As proof of workers' compensation coverage, I would like to provide you with the attached Certificate of
Consent to Self-Insure issued to Quality Comp, Inc. by the Department of Industrial Relations, Office of
Self-Insurance Plans. This Certificate carries an effective date of December 1, 2004 and does not have an
expiration date. The Quality Comp, Inc. program has excess insurance coverage with NY Marine &
General Insurance Company (NY-MAGIC). NY-MAGIC is a fully licensed and admitted writer of
Excess Workers' Compensation Insurance in the State of California (NAIC #16608),
Specific Excess Insurance
Excess Workers' Compensation: Statutory per occurrence excess of$500,000
Employers Liability: $1,000,000 Limit
Term of Coverage
Effective Date: January 1, 2019
Expiration: January 1, 2020
Please contact me if you have any questions or require additional information. Thank you.
Sincerely,
tacquclOne Harris
Director of Underwriting
RPS Monument
255 Great Valley rarkwry I 'Suite 700 I Malvern, PA 10355
T 60).64/A d6(' I TOLL FREE 877,60.8640 I F 6I0.6417:0662 I (A ticei iSYlt tiC19457•l www.monumentllc.com
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STATE OF CALIFORNIA Edmund G.Brown Jr.,Governor
DEPARTMENT OF INDUSTRIAL RELATIONS
OFFICE OF SELF-INSURANCE PLANS
s. l
11050 Olson Drive,Suite 230 k
Rancho Cordova,CA 95670 `
Phone No.(916)464-7000
FAX(916)464-7007
CERTIFICATION OF SELF-INSURANCE OF WORKERS'COMPENSATION
TO WHOM IT MAY CONCERN:
This certifies that Certificate of Consent to Self-Insure No.4515 was issued by the Director of Industrial Relations to:
Quality Comp, Inc.
under the provisions of Section 3700,Labor Code of California with an effective date of December 1,2004. The certificate
is currently in full force and effective.
Dated at Sacramento,California
This day the 11th of December 2017
mo •.-i ,
44
Lyn Asia Booz,Chief
ORIG: Jackie Harris
Director Of Underwriting
Monument Insurance Services
255 Great Valley Parkway,Suite 200
Malvern,Pa 19355
NUMBER:4515.0085 STATE OF CALIFORNIA
DEPARTMENT OF INDUSTRIAL RELATIONS
OFFICE OF THE DIRECTOR
CERTIFICATE OF CONSENT TO SELF-INSURE
THIS IS TO CERTIFY, That
Union Station Homeless Services
(Name of Affiliate)
STATE OF INCORPORATION CA
Quality Comp,Inc.
(Master CertifcateHolder)
STATE OF INCORPORATION CA
has complied with the requirements of the Director of Industrial Relations under the provisions of Sections 3700 to 3705,inclusive,of the Labor Code of the State of
California and is hereby granted this Certificate of Consent to Self-Insure,holder of Master Certificate No,4515.
This certificate may be revoked at any time for good cause shown.
EFFECTIVE DATE: April 1,2016 DEPARTMENT OF INDUSTRIAL RELATIONS
OF THE STATE OF CALIFORNIA
,a,:\A4ii ' , , d . ,• ,
Lyn Asio Boo;Actinof Christine Baker,Director
*Revocation of Certificate.—"A certificate of consent to self-insure may be revoked by the Director of Industrial Relations at any time for good cause after a hearing. Good cause includes,among
other things,the impairment of solvency of such employer,the inability of the employer to fulfill his obligations,or the practice of such employer or his agent in charge of the administration of
obligations,under the this division of any of the following:(a)Habitually and as a matter of practice and custom inducing claimants for compensation to accept less than the compensation due or
making it necessary for them to resort to proceedings against the employer to secure the compensation due;(b)Discharging his compensation obligations in a dishonest manner,(c)Discharging his
compensation obligations in such a manner as to cause injury to the public or those dealing with him"(Section 3702 of Labor Code)The Certificate may be revoked for non compliance with Title
8,California Administrative Code,Group 2—Administration of Self Insurance
A�® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YY
9YY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
Arthur J. Gallagher&Co. PHONE Evett Lam FAX
Insurance Brokers of CA. Inc., LIC#0726293 INC.No.Ext): 818-638-4835 (A/c,No):818-638-0835
505 N. Brand Boulevard, Suite 600 A DRIESS:
Glendale CA 91203 INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:Great American Insurance Company of NY 22136
INSURED UNIOSTA-05 INSURER B:
Union Station Homeless Services
825 E. Orange Grove Blvd. INSURER C:
Pasadena CA 91104 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:634619865 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDDIYYYY) (MM/DD/YYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY Y PAC4160341 1/1/2019 1/1/2020 EACH OCCURRENCE $1,000,000
CLAIMS-MADE X OCCUR DAMAGE TO RENTED
PREMISES(Ea occurrence) $1,000,000
MED EXP(Any one person) $20,000
PERSONAIL 8 ADV INJURY $1,000,000
GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000
X PRO-
POLICY JECT LOC PRODUCTS-COMP/OP AGG $3,000,000 _
OTHER: Employee Benefits $3,000,000
A AUTOMOBILE LIABILITY CAP4160342 1/1/2019 1/1/2020 Ea aBINED1SINGLE LIMIT $1,000,000
X ANY AUTO BODILY INJURY(Per person) $
X OWNED I- SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
X HIRED x NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident) $
Medical $5,000
A UMBRELLA LIAB X OCCUR UMB4160343 1/1/2019 1/1/2020 EACH OCCURRENCE $5,000,000
X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000
DED X RETENTION$1n non $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILITY Y/N STATUTE ER
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
OFFICER/MEMBEREXCLUDED? NIA
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
A Crime Coverage PAC4160341 1/1/2019 1/1/2020 Employee Dishonesty 1,000,000
Professional Liability Each Occurrence 1,000,000
i
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
Certificate holder is named as an additional insured as defined in the policy form if required in a written agreement.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of South Pasadena ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Stephanie DeWolfe, City Manager
1414 Mission Street A THORIZED REPRESENTATIVE
South Pasadena CA 91030 ``
{ '� 2N)
©1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
ACRD® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
9/17/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
Arthur J. Gallagher&Co. Natalia Dionela
PHONE FAX
Insurance Brokers of CA. Inc., LIC#0726293 (A/C.No.Ext):818.539.8633 (A/C.No):818.539.8733
505 N Brand Blvd, Suite 600 ADDRESS: Natalia_Dionela@ajg.com
Glendale CA 91203 INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:Quality Comp Inc 4515
INSURED UNIOSTA-02 INSURER B:
Union Station Homeless Services
825 E. Orange Grove Blvd. INSURERC:
Pasadena, CA 91104 INSURERD:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:1117244879 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP/YLIMITS
LTR INSD WVD POLICY NUMBER (MM/DDYYY) (MM/DD/YYYY)
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
DAMAGE TO RENTED
CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $
MED EXP(Any one person) $
PERSONAL&ADV INJURY $
GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
POLICY PRO-
JECT LOC PRODUCTS-COMP/OP AGG $
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
(Ea accident)
ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Per accident)
UMBRELLA LIAB OCCUR EACH OCCURRENCE _$
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
A WORKERS COMPENSATION 0150700416 1/1/2019 1/1/2020 PER
AND EMPLOYERS'LIABILITY STATUTE OTH-
ER
Y/N
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Evidence of Coverage
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of South Pasadena ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Stephanie DeWolfe, City Manager
1414 Mission Street AUTHORIZED REP ESENTATIVE
South Pasadena CA 91030 Raw.,„ )
©1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
co QUALITY COM I'
Workers' LWtivetisatimr ,Soit►l imt,
DATE:
TO:
ACCOUNT:
RE: Quality Comp, Inc.—Self-Insured Workers' Compensation Group
To Whom It May Concern:
As proof of workers'compensation coverage, I would like to provide you with the attached Certificate of
Consent to Self-Insure issued to Quality Comp, Inc. by the Department of Industrial Relations, Office of
Self-Insurance Plans. This Certificate carries an effective date of December 1, 2004 and does not have an
expiration date. The Quality Comp, Inc. program has excess insurance coverage with NY Marine &
General Insurance Company (NY-MAGIC). NY-MAGIC is a fully licensed and admitted writer of
Excess Workers' Compensation Insurance in the State of California(NAIC #16608).
Specific Excess Insurance
Excess Workers' Compensation: Statutory per occurrence excess of$500,000
Employers Liability: $1,000,000 Limit
Term of Coverage
Effective Date: January 1,2019
Expiration: January 1,2020
Please contact me if you have any questions or require additional information. Thank you.
Sincerely,
f .4
cgtfelne Harris
Director of Underwriting
RPS Monument
255 Great Valley Parkway I Suite 200) I Malvern, PA 19355
T 610.647.4466 I TOLL FREE 8/7.666,8640 I F 610.647.0662 I CA ticensett UD94574 www.monumentlic.com
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STATE OF CALIFORNIA Edmund G.Brown Jr.,Governor
DEPARTMENT OF INDUSTRIAL RELATIONS OFFICE OF SELF-INSURANCE PLANS
11050 Olson Drive,Suite 230
Rancho Cordova,CA 95670
Phone No.(916)464-7000
FAX(916)464-7007
CERTIFICATION OF SELF-INSURANCE OF WORKERS'COMPENSATION
TO WHOM IT MAY CONCERN:
This certifies that Certificate of Consent to Self-Insure No.4515 was issued by the Director of Industrial Relations to:
Quality Comp, Inc.
under the provisions of Section 3700,Labor Code of California with an effective date of December 1,2004. The certificate
is currently in full force and effective.
Dated at Sacramento,California
This day the 11th of December 2017
•i r'
Lyn Asia Booz,Chief
ORIG: Jackie Harris
Director Of Underwriting
Monument Insurance Services
255 Great Valley Parkway,Suite 200
Malvern, Pa 19355
NUMBER:4515.0085 STATE OF CALIFORNIA
DEPARTMENT OF INDUSTRIAL RELATIONS
OFFICE OF'till;DIRECTOR
CERTIFICATE OF CONSENT TO SELF-INSURE
THIS IS TO CERTIFY, That
Union Station Homeless Services
(Name of Affiliate)
STATE OF INCORPORATION CA
Quality Comp,Inc.
(Master CertificateHolder)
STATE OF INCORPORATION CA
has complied with the requirements of the Director of Industrial Relations under the provisions of Sections 3700 to 3705,inclusive,of the Labor Code of the State of
California and is hereby granted this Certificate of Consent to Self-Insure,holder of Master Certificate No,4515.
This certificate may be revoked at any time for good cause shown.*
EFFECTIVE DATE: April 1,2016 DEPARTMENT OF INDUSTRIAL RELATIONS
OF THE STATE OF CALIFORNIA
i / i ,.. ' .', , ' 7.-
R
' , , , „ .
, , •
Lyn Asio Booz,Actin of Christine Baker,Director
*Revocation of Certificate.—"A certificate of consent to self-insure may be revoked by the Director of Industrial Relations at any time for good cause after a hearing. Good cause includes,among
other things,the impairment of solvency of such employer,the inability of the employer to fulfill his obligations,or the practice of such employer or his agent in charge of the administration of
obligations,under the this division of any of the following:(a)Habitually and as a matter of practice and custom inducing claimants for compensation to accept less than the compensation due or
making it necessary for them to resort to proceedings against the employer to secure the compensation due;(b)Discharging his compensation obligations in a dishonest manner,(c)Discharging his
compensation obligations in such a manner as to cause injury to the public or those dealing with him."(Section 3702 of Labor Code.)The Certificate may be revoked for non compliance with Title
8,California Administrative Code,Group 2—Administration of Self Insurance
* S1 * 10/15/2019 * PAC-4160341-08-03 GREAT AMERICAN INS CO OF NY
*D/B* 446169812 178114
ARTHUR J GALLAGHER& COMPANY
505 N BRAND BLVD STE 600
GLENDALE CA 91203
* S1 * 10/15/2019 * PAC-4160341-08-03 GREAT AMERICAN INS CO OF NY
*D/B* 446169812 178114
IL 70 02 ( Ed . 10 07 )
Policy No. PAC 416-03-41 - 08
Effective Date of Change 10/07 /2019
POLICY CHANGES
THIS ENDORSEMENT
NAMED INSURED UNION STATION CHANGES THE POLICY.
HOMELESS SERVICES
AND ADDRESS: 825 E ORANGE GROVE BLVD PLEASE READ IT
PASADENA , CA 91104 CAREFULLY.
POLICY ALTERNATE MAILING ADDRESS: AGENT'S NAME AND ADDRESS:
ARTHUR J GALLAGHER & COMPANY
505 N BRAND BLVD STE 600
GLENDALE CA 91203
Insurance is afforded by the Company named below , a Capital Stock Corporation :
GREAT AMERICAN INSURANCE COMPANY OF NEW YORK
POLICY PERIOD: From 01 / 01 / 19 To 01 /01 / 20
12 : 01 A . M . Standard Time at the address of the Named Insured
NO CHANGE IN PREMIUM .
IT IS HEREBY AGREED AND UNDERSTOOD THAT THIS POLICY IS AMENDED AS FOLLOWS :
PER THE ATTACHED FORMS CG2026 , THE FOLLOWING ARE ADDITIONAL INSUREDS :
CITY OF SOUTH PASADENA OFFICIALS ,
OFFICERS , VOLUNTEERS , EMPLOYEES AND AGENTS
ATTN : STEPHANIE DEWOLFE , CITY MANAGER
1414 MISSION ST
SOUTH PASADENA CA 91030
CONTINUED ON PAGE 2 . . .
FORMS AND ENDORSEMENTS hereby added :
FORMS AND ENDORSEMENTS hereby amended :
FORMS AND ENDORSEMENTS hereby deleted :
Agent Signature Date
IL 70 02 (Ed. 10/07) PRO (Page 1 of 1)
* S1 * 10/15/2019 * PAC-4160341-08-03 GREAT AMERICAN INS CO OF NY
*D/B* 446169812 178114
IL 70 02 ( Ed . 10 07 )
Policy No. PAC 416-03-41 - 08
Effective Date of Change 10/ 07 / 2019
POLICY CHANGES
THIS ENDORSEMENT
NAMED INSURED UNION STATION CHANGES THE POLICY.
HOMELESS SERVICES
AND ADDRESS: 825 E ORANGE GROVE BLVD PLEASE READ IT
PASADENA CA 91104 CAREFULLY.
POLICY ALTERNATE MAILING ADDRESS: AGENT'S NAME AND ADDRESS:
ARTHUR J GALLAGHER & COMPANY
505 N BRAND BLVD STE 600
GLENDALE CA 91203
Insurance is afforded by the Company named below , a Capital Stock Corporation :
GREAT AMERICAN INSURANCE COMPANY OF NEW YORK
POLICY PERIOD: From 01 / 01 / 19 To 01 /01 /20
12 : 01 A . M . Standard Time at the address of the Named Insured
CONTINUED FROM PAGE 1 :
CITY OF ARCADIA OFFICIALS ,
OFFICERS , VOLUNTEERS , EMPLOYEES AND AGENTS
ATTN : DOMINIC LAZZARETTO , CITY MANAGER
240 W HUNTINGTON DR
ARCADIA CA 91007
ENDORSEMENT 8
FORMS AND ENDORSEMENTS hereby added : CG2026
FORMS AND ENDORSEMENTS hereby amended :
FORMS AND ENDORSEMENTS hereby deleted :
Agent Signature Date
101519 LJL
11_ 70 02 (E 10/07) PRO (Page 1 of 1)
L d.
* S1 " 10/15/2019 * PAC-4160341-08-03 GREAT AMERICAN INS CO OF NY
*D/B* 446169812 178114
CG 20 26 (Ed. 04 13)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Schedule
Name of Additional Insured Person(s) or Organization(s):
CITY OF SOUTH PASADENA OFFICIALS ,
OFFICERS , VOLUNTEERS , EMPLOYEES AND AGENTS
ATTN : STEPHANIE DEWOLFE , CITY MANAGER
1414 MISSION ST
SOUTH PASADENA CA 91030
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. SECTION II - WHO IS AN INSURED is amended to include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only with respect to liability for "bodily injury," "property damage"
or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or
omissions of those acting on your behalf:
1. in the performance of your ongoing operations; or
2. in connection with your premises owned by or rented to you.
However:
1. the insurance afforded to such additional insured only applies to the extent permitted by law; and
2. if coverage provided to the Additional Insured is required by a contract or agreement, the insurance
afforded to such additional insured will not be broader than that which you are required by the contract
or agreement to provide for such additional insured.
B. With respect to the insurance afforded to these Additional Insureds, the following is added to SECTION III -
LIMITS OF INSURANCE:
If coverage provided to the Additional Insured is required by a contract or agreement, the most we will pay
on behalf of the Additional Insured is the amount of insurance:
1. required by the contract or agreement; or
Copyright, ISO Properties, Inc., 2012
CG 20 26 (Ed. 04/13) (Page 1 of 2)
* Si * 10/15/2019* PAC-4160341-08-03 GREAT AMERICAN INS CO OF NY
*D/B* 446169812 178114
2. available under the applicable Limits of Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
Copyright, ISO Properties, Inc., 2012
CG 20 26 (Ed. 04/13) (Page 2 of 2)
* S1 * 10/15/2019 * PAC-4160341-08-03 GREAT AMERICAN INS CO OF NY
*D/B* 446169812 178114
CG 2 0 2 6 (Ed. 0 4 13)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Schedule
Name of Additional Insured Person(s) or Organization(s):
CITY OF ARCADIA OFFICIALS ,
OFFICERS , VOLUNTEERS , EMPLOYEES AND AGENTS
ATTN : DOMINIC LAZZARETTO , CITY MANAGER
240 W HUNTINGTON DR
ARCADIA CA 91007
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. SECTION II - WHO IS AN INSURED is amended to include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only with respect to liability for "bodily injury," "property damage"
or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or
omissions of those acting on your behalf:
1. in the performance of your ongoing operations; or
2. in connection with your premises owned by or rented to you.
However:
1. the insurance afforded to such additional insured only applies to the extent permitted by law; and
2. if coverage provided to the Additional Insured is required by a contract or agreement, the insurance
afforded to such additional insured will not be broader than that which you are required by the contract
or agreement to provide for such additional insured.
B. With respect to the insurance afforded to these Additional Insureds, the following is added to SECTION III -
LIMITS OF INSURANCE:
If coverage provided to the Additional Insured is required by a contract or agreement, the most we will pay
on behalf of the Additional Insured is the amount of insurance:
1. required by the contract or agreement; or
Copyright, ISO Properties, Inc., 2012
CG 20 26 (Ed. 04/13) (Page 1 of 2)
* S1 * 10/15/2019* PAC-4160341-08-03 GREAT AMERICAN INS CO OF NY
*D/B* 446169812 178114
2. available under the applicable Limits of Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
Copyright, ISO Properties, Inc., 2012
CG 20 26 (Ed. 04/13) (Page 2 of 2)