HomeMy WebLinkAboutAlzheimer's Family Services Center - 2008-10-01CITY OF HfUNTINGTON BEACH
INTERDEPARTMENTAL COMMUNICATION
ECONOMIC DEVELOPMENT
TO: Joan Flynn, City Clerk
FROM: Stanley Smalewitz, Director of Economic Development
DATE: December 12, 2008
SUBJECT: ODBG GRANT AGREEMENTS — TRANSMITTAL
Transmitted to your office for record management purposes are the original subgrantee
agreements between the City of Huntington Beach and the various non-profit organizations.
These grants were approved by City Council through the 2008/09 Action Plan for the
Community Development Block Grant program.
® AltaMed Health Services Corporation
® Alzheimer's Family Services enter
• Children's Bureau of Southern California
® Community Services Programs, Inc. (CSP)
® Fair Housing Council
Additionally, the following agreement is transmitted. This project was approved as an
amendment to the 2007/08 Action Plan.
Huntington Beach Youth Shelter
AGREEMENT BETWEEN
THE CITY OF HUNTINGTON BEACH
AND
ALZHEIMER'S FAMILY SERVICES CENTER
(Program No. B-08-MC-06-0506)
FOR PROGRAM YEAR 2008/2009
COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDS
THIS AGREEMENT, made and entered into by and between the CITY of HUNTINGTON
BEACH a municipal corporation, hereinafter referred to as "City", and ALZHEIMER'S
FAMILY SERVICES CENTER hereinafter referred to as "Subrecipient".
RECITALS
WHEREAS, the City has applied for and received funds from the United States
Government under Title I of the Housing and Community Development Act of 1974, Public Law
93-383; and
WHEREAS, the City wishes to engage the Subrecipient to assist the City in utilizing such
funds; and
WHEREAS, the City has environmental clearance to release the funds for this project;
NOW, THEREFORE, in consideration of these recitals, and the mutual covenants
contained herein, City and Subrecipient agree as follows:
1) National Objective
The Subrecipient certifies that the activities carried out with funds provided under this
Agreement will meet the CDBG program's National Objective of benefit to low/moderate
income persons as defined in 24 CFR Part 570.208.
The Subrecipient shall adhere to the terms of the City's CDBG Application and Subrecipient
Agreement and with assurances and agreements made by the City to the United States
Department of Housing and Urban Development.
2) Subrecipient Grant Amount and Scope of Work
The City has allocated Federal 2008-2009 CDBG funds in the amount of Ten Thousand
Dollars ($10,000) to the .Subrecipient to assist with the program costs for activities described
in the Scope of Work (Attachment 1).
3) Time of Performance
The services described above are generally provided on a weekly basis to eligible persons.
Reimbursable activities per this Grant Agreement may begin on October 1, 2008 and shall
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end on September 30, 2009.
4) Personnel Assigned
Subrecipient personnel assigned to carry out the Scope of Work shall, if required by the
standards of their profession, maintain all licenses and permits necessary to remain in
compliance with State and Federal requirements governing the profession. The City shall be
notified of all personnel assigned to carry out the Scope of Work and shall be notified if
there is a change in personnel.
5) Levels of Performance
The Subrecipient agrees to provide the levels of program service as described in the Scope
of Work (Attachment 1).
6) Budget
The budget (Attachment 2) as proposed in the Subrecipient Grant application shall be the
governing budget for this grant agreement and is incorporated herein by reference unless
modified and approved in writing by the City prior to this agreement.
In addition, the City may request a more detailed budget breakdown than originally
proposed and the Subrecipient shall provide such supplementary budget information in a
timely fashion in the form and content prescribed by the City. Both the City and
Subrecipient must approve any amendments to the budget in writing.
7) Project Schedule/Milestones
Services of the Subrecipient shall start no sooner than on the first day of October 2008 and
end on the thirtieth day of September 2009.
Every effort shall be made by the Subrecipient to expend the allocated funds in their entirety
by September 30, 2009. If the Subrecipient does not expend all funds by September 30,
2009, the City may reallocate the funds not yet drawn to another eligible CDBG project.
8) Compensation and Method of Payment
The City shall reimburse the Subrecipiemt-with CDBG funds for program costs related to
eligible services to not exceed the grant amount for the period beginning October 1, 2008
and ending September 30, 2009.
The City shall not provide any payments/reimbursements in advance of actual expenditures
by the Subrecipient. Funding is contingent upon the City receiving Community
Development Block Grant funds from HUD.
The Subrecipient shall submit to the City a 'Reimbursement Request" within thirty (30)
calendar days after the end of the first three quarters. The reimbursement request for the
fourth quarter is due by the October 15, 2009. The reimbursement requests shall include
documentation to verify that the expenditure of funds is consistent with the project
description/definition as approved. Prior to reimbursing the Subrecipient, the City will
verify that the Subrecipient has met all applicable regulations for the project.
Payroll records, receipts, paid invoices including an itemized statement of all costs are
08-1759/26137 Page 2 of 12
samples of appropriate methods of reimbursement documentation. The Activity Report
(Section 11) is due at the same time as the reimbursement request.
The Subrecipient may request reimbursement of up to one fourth (1/4) of the grant amount
for the following quarterly periods, unless receipts and appropriate documentation can be
provided to, and approved by, the City indicating the need to request funds greater than one
fourth (1 /4).
1 st Quarter -
10/08 through 12/08
2nd Quarter
-01/09 through 03/09
3rd Quarter -
04/09 through 06/09
4th Quarter -
07/09 through 09/09
9) ]Program Income
The Subrecipient shall report to the City any interest or other income earned as a direct
result of the use of Federal CDBG funds for the program outlined within this agreement. All
reported program income may be retained by the Subrecipient for services in connection
with providing housing, utilities, funds for medications, computer training and food to the
homeless or those who are at risk of homelessness. All provisions of this Agreement shall
apply to these activities. The program income, retained by the Subrecipient, must be
expended before additional funds are requested from the City. Any program income on
hand when the Agreement expires or received after the Agreement's expiration shall be paid
to the City. The requirements are set forth in the Code of Federal Regulations, Title 24,
Section 570.504(c).
10) record )Keeping requirements
The Subrecipient shall, at minimum, maintain the following records and reports to assist the
City in complying with its record keeping requirements.
a) Documentation of the income level, ethnicity, age of persons and/or households
participating in or benefiting from the Subrecipient's program;
b) Documentation of the number of persons and/or households participating in or
benefiting from the Subrecipient's program;
c) Documentation of all CDBG funds received from the City;
d) Documentation of expenses as identified in the quarterly report and
reimbursement requests;
e) Documentation of how and when a determination was made as to the eligibility
status of persons assisted, and
f) Any such other related records as the City shall require.
The Subrecipient shall maintain separate accounting records for the Federal CDBG funds
provided by the City. The City, Federal Grantor Agency, Comptroller General of the United
States, or any of their duly authorized representatives shall have access to all books,,
documents, papers and records maintained by the Subrecipient which directly pertain to the
above project for the purpose of audit, examination, excerpts and transcriptions.
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11) Reporting Requirements
The Subrecipient shall submit "Quarterly Activity Reports" at the same time as the
reimbursement request within thirty (30) calendar days of the end of the first three quarters.
The final quarterly report is due no later than October 15, 2009. Quarterly reports shall be
provided by the Subrecipient to the City indicating the number of persons assisted, income
and ethnicity of persons assisted, how/what assistance was provided, and a description of
how and when determination of eligibility status was made for persons assisted. The report
must include sufficient information to assist the City in monitoring the Subrecipient's
performance. The Subrecipient must demonstrate satisfactory performance prior to
reimbursement for expenditures.
12) Public Access to Program Records
The Subrecipient shall furnish and cause each of its own subrecipients or subcontractors to
furnish all information and reports required hereunder and will permit access to its books,
records and accounts by the City, HUD or its agent, or other authorized Federal officials for
purposes of investigation to ascertain compliance with the rules, regulations and provisions'
stated herein.
13) Records Retention
Unless otherwise notified by the City, the Subrecipient shall retain all financial records,
supporting documents and statistical reports related to the project identified under this
Agreement until September 30, 2014. All records subject to an audit finding must be
retained for five (5) years from the date the finding is made or until the finding has been
cleared by appropriate officials and the Subrecipient has been given official written notice.
14) Grant Closeout Procedures
The Subrecipient's obligation to the City 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 the City), and determining the custodianship of records. Not withstanding the
foregoing, the terms of this Agreement shall remain in effect during any period that the
Subrecipient has control over CDBG funds, including program income.
15) Uniform Administrative and Program Management Standards
The Subrecipient shall comply with applicable Uniform Administrative Requirements as
described in Section 570.502 of the federal regulations for the CDBG Program. The Federal
requirements are incorporated herein by reference.
16) Use and Reversion of Assets
Upon expiration of this Agreement, the Subrecipient shall transfer to the City any CDBG
funds on hand at the time of expiration and any accounts receivable attributable to the use of
CDBG funds. The Subrecipient shall be required to use any real property under the
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Subrecipient's control that was acquired or improved in whole or in part with CDBG funds
in excess of $25,000 as follows:
a) Used to meet one of the National Objectives in 24 CFR, Section 570.208 until
five (5) years after expiration of this Agreement; or,
b) Disposed of in .a manner that results in the City being reimbursed in the amount
of the current fair market value of the property less any portion of the value
attributable to expenditure of non-CDBG funds for acquisition or improvement
to the property, Reimbursement is not required after the period of time specified
in paragraph (a) of this section.
17) Deal Property
The use and disposition of real property and equipment under this Agreement shall be in
compliance with the requirements of 24 CFR Part 84 and 24 CFR 570.502, 570.503, and
570.504, as applicable, which include but are not limited to the following:
The Subrecipient shall transfer to the City any CDBG funds on hand and any accounts
receivable attributable to the use of funds under this Agreement at the time of expiration,
cancellation, or termination.
Real property under the Subrecipient's control that was acquired or improved, in whole or in
part, with funds under this Agreement in excess of $25,000 shall be used to meet one of the
CDBG National Objectives pursuant to 24 CFR 580.208 until five (5) years after expiration
of this Agreement [or such longer period of time as the City deems appropriate]. If the
Subrecipient fails to use CDBG-assisted real property in a manner that meets a CDBG
National Objective for the prescribed period of time, the Subrecipient shall pay the City an
amount equal to the current fair market value of the property less any portion of the value
attributable to expenditures of non-CDBG funds for acquisition of, or improvement to, the
property. Such payment shall constitute program income to the City. The Subrecipient may
retain real property acquired or improved under this Agreement after the expiration of the
five-year period [or such longer period of time as the City deems appropriate].
In all cases in which equipment acquired, in whole or in part, with funds under this
Agreement, is sold, the proceeds shall be program income) prorated to reflect the extent to
that funds received under this Agreement were used to acquire the equipment). Equipment
not needed by the Subrecipient for activities under this Agreement shall be (a) transferred to
the City for the CDBG program or (b) retained after compensating the City [an amount
equal to the current fair market value of the equipment less the percentage of non-CDBG
funds used to acquire the equipment].
18) Other Program Requirements
Reserved.
19) Suspension and 'Termination
In accordance with Title 24, Sections 85,43 and 85.44 of the Code of Federal Regulations,
this Agreement may be suspended or terminated if the Subrecipient fails to comply with any
term(s) of the award and/or the award is terminated for convenience. Title 24, Sections
85.43 and 85.44 of the Code of Federal Regulations are incorporated herein by reference as
08-1759/26137 Page 5 of 12
provisions of the Agreement.
20) Compliance with haws and regulations
The Subrecipient agrees to comply with the requirements of Title 24 of the Code of Federal
Regulations, Part 570 (the U.S. Housing and Urban Development regulations concerning
Community Development Block Grants (CDBG) including subpart K (Attachment 3), ,
except that:
a) The Subrecipient will not assume the City's environmental responsibilities as
described on Section 570.604; and
b) The Subrecipient will not assume the City's responsibility for initiating the
review process required under the provisions of 24 CFR Part 52.
The Subrecipient also agrees to comply with all other applicable Federal, state and local
laws, regulations, and policies governing the funds provided under this contract. The
Subrecipient further agrees to utilize funds available under this Agreement to supplement
rather than supplant funds otherwise available.
21) Antidiscrimination/Affirmative Action & Equal Employment Opportunity
The Subrecipient shall comply with all State and Federal laws regarding nondiscrimination
in the provision of services and the equal opportunity employment of personnel.
22) ]Financial Management
Accounting Standards. The Subrecipient agrees to comply with 24 CFR 84.21-28 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.
Cost Principles. The Subrecipient shall administer its program in conformance with OMB
Circulars A-122, "Cost Principles for Non -Profit Organizations," or A-21, "Cost Principles
for Educational Institutions," as applicable. These principles shall be applied for all costs
incurred whether charged on a direct or indirect basis.
23) Audit requirement
If the Subrecipient shall receive more than $300,000 in total federal hinds in one fiscal year
from the City of Huntington Beach and/or any other city or agency, the Subrecipient is
required to submit a Single Audit Report. As required by the Federal Single Audit Act, the
Subrecipient shall be required to submit to the City, a comprehensive financial audit
prepared by an independent, neutral third party auditor. The audit shall cover financial
operations of the Subrecipient for the period beginning October 1, 2008 and ending
September 30, 2009 and is due not later than one year after expiration of this Agreement.
24) religious and Lobbying Activities
Religious Activities. The Subrecipient agrees that funds provided under this contract will
not be utilized for religious activities or to promote religious interests. Religious entities
may use CDBG funds for secular activities only in accordance with the Federal regulations
specified in 24 CFR 570.2000), such as worship, religious instruction, or proselytization.
08-1759/26137 Page 6 of 12
Lobbying. The Subrecipient hereby certifies that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of it,
to any person for influencing or attempting to influence an officer or employee of
any agency, a Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with the awarding of any Federal
contract, the making of any Federal grant, the making of any Federal loan, the
entering into of any cooperative agreement, and the extension, continuation, renewal,
amendment, or modification of any Federal contract, grant, loan, or cooperative
agreement;
(2) If any funds other than Federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or any
employee of a Member of Congress in connection with this Federal contract, grant
loan, or cooperative agreement, it will complete and submit Standard Form-LLL,
"Disclosure Form to Report Lobbying," in accordance with its instructions; and
(3) It will require that the language of paragraph (d) of this certification be included in
the award documents for all subawards at all tiers (including subcontracts, subgrants,
and contracts under grants, loans, and cooperative agreements) and that all
Subrecipients shall certify and disclose accordingly:
Lobbying Certification. This certification is a material representation of fact upon which
reliance was placed when this transaction was made or entered into. Submission of this
certification is a prerequisite for making or entering into this transaction imposed by section
1352, title 31, U.S.C. Any person who fails to file the required certification shall be subject
to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
25) Budget Modifications
If the Subrecipient desires to modify the use of the CDBG funds following approval of this
agreement, a written request must be submitted to the City for review. No change in use of
the CDBG funds will permitted without prior written approval by the City, subject to the
provisions of the City's adopted Citizen Participation Plan.
26) Performance Monitoring
27)
The City will monitor the performance of the Subrecipient against goals and performance
standards required herein. Substandard performance as determined by the City will
constitute non-compliance with this Agreement. If action to correct such substandard
performance is not taken by the Subrecipient within a reasonable period of time after being
notified by the City, contract suspension or termination procedures will be initiated.
Conflict of Interest
The Subrecipient agrees to abide by the provisions of 24 CFR 84.42 and 570.611, which
include (but are not limited to) the following:
1) The Subrecipient shall maintain a written code or standards of conduct that shall govern
the performance of its officers, employees or agents engaged in the award and
08-1759/26137 Page 7 of 12
administration of contracts supported by Federal funds.
2) No employee, officer or agent of the Subrecipient shall participate in the selection, or in
the award, or administration of, a contract supported by Federal funds if a conflict of
interest, real or apparent, would be involved.
3) No covered persons who exercise or have exercised any functions or responsibilities
with respect to CDBG-assisted activities, or who are in a position to participate in a
decision -making process or gain inside information with regard to such activities, may
obtain a financial interest in any contract, or have a financial interest in any contract,
subcontract, or agreement with respect to the CDBG-assisted activity, or with respect to
the proceeds from the CDBG-assisted activity, either for themselves or those with whom
they have business or immediate family ties, during their tenure or for a period of one (1)
year thereafter. For purposes of this paragraph, a "covered person" includes any person
who is an employee, agent, consultant, officer, or elected or appointed official of the
City, the Subrecipient, or any designated public agency.
28) Procurement Standards and Methods
1) Compliance. The Subrecipient shall comply with current City policy concerning the
purchase of equipment and shall maintain inventory records of all non -expendable
personal property as defined by such policy as may be procured with funds provided
herein. All program assets (unexpended program income, property, equipment, etc.),
shall revert to the City upon termination of this Agreement.
2) OMB Standards. Unless specified otherwise within this agreement, the Subrecipient
shall procure all materials, property, or services in accordance with the requirements of
24 CFR 84.40-48.
3) 'gravel. The Subrecipient shall obtain written approval from the City for any travel
outside the metropolitan area with funds provided under this agreement.
29) Environmental Issues
1) Air and Water. The Subrecipient agrees to comply with the following requirements
insofar as they apply to the performance of this Agreement:
a) Clean Air Act, 42 U.S.C., 7401, et seq.;
b) Federal Water Pollution Control Act, as amended, 33 U.S.C., 1251, et seq., as
amended, 1318 relating to inspection, monitoring, entry, reports, and information, as
well as other requirements specified in said Section 114 and Section 308, and all
regulations and guidelines issued thereunder;
c) Environmental Protection Agency (EPA) regulations pursuant to 40 CFR Park 50,
as amended.
2) Flood Disaster Protection. In accordance with the requirements of the Flood Disaster
Protection Act of 1973 (42 U.S.C. 4001), the Subrecipient shall assure that for activities
located in an area identified by the Federal Emergency Management Agency (FEMA) as
having special flood hazards, flood insurance under the National Flood Insurance
Program is obtained and maintained as a condition of financial assistance for acquisition
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30)
31)
or construction purposes (including rehabilitation).
3) Lead -Based Paint. The Subrecipient agrees that any construction or rehabilitation of
residential structures with assistance provided under this Agreement shall be subject to
HUD Lead -Base Paint Regulations at 24 CFR 570.608, and 24 CFR Part 35, Subpart B.
Such regulations pertain to all CDBG-assisted housing and require that all owners,
prospective owners, and tenants of properties constructed prior to 1978 be properly
notified that such properties may include lead -based paint. Such notification shall point
out the hazards of lead -based paint and explain the symptoms, treatment and precautions
that should be taken when dealing with lead -based paint poisoning and the advisability
and availability of blood lead level screening for children under seven. The notice
should also point out that if lead -based paint is found on the property, abatement
measures may be undertaken. The regulations further require that, depending on the
amount of Federal funds applied to a property, paint testing, risk assessment, treatment
and/or abatement may be conducted.
4) Historic Preservation. The Subrecipient agrees to comply with the Historic
Preservation requirements set forth in the National Historic Preservation Act of 1966, as
amended (16 U.S.C. 470) and the procedures set forth in 36 CFR Part 800, Advisory
Council on Historic Preservation Procedures for Protection of Historic Properties,
insofar as they apply to the performance of this agreement. In general, this requires
concurrence from the State Historic Preservation Officer for all rehabilitation and
demolition of historic properties that are fifty years old or older or that are included on a
Federal, state, or local historic property list.
Notices
Communication and details concerning this contract shall be directed to the following
contract representatives:
City: Subrecipient:
Attn: CP Coordinator
Economic Development Department
P.O. Box 190
Huntington Beach, CA 92648
Phone: (714) 536-5542
Independent Contractor
Name
Dr. Cordula Dick-Muehlke
Organization
Alzheimer's Family Services Center
Address
9451 Indianapolis Avenue
Huntington Beach, CA 92646
Phone:
714 593-9630
Nothing contained in this Agreement is intended to, or shall be construed in any manner, as
creating or establishing the relationship of employer/employee between the parties. The
Subrecipient shall at all times remain an "independent contractor" with respect to the
services to be performed under this Agreement. The City shall be exempt from payment of
all Unemployment Compensation, FICA, retirement, life and/or medical insurance and
Workers' Compensation Insurance, as the Subrecipient is an independent contractor.
08-1759/26137 Page 9 of 12
32) Insurance
General Liability. In addition to the workers' compensation and employer's liability
insurance and Subrecipient's covenant to indemnify City, Subrecipient shall obtain and
furnish to City, a policy of general public liability insurance, including motor vehicle
coverage covering the program / project. This policy shall indemnify Subrecipient, its
officers, employees and agents while acting within the scope of their duties, against any and
all claims arising out or in connection with the program, and shall provide coverage in not
less than the following amount: combined single limit bodily injury and property damage,
including products/completed operations liability and blanket contractual liability, of One
Million Dollars ($1,000,000) per occurrence. If coverage is provided under a form which
includes a designated general aggregate limit, the aggregate limit must be no less than One
Million Dollars ($1,000,000) for the program / project. This policy shall name City, its
officers, elected or appointed officials, employees, agents, and volunteers as Additional
Insureds, and shall specifically provide that any other insurance coverage which may be
applicable to the program / project shall be deemed excess coverage and that Subrecipient's
insurance shall be primary.
Under no circumstances shall said above -mentioned insurance contain a self -insured
retention, or a "deductible" or any other similar form of limitation on the required coverage.
Workers Compensation and -Employers' Liability. Pursuant to California Labor Code
Section 1861, Subrecipient acknowledges awareness of Section 3700 et seq. of this Code,
which requires every employer to be insured against liability for workers' compensation;
Subrecipient covenants that it will comply with such provisions prior to commencing
performance of the work hereunder.
Subrecipient shall maintain workers' compensation and employer's liability insurance in an
amount of not less than the State statutory limits.
Subrecipient shall require all subcontractors to provide such workers' compensation and
employer's liability insurance for all of the subcontractors' employees. Subrecipient shall
furnish to City a certificate of waiver of subrogation under the terms of the workers'
compensation and employer's liability insurance and Subrecipient shall similarly require all
subcontractors to waive subrogation..
Certificate of Insurance. Prior to commencing performance of the work hereunder,
Subrecipient shall furnish to City certificates of insurance subject to approval of the City
Attorney evidencing the foregoing insurance coverages as required by this Agreement; the
certificates shall:
1. provide the name and policy number of each carrier and policy;
2. state that the policy is currently in force; and
3. promise to provide that such policies will not be canceled or modified
without thirty (30) days' prior written notice of City.
Subrecipient shall maintain the foregoing insurance coverages in force until the work under
this Agreement is fully completed and accepted by City.
The requirement for carrying the foregoing insurance coverages shall not derogate from the
provisions for indemnification of City by Subrecipient under the Agreement. City or its
08-1759/26137 Page 10 of 12
representative shall at all times have the right to demand the original or a copy of all the
policies of insurance. Subrecipient shall pay, in a prompt and timely manner, the premiums
on all insurance hereinabove required.
Subrecipient shall provide a separate copy of the additional insured endorsement to each of
Subrecipient's insurance policies, naming City, its officers, elected and appointed officials,
employees, agents and volunteers as Additional Insureds, to the City Attorney for approval
prior to any payment hereunder.
33) Hold Harmless and Indemnity Agreement
Subrecipient hereby agrees to protect, defend, indemnify and hold harmless City, its
officers, elected or appointed officials, employees, agents, and volunteers from and against
any and all, claims, damages, losses, expenses, judgments, demands defense costs, and
consequential damage or liability of any kind or nature, however caused, including those
resulting from death or injury to Subrecipient's employees and damage to Subrecipient's
property, arising directly or indirectly out of the obligations or operations herein undertaken
by Subrecipient, caused in whole or in part by any negligent act or omission of the
Subrecipient, any subcontractors, anyone directly or indirectly employed by any of them or
anyone for whose acts any of them may be liable, including but not limited to concurrent
active or passive negligence, except where caused by the active negligence, sole negligence,
or willful misconduct of the City. Subrecipient will conduct all defense at its sole cost and
expense and City shall approve selection of Subrecipient's counsel. City shall be reimbursed
for all costs and attorney's fees incurred by City in enforcing this obligation. This indemnity
shall apply to all claims and liability regardless of whether any insurance policies are
applicable. The policy limits do not act as a limitation upon the amount of indemnification
to be provided by Subrecipient.
34) Severabillity
If any provision of this Agreement is held invalid, the remainder of the Agreement shall not
be affected thereby and all other parts of this Agreement shall nevertheless be in full force
and effect.
35) Assignment of Agreement
The Subrecipient shall not assign this Agreement or any monies due thereunder without the
prior written consent of the City.
36) Successors and Assigns
Subject to the provisions of the Subrecipient Agreement Paragraph 16, "Hold Harmless and
Indemnity Agreement," all terms, conditions, and provisions hereof shall inure to and shall
bind each of the parties hereto, and each of their respective heirs, executors, administrators,
successors, and assigns.
37) Section Headings and Subheadings
The section headings and subheadings contained in this Agreement are included for
convenience only and shall not limit or otherwise affect the terms of this Agreement.
08-1759/26137 Page I of 12
38) Waiver
The City's failure to act with respect to a breach by the Subrecipient does not waive its right
to act with respect to subsequent or similar breaches. The failure of the City to exercise or
enforce any right or provision shall not constitute a waiver of such right or provision.
39) Authority to ]Execute this Agreement
The person or persons executing this Agreement on behalf of Subrecipient warrants and
represents that he/she has the authority to execute this Agreement on behalf of the
Subrecipient and has the authority to bind Subrecipient to the performance of its obligations
hereunder.
40) Entire Agreement
This agreement constitutes the entire agreement between the City and the Subrecipient for
the use of funds received under this Agreement and it supersedes all prior or
contemporaneous communications and proposals, whether electronic, oral, or written
between the City and the Subrecipient with respect to this Agreement.
IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed by
and through their authorized officers on �� — l , 20 dr.
ALZHEIMER' S FAMILY SERVICES
CENTER
By; �'
b (, Sha+f (A c 1(-
print name
ITS: (circle one) Chairman/Presiden ice Presiden
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CITY OF HUNTINGTON BEACH, a municipal
corporation of the State of California
!F
Director of Econo Development
APPROVED AS TO FORM:
Ci y Attorney Q
By: _
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print name
ITS: (circle one) Secretary/Chief Financial Officer/Asst.
Secretary <EErer
08-1759/26137 Page 12 of 12
ATTACHMENT 1
SCOPE OF WORK
Project Title
Alzheimer's Family Services Center
Description
This program provides day care services for Alzheimer's and dementia patients. As the only Alzheimer's Day
Care Resource Center in Orange County, the center provides services that are affordable to families of all
socioeconomic backgrounds. The center also supplements direct care with case management, support groups,
and educational seminars. CDBG funds will help pay for dementia -specific adult day health care. In 2006-07,
more than 263 volunteers provided thousands of hours of services (e.g. supervising participants, clerical tasks,
and agency leadership). Professional staff and volunteers will provide this continuing service during 2008-09.
Other funding includes other governmental grants, fund raising, fees and private grants.
Objective category: ® Suitable Living Environment ❑ Decent Housing ❑ Economic Opportunity
Outcome category: ® Availability/Accessibility ❑ Affordability ❑ Sustainability
Location/Target Area
Citywide
Objective Number
Project ID
SL-1
2008-4
HUD Matrix Code
CDBG Citation
05A — Senior Services
570.201(e)
Type of Recipient
CDBG National Objective
Subrecipient Private
L/M Limited Clientele
570.500(c)
Start Date (mm/dd/yyyy)
Completion Date
10/01/2008
09/30/2009
Performance Indicator
Annual Units
Seniors
85
Local ID
Units Upon Completion
85
Funding Sources:
CDBG
ESG
HOME
HOPWA
Total Formula
Prior Year Funds
Assisted Housing
PHA
Other Funding
Total
$10,000
..................................................................
$3,140,785
..................................................................
$3,150,785
...................................................................
The primary purpose of the project is to help: ❑ the Homeless ❑ Persons with HIV/AIDS ® Persons with Disabilities 0 Public Housing Needs
ATTACHMENT 2
BUDGET
ALZHEIMER' S FAMILY SERVICES CENTER
Salaries $10,000
?fit` DATE (MM/DDNY)
ACORDTM TE O� LIABILITY-INSURAN13CE _ r` 09/25/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
DW Harper Group AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
6 Hutton Center Drive Suite 1280 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICES BELOW.
Santa Ana, CA 92707
Phone: 714-444-4133 Fax: 714-444-4155 INSURERS AFFORDING COVERAGE
INSURED INSURER A: ,lames River Insurance Company
Adult Day Services of Orange County INSURER B:
DBA: Alzheimer's Family Services Center INSURERC'.
9451 Indianapolis Avenue INSURER D:
Huntington Beach, CA 92646 INSURER E:
THIS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 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 POLICES DESCRIBED HEREIN IS SUBJECT TO
ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY
POLICY
INSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
EFFECTIVE
DATE
EXPIRATION
DATE
MM/DD/YY
MM/DD/YY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
1,000,000
® COMMERCIAL GENERAL LIABILITY
FIRE DAMAGE (Any one fire)
$
50,000
MED EXP (Any one person)
❑® CLAIMS MADE ❑ OCCUR
PERSONAL & ADV INJURY
$
1,000,000
A
® Professional Liability
27336-1
09/28/08
09/28/09
GENERAL AGGREGATE
$
3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS-COMP/OPAGG
$
Included above
❑ POLICY ❑ PROJECT ❑ LOC
Retroactive Date: 9-28-04
$
AUTOMOBILE LIABILITY
❑ ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
❑ ALL OWNED AUTOS
❑ SCHEDULEDAUTOS
BODILY INJURY
(Per person)
$
❑ HIREDAUTOS
❑ NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
❑
❑
GARAGE LIABILITY
AUTO ONLY -EA ACCIDENT
$
ANY AUTO
OTHER THAN
EA
ACC
$
❑
AUTO ONLY:
AGG
$
EXCESS LIABILITY
ElOCCURR ❑ CLAIMS MADE
OrV
EACH OCCURRENCE
$
AGGREGATE
$
SELF -INSURED RETENTION
$
❑ DEDUCTIBLE
$
❑ RETENTION
$
STATU- OTH-
WORKERS COMPENSATION AND
TORWC Y LIMITS ER
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
E.L. DISEASE -EA EMPLOYEE
$
E.L. DISEASE -POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Evidence of Specified Medical Professional and General Liability Insurance for Adult Day Services of Orange County DBA: Alzheimer's Family Services
Center. The certificate holder is made additional insured solely as respects General Liability and only as required by a written contract between the certificate
holder and Adult Day Health Services of Orange County.
CERTIFICATE HOLDER I M ADDITIONAL INSLJREDINSLJRFD LETTER' A CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY
City of Huntington Beach, Economic
BROKER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE
Development Department
CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL
P.O. Box 190
SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY
Huntington Beach, CA 92648,
KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE }
A(:VRU 25-5 (7-W) u HwrcU I IUN 1 V00
510TIM,• K
COMPANY:
JAMES RIVER INSURANCE COMPANY
6641 WEST BROAD STREET, SUITE 300
RICHMOND, VA 23230
1. NAMED INSURED AND MAILING ADDRESS: PRODUCER: 17774
POLICY NUMBER
00027336-1
Alzheimers Family Services Center AMWins Ins. Brokerage (Chatsworth)
9451 Indianapolis Avenue 19867 Prairie #250
Huntington Beach, CA 92646 J Chatsworth, CA 91311
J
2. POLICY PERIOD: From 09/28/2008 to 09/28/2009 12:01 A.M. Standard Time at your Mailing Address above.
IN RETURN FOR THE PAYMENT OF THE PREMIUM, IN RELIANCE UPON STATEMENTS IN THE APPLICATION(S) AND SUBJECT TO ALL OF THE
TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
3. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED.
THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT.
COVERAGE PARTS PREMIUM
General Liability Coverage Parts $11,320.00
Professional Liability Coverage Parts Included
Inspection Fee $ 250.00
PREMIUM SHOWN IS PAYABLE AT INCEPTION TOTAL POLICY PREMIUM: $11,570.00
4. FORMS APPLICABLE TO ALL COVERAGES: See Schedule A —Schedule of Forms
5. FORM OF BUSINESS: Non -Profit Entity
Surplus Lines flax
$ Sw ' 10
Stamping Fee
Includes copyrighted material of Insurance Services Office, Inc. tidth its permission.
AH0001US O4-03 Copyright, Insurance Services Office, Ina, '1994
FORMS AND ENDORSEMENTS THAT APPLY TO THiS POLICY:
POLICY NO. 00027336-1
FORM NUMBER DESCRIPTION
AH0001 US-0403
Common Policy Declarations
AH0003US-0403
Professional Liability Coverage Part Declarations
AH0005US-0706
Commercial General Liability Policy Declarations
AP0001US-0403
Schedule
AH220OUS-0903
Professional Liability Policy
CG0002-1001
Commercial General Liability Coverage Form
AP010OUS-0403
Privacy Policy
AH2101US-0403
Multiple Coverage Parts Endorsement
AH2205US-0706
Combined Policy Exclusions
AH2207US-0607
Incident Reporting Endorsement
AH2208US-0104
Defense Outside the Limits of Insurance
AH2212US-0706
Physical Abuse or Sexual Misconduct Limits of Liability Endorsement
AH2213US-0706
Damages Definition Amendment
AH2307US-0403
Deductible Endorsement -
AH2311US-0107
Incident Reporting Endorsement
AH2315US-0507
Medical Director As An Insured
AP1008US-0905
HIPAA Exclusion
r-AP2009US-0206
Additional Insured as Required by Written Contract
AP2029US-1105
Combined Policy Exclusions
AP2031 US-1 105
Insured Versus Insured - Exclusion
AP2032US-0308
Employers Liability - Exclusion
AP2037US-1105
Absolute Pollution and Pollution Related Liability Exclusion - with Hostile Fire
Exception
AP2044US-0606
Assault and Battery Exclusion
AP2103US-0607
Minimum Policy Premium
AP2104US-0208
Common Policy Conditions
AP2107US-0403
Binding Arbitration
AP2112US-0804
Terrorism Exclusion
AP270OUS-0107
General Liability Changes Claims -Made to Claims -Made and Reported
AP2702US-0107
Extended Reporting Period Endorsement
AP5027R-0107
Rejection of Coverage for Certified Acts of Terrorism Coverage (Pursuant to
Terrorism Risk Insurance Act)
CG0435-0202
Employee Benefits Liability Coverage
CG2135-1001
Exclusion - Coverage C - Medical Payments
CG2167-0402
Fungi or Bacteria Exclusion
CG2244-0798
Exclusion - Services Furnished By Healthcare Providers
iL0021-0702
Nuclear Energy Liability Exclusion Endorsement (Broad Form)
AP0001 US O4-03 1 of 1
CERTHOLDER COPY
Si
STATE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807
COMPENSATION
INSURANCE
F W CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 11-20-2008 GROUP: 000587
POLICY NUMBER: 0000737-2007
CERTIFICATE ID: 11
CERTIFICATE EXPIRES.04-01-2009
04-01-2008/04-01-2009
CITY OF HUNTINGTON BEACH Si
ATTN: CAROL RUNZEL
PO BOX ISO
HUNTINGTON BEACH CA 92648-0190
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer.
We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance
afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy.
HORIZED REPRESENTAT14J PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE CDSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 04-01-2007 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY.
EMPLOYER
ALZHEIMER'S FAMILY SERVICES CENTER SJ
9451 INDIANAPOLIS AVE
HUNTINGTON BEACH CA 92846
]S1o,SJ]
(REV.2-05) PRINTED : 11-20-2008
INSURANCE
INDEMNIFICATION 1 WAIVER'
I
MODIFICATION
4`•i �I�?— --/ -I l•l 1 REQUEST
a `4.e ._
1. Requested by: Carol Runzel, Senior Administrative Analyst
2. Date: December 5, 2008
3. Name of contractor/permittee: Alzheimer's Family Resource Center
4. Description of work to be performed: Day Care Services for Dementia patients.
5. Value and length of contract: $10,000, one year
6. Waiver/modification request: Automobile Insurance
7. Reason for request and why it should be granted: Organization requires employees to
carry their own. The oraanization does not have auto insurance. See attached e-mail.
8. Identify the risks to the City in approving this waiver/modification: None.
Department He ignature ate:
APPROVALS
Approvals must be obtained in the order listed on this form. Two approvals are required
for a request to be granted. Approval from the City Administ ator, �ffice is only required if
Risk Management, and t ; City Attorney's �ffice;di'� ree.
'I. Risk Management
f
I Approved ❑ Denied �1�12
Signature Date
2. City Attorney's Office
Approved ❑ Denie
Signature Date
3. City Administrator's Office
❑ Approved ❑ Denied
Signature Date
If approved, the completed waiver/modification request is to be submitted to the
City Attorney's Office along with the contract for approval. Once the contract has been approved,
this form is to be filed with the Risk Management Division of Administrative Services
waiver form 12/5/2008 8:40:00 AM