HomeMy WebLinkAboutCOMMUNITY SERVICE PROGRAMS (CSP) - 1996-10-07•
•
;, je CITY OF HUNTINGTON BEACH
0 2000 MAIN STREET CALIFORNIA 92648
HUNTINGTON BEACH CITY HISTORIAN
Alicia M. Wentworth
Retired City Clerk
October 18, 1996
Barbara J. Morrison
16842 Von Karman # 425
Irvine, California 92714
Dear Ms. Morrison:
The City Council of the City of Huntington Beach at the regular meeting held
October 7, 1996, approved execution of the enclosed subgrantee agreement
between the city and CSP, Domestic Violence Services For Community Policing
To Combat Domestic Violence Program Funds for Housing And Community
Development Block Grant funds.
Enclosed is a duly executed copy of the agreement for your records.
Sincerely,
&X�� &Oeh�
Connie Brockway
City Clerk
CB:jc
Enclosure: Agreement
G:fb11owup: agrmtltr/Domestic: jc
Telephone: 714-536-5404
714-842-9825
Council/Agency Meeting Held: - - %h
Deferred/Continued to:
City Clerk's Sign re
Approved ❑ Conditionally Approved ❑ Denied
Council Meeting Date: October 7, 1996
Department ID Number: PD 96-020
CITY OF HUNTINGTON BEACH
REQUEST FOR COUNCIL ACTION
SUBMITTED TO: HONORABLE MAYOR AND CITY COUNCIL MEMBERS
SUBMITTED BY: MICHAEL T. UBERUAGA, City Administrator
PREPARED BY: RONALD E. LOWENBERG, Chief of Police
CI I92 ICf`r• rnKITDArTI IAI CGR\/IrGC GnC? r1nIVI1=CTIr \/lnl 1=AIrI= (,RAnIT
I
Statement of Issue, Funding Source, Recommended Action, Alternative Action(s), Analysis, Environm ntal Status, Attachment(s) /
Statement of Issue:
The purpose of this RCA is approval of contracts with Community Services Program (CSP)
and Interval House for a one year term, October 1, 1996 to September 30, 1997. These
contracts are required for the Federal Domestic Violence Grant that was previously
approved by the Council.
Fundinq Source:
Federal Citizens Option for Public Safety Program (COPS) Office -Department of Justice
Recommended Action:
Respectfully request the City Council approve and sign the attached contracts with CSP and
Interval House. ��I " /
Alternative Action(s):
1. Approve and sign contracts with CSP and Interval House.
2. Do not approve and sign contracts.
*QUEST FOR COUNCIL AC11ON
MEETING DATE: October 7, 1996
DEPARTMENT ID`NUMBER: PD 96-020
Analysis:
On August 5, 1996 Resolution #96-64 was passed by the City Council granting approval to
accept Community Policing to Combat Domestic Violence Federal Grant Funds of $198,505
and to enter into a collaboration with two community based organizations for one year.
Huntington Beach Police Department is to enter into a contractual agreement with the
Interval House Victims of Domestic Violence Shelter and CSP, Inc., Domestic Violence
Assistance Programs. The attached contracts, prepared by the City Attorney's Office, are
for the purposes of this grant.
Environmental Status:
None
Attachment(s):
1. Resolution #96-64
2. Contracts
RCADV.DOC -2- 09/17/96 10:40 AM
•
0
SUBGRANTEE AGREEMENT BETWEEN THE CITY OF
HUNTINGTON BEACH AND CSP, DOMESTIC VIOLENCE SERVICES
FOR COMMUNITY POLICING TO COMBAT DOMESTIC
VIOLENCE PROGRAM FUNDS
THIS AGREEMENT is entered into this 9_1h day of OC46 ;� , 1996, between
the CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California,
hereinafter referred to as "CITY," as an entitlement recipient in the U. S. Department of Justice. -
Office of Community Oriented Policing Services, and CSP, Domestic Violence Services, a nonprofit
California corporation, hereinafter referred to as "SUBGRANTEE," for the expenditure of
Community Policing to Combat Domestic Violence Program (CPCDVP) funds;
The Community Policing to Combat Domestic Violence Program, hereinafter referred to as
"CPCDVP," mandates that a Subgrantee Agreement be executed in order that such funds be utilized
by the parties hereto.
IT IS HEREBY AGREED that the following provisions are approved and shall constitute
the entire agreement between the CITY and SUBGRANTEE:
The purpose granting $85,840 in CPCDVP funds to SUBGRANTEE shall be
solely for training, field services, and victim/witness follow-up in the area of domestic violence, in
accordance with the Scope of Work, Attachment "A', which is hereby incorporated by this
reference. CPCDVP funds shall be expended within a time period not exceeding twelve (12)
consecutive months, oct . i, 1996:through_ Sent 3j; following the date of
execution of this agreement, in installments determined by CITY. Disbursements shall be made to
SUBGRANTEE following the submission of invoices in a form prescribed.by CITY, detailing
such expenses. SUBGRANTEE agrees to submit requests for disbursement fifteen (15) days
after the end of each period which are:
WPUG:AgreeMomestic
RLs 96-519
a. September 1, 1996 through November 1996;
b. December 1, 1996 through February 1997;
C. March 1, 1997 through May 1997;
d. June 1, 1997 through August 31, 1997.
CITY shall disburse funds based upon the submittal of such invoices within thirty (30)
days after receipt thereof, provided CITY is satisfied that such expenses have been incurred within
the scope of this Agreement and that SUBGRANTEE is in compliance with the terms and
conditions of this Agreement. City has the right to recapture all or a portion of CPCDVP funds
not requested for disbursement 30 days after the end of the fiscal year, June 30, 1996.
2. SUBGRANTEE agrees to conduct all activities of the organization, whether
funded in whole or in part by CPCDVP funds from CITY, in accordance with the provisions
contained in the Federal Office of Management and Budget ("OMB") Circular A-87 and its
attachments, including those for contracts in excess of Ten Thousand Dollars ($10,000.00) and
including the provisions relating to audit requirements and resolution of audit findings as provided
in Circular A-128. SUBGRANTEES who have received $25,000 or more in grant funds are
required to submit an annual report including either a single audit or program audit reports, which
evidence an audit was completed in accordance with specific program requirements of the OMB
Circular (i.e., A-128 or A-133).
3. The CITY shall have the right to recapture all or a portion of CPCDVP funds
disbursed to SUBGRANTEE should the SUBGRANTEE fail to comply with all of the terms and
conditions of this agreement or refuse to accept any conditions which may subsequently be
imposed by the U. S. Department of Justice for the operation of the Community Policing to
Combat Domestic Violence Program.
2
TPUG:AgreeMomestic
RLS 96-519
•
•
4. SUBGRANTEE shall not dispose of any real or personal property acquired in full
or in part with CPCDVP funds through sale, use, or relocation without the express and prior
written permission of the City, and SUBGRANTEE agrees to maintain program records for a
minimum of three years after the close-out of the subgrant and to make such records available for
onsite monitoring by CITY not less than annually and to periodic inspections by HUD officials
during this three-year period.
5. SUBGRANTEE agrees that no officer, employee, agent, or assignee of CITY
having direct or indirect control of CPCDVP funds granted to the CITY shall serve as an officer
of SUBGRANTEE. Further, any conflict or potential conflict of interest of any officer of
SUBGRANTEE shall be fully disclosed to the City prior to the execution of this agreement and
shall be attached to and become a part hereof.
6. SUBGRANTEE agrees that any earned interest income on funds generated
through the use or investment of funds received from CITY shall be used in conformance with
program income requirements set forth in Code of Federal Regulations 570.504. The
SUBGRANTEE shall disclose to the CITY all program income received utilizing CPCDVP funds
administered under this Agreement.
7. SUBGRANTEE agrees that in the event it is unable to perform or defaults upon
any provision contained herein, the CITY shall have the right to recapture the full amount of
funds granted to SUBGRANTEE.
8. SUBGRANTEE acknowledges that the CITY shall disburse funds to
SUBGRANTEE only upon execution of this agreement, and CITY is empowered only to provide
funds to SUBGRANTEE pursuant to the provisions of this agreement.
3
7/PL:G: Agree:Domestic
RLS 96-519
0
•
9. SUBGRANTEE hereby agrees to protect, defend, indemnify and hold and save
harmless CITY, its officers, and employees against any and all liability, claims, judgments, costs
and demands, however caused, including those resulting from death or injury to
SUBGRANTEE'S employees and damage to SUBGRANTEE'S property, arising directly or
indirectly out of the obligations or operations herein undertaken by SUBGRANTEE, including
those arising from the concurrent negligence of CITY, but save and except those which arise out
of the sole negligence, or the sole willful misconduct of CITY. SUBGRANTEE will conduct all
defense at its sole cost and expense. CITY shall be reimbursed by SUBGRANTEE for all costs
or attorney's fees incurred by CITY in enforcing this obligation.
10. Pursuant to California Labor Code Section §1861, SUBGRANTEE
acknowledges awareness of Section 3700 et seq. of said code, which requires every employer to
be insured against liability for workers' compensation; SUBGRANTEE convenants that it will
comply with such provisions prior to commencing performance of the work hereunder.
SUBGRANTEE shall maintain such workers compensation insurance in an amount of not
less than One Hundred Thousand dollars ($100,000) bodily injury by accident, each occurrence,
One Hundred Thousand Dollars ($100,000) bodily injury by disease, each employee, and Two
Hundred Fifty Thousand. Dollars ($250,000) bodily injury by disease, policy limit, at all times
incident hereto, in forms and underwritten by insurance companies satisfactory to CITY.
SUBGRANTEE shall require all subcontractors to provide such workers' compensation
insurance for all of the subcontractors' employees. SUBGRANTEE shall furnish to CITY a
certificate of waiver of subrogation under the terms of the worker's compensation insurance and
SUBGRANTEE shall similarly require all subcontractors to waive subrogation.
4
7/PL:G:Agree:Domestic
RLS 96-519
11. INSURANCE. In addition to the workers compensation insurance and
SUBGRANTEE's covenant to indemnify CITY, SUBGRANTEE shall obtain and furnish to
CITY, a policy of general public liability insurance, including motor vehicle coverage covering the
I PROJECT. Said policy shall indemnify SUBGRANTEE, its officers, agents and employees, while
acting within the scope of their duties, against any and all claims of arising out of or in connection
with the PROJECT, 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 $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
$1,000,000. Said policy shall name CITY, its officers, and employees as Additional Insureds, and
shall specifically provide that any other insurance coverage which may be applicable to the
PROJECT shall be deemed excess coverage and that SUBGRANTEE's insurance shall be
primary.
Under no circumstances shall said abovementioned insurance contain a self -insured
retention; or a "deductible" or any other similar form of limitation on the required coverage.
12. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED
ENDORSEMENTS. Prior to commencing performance of the work hereunder, SUBGRANTEE
shall, furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing
the foregoing insurance coverages as required by this Agreement; said certificates shall:
1. provide the name and policy number of each carrier and 'policy;
2. shall state that the policy is currently in force;
3. shall promise to provide that such policies will not be canceled or modified without
thirty (30) days prior written notice of CITY; and
5
WPLZ AgreeMomestic
RLS 96-519
• 1 •
4. shall state as follows: "The above detailed coverage is not subject to any
deductible or self -insured retention, or any other form of similar type
limitation. "
SUBGRANTEE 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 SUBGRANTEE under the Agreement. CITY
or its representative shall at all times have the right to demand the original or a copy of all said
policies of insurance. SUBGRANTEE shall pay, in a prompt and timely manner, the premiums on
all insurance hereinabove required
A separate copy of the additional insured endorsement to each of
SUBGRANTEE's insurance policies, naming the CITY, its officers and employees as Additional
Insureds shall be provided to the City Attorney for approval prior to any payment hereunder.
„ 13. CALIFORNIA PREVAILING WAGE LAW. The CITY has ascertained from the
Director of Industrial Relations of the State of California the general, prevailing rate of per diem
wages and the general prevailing rate for legal holiday and overtime work in the locality in which
the works is to be performed for each craft or type of work needed to execute this Agreement,
and the same has been set forth by resolution on file in the office of the City Clerk of CITY.
SUBGRANTEE and any subcontractor under it shall pay not less than said prevailing wage rates
to all workers employed on this Subgrantee Agreement, as required by California Labor Code
Sections 1771 and 1774. In accordance with the provisions of Section 3700 SUBGRANTEE
agrees to secure payment of compensation to every employee.
6
7MUG:AgreeMomestic
RIS 96-519
14. CALIFORNIA PREVAILING WAGE LAW - PENALTY. Pursuant to this
Agreement and in accordance with section 1774 and 1775 of the California Labor Code,
SUBGRANTEE shall, a penalty to CITY, forfeit twenty-five dollars ($25) for each calendar day
or portion thereof for each worker paid (either by SUBGRANTEE or any of its subcontractors)
less than the prevailing wage rate established for that particular craft or type of work.
15. CALIFORNIA EIGHT -HOUR LAW. California Labor Code, Section 1810 et
seq., shall apply to the performance of this Agreement; thereunder, not more than eight (8) hours
shall constitute one day's work and SUBGRANTEE and each subcontractor employed by its
hereunder, shall not require more than eight (8) hours of labor per day or forty (40) hours per
week from any one person employed by it hereunder, except as stipulated in California Labor
Code, Section 1815. SUBGRANTEE and each subcontractor employed by it hereunder shall, in.
accordance with Section 1812, keep an accurate record, open to inspection at all reasonable
hours, showing the name and actual hours worked each calendar day and each calendar week by
each worker employed in connection with the PROJECT.
16. CALIFORNIA EIGHT HOUR LAW - PENALTY. Pursuant to this Agreement
and in accordance with California Labor Code Section 1813, SUBGRANTEE shall, as a penalty
to CITY, forfeit twenty-five dollars ($25) for each worker employed hereunder by
SUBGRANTEE or any subcontractor for each calendar day during which such worker is required
or permitted to work more than eight (8) hours in any one (1) calendar day or forty (40) hours in
any one (1) calendar week in violation of California Labor Code Section 1815.
17. PAYMENT OF TRAVEL AND SUBSISTENCE ALLOWANCE. Section
1773.8 of the California Labor Code, regarding the employment of apprentices, is applicable to
this PROJECT.
7
7/PL:G: Agree Momestic
RLS 96-519
•
CJ
18. EMPLOYMENT OF APPRENTICES. Section 1777.5 of the California Labor
Code, regarding the employment of apprentices, is applicable to this paragraph.
19. PAYROLL RECORDS. SUBGRANTEE agrees to keep accurate payroll record
showing the name, address, social security number, work classification, straight time and overtime
hours worked each day and week, and the actual per diem wages paid to each journeyman,
apprentice or worker employed by it in connection with the project and agrees to require each of
its subcontractors to do the same. SUBGRANTEE further agrees that its payroll records and
those of its subcontractors, if any, shall be available at all reasonable times to the CITY, and the
employee or his representative, and the Division of Labor Standards Enforcement and the
Division of Apprenticeship Standards, and to comply with all of the provisions of California
Labor Code Section 1776, in general.
20. INDEPENDENT CONTRACTOR. It is understood and agreed that the
SUBGRANTEE is, and shall be, acting at all times hereunder as an independent contractor and
not as'an employee of CITY. SUBGRANTEE shall secure, at its expense, and be responsible for
any and all payment of income tax, social security, state disability insurance compensation,
unemployment compensation and other payroll deductions for SUBGRANTEE and its officers,
agents and employees, and all business licenses, if any, in connection with the project.
21. All notices pertaining to this Agreement, and any communications from the parties
may be made by delivery of said notices in person or by depositing said notices in the U.S. Mail,
registered or certified mail, return, receipt requested, postage prepaid and addressed as follows:
8
WPL:G:AgmeMomestic
RLS 96-519
•
•
To SUBGRANTEE:
CSP, Domestic Violence Services
16842 Von Karman #425
Irvine, 'CA. 92714
Attention: Barbara J. Morrison
To CITY:
City of Huntington Beach
Police Department
2000 Main Street
Huntington Beach, CA 92648
Attention: R. E. Lowenberg
Any of the parties may cancel this Agreement by giving thirty (30) days written notice of
said cancellation to the other party hereto. In the event .of termination or cancellation for any
reason, CITY shall be liable for services rendered up to such termination.
This document fully expresses all understandings of the parties concerning all matters
covered and shall constitute the total Agreement. No prior written or oral provisions or
understanding, between the parties shall have any force or affect. No addition to or alteration of
the terms of this Agreementshall be valid unless made in writing and formally adopted in the same
manner as this Agreement.
-, 22. SIGNATURES/TIME OF EXECUTION, This agreement shall be void and its
terms shall have no force or effect whatsoever if not signed by authorized agents or officers of
SUBGRANTEE within thirty (30) days of receipt of this document. It shall be the responsibility
9
7/PL:G:Agree:Domeslic
RLs 96-519
•
•
of the City to transmit this agreement and any other necessary documentation to SUBGRANTEE
and to record the date of receipt thereof.
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed
by and through their authorized offices the day, month and year first above written.
CSP DOMESTIC VIOLENCE SERVICES, a
nonprofit California co r tion
By: J-01
�s
ITS: (circle one Secretat /Chief Financial
OfficetUsst. Secretary - Treasurer
REVIE D AND APPROVED:
City AdIninistrator
CITY OF HUNTINGTON BEACH, A
municipal corporation of the State of
California
Mayor
ATTEST:
City Clerk
APPROVED AS TO FORM:
it e �a
y Atto �1n y
10
7/PL O AgreeMomestic
RLS 96-519
SUBGRANTEE AGREEMENT BETWEEN THE CITY OF
HUNTINGTON BEACH AND CSP, DOMESTIC VIOLENCE SERVICES
FOR COMMUNITY POLICING TO COMBAT DOMESTIC
VIOLENCE PROGRAM FUNDS
SCOPE OF WORK
ATTACHMENT "A"
1. Services to be provided by CSP, Domestic Violence Services:
orders;
a. Respond to a victim's immediate emotional and/or physical needs including food, clothing,
lodging, transportation or financial assistance;
b. Telephone and, in -person support counseling services;
C. Assist the victim to participate in the judicial process, including court support and
accompaniment;
d. Advocate on behalf of the victim, i.e., filing crime victim compensation claims,
intervention with employers and/or creditors, case information and disposition, translation
services;
e. Assist in the preparation of Temporary Restraining Orders (TRO), including custody
f. Refer to community resources appropriate to the victim's needs, i.e., long-term counseling
and shelter care; and
g. Provide the Domestic Violence Prevention Act and Family Law Act at regularly scheduled
officer briefings and other designated forums as appropriate.
The above victim services shall be provided in the Huntington Beach Police Department or in the field
Monday through Friday, 8:00 a.m. through 5:00 p.m. at the request of an investigating officer.
2. In addition, SUBGRANTEE agrees to supply the following:
a. One (1) full-time Victim Specialist on site at the Huntington Beach Police Department for
immediate response and continued support services to victims of domestic violence;
b. An Education Specialist to train officers on the problem of domestic violence, emergency
protective orders, and temporary restraining orders; and
C. All office supplies required for daily activities, liability insurance, travel costs for victim
outreach, court support and accompaniment.
7/PL:G:Agree Momestic
RLS 96-519
DATE (MNI/DDrM
08/28/96
PRooucER
THIS CERTIFICATE IS ISSUED AS A MATTER F INFORMATION
ONLY AND CONFERS NO RIGHTS UPON E CERTIFICATE
Chapman &Associates Inc
HOLDER. THIS CERTIFICATE DOES NOT ND, EXTEND OR
261 North San Gabriel Blvd.
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
GE
COMPANY
A Great American
INSURED •COMPANY
Community Service Program Inc
B
16842 Von Karman Avenu
Irvine, CA 92714 ;PAO Mf
COMPANY
C
COMPANY
LJF
D
RIRIE 1151 111 11 1111 ZZ51 NOR R111 R1
'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.
co
LTA
TYPE OF INSURANCE
I
POLICY NUMBER
I I
POLICY EFFECTIVE
DATE (MMIDDf
POLICY EXPIRATION
)/YY) I
LIMITS
.
A
GENERAL
LIABILITY
PAC720684403
10/01/95
10101/96
GENERAL AGGREGATE
$ 2,000,000
X
PRODUCTS - COMP/OP AGG
$ 1,000,000
COMMERCIAL GENERAL LIABILITY
7 CLAIMS MADE 7x OCCUR
w
PERSONAL & ADV INJURY
$
X
EACH OCCURRENCE
.1,000,000
6 1,000,000
OWNER'S & CONTRACTOR'S PROT
X
FIRE DAMAGE (Anyone fire)
S 50,000
Professional
X
I Personal Inry
M ED EXP (Any one person)
$ 5,000
A
AUTOMOBILE
LIABILITY
PAC720684403
10/01/95
10/01/96
COMBINED SINGLE LIMIT
$ 11000,000
ANY AUTO
BODILY INJURY
ALL OWNED AUTOS
SCHEDULED AUTOS
(Per person)
X
BODILY INJURY
HIRED AUTOS
x
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
A'J '1'0 FORKV
GARAGE LIABILITY
F77717.11
AUTO ONLY - EA ACCIDENT
S
ANY AUTO
fi E, y
OTHER THAN AUTO ONLY:
EACH ACCIDENT
S
$
3YTM
AGGREGATE
$
EXCESS LIABILITY
T
7
EACH OCCURRENCE
$
AGGREGATE
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EL EACH ACCIDENT
EMPLOYERS' LIABILITY
r
EL DISEASE -POLICY
THE PROPRIETOR/
PARTNERS/EXECUTIVE INCL
EL DISEASE - EA EMPLOYEE
S
OFFICERS EXCL
A
OTHER
Crime
CRP790314001
10/01/95
10/01/96
Emp Dishonest 350,000
Deductible 1,000
DESCRIPTION OP OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEM
Certificate holder, Its agents, ofricers, employees and volunteers are
named as additional insured as respects their Interest in connection with
the named insured. This Insurance is considered primary & non-contributory
.. ................
. . . . . . . . . . .
R ZEEIF53171111 I 1 111111 1 111 ------- I -------- --------
City or Huntington Beach
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE
Police Department
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL 111INIMMUCIUK" MAIL
.
30
DAYS wmrrEm NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
2000 Main Street
Attn: Sgt. Ron Burgess
srz to
Huntington Beach, CA 92648
X No
AU
INSURED: Community Service Program Inc
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS - (Continued):
with any insurance carried by the certificate holder. No deductible or
self insured retention applies to any insurance stated on this form.
POLICY NUMBER:.PAC220684403 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED --DESIGNATED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
Name of Person or Organlzatlon:
City of Huntington Beach
Police Department
2000 Main Street
attn: Sgt. Ron Burgess
Huntington Beach, cA 92648.
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
WHO IS AN INSURED (Section 11) is amended to include as an insured the person or organization shown in the
Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or
rented to you.
Community Service Programs Inc.
16842 Von Karman Avenue
Irvine, CA 92714
CG 20 261185' Copyright. Insurance Services 015M Inc..1984 . ❑