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HomeMy WebLinkAboutHBCOA - Huntington Beach Council on Aging - 2011-05-02Council/Agency Meeting Held:_ 14, Deferred/Continued to: *Appro ed ❑ Conditionally Approved 0 Denied Ci . Jerk ignat e Council Meeting Date: May 2, 2011 Departmen ID Number: CS-11-008 14, SUBMITTED TO: Honorable Mayor and City Council Members SUBMITTED BY: Fred A. Wilson, City Manager PREPARED BY: Paul Emery, Deputy City Manager/Interim Community Services Director SUBJECT: Approve a Memorandum of Understanding (MOU) between the City of Huntington Beach and the Huntington Beach Council on Aging (HBCOA) Statement of Issue: City of Huntington Beach staff together with the Huntington Beach Council on Aging (HBCOA) has been working to enhance the dignity and quality of life of City Seniors through comprehensive services, education, and advocacy aimed to empower and meet the needs of the senior population. City staff worked closely with the HBCOA to revise the existing Memorandum of Understanding (MOU) for the purpose of memorializing this ongoing collaborative. There is a need to approve the MOU. Financial Impact: None Recommended Action: Motion to: Approve the updated "Memorandum of Understanding between the City of Huntington Beach and the Huntington Beach Council on Aging;" and, authorize the Mayor and City Clerk to execute the Memorandum of Understanding. Alternative Action(s): Do not approve the Memorandum of Understanding between the City and the Huntington Beach Council on Aging and direct staff accordingly. HB -115- Item 7. - 1 INTENTIONALLY LEFT BLANK REQUEST FOR COUNCIL ACTION MEETING DATE: 5/2/2011 DEPARTMENT ID NUMBER: CS 11-008 Analysis: The Huntington Beach City Council, at their September 17, 1973, meeting, voted unanimously to "sanction and officially recognize" the HBCOA so as to implement programs to benefit the community's senior citizens. On November 5, 1973, City Council voted to adopt the HBCOA bylaws and to appoint a council delegate to the organization. The HBCOA has been advocating on behalf of Huntington Beach Senior Citizens for nearly 40 years. The mission of the HBCOA is to enhance the dignity and quality of life of city seniors through comprehensive services, education, and advocacy, aimed to empower and meet the needs of a diverse population. In 2006, city staff and HBCOA officials defined the roles of each party through the development and adoption of a Memorandum of Understanding. The city provides recreation and social services programs to the community. The HBCOA is an advocate and fundraiser for programs and services benefitting Huntington Beach Seniors. The language of the MOU has been changed to reflect the addition of "Huntington Beach" or "HB" to the title of the Council on Aging, changing the "Council on Aging" (COA) to the "Huntington Beach Council on Aging" (HBCOA) throughout the document. The main points of the MOU (Attachment 1) remain the same. The city will continue to provide the HBCOA access to the Senior Center to conduct business, including office space and meeting rooms. The city will also provide minimal staff support and building space as needed to produce the "Bright Outlook" newsletter and for HBCOA board meetings and events. Under the conditions of the MOU, the HBCOA, a 501(c)(3) non-profit charitable organization, will act in concert with the city to support county, state, and federal efforts on behalf of the senior citizens of Huntington Beach, and to secure the aid afforded by public agencies. The HBCOA shall provide financial support to the city's Senior Services operation and programming. The MOU has a five-year term with the option of an additional five years by mutual consent. City staff recommends Council approval of the MOU with the Huntington Beach Council on Aging. Environmental Status: None Strategic Plan Goal: Improve Internal and External Communication Attachment(s): Item 7. - 2 HB -116- AM All 0 - , "A�' FIAML- A HB - 1 - Item 7. - 3 MEMORANDUM OF UNDERSTANDING BETWEEN THE CITY OF HUNTINGTON BEACH AND THE HUNTINGTON BEACH COUNCIL ON AGING THIS MEMORANDUM OF UNDERSTANDING ("MOU") is made and entered into on Off. , 2011, by and between the CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California (hereinafter referred to as "CITY"), and THE HUNTINGTON BEACH COUNCIL ON AGING, a 5016 charitable organization (hereinafter referred to as "HBCOA"). WHEREAS, the CITY of Huntington Beach City Council (hereinafter referred to as "CITY COUNCIL"), at their September 17, 1973 meeting, voted unanimously to "sanction and officially recognize" the HBCOA, so as to implement programs to benefit the community's senior citizens; and On November 5, 1973, CITY COUNCIL voted to adopt the HBCOA bylaws and to appoint a council delegate to the organization; and CITY is committed to the HBCOA Mission, "To work with CITY staff and volunteers to enhance the dignity and quality of life of City seniors through comprehensive services, education, and advocacy, aimed to empower and meet the needs of a diverse population," and shall provide staff through the Community Services Department/Senior Services to assist the HBCOA. NOW, THEREFORE, for and in consideration of the promises and covenants hereinafter contained and intending to be legally bound, the parties covenant and agree as follows: SECTION 1. TERM This MOU will become effective on the date it is approved by CITY COUNCIL and shall terminate five (5) years thereafter, except with respect to any obligations hereunder which are to be performed thereafter. Upon mutual written consent of the parties, this Agreement may be extended for additional five (5) year terms. 11-2867/61945 SECTION 2. OBLIGATIONS OF CITY The obligations of the CITY pursuant to this Agreement shall be as follows: I . CITY shall provide the use of an office area in the Seniors' Center for HBCOA to maintain its records and correspondence and conduct official HBCOA business and activities. 2. CITY shall provide HBCOA the use of a city computer for the purpose of maintaining records, where required. 3. CITY shall, with approval of the Center Supervisor, provide the HBCOA with use of conference/meeting rooms within the Seniors' Center for holding support and committee meetings in which to conduct routine business for the HBCOA. 4. CITY shall, with approval of the Center Supervisor, provide the HBCOA use of community halls within the Seniors' Center for the purpose of holding corporate meetings, tournaments, senior dances, and other approved events as they occur. 5. CITY shall provide staff support for the generation of Board meeting agendas and distribution of agendas and minutes and for the monthly HBCOA Board Meetings. HBCOA's Recording Secretary shall take and prepare meeting minutes. 6. CITY shall organize volunteer support for processing any donations made to the HBCOA through the "Outreach Program." 7. CITY shall provide Staff support for the monthly HBCOA dance by providing custodial support for the room set-up and opening and closing the building. 8. CITY shall collect senior transportation donations and deposit them with the HBCOA to be used for senior transportation enhancements. City shall provide periodic transportation expenditure reports to the HBCOA. 11-2867/61945 2 9. CITY shall provide staff support, based on staff availability, for HBCOA fundraising events, including Senior Saturday, the HBCOA Golf Tournament, and other approved events. 10. CITY shall work in concert with HBCOA to produce the monthly Bright Outlook newsletter. The newsletter will advise CITY seniors of events and opportunities provided by HBCOA and by the CITY at the Seniors' Center and through the Senior Outreach program. 11. CITY shall provide supervisory staff support, based on staff availability, to work closely with the HBCOA Executive Board on broad issues, such as event planning, Board development and organizational structure of HBCOA. SECTION 3. OBLIGATIONS OF HBCOA The obligations of the HBCOA pursuant to this Agreement shall be as follows: HBCOA, as a 501(c)3 Charitable Organization, shall provide its services as an organization accepting public and private donations intended for CITY use in the furthering of senior activities within existing or future CITY programs, wherein the donor wishes to use the benefits of a charitable organization in lieu of a direct gift to the CITY. 2. HBCOA shall, from time to time, provide financial support to CITY's Community Services Department for its senior programs, within the scope of the HBCOA Charter and as negotiated with CITY. This scope shall include, but is not limited to, payment of salaries or partial salaries for CITY personnel through direct gifts to the CITY and/or funds to hire personnel through outside agencies. 3. Personnel hired by the CITY, through the use of HBCOA donated funds, shall be the sole responsibility of the CITY. The HBCOA shall have no liability as to the actions of the CITY or its employees. 11-2867/61945 3 4. HBCOA shall act in concert with city, county, state, and federal agencies to ensure the senior citizens of Huntington Beach are treated with respect and dignity and are provided the aid afforded by public agencies such as, but not limited to, congregate meals and transportation. 5. The HBCOA Board shall work in concert with CITY's staff to produce a monthly newsletter, the Bright Outlook, advising CITY seniors of events and opportunities at the Seniors' Center and the Senior Outreach Center. Copies of this newsletter shall be distributed to HBCOA members and delivered to select facilities in the city for distribution. 6. HBCOA shall be responsible for collecting donations for the Senior Transportation Program. These funds will be deposited into a CITY donation account on a periodic basis, to be used by CITY for senior transportation enhancements. 7. HBCOA shall provide volunteer support to generate correspondence including, but not limited to, "Thank You" notes from the HBCOA to various citizens. HBCOA shall provide volunteer support for the processing and tracking of HBCOA membership revenues and maintaining the membership database. SECTION 4. ACCESS TO CITY MARKS AND LOGOS HBCOA shall have the right to use the official Huntington Beach City logo, surfboard logo, and CITY's "Surf City Huntington Beach" trademark with the prior written approval of CITY's Director of Community Services before using any of these logos or trademark, which approval shall be at the sole discretion of the Director. Note: The surfboard logo is not the property of CITY. HBCOA will use neither logo for commercial purposes. 11-2867/61945 4 SECTION 5. HOLD HARMLESS HBCOA shall protect, defend, indemnify and hold harmless CITY, its officers, officials, employees, and agents from and against any and all liability, loss, damage, expenses, costs (including without limitation, costs and fees of litigation of every nature) arising out of or in connection with performance of this MOU or its failure to comply with any of its obligations contained in this MOU except such loss or damage which was caused by the sole negligence or willful misconduct of CITY. SECTION 6. WORKERS' COMPENSATION INSURANCE Pursuant to California Labor Code Section 1861, HBCOA acknowledges awareness of Section 3700 et seq. of said Code, which requires every employer to be insured against liability for workers' compensation; HBCOA covenants that it will comply with such provisions prior to commencing performance of the work hereunder. HBCOA shall maintain 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, Two Hundred Fifty Thousand Dollars ($250,000) bodily injury by disease, policy limit. HBCOA shall require all subcontractors to provide such workers' compensation insurance for all of the subcontractors' employees. HBCOA shall furnish to CITY a certificate of waiver of subrogation under the terms of the workers' compensation insurance and HBCOA shall similarly require all subcontractors to waive subrogation. SECTION 7. GENERAL LIABILITY INSURANCE In addition to the workers' compensation insurance and HBCOA's covenant to indemnify CITY, HBCOA shall obtain and furnish to CITY, a policy of general public liability insurance, 11-2867/61945 including motor vehicle coverage. Said policy shall indemnify HBCOA, its officers, agents and employees, while acting within the scope of their duties, against any and all claims arising out of or in connection with this Agreement, 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 agents, its officers, employees and volunteers as Additional Insureds, and shall specifically provide that any other insurance coverage which may be applicable shall be deemed excess coverage and that HBCOA's insurance shall be primary. Under no circumstances shall the above -mentioned insurance contain a self -insured retention, or a "deductible," or any other similar form of limitation on the required coverage. SECTION 8. CERTIFICATES OF INSURANCE; ADDITIONAL INSURED ENDORSEMENTS Prior to commencement of this Agreement, HBCOA shall furnish to CITY certificates of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverage as required by this Agreement; these certificates shall: (a) provide the name and policy number of each carrier and policy; (b) state that the policy is currently in force; and (c) promise to provide that such policies shall not be canceled or modified without thirty (30) days' prior written notice of CITY; however, ten (10) days' prior written notice in the event of cancellation for nonpayment of premium. 11-2867/61945 6 HBCOA shall maintain the foregoing insurance coverage in force during the entire term of the Agreement or any renewals or extensions thereof or during any holdover period. The requirement for carrying the foregoing insurance coverage shall not derogate from HBCOA's defense, hold harmless and indemnification obligations as set forth in this Agreement. CITY or its representatives shall at all times have the right to demand the original or a copy of any or all the policies of insurance. HBCOA shall pay, in a prompt and timely manner, the premiums on all insurance hereinabove required. SECTION 9. ASSIGNING AS BREACH Neither party shall encumber, assign, or otherwise transfer this MOU, or any right or interest in this MOU, without the express written consent of the other party. A consent by a party to one assignment or transfer to another person shall not be deemed to be a consent to any subsequent assignment or transfer to another person. Any encumbrance, assignment or transfer, without the prior written consent of the other party, whether it is voluntary or involuntary, by operation of law or otherwise, is void and shall, at the option of the other party, terminate this I►AMl�>w SECTION 10. TERMS BINDING ON SUCCESSORS All the terms, covenants and conditions of this MOU shall inure to the benefit of and be binding upon the parties and their successors and assigns. The provisions of this Section shall not be deemed as a waiver of any of the conditions against assignment hereinbefore set forth. SECTION 11. CONFLICT OF INTEREST HBCOA shall employ no CITY official or any regular CITY employee in the work performed pursuant to this MOU. No officer or employee of CITY shall have any financial 11-2867/61945 7 interest in this MOU in violation of the applicable provisions of the California Government Code. SECTION 12. PHOTOGRAPHY CITY may grant permits to persons engaged in the production of still and motion pictures, television programs, advertising and related activities, to take photographs and/or motion pictures of HBCOA activities. However, consistent with good safety practices, CITY will endeavor to give 24-hour advance notification of such activities to HBCOA. In addition, if CITY receives compensation from such persons for such production, CITY will grant 50% of such compensation to HBCOA for support of HBCOA's activities as set forth under this MOU. SECTION 13. NONDISCLOSURES/PRESS RELEASES HBCOA shall consult with CITY prior to issuing any press releases or otherwise making any public statements with respect to this MOU, the transactions contemplated herein, or matters arising herefrom. SECTION 14. CUMULATIVE REMEDIES The remedies given to the parties in this MOU shall not be exclusive but shall be cumulative and in addition to all remedies now or hereafter allowed by law or elsewhere provided in this MOU. SECTION 15. WAIVER OF BREACH The waiver by CITY of any breach by HBCOA of any of the provisions of this MOU, irrespective of the length of time for which such failure continues, shall not constitute a waiver of such breach or a waiver of any subsequent breach by HBCOA, either of the same or another provision of this MOU. 11-2867/61945 SECTION 16. FORCE MAJEURE - UNAVOIDABLE DELAYS Should the performance of any act required by this MOU to be performed by either CITY or HBCOA be prevented or delayed by reason of an act of God, strike, lockout, labor troubles, inability to secure materials, restrictive governmental laws or regulations, or any other cause (except financial inability) not the fault of the party required to perform the act, the time for performance of the act will be extended for a period equivalent to the period of delay and performance of the act during the period of delay will be excused. SECTION 17. NOTICE Any written notice, given under the terms of this MOU, shall be either delivered personally or mailed, certified mail, postage prepaid, addressed to the party concerned, as follows: CITY Director of Community Services City of Huntington Beach 2000 Main Street, P.O. Box 190 Huntington Beach, CA 92648 Phone: (714) 536-5291 Huntington Beach Council on Aging Attn: President 1706 Orange Avenue Huntington Beach, CA 92648 Phone (714) 374-1524 If a party desires to change the address for notices set forth herein, said party shall provide 30 days advance written notice to the other party of any such change. SECTION 18. ATTORNEY'S FEES In the event suit is brought by either party to enforce the terms and provisions of this MOU or to secure the performance hereof, each party shall bear its own attorney's fees. The prevailing party shall not be entitled to recover its attorney's fees from the non -prevailing party. SECTION 19. CONTROLLING LAW AND VENUE The rights and liabilities of the parties, and the interpretation and construction of this MOU, shall be determined in accordance with the laws of the State of California. Any controversy arising 11-2867/61945 9 out of or under this MOU, if litigated, shall be adjudicated in a court of competent jurisdiction in Orange County, California. SECTION 20. SECTION TITLES The section titles in this MOU are inserted only as a matter of convenience and for reference, and in no way define, limit or describe the scope of intent of this MOU or in any way affect this MOU. SECTION 21. TIME OF ESSENCE Time is of the essence with respect to all provisions of this MOU in which a definite time for performance is specified including, but not limited to, the expiration of this MOU. SECTION 22. SURVIVAL OF INDEMNITIES Termination of this MOU shall not affect the right of CITY to enforce any and all indemnities given or made by HBCOA under this MOU, nor shall it affect any provision of this MOU that expressly states that the provision shall survive termination thereof. SECTION 23. NONLIABILITY OF CITY OFFICIAL. EMPLOYEES OR AGENTS No elective or appointed CITY or CITY affiliated board, commission or member thereof, or officer, official, employee or agent of CITY shall be personally liable to HBCOA, its successors and assigns, of any default or breach by CITY under this MOU or for any amount which may become due to HBCOA, its successors and assigns, under this MOU or for any obligation of CITY under this MOU. SECTION 24. TERMINATION This MOU may be terminated by either party with or without cause upon sixty (60) days notice in writing. 11-2867/61945 10 SECTION 25. MODIFICATIONS IN WRITING This MOU contains and embraces the entire agreement between the parties hereto and neither it nor any part of it may be changed, altered, modified, limited or extended orally or by any other agreement between the parties unless such agreement be expressed in writing, signed and acknowledged by CITY and HBCOA, or their successors in interest. SECTION 26. PARTIAL INVALIDITY Should any provision of this MOU be held by a court of competent jurisdiction to be either invalid, void, or unenforceable, the remaining provisions of this MOU shall remain in full force and their effect unimpaired by the holding, so long as the reasonable expectations of the parties hereto are not materially impaired. SECTION 27. MOU IN COUNTERPARTS This MOU may be executed in counterparts, each of which shall be deemed an original, but all of which taken together shall constitute one and the same document. SECTION 28. NO TITLE INTEREST No title interest of any kind is hereby given and HBCOA shall never assert any claim or title to the Seniors' Center or any other public property. Use of the Seniors' Center by HBCOA is non- exclusive, and the Seniors' Center shall at all times during its operating hours remain open for use by the public. SECTION 29. ENTIRETY The foregoing sets forth the entire agreement between the parties. 11-2867/61945 11 IN WITNESS WHEREOF, the parties hereto have caused this MOU to be executed by and through their authorized officers the day, month and year first above written. HUNTINGTON BEACH COUNCIL ON AGING, an unincorporated association: print name title 11-2867/61945 12 CITY OF HUNTINGTON BEACH, a municipal corporation of the State of California a '--Mayor APPROVED AS TO FORM: ,1 City Attorney Dy.0 t 19 INITIATED D APPROVED: r Director of CAmmunity Services OP ID: PC CERTIFICATE OF LIiA ILITY INSURANCE DAT3/29D,YYYY) 03/29/11 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must 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 626-405-8031 Chapman 626-405-0585 License #0522024 P. 0. Box 5466 Pasadena, CA 91117-0465 CONTACT PHONE aC No E-MAIL ADDRESS: PRODUCER HUNTI-4 CUSTOMER INSURERS AFFORDING COVERAGE NAIC 0 INSURED Huntington Beach Council on Aging 1706 Orange Huntington Beach, CA 92648 INSURERA-NIAC 10023 INSURER B : INSURERC: INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE DL B POLICY NUMBER POLICY EFF MMIDD POLICY EXP MM/DD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X 201016779NPO 09/29/10 09/29/11 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 600,000 MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 17 POLICY PRO- FLOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNEDAUTOS SCHEDULEDAUTOS HIREDAUTOS NON-OWNEDAUTOS 201015779NP0 P VED At TO F' 09/29/10 08/29/11 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Par accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE n MCGMTH C AttO e �� EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE F—] OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If es, describe under DESCRIPTION OF OPERATIONS below NIA WC STATU- OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT 1 $ T-1 I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, B more space Is required) IThe City of Huntington Beach its officers, elected or appointed officials, employees, agents and volunteers are named additional insured with respect to the operations of the named insured per the attached CG 2010 endorsement. 1n3:11t2L91 11:1:LeiR-913:1 City of Huntington Beach Community Services Department 2000 Main Street Huntington Beach, CA 92648 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE gam'' " — ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD V POLICY NUMBER, ?Ql,. 15779�NPQ COMMERCIAL GENERAL LIABILITY CG"20.,10-07 04 THIS ENDOItSEIVIENTCHANGES THE POLICY. ..PLEASE READ ITCAREFULLY. Thit.en'dorsementmodifies insurance,, provided undI:NJoll owin COVIVIERCIAL GENERAL LIABILITY COVERAGE PART SCH EDULE IIAEDULE NameOfAddltjonal Ins -tired Person(s) A. Section 11 - Who Is An Insured is amended to include as. an additional insured "the oerson(s) or organization(s) -shown in the Schedule, but only with respect to liabilit , y for "bodily injury", "property damage" or "personal and advertisin Jpjqry." caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts 0rornis.sions of those -:acting o your' n behalf,, in the performance ., your ongoing operations .Qf for the additionati,nsured(.i5) at the: Iodation('§)',desig- natedabove. Of B. With respect to. the insurance afforded to these additional insureds, the following additional exclu- ,SiMs apply: This insurance does,not apply- to "bodily injury'.' or "property damage" occ.urring.aft r: A., All work,, including materials, parts or equip- 00 furnished.: in connectionwithauch work, on the project (other than service, maintenance or repairs) to be performed .by or on behalf of the additional , , I , nsured.1s)-at the location of the covered: operations has been completed; ,or 2. That portion ion of "your work' out of which the injury.or dampge,,.zrjses s " been putto its in- tended use by any Berson or Organization other than another contractor or sul5contractor engaged in- performing operations for a prink pal as'a part of the same project. CG 20 10:07 04 0, ISOProperties, Inc., 2'004 Rage 1 of, 1 13 J • CITY OF HUNTINGTON BEACH 2000 Main Street, Huntington Beach, CA 92648 Declaration of Non -Employer Status The State of California requires every enterprise or business to provide workers compensation insurance coverage. If you have no employees, you may make a declaration to that effect by completing and signing this form and returning to: City of Huntington Beach 2000 Main Street Huntington Beach, CA 92.648 1 certify that in the performance of the activity or work for which this permit is issued, I shall not employ any person In any manner so as to become subject to California Workers' Compensation Insurance requirements. 1 authorize the City of Huntington Beach to immediately and retroactively revoke the license or permit issued under this declaration if I hire any employee(s) or become subject to the provision of the laws requiring Workers' Compensation Insurance. Company game: `J II2 169- MILI(i rJx. Ln- hold N fAC-10S Address: )'71V C)rcte Aug, N,6 Applicant c Ijdw p r, n Or Applicant's Signature: Title: Mom -- Date Signed: S `3 1 ` P Telephone. Number: City of Huntington Beach 2000 Main Street ♦ Huntington Beach, CA 92648 (714) 536-5227 ♦ www.huntingtonbeachca.gov Office of the City Clerk Joan L. Flynn, City Clerk May 4, 2011 Huntington Beach Council on Aging ATTN: President 1706 Orange Avenue Huntington Beach, CA 92648 To Whom It May Concern: Enclosed is a duly executed copy of the Memorandum of Understanding between the City of Huntington Beach and the Huntington Beach Council on Aging. Sincerely, Jo L. Flynn, CIVIC City Clerk Enclosure JF:pe Ufollowup:agrmthr Sister Cities: Anjo, Japan ♦ Waitakere, New Zealand