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HomeMy WebLinkAboutRobyne's Nest - 2023-07-01 (2) AGREEMENT BETWEEN THE CITY OF HUNTINGTON BEACH AND ROBYNE'S NEST (Program No. B-23-MC06-0506) FOR PROGRAM YEAR 2023/2024 COMMUNITY DEVELOPMENT BLOCK GRANT(CDBG) FUNDS THIS AGREEMENT is made and entered into on the 1 St of July, 2023 by and between the CITY OF HUNTINGTON BEACH a municipal corporation, hereinafter referred to as "City," and ROBYNE'S NEST , 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 2023-2024 CDBG funds in the amount of Fifty Thousand Dollars ($50,000) to the Subrecipient to assist with the program costs for activities described in the Scope of Work and Budget(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 July 1, 2023 and shall end on June 30, 2024. 23-12957/311689 1 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 and Budget (Attachment 1). 6) Budget The budget is described in the Scope of Work and Budget (Attachment 1) shall be the governing budget for this grant agreement unless modified and approved in writing by the City. 7) Project Schedule/Milestones Services of the Subrecipient shall start no sooner than on the first day of July 2023 and end on the thirtieth day of June 2024. Every effort shall be made by the Subrecipient to expend the allocated funds in their entirety by June 30, 2024. If the Subrecipient does not expend all funds by June 30, 2024, the City may reallocate the funds not yet drawn to another eligible CDBG projects. 8) Compensation and Method of Payment The City shall reimburse the Subrecipient with CDBG funds for program costs related to eligible services to not exceed the grant amount for the period beginning July 1, 2023 and ending June 30, 2024. 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 monthly "Payment Request" within fifteen (15) calendar days after the end of the first three quarters with the final report for 2023/2024 fiscal year delivered by July 15, 2024. 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 samples of appropriate methods of reimbursement documentation. A Quarterly Accomplishment Report(Section 11) is due at the same time as the quarterly payment request. 9) Program Income The Subrecipient shall report to the City any interest or other income earned as a direct 23-12957/311689 2 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 services detailed in the Scope of Work and Budget (Attachment 1). 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 CD$G 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. 11) Reporting Requirements The Subrecipient shall submit "Quarterly Accomplishment Reports" within fifteen (15) calendar days of the end of the first three quarters. The final quarterly report is due no later than July 15, 2024. 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 23-12957/311689 3 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, 2Q29. 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. Notwithstanding 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 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) Real 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. 23-12957/311689 4 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 provisions of the Agreement. 20) Compliance with Laws 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. 23-12957/311689 5 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 funds 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 July 1, 2022 and ending June 30, 2023 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 570.200(j), such as worship,religious instruction, or proselytization. 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 23-12957/311689 6 (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 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. 27) 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: 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 administration of contracts supported by Federal funds. 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. 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. 23-12957/311689 7 28) Procurement Standards and Methods 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. 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. Travel. 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 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. 23-12957/311689 8 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. 30) Notices Communication and details concerning this contract shall be directed to the following contract representatives: City: Subrecipient: City of Huntington Beach Robyne's Nest Attn: Charles Kovac, Housing Mgr. Attn: Robyne Wood, Founder/Executive Directoi 2000 Main Street, 5th Floor 7602 Talbert Avenue, Suite F Huntington Beach, CA 92648 Huntington Beach, CA 92648 Phone: (714) 374-5316 (714) 369-6102 31) Independent Contractor 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. 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. 23-12957/311689 9 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 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 23-12957/311689 10 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) Severability 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. 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. 23-12957/311689 11 IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed by and through their authorized officers on `,L+I y , 2023. ROBYNE'S NEST I ROBYN'S NEST CITY OF HUNTINGTON BEACH, a municipal corporation o State of California B . Directo of Community Development print name APPROVED AS 'Ft ►. ' ► ; ITS: (circle one) ChairmanJside 3Vice President .4 City Attorn; ki. , AND ^'W BY lec/C1i r leck?yri ,.l hd Receive and File print name ITS: (circle one) Secretary/Chief Financial2'1"flt, 9'044444 t Officer/Asst. Secretary- Treasurer Q(�y��C -Qwe'� ���i'A^{�7/ City Clerk /04/23 23-12957/311689 12 • ATTACHMENT 1 SCOPE OF SERVICES AND BUDGET 23-12957/311689 13 ATTACHMENT A FY 2023-24 SCOPE OF SERVICES AND BUDGET ROBYNE'S NEST A. SCOPE OF SERVICES Outcome Statement: This project will identify at-risk and homeless high school students and provide them a path to become stable and productive citizens. They will assist students with security, routing and a place to belong. Their purpose sit o enable students to complete their high school diploma and continue onward with college, trade school, or military programs. Robyne's Nest provides housing resources; basic needs such as food, clothing and supplies; educational assistance such as tutoring, Chromebooks, school supplies, and fees; and overall help with health and wellbeing in the form of counseling, therapy, mentoring, and life skills. This project furthers Priority #2 in the City of Huntington Beach's adopted Housing and Community Development Consolidated Plan (HUD 5-year plan), which is to support efforts to address homelessness. Principal Task: Between July 1, 2023 and June 30, 2024, Robyne's Nest will: 1. Provide services to 43 unduplicated homeless or at-risk Huntington Beach youth. Robyne's Nest will submit a quarterly Grantee Performance Report (GPR) on these goals by the 15t" of each month following the end of the quarter over the duration of this agreement. B. PROJECT FUNDING & COST ESTIMATES With the submission of monthly invoices together with proper support documentation, for the services and authorized budget items described in Section A of this Attachment, Robyne's Nest will be reimbursed on a quarterly basis in accordance with the following annual project budget: Personnel: $40,000 Therapy Program: $10,000 Total Robyne's Nest Budget: $50,000 23-12957/311689 14 r V-, ® DATE(MM10DlYYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE `,../..- 10/1212023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION 1S 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). CONTACT PRODUCER Gregory M Gath Don Gath Insurance Agency PHONE FAX 2199 Temple Ave I LINC. o.Ext): (562)498-6701 (allo):(562)985.1349 Signal Hill,CA 90755 ADDRESS: greg@gathinsurance.com License#:0447779 INSURER(S►AFFORDING COVERAGE NAIC!! , INSURER A: Great American Insurance Company 002213 INSURED INSURERS: Employers Preferred Ins Co 10346 Robyne's Nest INSURERC: 7602 Talbert Ave Suite F INSURERO: Huntington Beach,CA 92648-1301 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00001999-286325 REVISION NUMBER: 6 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 ADDLSUBR POLICYEFF POLICY EXP LTR TYPE OP INSURANCE INSR WVb POLICY NUMBER IMM oorryVYI IMM!OD1YYYY1 LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y PAC 2471709 05 03/06/2023 03/0612024 EACH OCCURRENCE S 1,000,000 , DAMAGE TO RENTED CLAIMS-MADE n OCCUR PREMISES(Ea occurrence) $ 100,000 _ MED EXP(Anyone person) $ 5,000 PERSONAL.4 ADV INJURY S 1,000,000 GEiNt AGGREGATE LIMIT APPLIESPER: GENERAL AGGREGATE $ 2,000,000 XlPOLICY n EEC n LOC PRODUCTS-COMP/OP AGO $ 2,000,000 OTHER: S A AUTOMOBILE LIABILITY PAC 2471709 05 03/06/2023 03/06/2024 CEaacadaDtl INGLELIMIT $ 1,000.000 ANY AUTO BODILYINJURY(Perperson) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS MIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) S A X UMBRELLA LIAR _ OCCUR UMB4695847 03/06/2023 0310612024 EACH OCCURRENCE $ 1,000,000 EXCESS UAB X CLAIMS-MADE AGGREGATE $ 1,000,000 DED I RETENTIONS S WORKERS COMPENSATION B AND EMPLOYERS'LIABILITY I iBIG 4944010 01 0310112023 03/0112024 X STATUTE FAH ANY PROPRIETOR/PARTNER/EXECUTIVE NiH1A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) EL.DISEASE-EA EMPLOYEE$ 1,000,000 It yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POUCYLIAIIT $ 1,000,000 DESCRIPTION OF OPERATIONS!-LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached II more space Is required) City of Huntington Beach,its officers,elected or appointed officials,employees,agents and AVi@l11i'1:D AS TO FORM 2000 Main St.Huntington Beach,CA 92648 ex( By: • MICHAEL E.GATES CITY ATTORNEY CITY OF HUNTINGTON BEACH CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN The City of Huntington Beach ACCORDANCE WITH THE POLICY PROVISIONS. 2000 Main Street Huntington Beach,CA 92648 AUTHOlIA4irtrjj144 RIZEDREPRESENTATRIE I (GMG) 5 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by GMG on October 12,2023 at 12:33PM * S1 * 10/11/2023*PAC 2471709 05 GREAT AMERICAN ASSURANCE COMPANY *D/B* 706362922 694948 CG 20 26(Ed. 12119) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): CITY OF HUNTINGTON BEACH, ITS OFFICERS, ELECTED OR APPOINTED OFFICIALS EMPLOYEES, AGENTS AND VOLUNTEERS 2000 MAIN ST. HUNTINGTON BEACH, CA 92648 Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II -Who Is An Insured is amended to include as an additional insured the person(s)or organization(s) shown in the Schedule, but only with respect to liability for"bodily injury", "property damage"or"personal and advertising injury"caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the Additional Insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. ©Insurance Services Office, Inc., 2018 CG 20 26(Ed. 12/19) (Page 1 of 1) * S1 * 10/11/2023*PAC 2471709 05 GREAT AMERICAN ASSURANCE COMPANY *D/3* 706362922 694948 IL 70 02(Ed. 10/07) Policy No. PAC 2471709 05 Effective Date of Change 10/04/2023 POLICY CHANGES NAMED INSURED ROBYNE'S NEST THIS ENDORSEMENT CHANGES THE POLICY. AND ADDRESS: 7602 TALBERT AVE STE F PLEASE READ IT HUNTINGTON BEACH, CA 92648 CAREFULLY. POLICY ALTERNATE MAILING ADDRESS: AGENT'S NAME AND ADDRESS: DON GATH INSURANCE AGENCY PO BOX 90245 LONG BEACH, CA 90809 0245 Insurance is afforded by the Company named below, a Capital Stock Corporation: GREAT AMERICAN ASSURANCE COMPANY POLICY PERIOD: From 03/06/2023 To 03/06/2024 12:01 A.M. Standard Time at the address of the Named Insured NO CHANGE IN PREMIUM IT IS HEREBY AGREED AND UNDERSTOOD THAT THIS POLICY IS AMENDED AS FOLLOWS: THE FOLLOWING IS ADDED AS AN ADDITIONAL INSURED: CITY OF HUNTINGTON BEACH, ITS OFFICERS, ELECTED OR APPOINTED OFFICIALS, EMPLOYEES, AGENTS AND VOLUNTEERS 2000 MAIN ST. HUNTINGTON BEACH, CA 92648 ENDORSEMENT #2 ANY AMENDED FORMS ATTACHED TO THIS CHANGE DISPLAY PREMIUMS FOR A FULL POLICY TERM. Forms and Endorsement Activity IL 70 02(Ed. 10/07) (Page 1 of 2) * S1 * 10/11/2023* PAC 2471709 05 GREAT AMERICAN ASSURANCE COMPANY *D/B* 706362922 694948 CG2026 12/19 ADDL INS-DESIGNATED PERSON/ORGANI ADDED 10/12/2023 A ent-Si nat re Date 9 9 IL 70 02(Ed. 10/07) (Page 2 of 2) I S1 * 02/07/2023* PAC 2471709 05 I GREAT AMERICAN ASSURANCE COMPANY *D/B* 706362922 694948 see page 10,section R CG 89 70 (Ed. 11/14) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SIGNATURE GENERAL LIABILITY BROADENING ENDORSEMENT This Endorsement modifies and is subject to the insurance provided under the following form: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following extension only applies in the event that no other specific coverage for the indicated loss exposure is provided under this Policy. If other specific coverage applies, the terms, conditions and limits of that Coverage are the exclusive coverage applicable under this Policy, unless otherwise noted in this Endorsement. This is a summary of the various additional coverages and coverage modifications provided by this Endorsement. For complete details on specific coverages, consult the actual policy wording. Coverage Description Limit of Insurance Page Non-Owned Aircraft Included 2 Non-Owned Watercraft Included 2 Bodily Injury - Mental Injury, Mental Anguish, Humiliation or Shock Included 3 Medical Payments $ 20,000 3 Damage to Premises Rented to You $ 1,000,000 3 Supplementary Payments - Ball Bonds $ 3,000 4 Supplementary Payments - Loss of Earnings $ 1,000 per day 4 Newly Formed or Acquired Organizations Included 4 Unintentional Failure to Disclose Hazards Included 5 Knowledge of Occurrence, Claim or Suit Included 5 Property Damage Liability - Elevators Included 5 Property Damage Liability - Borrowed Equipment Included 5 Liberalization Clause Included 6 Amendment of Pollution Exclusion (Premises) Included 6 Limited Property Damage to Property of Others $ 5,000 6 Additional Insured - Manager or Lessor of Premises Included 7 CG 89 70 (Ed. 11/14) (Pace 1 of 12) * S1 *02/07/2023*PAC 2471709 05 GREAT AMERICAN ASSURANCE COMPANY *D/B* 706362922 694948 Coverage Description Limit of Insurance Page Additional Insured - Funding Sources Included 7 Additional Insured - By Contract Included 8 Primary and Non-Contributory Additional Insured Extension Included 10 Additional Insureds - Protection of Your Limits Included 10 Blanket Waiver of Transfer of Rights of Recovery Against Others Included to Us (Subrogation) 11 Property Damage Extension With Voluntary Payments $ 1,000/$ 5,000 11 Who Is An Insured - Fellow Employee Extension - Management Included Employees 12 Broadened Personal and Advertising Injury Included 12 A. Non-Owned Aircraft Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability, exclusion g. Aircraft, Auto or Watercraft does not apply to an aircraft provided: 1. it is not owned by any insured; 2. it is hired, chartered or loaned with a trained paid crew; 3. the pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating him or her a commercial or airline pilot; and 4. it is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the Insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this Policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. Non-Owned Watercraft Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability, subparagraph (2) of exclusion g. Aircraft, Auto or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) less than 60 feet long; and f.• CG 89 70 (Ed. 11/141 (Paae 2 of 121 * Si *02/07/2023* PAC 2471709 05 GREAT AMERICAN ASSURANCE COMPANY *D/B* 706362922 694948 (b) not being used to carry persons or property for a charge. C. Bodily Injury - Mental Injury, Mental Anguish, Humiliation or Shock Under SECTION V - DEFINITIONS, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness, or disease, including death of a person. "Bodily Injury" also means mental injury, mental anguish, humiliation, or shock if directly resulting from physical injury, sickness, or disease to that person. D. Medical Payments If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this Policy are amended as follows: The Medical Expense Limit in paragraph 7. of SECTION III - LIMITS OF INSURANCE is replaced by the following Medical expense Limit: The Medical Expense Limit provided by this Policy shall be the greater of: a. $ 20,000; or b. the amount shown in the Declarations for Medical Expense Limit This provision 7. is subject to all the terms of SECTION Ill - LIMITS OF INSURANCE. E. Damage to Premises Rented to You If Damage to Premises Rented to You is not otherwise excluded from this Coverage Part: 1. Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability: 3. The last paragraph of paragraph 2. Exclusions is deleted in its entirety and replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, leakage from an automatic fire protection system or water to premises while rented to you or temporarily occupied by you with permission of the owner. A separate Limit of Insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. However, this insurance does not apply to damage to premises while rented to you, or temporarily occupied by you with the permission of the owner, caused by: i. rupture, bursting, or operation of pressure relief devices; H. rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or resulting from water; iii. explosion of steam boilers, steam pipes, steam engines, or steam turbines; or iv. flood 2. Paragraph 6. Under SECTION III - LIMITS OF INSURANCE is deleted in its entirety and replaced with the following: CG 89 70 (Ed. 11/14) (Pace 3 of 12) * S1 *02/07/2023*PAC 2471709 05 GREAT AMERICAN ASSURANCE COMPANY *D/5* 706362922 694948 6. Subject to paragraph 5. above, the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage caused by' fire, lightning, explosion, smoke, leakage from automatic fire protection system or water while rented to you or temporarily occupied by you with the permission of the owner, for all such damage caused by fire, lightning, explosion, smoke, leakage from automatic fire protection systems or water proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, leakage from automatic fire protection systems or water or any combination of the six, is the higher of $ 1,000,000 or the amount shown in the Declarations for the Damage to Premises Rented to You Limit. 3. Under SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS, subsection 4. Other Insurance, paragraph b. Excess Insurance where the words "Fire insurance" appear they are changed to "insurance for fire, lightning, explosion, smoke, leakage from an automatic fire protection system or water." 4. As regards coverage provided by this provision I. Damage to Premises Rented to You - paragraph 9.a. of Definitions is replaced with the following: 9. a. a contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, leakage from automatic fire protection systems or water to premises while rented to you or temporarily occupied by you with the permission of the owner is not an "insured contract"; F. Supplementary Payments 1. In the Supplementary Payments - Coverages A and B provision, paragraph 1.b. is replaced with: b. Up to $ 3,000 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. All reasonable expenses incurred by the Insured at our request to assist us in the investigation or defense of the claim or "suit," including actual loss of earnings up to $ 1,000 a day because of time off work. G. Newly Formed or Acquired Organizations Paragraph 3. of SECTION II - WHO IS AN INSURED is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a named insured if there is no other similar insurance available to that organization. However: a. coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. coverage A does not apply to "bodily injury" or property damage that occurred before you acquired or formed the organization; and c. coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. r CG 89 70 (Ed. 11/141 (Page 4 of 12) * S1 *02/07/2023*PAC 2471709 05 GREAT AMERICAN ASSURANCE COMPANY *D/B* 706362922 694948 d. records and descriptions of operations must be maintained by the first named insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a named insured in the Declarations or qualifies as an insured under this provision. H. Unintentional Failure to Disclose Hazards Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added to Condition 6. Representations: Failure of the Insured to disclose all hazards existing as of the inception date of this Policy shall not prejudice the insurance with respect to the coverage afforded by this Policy, provided such failure or omission is not intentional on the part of the Insured. I. Knowledge of Occurrence, Claim or Suit Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added to Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit: Knowledge of any occurrence, claim, or suit by any agent, servant or employee of the Named Insured does not in itself constitute knowledge by the Insured unless notice of such injury, claim or suit shall have been received by: a. you, if you are an individual; b. a partner, if you are a partnership c. an executive officer or insurance manager, if you are a corporation. J. Property Damage Liability - Elevators 1. Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability, subparagraphs (3), (4) and (6) of exclusion j. Damage to Property do not apply if such property damage results from the use of elevators. 2. The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Condition 4. Other Insurance, paragraph b. Excess Insurance: The insurance afforded by this provision of this Endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. K. Property Damage Liability - Borrowed Equipment 1. Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability, subparagraph (4) of exclusion j. Damage to Property does not apply to "property damage" to borrowed equipment while not being used to perform operations at a job site. 2. The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY Conditions, Condition 4. Other Insurance, paragraph b. Excess Insurance: The insurance afforded by this provision of this Endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. { CG 89 70 (Ed. 11/141 (Pace 5 of 12) * S1 *02/07/2023*PAC 2471709 05 GREAT AMERICAN ASSURANCE COMPANY *D/B* 706362922 694948 L. Liberalization Clause If we revise this Signature General Liability Broadening Endorsement to provide more coverage • without additional premium charge, your policy will automatically provide the coverage as of the date the revision is effective in your state. M. Amendment of Pollution Exclusion (Premises) 1. The following is added to paragraph (1)(a) of Exclusion f. of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability: (iv) "Bodily injury" or "property damage" arising out of the actual discharge, dispersal, seepage, migration, release or escape of "pollutants." As used in this Endorsement, the actual discharge, dispersal, seepage, migration, release or escape of pollutants must: (aa) commence on a clearly identifiable day during the policy period; and (bb) end, in its entirety, within seventy-two (72) hours of the commencement of the discharge, dispersal, seepage, migration, release or escape of "pollutants"; and (cc) be discovered and reported to us within fifteen (15) days of the clearly identifiable day that the discharge, dispersal, seepage, migration, release or escape of "pollutants" commences; and (dd) be neither expected nor intended from the standpoint of any insured; and (ee) be unrelated to any previous discharge, dispersal, seepage, migration, release or escape; and (ff) not originate at or from a storage tank or other container, duct or piping which: a. is below the surface of the ground or water; or b. at any time has been buried under the surface of the ground or water and then is subsequently exposed. 2. For the purposes of this coverage, the following is added to the definition of "property damage" of SECTION V - DEFINITIONS and applies only as respects this coverage: Land or water, whether below ground level or not, is not tangible property. 3. Coverage provided hereunder does not apply to any discharge, dispersal, seepage, migration, release or escape that is merely threatened or alleged rather than shown to have actually occurred. N. Limited Property Damage to Property of Others The following is added under SECTION I - SUPPLEMENTARY PAYMENTS - COVERAGES A and B: 3. We will pay up to $ 5,000 for loss to personal property of others while in the temporary care, custody or control of an insured caused by any person participating in your organized activities. For the purpose of this supplementary payment, loss shall mean damage or destruction but does not include mysterious disappearance or loss of use. In the event of a theft, a police report must be filed. This supplementary payment does not apply if: a. coverage is otherwise provided by the Property Coverage part (if any) of this Policy; or CG 89 70 (Ed. 11114) (Page 6 of 12) * S1 *02/07/2023 *PAC 2471709 05 GREAT AMERICAN ASSURANCE COMPANY *D/B* 706362922 694948 b. the loss is covered by any other insurance you have or by any insurance of such person who causes such loss. These payments will not reduce the Limits of Insurance. O. Additional Insured - Manager or Lessor of Premises 1. SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization from whom you lease or rent property and which requires you to add such person or organization as an additional insured an this Policy under: (a) a written contract; or (b) an oral agreement or contract where a Certificate of Insurance showing that person or organization as an additional insured has been issued; but the written or oral contract or agreement must be an "insured contract," and, (i) currently in effect or become effective during the term of this Policy; and (II) executed prior to the "bodily injury," "property damage," "personal and advertising injury." 2. With respect to the insurance afforded to the Additional Insured identified in paragraph 1. above, the following additional provisions apply: (a) This insurance applies only with respect to the liability arising out of the ownership, maintenance or use of that part of the premises leased to you. (b) The Limits of Insurance applicable to the Additional Insured are the lesser of those specified in the written contract or agreement or in the Declarations for this Policy and subject to all the terms, conditions and exclusions for this Policy. The Limits of Insurance applicable to the Additional Insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. (c) In no event shall the coverages or Limits of Insurance in this Coverage Form be increased by such contract. (d) Coverage provided herein is excess over any other valid and collectible insurance available to the Additional Insured whether the other insurance is primary, excess, contingent or on any other basis unless a written contractual arrangement specifically requires this insurance to be primary. (e) This insurance applies only to the extent permitted by law. 3. This insurance does not apply to: (a) Any "occurrence" or offense which takes place after you cease to be a tenant in that premises. (b) Structural alterations, new construction or demolition operations performed by or on behalf of the Additional Insured. P. Additional Insured - Funding Sources 1. SECTION 11 - WHO IS AN INSURED is amended to include as an additional insured any Funding Source which requires you in a written contract to name the Funding Source as an additional insured but only with respect to liability arising out of: CG 89 70 (Ed. 11/14) (Pape 7 of 12) * S1 *02/07/2023*PAC 2471709 05 GREAT AMERICAN ASSURANCE COMPANY *D/B* 706362922 694948 a. your premises; or b. "your work" for such additional insured; or c. acts or omissions of such additional insured in connection with the general supervision of "your work" and only to the extent set forth as follows: a. The Limits of Insurance applicable to the Additional Insured are the lesser- of those specified in the written contract or agreement or in the Declarations for this Policy and subject to all the terms, conditions and exclusions for this Policy. The Limits of Insurance applicable to the Additional Insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. b. The insurance afforded to the Additional Insured only applies to the extent permitted by law c. If coverage provided to the Additional Insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. d. In no event shall the coverages or Limits of Insurance in this Coverage Form be increased by such contract. Q. Additional Insureds - By Contract 1. SECTION II - WHO IS AN INSURED is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" arising out of: a. your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the Additional Insured that are subject of the written contract or written agreement provided that the "bodily injury" or "property damage occurs, or the "personal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or b. the maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or c. the Additional Insureds financial control of you; or d. operations performed by you or on your behalf for which the state or political subdivision has issued a permit However: 1. the insurance afforded to such additional insured only applies to the extent permitted by law; and 2. if coverage provided to the Additional Insured is required by contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide such additional insured. With respect to paragraph 1.a. above, a person's or organization's status as an additional insured under this Endorsement ends when: CG 89 70 (Ed. 11/14) (Page 8 of 12) * S1 *02/07/2023* PAC 2471709 05 GREAT AMERICAN ASSURANCE COMPANY *D/B* 706362922 694948 (1) all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed for or on behalf of the Additional Insured(s) at the location of the covered operations has been completed; or (2) that portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to paragraph 1.b. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this Endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage." We have no duty to defend an additional insured under this Endorsement until we receive written notice of a "suit" by the Additional Insured as required in paragraph b. of Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITION. 2. With respect to the insurance provided by this Endorsement, the following are added to paragraph 2. Exclusions under SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" that occurs prior to your commencing operations at the location where such "bodily injury" or "property damage" occurs. b. "Bodily injury," "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, including: (1) the preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that Insured, if the "occurrence" which caused the "bodily injury" or "property damage," or the offense which caused the "personal and advertising injury," involved the rendering of, or failure to render, any professional architectural, engineering or surveying services. c. "Bodily injury" or "property damage" occurring after: (1) all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed for or on behalf of the Additional Insured(s) at the location of the covered operations has been completed; or (2) that portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 89 70 (Ed. 11/14) (Page 9 of 12) * S1 *02/07/2023* PAC 2471709 05 GREAT AMERICAN ASSURANCE COMPANY *D/B* 706362922 694948 d. Any person or organization specifically designated as an additional insured for ongoing operations by a separate additional insured endorsement issued by us and made part of this Policy. 3. With respect to the insurance afforded to these Additional Insureds, the following is added to SECTION III - LIMITS OF INSURANCE: If coverage provided to the Additional Insured is required by a contract or agreement, the most we will pay on behalf of the Additional Insured is the amount of insurance: a. required by the contract or agreement; or b. available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This Endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. R. Primary and Non-Contributory Additional Insured Extension This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this Policy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: a. The following is added to paragraph a. Primary Insurance: This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) the Additional Insured is a named insured under such other insurance; and (2) you have agreed in writing In a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the Additional Insured. b. The following is added to paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the Additional Insured is designated as a named insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the Additional Insured has been added as an additional insured on other policies. S. Additional Insureds - Protection of Your Limits This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this Policy. 1. The following is added to Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit: An additional insured under this Endorsement will as soon as practicable: CG 89 70 (Ed. 11/14) (Pane 10 of 12) * S1 *02/07/2023*PAC 2471709 05 GREAT AMERICAN ASSURANCE COMPANY *D/B* 706362922 694948 a. give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the Additional Insured; and c. agree to make available any other insurance which the Additional Insured has for a loss we cover under this Coverage Part. d. we have no duty to defend or indemnify an additional insured under this Endorsement until we receive written notice of a "suit" by the Additional Insured. 2. The Limits of Insurance applicable to the Additional Insured are those specified in a written contract or written agreement or the Limits of Insurance stated in the Declarations of this Policy and defined in SECTION III - LIMITS OF INSURANCE of this Policy, whichever are less. These limits are inclusive of and not in addition to the Limits of Insurance available under this Policy. T. Blanket Waiver of Transfer of Rights of Recovery Against Others to Us (Subrogation) Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added to Condition 8. Transfer of Rights of Recovery Against Others to Us: If required by a written contract or written agreement, we waive any right of recovery we may have against a person or organization because of payment we make for injury or damage arising out of your ongoing operations or "your work" done under a contract for that person or organization and included in the "products-completed operations hazard" provided that the injury or damage occurs subsequent to the execution of the written contract or written agreement. U. Property Damage Extension with Voluntary Payments 1. The following is added to paragraph 1. Insuring Agreement of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability: At your request we will pay for "loss" to property of others caused by your business operations for which this Policy provides liability insurance. Such payment will be made without regard to your legal obligation to do so. The "loss" must occur during the policy period and must take place in the "coverage territory." 2. With respect to the coverage afforded under paragraph 1. above, paragraph 2. Exclusions of SECTION I - COVERAGES A - Bodily Injury and Property Damage Liability is amended as follows: Exclusions j.(3), j.(4), j.(5) and j.(6) are deleted. 3. As respects coverage afforded by this coverage, SECTION III - LIMITS OF INSURANCE is replaced by the following: Regardless of the number of Insureds, claims made or "suits" brought or persons or organizations making claims or bring "suits": 1. Subject to 2. Below, the most we will pay for one or more `loss" arising out of any one "occurrence" is $ 1,000. 2. The aggregate amount we will pay for the sum of all "loss" in an annual period is $ 5,000. This aggregate amount is part of and not in addition to the General Aggregate Limit described In paragraph 2. of SECTION III - LIMITS OF INSURANCE. CG 89 70 (Ed. 11/14) (Page 11 of 12) * S1 *02/07/2023*PAC 2471709 05 GREAT AMERICAN ASSURANCE COMPANY *D/B* 706362922 694948 V. Who Is an Insured - Fellow Employee Extension - Management Employees 1. The following is added to paragraph 2.a.(1) of SECTION II - WHO IS AN INSURED: Paragraph (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, including the direct supervision of other "employee" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury," caused in whole or in part by their intoxication by liquor or controlled substances. This coverage is excess over any other valid and collectable insurance available to your "employee." W. Broadened Personal and Advertising Injury 1. Unless "Personal and Advertising Injury" is excluded from this Policy, the following is added to SECTION V - DEFINITIONS Item 14.: h. mental injury, mental anguish, humiliation, or shock, if directly resulting from Items 14.a. through 14.e. CG 89 70 (Ed. 11/14) (Page 12 of 12)