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HomeMy WebLinkAboutWomens Resource Center; 2020-01-08;City Attorney Approved Version 1/30/13 1 AMENDMENT NO. 1 TO EXTEND AND AMEND AGREEMENT FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS WOMEN’S RESOURCE CENTER, INC. This Amendment No. 1 is entered into and effective as of the _______ day of ___________________________, 2020, extending and amending the agreement dated January 8, 2020 (the “Agreement”) by and between the City of Carlsbad, a municipal corporation, ("City"), and Women’s Resource Center, Inc., a California non-profit (“Contractor") (collectively, the “Parties”) for Federal Community Development Block Grant Funds. RECITALS A.The Parties desire to alter the Agreement’s scope of work and increase fundingthat will be used to respond to, prepare, and prevent COVID-19 within the FY19 Annual Action Plan; and B.The Parties desire to extend the Agreement for a period of one (1) year; and C.The Parties have negotiated and agreed to a supplemental scope of work and feeschedule, which is attached to and incorporated in by this reference as Exhibit “A”, Scope of Services and Fee. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Contractor agree as follows: 1.That the Agreement, as may have been amended from time to time, is hereby extended for a period of one (1) year ending on June 30, 2021, and increased funding to add five thousand dollars ($5,000). 2.In addition to those services contained in the Agreement, as may have beenamended from time to time, Contractor will provide those services described in Exhibit "A". With this Amendment, the total Agreement amount shall not exceed fifteen thousand dollars ($15,000). 3.Contractor will complete all work described in Exhibit “A” by June 30, 2021. 4.All other provisions of the Agreement, as may have been amended from time totime, will remain in full force and effect. 5.All requisite insurance policies to be maintained by the Contractor pursuant to theAgreement, as may have been amended from time to time, will include coverage for this Amendment. /// /// DocuSign Envelope ID: DE130481-9808-4E1B-9D78-1F72501A2505 2nd July City Attorney Approved Version 1/30/13 2 6.The individuals executing this Amendment and the instruments referenced in it onbehalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Amendment. WOMEN’S RESOURCE CENTER, INC., a California non-profit CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Jeff Murphy Community Development Director Marina Araiza/CEO (print name/title) ATTEST: By: Tammy McMinn for BARBARA ENGLESON (sign here) Laure-Jane Stephenson/CFO City Clerk (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A Group B Chairman, President, or Vice-President Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CELIA A. BREWER, City Attorney BY: _____________________________ Assistant City Attorney DocuSign Envelope ID: DE130481-9808-4E1B-9D78-1F72501A2505 City Attorney Approved Version 1/30/13 3 EXHIBIT “A” SCOPE OF SERVICES AND FEE Program supplies including hygiene, food, other basic needs in response to COVID-19. Fee: $5,000 DocuSign Envelope ID: DE130481-9808-4E1B-9D78-1F72501A2505 ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTRINSD WVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 3/30/2020 License # 0L48969 (619) 233-8000 (619) 864-7106 Women's Resource Center, Inc. 1963 Apple Street Oceanside, CA 92054 27847 A 1,000,000 X 2020-07149 4/1/2020 4/1/2021 500,000 20,000 1,000,000 3,000,000 3,000,000 1,000,000A 2020-07149 4/1/2020 4/1/2021 1,000,000A 2020-07149-UMB 4/1/2020 4/1/2021 1,000,000 10,000 B WSD504735801 4/1/2020 4/1/2021 1,000,000 N 1,000,000 1,000,000 Additional insureds are included as/where required by written contract as respects to General Liability, but limited to the operations of the Insured under said contract, and always subject to all the policy terms, conditions and exclusions per endorsements attached. CDBG Coordinator, City of Carlsbad The Housing & Development Dept. 1200 Carlsbad Village Drive Carlsbad, CA 92008 WOMERES-02 SEBGE1 C3 Risk & Insurance Services 404 Camino Del Rio S. STE 410 San Diego, CA 92108 policy@c3insurance.com Nonprofits Insurance Alliance Of California Insurance Company Of The West X X X X X X X X DocuSign Envelope ID: DE130481-9808-4E1B-9D78-1F72501A2505 AGREEMENT BETWEEN THE CITY OF CARLSBAD AND THE WOMAN'S RESOURCE CENTER FOR FEDERAL COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS THIS AGREEMENT ("Agreement") made and entered into as of this '.n:]h day of ~ ~ 20 __].Q_ by and between the CITY OF CARLSBAD ("City") and WOMAN'SR OURCE CENTER, a non-profit corporation ("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 as amended to fund eligible activities which benefit persons of low and moderate income under Catalog of Federal Domestic Assistance number 14.218; and, WHEREAS, the City wishes to provide assistance to non-profit public service providers who offer services for lower income Carlsbad residents; and, WHEREAS, the Subrecipient can provide these basic services for lower mcome households with some assistance from the City; and, WHEREAS, the City has determined that the services offered by the Woman's Resource Center are exempt from environmental review under 24 CFR Section 58.34(a)(4); and, WHEREAS, the U.S. Department of Housing and Urban Development has approved the City's Annual Consolidated Plan for Community Development Block Grant funds (hereinafter referred to as the "Annual Consolidated Plan"). NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Subrecipient agree as follows: 1. STATEMENT OF WORK The City has allocated federal community development block grant ("CDBG") funds, in the amount of ten thousand dollars ($10,000) to the Subrecipient for provision of services through their offices located at 1963 Apple St., Oceanside, CA 92054 for the period beginning July 1, 2019 and ending June 30, 2020. The Subrecipient agrees to use all federal funds provided by the City to the Subrecipient pursuant to the provisions of this Agreement, the Scope of Work, attached hereto as Exhibit "A", and in accordance with the terms of the Annual Consolidated Plan. Every effort shall be made by the Subrecipient to expend the allocated funds in their entirety by April 20, 2020 . If the Subrecipient will be unable to expend all of the funds allocated to the project by the noted date, the Subrecipient shall request an extension from the City for continued use of the funds on the approved project based on progress made by the Subrecipient towards CA 05/25/2016 completing the subject project. The City may agree to grant the extension or notify the Subrecipient that, in its sole discretion, the funds must be reallocated to another eligible activity due to slow project progress. 2. DISBURSEMENT OF FUNDS The City shall reimburse the Subrecipient with CDBG funds for necessary and reasonable costs related to the provision of services for eligible residents of Carlsbad for the term of this Agreement. The reimbursements for costs shall not exceed a total of $10,000. However, no more than 90 percent of the total agreed upon compensation will be paid during the performance of this Agreement. The balance due (remaining l 0 percent) shall be paid upon final certification by the City that Subrecipient has administered the services and activities in compliance with all applicable Federal, state, and local rules and regulations governing these funds, and in a manner satisfactory to the City. Payment for eligible expenses shall be made in accordance with budget information provided in Exhibit "B" and in accordance with performance. Subrecipient represents that the budget includes only allowable costs and an accurate analysis of costs applicable to the CDBG funds pursuant to 24 CFR Section 570.502. Subrecipient shall submit a "Request for Reimbursement" to the City for compensation of eligible and actual expenses incurred. The City shall not provide any payments/reimbursements in advance of actual expenditures by the Subrecipient. Subrecipient may request reimbursements anytime after this Agreement is approved by the City Council and continue until the expiration date, or amended expiration date, of this Agreement. Each request for reimbursement shall include documentation to verify expenditure of funds are consistent with this Agreement, the Statement of Work, the Annual Consolidated Plan, and with all applicable Federal, state, and local rules and regulations governing these funds. Payroll records, receipts, paid invoices including an itemized statement of all costs are samples of appropriate methods of reimbursement documentation. 3. PROGRAM INCOME The Subrecipient shall report, to the City, any interest, or other income, earned as a direct result of the use of federal CDBG funds for the program outlined within this Agreement. All reported program income may be retained by the Subrecipient for costs related to the subject program activities. However, the program income, retained by the Subrecipient, must be expended before additional funds are requested from the City. The requirements are set forth in 24 CFR Section 570.504 which is incorporated herein by reference. 4. LABOR, MATERIALS AND SUPPLIES: The Subrecipient shall furnish all labor, materials and services and bear all expenses necessary to provide the subject program as outlined in this agreement. Under this Agreement, the City's only 2 CA 05/25/2016 financial obligation to the Subrecipient is to provide the CDBG funds of $10,000 maximum as allocated by the City Council for program year 2019-2020. 5. RECORDS AND REPORTS The Subrecipient shall maintain all records required by the Federal regulations specified in 24 CFR Section 570.506 that are pertinent to the activities to be funded under this Agreement. Such records shall include but not be limited to: a. Records providing a full description of each activity undertaken; b. Records demonstrating each activity undertaken meets one of the National Objectives of the CDBG program; c. Records required to determine the eligibility of activities; d. Records demonstrating compliance with 24 CFR Section 570.505 regarding change of use of real property acquired or improved with CDBG assistance; e. Records demonstrating compliance with the requirements in 24 CFR Section 570.606 regarding acquisition, displacement, relocation, and replacement housing; f. Records documenting compliance with the fair housing and equal opportunity components of the CDBG program; g. Documentation of all CDBG funds received from the City, eligible expenses incurred for administration of each activity, and other financial records as required by 24 CFR Section 570.502, and 0MB (the United States Office of Management and Budget) Circular A-110; and, h. Any other related records as the City shall require to demonstrate compliance with applicable Federal, state, and local rules and regulations governing these funds. The Subrecipient shall submit quarterly "Progress Reports" within ten (10) calendar days of the end of each quarter for the full term of this Agreement. The final progress report is due no later than June 30, 2020. 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. At a minimum, the performance reports shall include the following information: a. Total number of persons/households participating in the program during reported period; b. Total number of participants from Carlsbad; c. Number of low/moderate income Carlsbad persons/households participating in the program during the reporting period; d. Age and ethnic background of Carlsbad participants; and, e. Summary of program(s) provided to Carlsbad participants. f. Quarterly reports must be submitted by the following: October 10, January 10, April 10, and June 20. The Subrecipient shall maintain client data demonstrating client eligibility for services provided. 3 CA 05/25/2016 Such data shall include at the minimum client name, address, ethnicity, income level or other basis for determining eligibility, and a description of the service provided. This data shall assist the Subrecipient in completing the required quarterly progress reports to be submitted to the City. 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. 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 for a period of five (5) years after the termination of all activities funded under this Agreement. All records subject to litigation, claims, audit findings, negotiations, or other actions must be retained for five (5) years from the date such action commenced or until completion of the action and resolution of all issues by the appropriate officials and verified by official written notice to the Subrecipient, whichever occurs later .. If the Subrecipient shall receive more than $750,000 in total federal funds in one fiscal year from the City of Carlsbad 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 term of this Agreement and is due not later than one year after expiration of the agreement. The Subrecipient shall also be required to submit a second audit for the following period covered under the fiscal year beginning July 1, 2017 and ending June 30, 2018 for any funds received in fiscal year 2017-2018 per this Agreement. 6. PROGRAM REQUIREMENTS The Subrecipient agrees to comply with the requirements of Title 24 of the Code of Federal Regulations, Part 570 (the Housing and Urban Development regulations concerning Community Development Block Grants). The Subrecipient also agrees to adhere to the terms of the City's CDBG Application and Subrecipient Agreement on file at the Housing and Redevelopment Department and with assurances and agreements made, by the City to the United States Department of Housing and Urban Development of which the Subrecipient is given notice. The Subrecipient shall comply with applicable Uniform Administrative Requirements as described in 24 CFR Section 570.502, the federal regulations for the CDBG Program; the federal requirements are set forth, and incorporated by reference herein, as a provision of this Agreement. The Subrecipient shall carry out all activities in compliance with all Federal laws and regulations as described in Subpart K of the CDBG Program Regulations, such as affirmatively furthering fair housing, labor standards (Davis Bacon Act), displacement, relocation and acquisition, and 4 CA 05/25/2016 employment and contracting opportunities, except that: a. The Subrecipient will not assume the City's environmental responsibilities as described in 24 CFR 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 Section 52. The provisions of Subpart K, of the COBO Program Regulations, incorporated herein by reference, are a condition of this Agreement. The Subrecipient shall comply with all federal regulations related to the use of CDBO funds by religious organizations, if applicable to this Agreement and the approved project outlined herein. 7. CHANGES IN USE OF FUNDS Changes in the use of COBO funds must be approved by the City Council and the U.S. Department of HUD. If the Subrecipient desires a change in the use of the COBO funds following approval of this Agreement, a written request must be submitted to the City for review by the City Council. No change in use of the COBO funds will be permitted without prior written approval of the City Council. 8. NONDISCRIMINATION CLAUSE The Subrecipient shall comply with all state and federal laws regarding nondiscrimination in the provision of services and the equal opportunity employment of personnel. 9. SUSPENSION AND TERMINATION OF AGREEMENT In accordance with 24 CFR Sections 85.43 and 85.44, this Agreement may be suspended or terminated if the Subrecipient fails to comply with any term(s) of the award. 24 CFR Sections 85.43 and 85.44 are incorporated herein by reference, as provisions of this Agreement. 10. REVERSION OF ASSETS Upon expiration of the Agreement, the Subrecipient shall transfer to the City any COBO funds on hand at the time of expiration and any accounts receivable attributable to the use of CDBO 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 COBO funds in excess of $25,000 to either be: a) Used to meet one of the national objectives in 24 CFR Section 570.208 of the federal regulations until five (5) years after expiration of the 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 5 CA 05/25/2016 attributable to expenditures of non-CD BG funds for acquisition, or improvement to, the property. Reimbursement is not required after the period of time specified in paragraph (a) of this section. 11. HOLD HARMLESS AGREEMENT The City, its officers, and employees shall not be liable for any claims, liabilities, penalties, fines, or any damage to goods, or real or personal property of any person whatsoever, nor for personal injuries or death caused by, or claimed to have been caused by, or resulting from, any intentional or negligent acts, errors or omission of Subrecipient or Subrecipient's agents, employees, or representatives arising directly or indirectly out of performance of the project outlined in this Agreement. Subrecipient agrees to defend, indemnify, and hold free and harmless the City, its officers, employees and agents against any of the foregoing liabilities or claims of any kind and any cost or expenses incurred by the City including attorneys' fees, on account of any of the foregoing liabilities, including liabilities or claims arising out of alleged defects in any plans or specifications for the project or facility. 12. ASSIGNMENT OF AGREEMENT The Subrecipient shall not assign this Agreement or any monies due thereunder without the prior written consent of the City Council. 13. SUCCESSORS OR ASSIGNS Subject to the provisions of this Subrecipient Agreement Paragraph 11, "Hold Harmless 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. 14. INSURANCE If the Subrecipient shall receive more than $5,000 from the City in CDBG funds and/or other funds, the Subrecipient shall obtain and maintain policies of Commercial General Liability insurance and a combined policy of worker's compensation and employers liability insurance in an insurable amount of not less than one million dollars ($1,000,000) each, unless a lower amount is approved by the Risk Manager or the City Manager. The insurance will be obtained from an insurance carrier admitted and authorized to do business in the State of California. The insurance carrier is required to have a current Best's Key Rating of not less than "A-:VII" or have a surplus line insurer which is on the State of California's List of Eligible Surplus Line Insurers with a current Best's Key Rating of not less than "A:X". The City shall be named as an additional insured on the Commercial General Liability Policy which shall provide primary coverage to the City. 6 CA 05/25/2016 This insurance shall be in force during the term of this Agreement and shall not be canceled or materially changed without ten (10) days prior written notice to the City sent by certified mail. The Subrecipient shall furnish certificates of insurance and required endorsements to the Housing and Neighborhood Services Director before commencement of work. T) Dated: Cf-ex V-11 By: //&tie~F~-.J: Dated: CJ_/z'i / 2619 r , CITY OF CARLSBAD: Dated: O\ /l:>t I 1vO (Proper notarial acknowledgment of execution by Subrecipient must be attached. Chairman, president or vice-president and secretary, assistant secretary, CFO or assistant treasurer must sign for corporations. Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation.) APPROVED AS TO FORM: Celia A. Brewer, City Attorney By: 1JUR ~ Ronemp, AssistantCityAorney Dated: ! d--/S\ [ fj 7 CA 05/25/2016 EXHIBIT "A" CITY OF CARLSBAD COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM Contract Term: Subrecipient Name: Address: SCOPE OF WORK July 1, 2019 to June 30, 2020 Women's Resource Center I 963 Apple St., Oceanside, CA 92054 Project Description: Meal delivery and welfare check for low income seniors in Carlsbad Project Goals & Objectives: (Please Attach Additional Sheets As Necessary.) 1. CDBG funds will be used to fund the following activities in compliance with the project description outlined and in conformance with the Federal regulations for the CDBG program: (Please specify if CDBG funds will be used to fund costs associated with staffing, rents, utilities, supplies, etc.) Funds will be used to assist in paying for staff costs related to the operation of the shelter. 2. Project objectives to be accomplished during the contract period: (Please describe the specific services or activities to be provided to low/moderate income Carlsbad residents with the CDBG funds awarded. If applicable, please provide a target objective for the number of persons/households to benefit from the Subrecipient's services/project.) Approximately 32 Carlsbad residents will be provided with shelter and case management services. 3. Project objectives performance measures: a. Provide quarterly performance reports to the City of Carlsbad, Housing and Neighborhood Services Department on the CDBG Quarterly Performance Report form as provided. b. Maintain records, invoices, and relevant statistics supporting the quarterly reports. c. Provide a final performance report, including an evaluation report of the program's success in meeting established goals, to the City of Carlsbad Housing and Neighborhood Services Department within 10 days of termination of the contract date on the CDBG Annual Performance Report form as provided. d. Provide notification to the City of any audits or investigations including results, findings, and/or liens. CA 8/13/2012 EXHIBIT "B" CITY OF CARLSBAD COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM BUDGET Contract Term: July 1, 2019 to June 30, 2020 Subrecipient Name: Woman's Resource Center Address: 1963 Apple St., Oceanside, CA 92054 Project Description: Alternatives to abuse domestic violence shelter Cost Breakdown: All funds will be used to assist in paying for staffing costs related to the operation of the shelter. CA 8/13/2012 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Orange before me, Kimberly Tula, Notary Public (insert name and title of the officer) personally appeared --=+-....;;.....:..,_ ....... .....,,.'-'-"1,1,,....L---".--------.,...------.,---.--- who proved to me on the bas, of satisfactory evidence to be the person whose name is/a subscribed to the within instrument and acknowledged to me that he/s~~ey executed the same in his/h)t.r/ttmir authorized capacity(i~). and that by his/h~h'eir signature~ on the instrument the person(s.), or the entity upon behalf of which the perso~ acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 1.IIIIIQ~llttll~!llHUIHIHlllllHHttltlll!lllllll!MllllltllllalllllllllllllUONIN!llll8llfl!llflllJll~MlllOIOIIDllfflllllJll A notary public or other officer completing this certificate verifies only the identity of the Individual who signed the document to which this certificate Is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of SArJ D, f:::::t:::. p } On lY-01/-/-_2 1 :::b/2. before me, ;Joey Lt}J.,.Plt;.,,z ~.f'l~L Date "-Here Insert Name and Title of the Officer personally appeared H~ t2rLu.&,::r::r~------- NamefsJ of Sig;;;{~( who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within Instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. Place Notary Seal and/or Stamp Above Description of Attached Document I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph Is true and correct. WITNESS my hand and official seal. --Title or Type of Document: --------------::::,,..-:~----------- Document Date: _____________ ""7"'.c;;._ _____ Number of Pages: ___ _ Signer(s) Other Than Named Above: ---,,.,.-c'---------------------- Capaclty(les) Claimed by Signe Signer's Name: ___ "7",:;;_ ______ _ □ Corporate Officer - □ Partner-□ 1ted a lndlvldu □ Tru D e(s): _____ _ □ General □ Attorney in Fact □ Guardian or Conservator Signer's Name: ___________ _ D Corporate Officer -Title(s): ______ _ o Partner -□ Limited □ General □ Individual □ Attorney in Fact □ Trustee □ Guardian or Conservator D Other: ______________ _ Signer is Representing: ________ _ uttl!lflll•llllllMllD~~IIHfUll!lltllfllDIOl!lfllllfWIOllllfWflllllllll~--•-1111 .. ]10 ©2018 National Notary Association ~ WOMERES-02 SEBGE1 ACORD" CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY) ~ 10/2/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer riQhts to the certificate holder in lieu of such endorsement(s). PRODUCER License # 0L48969 22ij{~CT C3 Risk & Insurance Services FitJ8,Ntio, Ext): (760) 730-2939 I FAX 404 Camino Del Rio S. STE 410 (A/C,No):(619) 864-7106 San Diego, CA 92108 lith'M~ss: policy@c3insurance.com INSURER{Sl AFFORDING COVERAGE NAIC# INSURER A: Nonorofits Insurance Alliance Of California INSURED INSURER a: Insurance Comoanv Of The West 27847 Women's Resource Center, Inc. INSURER C: 1963 Apple Street INSURER D: Oceanside, CA 92054 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 TYPE OF INSURANCE ~.?.P~ SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS I TR un,n A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 -D CLAIMS-MADE CR] OCCUR ~~~b~iJ9E~~~~~nce\ 100,000 X X 2019-07149 4/1/2019 4/1/2020 $ -20,000 MED EXP fAnv one oerson\ $ f------1,000,000 PERSONAL & ADV INJURY $ f------3,000,000 ~'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY □ ~r8r □ LOC PRODUCTS -COMP/OP AGG $ 1,000,000 OTHER: $ ✓ A AUTOMOBILE LIABILITY ~~~~~~~~tf 1NGLE LIMIT $ 1,000,000 f------ ANY AUTO 2019-07149 4/1/2019 4/1/2020 BODILY INJURY /Per oerson\ $ f------OWNED -SCHEDULED f------AUTOS ONLY f------AUTOS BODILY INJURY /Per accident\ $ X ~LRTWsoNLY X ~8to'§~'t~ f~OPERTY11~AMAGE $ eraoodent f-------$ A X UMBRELLA LIAS ~ OCCUR EACH OCCURRENCE $ 1,000,000 -2019-07149-UMB 4/1/2019 4/1/2020 1,000,000 EXCESS LIAS CLAIMS-MADE AGGREGATE $ ✓ DED I I RETENTION$ $ B WORKERS COMPENSATION x I rrfTIITE 1 I OTH- AND EMPLOYERS' LIABILITY ER Y/N WSD504735800 4/1/2019 4/1/2020 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE [[] E.L EACH ACCIDENT $ iiJFICER/MEMBER EXCLUDED? NIA 1,000,000 ( andatory In NH) E.L DISEASE -EA EMPLOYEE $ ~~1'2:~rt-¥~~ tf'gPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES {ACORD 101, Addltlonal Remarks Schedule, may be attached If more space Is required) Additional insureds are included as/where required by written contract as respects to General Liability, but limited to the operations of the Insured under said contract, and always subject to all the policy terms, conditions and exclusions per endorsements attached. The City of Carlsbad, (or if applicable -the City of Carlsbad Redevelopment Agency, Housing Authority or Carlsbad Municipal Water District) its officials, employees and volunteers must be named as an additional insured with respect to liability arising out of activities performed by or on behalf of the Named Insured (General Liability only). The full limits available to the named insured shall also be available and applicable to the City as an additional insured. Primary Non-Contributory and Waiver of Subrogation included. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City Of Carlsbad THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1200 Carlsbad Village Drive Carlsbad, CA 92008 AUTHORIZED REPRESENTATIVE IJJu.r- I ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 2019-07149 Named Insured: Womens Resource Center, Inc. COMMERCIAL GENERAL LIABILITY CG 20 12 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION -PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Any state or political subdivision that issues a permit or authorization to the named insured. 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 any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. 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. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products-completed operations hazard". B. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: COMMERCIAL AUTO CA 04 4410 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization with whom you have a written contract currently in effect or becoming effective during the term of this policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 4410 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 1-□1 NONPROFITS INSURANCE POLICY NUMBER: 2019-07149 FORM: NIAC-E611117 NAMED INSURED: Women's Resource Center, Inc. -ALLLANCE OF CALIFORNIA A H•ad for lnsuranc•. A H11art for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT FOR PUBLIC ENTITIES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City Of Carlsbad its officials, employees, and volunteers The City of Carlsbad Redevelopment Agency, Housing Authority, or Carlsbad Municipal Water District "per written contract." A. Section II -Who Is An Insured is amended to include any public entity as an additional insured for whom you are performing operations, who may be named in the schedule above, when you have agreed in a written contract or written agreement that such public entity be added as an additional insured(s) on your policy, but only with respect to liability for "bodily injury'', "property damage" or "personal and advertising injury'' caused, in whole or in part, by: 1. Your negligent acts or omissions; or 2. The negligent acts or omissions of those acting on your behalf; in the performance of your ongoing operations: No such public entity is an additional insured for liability arising out of the "products-completed operations hazard" or for liability arising out of the sole negligence of that pubic entity. B. With respect to the insurance afforded to these additional insured(s), the following additional exclusions apply. This insurance does not apply to "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 by 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 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. C. The following is added to SECTION Ill -LIMITS OF INSURANCE: The limits of insurance applicable to the additional insured(s) are those specified in the written contract between you and the additional insured(s), or the limits available under this policy, whichever are less. These limits are part of and not in addition to the limits of insurance under this policy. NIAC-E61 11 17 Page 1 of 2 1-□1 NONPROFITS INSURANCE -ALLIANCE OF CALIFORNIA POLICY NUMBER: 2019-07149 FORM: NIAC-E611117 NAMED INSURED: Women's Resource Center, Inc. A H•ad for lnsuranc•. A H11art for Nonprofits. D. A. With respect to the insurance provided to the additional insured(s), Condition 4. Other Insurance of SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Other Insurance a. Primary Insurance This insurance is primary if you have agreed in a written contract or written agreement: (1) That this insurance be primary. If other insurance is also primary, we will share with all that other insurance as described in c. below; or (2) The coverage afforded by this insurance is primary and non-contributory with the additional insured(s)' own insurance. Paragraphs (1) and (2) do not apply to other insurance to which the additional insured(s) has been added as an additional insured or to other insurance described in paragraph b. below. b. Excess Insurance This insurance is excess over: 1. Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (b) That is fire, lightning, or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises temporarily occupied by you with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION I -COVERAGE A -BODILY INJURY AND PROPERTY DAMAGE. (e) Any other insurance available to an additional insured(s) under this Endorsement covering liability for damages which are subject to this endorsement and for which the additional insured(s) has been added as an additional insured by that other insurance. (1) When this insurance is excess, we will have no duty under Coverages A or B to defend the additional insured(s) against any "suit" if any other insurer has a duty to defend the additional insured(s) against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured(s)' rights against all those other insurers. (2) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self-insured amounts under all that other insurance. (3) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Methods of Sharing If all of the other insurance available to the additional insured(s) permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any other the other insurance available to the additional insured(s) does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. NIAC-E61 11 17 Page 2 of 2