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Home My WebLink AboutInterfaith Community Services; 2024-06-05; PSA25-01HMLPSA25-01HML Page 1 City Attorney Approved Version 12/22/2023 AGREEMENT FOR SUBSTANCE USE DISORDER OUTREACH & EDUCATION SERVICES INTERFAITH COMMUNITY SERVICES THIS AGREEMENT is made and entered into as of the ______________ day of _________________________, 2024, by and between the City of Carlsbad, California, a municipal corporation ("City") and Interfaith Community Services, Inc., a non-profit organization, ("Contractor"). RECITALS A. City requires the professional services of a consultant that is experienced in substance use disorder outreach and education. B. Contractor has the necessary experience in providing professional services and advice related to substance use disorder outreach and education. C. Contractor has submitted a proposal to City and has affirmed its willingness and ability to perform such work. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Contractor agree as follows: 1. SCOPE OF WORK City retains Contractor to perform, and Contractor agrees to render, those services (the "Services") that are defined in attached Exhibit "A," which is incorporated by this reference in accordance with this Agreement’s terms and conditions. 2. STANDARD OF PERFORMANCE While performing the Services, Contractor will exercise the reasonable professional care and skill customarily exercised by reputable members of Contractor's profession practicing in the Metropolitan Southern California area, and will use reasonable diligence and best judgment while exercising its professional skill and expertise. 3. TERM The term of this Agreement will be effective for a period of one-year (1) year from July 1, 2024, through June 30, 2025. The City Manager may amend the Agreement to extend it for four (4) additional one (1) year terms or parts thereof. Extensions will be based upon a satisfactory review of Contractor's performance, City needs, and appropriation of funds by the City Council. The parties will prepare a written amendment indicating the effective date and length of the extended Agreement. 4. TIME IS OF THE ESSENCE Time is of the essence for each and every provision of this Agreement. 5. COMPENSATION The total fee payable for the Services to be performed during the initial Agreement term shall not exceed eighty thousand dollars ($80,000). No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. If the City elects to extend the Agreement, the amount shall not exceed one hundred thousand dollars ($100,000) per Agreement year. The City reserves the right to withhold a ten percent (10%) retention until City has accepted the work and/or Services specified in Exhibit "A." DocuSign Envelope ID: A30857A7-B63F-464D-B1C8-E78880D02D70 5th June PSA25-01HML Page 2 City Attorney Approved Version 12/22/2023 Incremental payments, if applicable, should be made as outlined in attached Exhibit "A." 6. STATUS OF CONTRACTOR Contractor will perform the Services in Contractor's own way as an independent contractor and in pursuit of Contractor's independent calling, and not as an employee of City. Contractor will be under control of City only as to the result to be accomplished, but will consult with City as necessary. The persons used by Contractor to provide services under this Agreement will not be considered employees of City for any purposes. The payment made to Contractor pursuant to the Agreement will be the full and complete compensation to which Contractor is entitled. City will not make any federal or state tax withholdings on behalf of Contractor or its agents, employees or subcontractors. City will not be required to pay any workers' compensation insurance or unemployment contributions on behalf of Contractor or its employees or subcontractors. Contractor agrees to indemnify City within thirty (30) days for any tax, retirement contribution, social security, overtime payment, unemployment payment or workers' compensation payment which City may be required to make on behalf of Contractor or any agent, employee, or subcontractor of Contractor for work done under this Agreement. At the City’s election, City may deduct the indemnification amount from any balance owing to Contractor. 7. SUBCONTRACTING Contractor will not subcontract any portion of the Services without prior written approval of City. If Contractor subcontracts any of the Services, Contractor will be fully responsible to City for the acts and omissions of Contractor's subcontractor and of the persons either directly or indirectly employed by the subcontractor, as Contractor is for the acts and omissions of persons directly employed by Contractor. Nothing contained in this Agreement will create any contractual relationship between any subcontractor of Contractor and City. Contractor will be responsible for payment of subcontractors. Contractor will bind every subcontractor and every subcontractor of a subcontractor by the terms of this Agreement applicable to Contractor's work unless specifically noted to the contrary in the subcontract and approved in writing by City. 8. OTHER CONTRACTORS The City reserves the right to employ other Contractors in connection with the Services. 9. INDEMNIFICATION Contractor agrees to defend (with counsel approved by the City), indemnify, and hold harmless the City and its officers, elected and appointed officials, employees and volunteers from and against all claims, damages, losses and expenses including attorneys fees arising out of the performance of the work described herein caused by any negligence, recklessness, or willful misconduct of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. The parties expressly agree that any payment, attorney’s fee, costs or expense City incurs or makes to or on behalf of an injured employee under the City’s self-administered workers’ compensation is included as a loss, expense or cost for the purposes of this section, and that this section will survive the expiration or early termination of this Agreement. DocuSign Envelope ID: A30857A7-B63F-464D-B1C8-E78880D02D70 PSA25-01HML Page 3 City Attorney Approved Version 12/22/2023 10. INSURANCE Contractor will obtain and maintain for the duration of the Agreement and any and all amendments, insurance against claims for injuries to persons or damage to property which may arise out of or in connection with performance of the services by Contractor or Contractor’s agents, representatives, employees or subcontractors. 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 with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. 10.1 Coverages and Limits. Contractor will maintain the types of coverages and minimum limits indicated below, unless Risk Manager or City Manager approves a lower amount. These minimum amounts of coverage will not constitute any limitations or cap on Contractor's indemnification obligations under this Agreement. City, its officers, agents and employees make no representation that the limits of the insurance specified to be carried by Contractor pursuant to this Agreement are adequate to protect Contractor. If Contractor believes that any required insurance coverage is inadequate, Contractor will obtain such additional insurance coverage, as Contractor deems adequate, at Contractor's sole expense. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. 10.1.1 Commercial General Liability (CGL) Insurance. Insurance written on an “occurrence” basis, including personal & advertising injury, with limits no less than $2,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. 10.1.2 Automobile Liability. (if the use of an automobile is involved for Contractor's work for City). $2,000,000 combined single-limit per accident for bodily injury and property damage. 10.1.3 Workers' Compensation and Employer's Liability. Workers' Compensation limits as required by the California Labor Code. Workers' Compensation will not be required if Contractor has no employees and provides, to City's satisfaction, a declaration stating this. 10.1.4 Professional Liability. Errors and omissions liability appropriate to Contractor’s profession with limits of not less than $1,000,000 per claim. Coverage must be maintained for a period of five years following the date of completion of the work. 10.2 Additional Provisions. Contractor will ensure that the policies of insurance required under this Agreement contain, or are endorsed to contain, the following provisions: 10.2.1 The City will be named as an additional insured on Commercial General Liability which shall provide primary coverage to the City. 10.2.2 Contractor will obtain occurrence coverage, excluding Professional Liability, which will be written as claims-made coverage. DocuSign Envelope ID: A30857A7-B63F-464D-B1C8-E78880D02D70 PSA25-01HML Page 4 City Attorney Approved Version 12/22/2023 10.2.3 This insurance will be in force during the life of the Agreement and any extensions of it and will not be canceled without thirty (30) days prior written notice to City sent by certified mail pursuant to the Notice provisions of this Agreement. 10.3 Providing Certificates of Insurance and Endorsements. Prior to City's execution of this Agreement, Contractor will furnish certificates of insurance and endorsements to City. 10.4 Failure to Maintain Coverage. If Contractor fails to maintain any of these insurance coverages, then City will have the option to declare Contractor in breach, or may purchase replacement insurance or pay the premiums that are due on existing policies in order to maintain the required coverages. Contractor is responsible for any payments made by City to obtain or maintain insurance and City may collect these payments from Contractor or deduct the amount paid from any sums due Contractor under this Agreement. 10.5 Submission of Insurance Policies. City reserves the right to require, at any time, complete and certified copies of any or all required insurance policies and endorsements. 11. BUSINESS LICENSE Contractor will obtain and maintain a City of Carlsbad Business License for the term of the Agreement, as may be amended from time-to-time. 12. ACCOUNTING RECORDS Contractor will maintain complete and accurate records with respect to costs incurred under this Agreement. All records will be clearly identifiable. Contractor will allow a representative of City during normal business hours to examine, audit, and make transcripts or copies of records and any other documents created pursuant to this Agreement. Contractor will allow inspection of all work, data, documents, proceedings, and activities related to the Agreement for a period of three (3) years from the date of final payment under this Agreement. 13. OWNERSHIP OF DOCUMENTS All work product produced by Contractor or its agents, employees, and subcontractors pursuant to this Agreement is the property of City. In the event this Agreement is terminated, all work product produced by Contractor or its agents, employees and subcontractors pursuant to this Agreement will be delivered at once to City. Contractor will have the right to make one (1) copy of the work product for Contractor’s records. 14. COPYRIGHTS Contractor agrees that all copyrights that arise from the services will be vested in City and Contractor relinquishes all claims to the copyrights in favor of City. 15. NOTICES The name of the persons who are authorized to give written notice or to receive written notice on behalf of City and on behalf of Contractor under this Agreement are: DocuSign Envelope ID: A30857A7-B63F-464D-B1C8-E78880D02D70 PSA25-01HML Page 5 City Attorney Approved Version 12/22/2023 For City: For Contractor: Name Chris Shilling Name Greg Anglea Title Homeless Services Manager Title Chief Executive Officer Dept Housing & Homeless Services Address 550 W. Washington Ave. CITY OF CARLSBAD Escondido, CA 92025 Address 1200 Carlsbad Village Dr. Phone 760-489-6380 Carlsbad, CA 92008 Email ganglea@interfaithservices.org Phone 442-339-2284 Each party will notify the other immediately of any changes of address that would require any notice or delivery to be directed to another address. 16. CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the requirements of the City of Carlsbad Conflict of Interest Code. The Contractor shall report investments or interests as required in the City of Carlsbad Conflict of Interest Code. Yes ☐ No ☒ If yes, list the contact information below for all individuals required to file: Name Email Phone Number 17. GENERAL COMPLIANCE WITH LAWS Contractor will keep fully informed of federal, state and local laws and ordinances and regulations which in any manner affect those employed by Contractor, or in any way affect the performance of the Services by Contractor. Contractor will at all times observe and comply with these laws, ordinances, and regulations and will be responsible for the compliance of Contractor's services with all applicable laws, ordinances and regulations. Contractor will be aware of the requirements of the Immigration Reform and Control Act of 1986 and will comply with those requirements, including, but not limited to, verifying the eligibility for employment of all agents, employees, subcontractors and consultants whose services are required by this Agreement. 18. CALIFORNIA AIR RESOURCES BOARD (CARB) ADVANCED CLEAN FLEETS REGULATIONS Contractor’s vehicles with a gross vehicle weight rating greater than 8,500 lbs. and light-duty package delivery vehicles operated in California may be subject to the California Air Resources Board (CARB) Advanced Clean Fleets regulations. Such vehicles may therefore be subject to requirements to reduce DocuSign Envelope ID: A30857A7-B63F-464D-B1C8-E78880D02D70 PSA25-01HML City Attorney Approved Version 12/22/2023 Page 6 emissions of air pollutants. For more information, please visit the CARB Advanced Clean Fleets webpage at https://ww2.arb.ca.gov/our-work/programs/advanced-clean-fleets. 19. DISCRIMINATION AND HARASSMENT PROHIBITED Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination and harassment. 20. DISPUTE RESOLUTION If a dispute should arise regarding the performance of the Services the following procedure will be used to resolve any questions of fact or interpretation not otherwise settled by agreement between the parties. Representatives of Contractor or City will reduce such questions, and their respective views, to writing. A copy of such documented dispute will be forwarded to both parties involved along with recommended methods of resolution, which would be of benefit to both parties. The representative receiving the letter will reply to the letter along with a recommended method of resolution within ten (10) business days. If the resolution thus obtained is unsatisfactory to the aggrieved party, a letter outlining the disputes will be forwarded to the City Manager. The City Manager will consider the facts and solutions recommended by each party and may then opt to direct a solution to the problem. In such cases, the action of the City Manager will be binding upon the parties involved, although nothing in this procedure will prohibit the parties from seeking remedies available to them at law. 21. TERMINATION In the event of the Contractor's failure to prosecute, deliver, or perform the Services, City may terminate this Agreement for nonperformance by notifying Contractor by certified mail of the termination. If City decides to abandon or indefinitely postpone the work or services contemplated by this Agreement, City may terminate this Agreement upon written notice to Contractor. Upon notification of termination, Contractor has five (5) business days to deliver any documents owned by City and all work in progress to City address contained in this Agreement. City will make a determination of fact based upon the work product delivered to City and of the percentage of work that Contractor has performed which is usable and of worth to City in having the Agreement completed. Based upon that finding City will determine the final payment of the Agreement. City may terminate this Agreement by tendering thirty (30) days written notice to Contractor. Contractor may terminate this Agreement by tendering thirty (30) days written notice to City. In the event of termination of this Agreement by either party and upon request of City, Contractor will assemble the work product and put it in order for proper filing and closing and deliver it to City. Contractor will be paid for work performed to the termination date; however, the total will not exceed the lump sum fee payable under this Agreement. City will make the final determination as to the portions of tasks completed and the compensation to be made. 22. COVENANTS AGAINST CONTINGENT FEES Contractor warrants that Contractor has not employed or retained any company or person, other than a bona fide employee working for Contractor, to solicit or secure this Agreement, and that Contractor has not paid or agreed to pay any company or person, other than a bona fide employee, any fee, commission, percentage, brokerage fee, gift, or any other consideration contingent upon, or resulting from, the award or making of this Agreement. For breach or violation of this warranty, City will have the right to annul this Agreement without liability, or, in its discretion, to deduct from the Agreement price or consideration, or otherwise recover, the full amount of the fee, commission, percentage, brokerage fees, gift, or contingent fee. DocuSign Envelope ID: A30857A7-B63F-464D-B1C8-E78880D02D70 PSA25-01HML City Attorney Approved Version 12/22/2023 Page 7 23. CLAIMS AND LAWSUITS By signing this Agreement, Contractor agrees that any Agreement claim submitted to City must be asserted as part of the Agreement process as set forth in this Agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that if a false claim is submitted to City, it may be considered fraud and Contractor may be subject to criminal prosecution. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act applies to this Agreement and, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of information. If City seeks to recover penalties pursuant to the False Claims Act, it is entitled to recover its litigation costs, including attorney's fees. Contractor acknowledges that the filing of a false claim may subject Contractor to an administrative debarment proceeding as the result of which Contractor may be prevented to act as a Contractor on any public work or improvement for a period of up to five (5) years. Contractor acknowledges debarment by another jurisdiction is grounds for City to terminate this Agreement. 24. JURISDICTION AND VENUE Any action at law or in equity brought by either of the parties for the purpose of enforcing a right or rights provided for by this Agreement will be tried in a court of competent jurisdiction in the County of San Diego, State of California, and the parties waive all provisions of law providing for a change of venue in these proceedings to any other county. 25. SUCCESSORS AND ASSIGNS It is mutually understood and agreed that this Agreement will be binding upon City and Contractor and their respective successors. Neither this Agreement nor any part of it nor any monies due or to become due under it may be assigned by Contractor without the prior consent of City, which shall not be unreasonably withheld. 26. ENTIRE AGREEMENT This Agreement, together with any other written document referred to or contemplated by it, along with the purchase order for this Agreement and its provisions, embody the entire Agreement and understanding between the parties relating to the subject matter of it. In case of conflict, the terms of the Agreement supersede the purchase order. Neither this Agreement nor any of its provisions may be amended, modified, waived or discharged except in a writing signed by both parties. This Agreement may be executed in counterparts. DocuSign Envelope ID: A30857A7-B63F-464D-B1C8-E78880D02D70 PSA25-01HML City Attorney Approved Version 12/22/2023 Page 8 27. AUTHORITY The individuals executing this Agreement and the instruments referenced in it on behalf 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 Agreement. Executed by Contractor this___________ day of _______________________, 2024. CONTRACTOR CITY OF CARLSBAD, a municipal corporation of the State of California Interfaith Community Services, a non-profit organization By: By: (sign here) Geoff Patnoe, Assistant City Manager Greg Anglea, Chief Executive Officer (print name/title) ATTEST: By: SHERRY FREISINGER, City Clerk (sign here) By: Deputy 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, Secretary, President, or Assistant Secretary, Vice-President 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: CINDIE K. McMAHON, City Attorney BY: _____________________________ Allegra Frost, Senior Assistant City Attorney DocuSign Envelope ID: A30857A7-B63F-464D-B1C8-E78880D02D70 June4 PSA25-01HML City Attorney Approved Version 12/22/2023 Page 9 EXHIBIT A SCOPE OF SERVICES A. Provide a minimum of one (1) full-time Outreach SUD Counselor (Certified or Registered), one (1) full time Peer Support Specialist, and at least .05 FTE Program Manager. The Outreach SUD Counselor and Peer Support Specialist will provide Substance Use Disorder (SUD) mobile outreach and intake working closely with other homeless outreach teams and community partners to identify individuals experiencing homelessness with Opioid Use Disorder (OUD) and any co-occurring Substance Abuse Disorder/Mental Health (SUD/MH) needs and provide screening, peer support, intake coordination, and transportation to treatment. B. Conduct outreach and other engagement activities to identify eligible individuals and households, including households in shelter programs and affordable housing properties. C. Work collaboratively to screen and assess referrals from the Carlsbad Police Department, Carlsbad Fire Department and Carlsbad Housing & Homeless Services Department. D. Work as part of a multidisciplinary team to coordinate client care. Attend and participate in regularly scheduled outreach and care conferencing meetings. E. Collaborate with regional Emergency Department social workers, substance use disorder counselors, and mental health practitioners to facilitate continuum of care and system navigation for clients. F. Conduct outreach and engagement from a harm reduction approach, developing rapport while identifying risks and needs. G. Conduct in-the-field screening and provide assessment and ongoing reassessments. H. Develop personalized strengths-based plans to reduce the negative physical and psychological impacts of drugs and alcohol. Help develop informal support systems as appropriate. I. Provide linkage to and support of engagement with recovery support services, such as vocational, educational, or crisis care services. Develop plans to reduce barriers to maintaining sobriety including; sober living, transportation, support groups, outpatient treatment and other needs as appropriate. J. Provide referral and coordination into Medication Assisted Treatment (MAT), detox and other treatment options. K. Collaborate across applicable agencies, providers and programs to enhance service and referral capacity. L. Provide outreach, presentations and resources to middle and high schools that serve Carlsbad residents to provide education and programs that discourage or prevent drug misuse. M. Participate in youth services collaboration and refer middle and high school youth with drug related offenses or who have been identified as high risk to appropriate resources. DocuSign Envelope ID: A30857A7-B63F-464D-B1C8-E78880D02D70 PSA25-01HML City Attorney Approved Version 12/22/2023 Page 10 N. Maintain a written grievance procedure, including a formal process for participants to provide feedback and to resolve conflicts experienced within the program. O. Complete accurate and thorough documentation in a timely manner. Maintain documentation of client meetings and interactions, including conversations and progress towards goals. P. Maintain regular communication with Housing & Homeless Services Department staff. Q. Provide the Housing & Homeless Services Department with monthly data reports of services provided and outcomes. R. All billing invoices shall be submitted by the 15th of the month to the Housing & Homeless Services Department. The invoices shall include accompanying documentation for funds expended, which shall include but not be limited to documentation of timecards, mileage, and operating costs. S. Operate within the budget set forth in Exhibit “B.” a. If there is a possibility that any portion of the total fee payable for the Services under the Agreement may not be expended by the date of contract termination, City and Contractor agree to mutually decide how such excess funds will be reallocated and fully expended in the budget (Exhibit “B”). In such case, Contractor agrees to draft an amended budget (amended Exhibit “B”) to reallocate the excess funds, which will require a contract amendment subject to approval by the city manager or designee. b. City and Contractor further agree to discuss and mutually determine any necessary changes to the budget during the lifetime of the Agreement. In the event of a mutually agreeable budget modification, Contractor agrees to draft an amended budget (amended Exhibit “B”), which will require a contract amendment subject to approval by the city council or city manager or designee, depending on the value and nature of the budget modification. DocuSign Envelope ID: A30857A7-B63F-464D-B1C8-E78880D02D70 PSA25-01HML City Attorney Approved Version 12/22/2023 Page 11 EXHIBIT B BUDGET City of Carlsbad - SUD Outreach & Education Personnel City Funds Requested Leveraged/In- Kind Funds Total Project Outreach SUD Counselor 1.0 FTE $43,264 $10,816 $54,080 Peer Support Specialist 1.0 FTE $ - $47,840 $47,840 Program Manager (RWC) - .05 FTE $3,250 - $ $3,250 Program Manager (CSC) - .05 FTE $ $3,392 $3,392 Triage Receptionist (RWC) - .05 FTE $ $2,496 $2,496 SAMSHA AOD Counselor (RWC) - .05 FTE $ $2,704 $2,704 SAMHSA Peer Supp Spec (RWC) - .05 FTE $ $2,392 $2,392 Subtotal $46,514 $69,640 $116,154 Benefits @ 35% $16,280 $24,374 $40,654 Total Personnel $62,794 $69,640 $132,434 Operating Costs City Funds Requested Other Funds Total Project Occupancy Expenses $3,888 $ $3,888 Employment recruitment $250 $ $250 Staff training $500 $500 $1,000 Laptop with monitor $1,200 $1,200 $2,400 Cellular phone $720 $720 $1,440 Staff mileage $1,008 $ $1,008 Vehicle gas/insurance/maintenance $1,200 $ $1,200 Office supplies $360 $150 $510 Program supplies $300 $150 $459 Printing/duplication $200 $75 $275 IT/Licenses $308 $ $308 Subtotal Operating Costs $9,934 $2,795 $12,729 Subtotal Direct Costs $72,727 $72,435 $145,163 10% Admin $7,273 $7,244 $14,516 Total $ 80,000 $79,679 $159,679 DocuSign Envelope ID: A30857A7-B63F-464D-B1C8-E78880D02D70 DocuSign Envelope ID: A30857A7-B63F-464D-B1C8-E78880D02D70 -.,.«; pEOPt~ (l, ... -..<,~ ~v (,o -2-~ 1,.......,...---1 n-t -er-----tm l community services $ RESOLUTION OF THE BOARD OF DIRECTORS OF INTERFAITH COMMUNITY SERVICES, INC. Authorized Signatory for Contracts & Financial Instruments The Board of Directors of Interfaith Community Services Inc., at the monthly Board of Directors meeting held on July 26, 2023 hereby resolves to authorize Greg Anglea, Chief Executive Officer, or Dr. Kadri Webb, Chair of the Board, to sign grant applications on behalf of Interfaith Community Services Inc. when timing does not allow for full board review at a regularly scheduled board meeting during the 2023-2024 fiscal year. Signed copies of any resolutions shall be included in the next regularly scheduled board package. When feasible, such grant applications will also be reviewed by an appropriate board committee. July 26, 2023 Date July 26, 2023 Lisa Brinig, CFP Date Secretary, Board of Directors July 26, 2023 Greg Anglea Date Chief Executive Officer Interfaith Community Services 550 West Washington Avenue, Escondido, CA 92025 • (760) 489-6380 • www.interfaithservices.org 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 8/4/2023 License # 0C32169 (619) 937-0164 18058 Interfaith Community Services 550 W. Washington Escondido, CA 92025 13269 A 1,000,000 X X PHPK2586415 8/1/2023 8/1/2024 1,000,000 20,000 1,000,000 3,000,000 3,000,000 1,000,000A PHPK2586415 8/1/2023 8/1/2024 10,000,000A PHUB876039 8/1/2023 8/1/2024 10,000,000 10,000 B X M1302803 7/1/2023 7/1/2024 1,000,000 1,000,000 1,000,000 A Professional Liab.PHPK2586415 8/1/2023 Agg $3M, Occ $1M Ded 0 A Abuse & Molestation PHPK2586415 8/1/2023 8/1/2024 Agg $2M, Occ $1M Ded 0 RE: 5731 PALMER WAY, STE. A, CARLSBAD, CA 92010. CITY OF CARLSBAD CITY HALL HOUSING AND NEIGHBORHOOD SVS. IS INCLUDED AS ADDITIONAL INSURED WITH REGARDS TO GENERAL LIABILITY PER ATTACHED FORMS. WAIVER OF SUBROGATION APPLIES WITH REGARDS TO THE GENERAL LIABILITY AND WORKERS COMPENSATION PER THE ATTACHED FORMS. 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liable for an injury covered by this policy. We will not enforce our right against any person or organization with whom you have a written contract that requires you to obtain this agreement from us. The additional premium for this endorsement shall be 2.00% of the California workers compensation premium otherwise due. Minimum Premium: $0 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 07/01/2023 Insured INTERFAITH COMMUNITY SERVICES Policy No. M1302803 CA Policy Period 07/01/2023 To 07/01/2024 Issued On 06/23/2021 WC-99-04-258 (Ed. 10-07) ZENITH INSURANCE COMPANY - 13145 At San Diego, CA Endorsement No. 16 DocuSign Envelope ID: A30857A7-B63F-464D-B1C8-E78880D02D70 TheZCNlh·