HomeMy WebLinkAbout2010 CON Trauma Intervention Programs of San Diego County - CDBG 09-10SUBRECIPIENT AGREEMENT
By and Between the
City of National City
and
Trauma Intervention Programs of San Diego County, Inc.
for the
Trauma Intervention Program/ Crisis Intervention Team
THIS AGREEMENT, entered this co NA day of s1/41" , 2010 by and between
the City of National City (herein called the "Grantee") and Trauma Intervention Programs of
San Diego County, Inc. (herein called the "Subrecipient.")
WHEREAS, the Grantee has applied for and received funds from the United States Government under
Title I of the Housing and Community Development Act of 1974, as amended (HCD Act), Public Law
93-383; and
WHEREAS, the Grantee wishes to engage the Subrecipient to assist the Grantee in utilizing such
funds;
NOW, THEREFORE, it is agreed between the parties hereto that;
SCOPE OF SERVICE
A. Activities: The Subrecipient will be responsible for administering the program titled,
Trauma Intervention Program/ Crisis Intervention Team in a manner satisfactory
to the Grantee and consistent with any standards required as a condition of providing
these funds. Such program will include activities eligible under the Community
Development Block Grant (CDBG) program, as specified in Exhibit A, attached and
incorporated herein.
B. National Objectives: All activities funded with CDGB funds must meet one of the CDBG
program's National Objectives: benefit low- and moderate -income persons; aid in the
prevention or elimination of slums or blight; or meet community development needs
having a particular urgency, as defined in 24 CFR 570.208
The Subrecipient certifies that the activity(ies) carried out under this Agreement will meet
the National Objective of benefiting low- and moderate -income persons.
C. Levels of Accomplishment — Goals and Performance Measures: The levels of
accomplishment may include such measures as units rehabilitated, persons or households
assisted, or meals served, and should include periods for performance. Refer to Exhibit A
for levels of program services.
D. Staffing: Subrecipient shall be responsible for staff and time to be allocated to each
activity, as set forth in Exhibit A, attached hereto and incorporated herein.
E. Performance Monitoring: The Grantee will monitor the performance of the Subrecipient
against goals and performance standards as stated above. Substandard performance as
determined by the Grantee will constitute noncompliance 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 Grantee, contract suspension or
termination procedures will be initiated.
II. TIME OF PERFORMANCE
Services of the Subrecipient shall start on the lst day of July, 2009 and end on the 30th day of
June of 2010 in the case of Public Services and in the case of Capital Improvements end on
June 30, 2011. The term of this Agreement and the provisions herein shall be extended to
cover any additional time period during which the Subrecipient remains in control of CDBG
funds or other CDBG assets, including program income.
III. BUDGET
Any indirect costs charged must be consistent with the conditions of Paragraph VII (C)(2) of
this Agreement. Subrecipient shall adhere to the budget breakdown, attached as Exhibit B
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and incorporated herein. Both the Grantee and the Subrecipient must approve any
amendments to the budget in writing.
IV. PAYMENT
It is expressly agreed and understood that the total amount to be paid by the Grantee under
this Agreement shall not exceed Eight Thousand Dollars ($8,000.00). Drawdowns for the
payment of eligible expenses shall be made against the line item budgets specified in
Paragraph III herein and in accordance with performance. Expenses for general administration
shall also be paid against the line item budgets specified in Paragraph III and in accordance
with performance.
Payments may be contingent upon certification of the Subrecipient's financial management
system in accordance with the standards specified in 24 CFR 84.21.
V. NOTICES
Notices required by this Agreement shall be in writing and delivered via mail (postage
prepaid), commercial courier, or personal delivery or sent by facsimile or other electronic
means. Any notice delivered or sent as aforesaid shall be effective on the date of delivery or
sending. All notices and other written communications under this Agreement shall be
addressed to the individuals in the capacities indicated below, unless otherwise modified by
subsequent written notice.
Communication and details concerning this contract shall be directed to the following contract
representatives:
Grantee
Subrecipient
Contact Person:
Carlos Aguirre
Contact Person:
Mandy Atkission
Organization:
City of National City
Organization: Trauma Intervention
Programs of San Diego County, Inc.
Address: 1243 National City Boulevard
National City, CA 91950-4301
Address: 2560 Orion Way,
Carlsbad CA 92010
Telephone:
(619) 336-4391
Telephone:
(760) 518-5430
Email:
caguirre@nationalcityca.gov
Email:
tipsandiego@sbcglobal.com
VI. GENERAL CONDITIONS
A. General Compliance: 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 of these regulations, except that (1) the Subrecipient does not
assume the recipient's environmental responsibilities described in 24 CFR 570.604 and
(2) the Subrecipient does not assume the recipient's responsibility for initiating the
review process 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.
B. "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 Grantee 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.
C. Hold Harmless: The Subrecipient shall hold harmless, defend and indemnify the
Grantee from any and all claims, actions, suits, charges and judgments whatsoever that
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arise out of the Subrecipient's performance or nonperformance of the services or subject
matter called for in this Agreement.
D. Workers' Compensation: The Subrecipient shall comply with all of the provisions of
the Workers' Compensation Insurance and Safety Acts of the State of California, the
applicable provisions of Division 4 and 5 of the California Government Code and all
amendments thereto; and all similar state or Federal acts or laws applicable; and shall
indemnify, and hold harmless the Grantee and its elected officials, officers, and
employees from and against all claims, demands, payments, suits, actions, proceedings
and judgments of every nature and description, including reasonable attorney's fees and
defense costs presented, brought or recovered against the Grantee or its elected
officials, officers, employees, or volunteers, for or on account of any liability under any
of said acts which may be incurred by reason of any work to be performed by the
Grantee under this Agreement.
Insurance & Bonding: The Subrecipient, at its sole cost and expense, shall purchase
and maintain, and shall require its subcontractors when applicable, to purchase and
maintain throughout the term of this agreement, the following insurance policies
attached as Exhibit F:
❑ 1. If checked, Professional Liability Insurance (errors and omissions) with
minimum limits of $1,000,000 per occurrence.
2. Automobile insurance covering all bodily injury and property damage
incurred during the performance of this Agreement, with a minimum coverage of
$1,000,000 combined single limit per accident. Such automobile insurance shall include
owned, non -owned, and hired vehicles ("any auto").
3. Commercial general liability insurance, with minimum limits of
$1,000,000 per occurrence/$2,000,000 aggregate, covering all bodily injury and
property damage arising out of its operations under this Agreement.
4. Workers' compensation insurance in an amount sufficient to meet
statutory requirements covering all of subrecipient's employees and employers' liability
insurance with limits of at least $1,000,000 per accident. In addition, the policy shall be
endorsed with a waiver of subrogation in favor of the Grantee. Said endorsement shall
be provided prior to commencement of Work under this Agreement.
5. The aforesaid policies shall constitute primary insurance as to the
Grantee, its officers and employees, so that any other policies held by the Grantee shall
not contribute to any loss under said insurance. Said policies shall provide for thirty
(30) days prior written notice to the Grantee of cancellation or material change.
6. Said policies, except for the professional liability and workers'
compensation policies, shall name the Grantee and its elected officials, officers, agents
and employees as additional insureds, and separate additional insured endorsements
shall be provided.
7. If required insurance coverage is provided on a "claims made" rather
than "occurrence" form, the Subrecipient shall maintain such insurance coverage for
three years after expiration of the term (and any extensions) of this Agreement. In
addition, the "retro" date must be on or before the date of this Agreement.
8. Any aggregate insurance limits must apply solely to this Agreement.
9. Insurance shall be written with only California admitted companies
which hold a current policy holder's alphabetic and financial size category rating of not
less than A VIII according to the current Best's Key Rating Guide, or a company equal
financial stability that is approved by the National City Risk Manager. In the event
coverage is provided by non -admitted "surplus lines" carriers, they must be included on
the most recent California List of Eligible Surplus Lines Insurers (LESLI list) and
otherwise meet rating requirements.
10. This Agreement shall not take effect until certificate(s) or other
sufficient proof that these insurance provisions have been complied with, are filed with
and approved by the National City Risk Manager. If the Subrecipient does not keep all of
such insurance policies in full force and effect at all times during the terms of this
Agreement, the Grantee may elect to treat the failure to maintain the requisite
insurance as a breach of this Agreement and terminate the Agreement as provided
herein.
11. All deductibles and self -insured retentions in excess of $10,000 must
be disclosed to and approved by the Grantee.
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The Subrecipient shall carry sufficient insurance coverage to protect contract assets from
loss due to theft, fraud and/or undue physical damage, and as a minimum shall
purchase a blanket fidelity bond covering all employees in an amount equal to cash
advances from the Grantee. The Subrecipient shall comply with the bonding and
insurance requirements of 24 CFR 84.31 and 84.48, Bonding and Insurance.
F. Grantee Recognition: The Subrecipient shall insure recognition of the role of the
Grantee in providing services through this Agreement. All activities, facilities and items
utilized pursuant to this Agreement shall be prominently labeled as to funding source. In
addition, the Subrecipient will include a reference to the support provided herein in all
publications made possible with funds made available under this Agreement.
G. Amendments: The Grantee or Subrecipient may amend this Agreement at any time
provided that such amendments make specific reference to this Agreement, and are
executed in writing, signed by a duly authorized representative of each organization, and
approved by the Grantee's governing body. Such amendments shall not invalidate this
Agreement, nor relieve or release the Grantee or Subrecipient from its obligations under
this Agreement.
The Grantee may, in its discretion, amend this Agreement to conform with Federal, state
or local governmental guidelines, policies and available funding amounts, or for other
reasons. If such amendments result in a change in the funding, the scope of services, or
schedule of the activities to be undertaken as part of this Agreement, such modifications
will be incorporated only by written amendment signed by both Grantee and
Subrecipient.
H. Suspension or Termination: In accordance with 24 CFR 85.43, the Grantee may
suspend or terminate this Agreement if the Subrecipient materially fails to comply with
any terms of this Agreement, which include (but are not limited to) the following:
1. Failure to comply with any of the rules, regulations or provisions referred to herein,
or such statutes, regulations, executive orders, and HUD guidelines, policies or
directives as may become applicable at any time;
2. Failure, for any reason, of the Subrecipient to fulfill in a timely and proper manner
its obligations under this Agreement;
3. Ineffective or improper use of funds provided under this Agreement; or
4. Submission by the Subrecipient to the Grantee reports that are incorrect or
incomplete in any material respect.
The Grantee shall have the right, in accordance with 24 C.F.R. 85.43, to terminate this
Agreement immediately or withhold payment of invoice for failure of the SUB -RECIPIENT
to comply with the terms and conditions of this Agreement. Should the Grantee decide
to terminate this Agreement, after a full evaluation of all circumstances has been
completed, the SUB -RECIPIENT shall, upon written request, have the right to an appeal
process. A copy of the appeal process will be attached to any termination notice.
If the Grantee finds that the SUB -RECIPIENT has violated the terms and conditions of
this Agreement, the SUB -RECIPIENT may be required to:
1. Repay all monies received from the Grantee under this Agreement; and/or
2. Transfer possession of all materials and equipment purchased with grant money to
the Grantee.
In the case of early termination, a final payment may be made to the SUB -RECIPIENT
upon receipt of a Final Report and invoices covering eligible costs incurred prior to
termination. The total of all payments, including the final payment, shall not exceed the
amount specified in this Agreement.
I. Termination for Convenience: In accordance with 24 CFR 85.44, this Agreement
may also be terminated for convenience by either the Grantee or the Sub -recipient, in
whole or in part, by setting forth the reasons for such termination, the effective date,
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and, in the case of partial termination, the portion to be terminated. However, if in the
case of a partial termination, the Grantee determines that the remaining portion of the
award will not accomplish the purpose for which the award was made, the Grantee may
terminate the award in its entirety. Grantee and sub -recipient agree to provide written
notice to the other party thirty (30) days prior to the effective date of any termination,
in whole or part, for convenience.
VII. ADMINISTRATIVE REQUIREMENTS
A. Financial Management
1. 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.
2. 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.
B. Documentation and Record Keeping
1. Records to be Maintained: The Subrecipient shall maintain all records required by
the Federal regulations specified in 24 CFR 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 that each activity undertaken meets one of the
National Objectives of the CDBG program;
c. Records required to determine the eligibility of activities;
d. Records required to document the acquisition, improvement, use or disposition
of real property acquired or improved with CDBG assistance;
e. Records documenting compliance with the fair housing and equal opportunity
components of the CDBG program;
f. Financial records as required by 24 CFR 570.502, and 24 CFR 84.21-28; and
g. Other records necessary to document compliance with Subpart K of 24 CFR
Part 570.
2. Retention: The Subrecipient shall retain all financial records, supporting
documents, statistical records, and all other records pertinent to the Agreement for
a period of four (4) years. The retention period begins on the date of the submission
of the Grantee's annual performance and evaluation report to HUD in which the
activities assisted under the Agreement are reported on for the final time.
Notwithstanding the above, if there is litigation, claims, audits, negotiations or other
actions that involve any of the records cited and that have started before the
expiration of the four-year period, then such records must be retained until
completion of the actions and resolution of all issues, or the expiration of the four-
year period, whichever occurs later.
3. Client Data: The Subrecipient shall maintain client data demonstrating client
eligibility for services provided. Such data shall include, but not be limited to, client
name, address, income level or other basis for determining eligibility, and
description of service provided. Such information shall be made available to Grantee
monitors or their designees for review upon request.
4. Disclosure: The Subrecipient understands that client information collected under
this contract is private and the use or disclosure of such information, when not
directly connected with the administration of the Grantee's or Subrecipient's
responsibilities with respect to services provided under this contract, is prohibited by
the State and for Federal law unless written consent is obtained from such person
receiving service and, in the case of a minor, that of a responsible parent/guardian.
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5. Close-outs: The Subrecipient's obligation to the Grantee 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 Grantee), and determining
the custodianship of records. Not withstanding 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.
6. Audits & Inspections: All Subrecipient records with respect to any matters
covered by this Agreement shall be made available to the Grantee, grantor agency,
and the Comptroller General of the United States or any of their authorized
representatives, at any time during normal business hours, as often as deemed
necessary, to audit, examine, and make excerpts or transcripts of all relevant data.
Any deficiencies noted in audit reports must be fully cleared by the Subrecipient
within 30 days after receipt by the Subrecipient. Failure of the Subrecipient to
comply with the above audit requirements will constitute a violation of this contract
and may result in the withholding of future payments. The Subrecipient hereby
agrees to have an annual agency audit conducted in accordance with current
Grantee policy concerning subrecipient audits and OMB Circular A-133.
7. Additional Documentation: Subrecipient agrees to provide a list of its Board of
Directors, By -Laws, Exhibit C, and any additional documents, as required in Exhibit
"D" and "E," attached and incorporated herein.
C. Reporting and Payment Procedures
1. Program Income: The Subrecipient shall report quarterly all program income (as
defined at 24 CFR 570.500(a)) generated by activities carried out with CDBG funds
made available under this contract. The use of program income by the Subrecipient
shall comply with the requirements set forth at 24 CFR 570.504. By way of further
limitations, the Subrecipient may use such income during the contract period for
activities permitted under this contract and shall reduce requests for additional
funds by the amount of any such program income balances on hand. All unexpended
program income shall be returned to the Grantee at the end of the contract period.
Any interest earned on cash advances from the U.S. Treasury and from funds held in
a revolving fund account is not program income and shall be remitted promptly to
the Grantee.
2. Indirect Costs: If indirect costs are charged, the Subrecipient will develop an
indirect cost allocation plan for determining the appropriate Subrecipient's share of
administrative costs and shall submit such plan to the Grantee for approval, in a
form specified by the Grantee.
3. Payment Procedures: The Grantee will pay to the Subrecipient funds available
under this Agreement based upon information submitted by the Subrecipient and
consistent with any approved budget and Grantee policy concerning payments. With
the exception of certain advances, payments will be made for eligible expenses
actually incurred by the Subrecipient, and not to exceed actual cash requirements.
Payments will be adjusted by the Grantee in accordance with advance fund and
program income balances available in Subrecipient accounts. In addition, the
Grantee reserves the right to liquidate funds available under this contract for costs
incurred by the Grantee on behalf of the Subrecipient.
4. Progress Reports: The Subrecipient shall submit regular Progress Reports to the
Grantee in the form, content, and frequency as required by the Grantee.
D. Procurement:
1. Compliance: The Subrecipient shall comply with current Grantee 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 Grantee upon termination of this Agreement.
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2. 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.
3. Travel: The Subrecipient shall obtain written approval from the Grantee for any
travel outside the metropolitan area with funds provided under this Agreement.
E. Use and Reversion of Assets:
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:
1. The Subrecipient shall transfer to the Grantee 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.
2. 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 570.208 until five
(5) years after expiration of this Agreement [or such longer period of time as the
Grantee 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 Grantee 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 Grantee. 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 Grantee
deems appropriate].
3. 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 Grantee for the CDBG program or (b)
retained after compensating the Grantee [an amount equal to the current fair
market value of the equipment less the percentage of non-CDBG funds used to
acquire the equipment].
VIII. RELOCATION, REAL PROPERTY ACQUISITION AND ONE -FOR -ONE HOUSING
REPLACEMENT
The Subrecipient agrees to comply with (a) the Uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970, as amended (URA), and implementing
regulations at 49 CFR Part 24 and 24 CFR 570.606(b); (b) the requirements of 24 CFR
570.606(c) governing the Residential Anti -displacement and Relocation Assistance Plan
under section 104(d) of the HCD Act; and (c) the requirements in 24 CFR 570.606(d)
governing optional relocation policies. [The Grantee may preempt the optional policies.]
The Subrecipient shall provide relocation assistance to displaced persons as defined by
24 CFR 570.606(b)(2) that are displaced as a direct result of acquisition, rehabilitation,
demolition or conversion for a CDBG-assisted project. The Subrecipient also agrees to
comply with applicable Grantee ordinances, resolutions and policies concerning the
displacement of persons from their residences.
IX. PERSONNEL & PARTICIPANT CONDITIONS
A. Civil Rights
1. Compliance: The Subrecipient agrees to comply with local and state civil rights
ordinances here and with Title VI of the Civil Rights Act of 1964 as amended, Title
VIII of the Civil Rights Act of 1968 as amended, Section 104(b) and Section 109 of
Title I of the Housing and Community Development Act of 1974 as amended, Section
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504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990,
the Age Discrimination Act of 1975, Executive Order 11063, and Executive Order
11246 as amended by Executive Orders 11375, 11478, 12107 and 12086.
2. Nondiscrimination: The Subrecipient agrees to comply with the non-
discrimination in employment and contracting opportunities laws, regulations, and
executive orders referenced in 24 CFR 570.607, as revised by Executive Order
13279. The applicable non-discrimination provisions in Section 109 of the HCDA are
still applicable.
4. Land Covenants: This contract is subject to the requirements of Title VI of the
Civil Rights Act of 1964 (P. L. 88-352) and 24 CFR 570.601 and 570.602. In regard
to the sale, lease, or other transfer of land acquired, cleared or improved with
assistance provided under this contract, the Subrecipient shall cause or require a
covenant running with the land to be inserted in the deed or lease for such transfer,
prohibiting discrimination as herein defined, in the sale, lease or rental, or in the use
or occupancy of such land, or in any improvements erected or to be erected thereon,
providing that the Grantee and the United States are beneficiaries of and entitled to
enforce such covenants. The Subrecipient, in undertaking its obligation to carry out
the program assisted hereunder, agrees to take such measures as are necessary to
enforce such covenant, and will not itself so discriminate.
4. Section 504: The Subrecipient agrees to comply with all Federal regulations issued
pursuant to compliance with Section 504 of the Rehabilitation Act of 1973 (29 U.S.C.
794), which prohibits discrimination against the individuals with disabilities or
handicaps in any Federally assisted program. The Grantee shall provide the
Subrecipient with any guidelines necessary for compliance with that portion of the
regulations in force during the term of this Agreement.
B. Affirmative Action
1. Approved Plan: The Subrecipient agrees that it shall be committed to carry out
pursuant to the Grantee's specifications an Affirmative Action Program in keeping
with the principles as provided in President's Executive Order 11246 of September
24, 1966. The Grantee shall provide Affirmative Action guidelines to the Subrecipient
to assist in the formulation of such program. The Subrecipient shall submit a plan for
an Affirmative Action Program for approval prior to the award of funds, consistent
with the policy in Exhibit "F", attached hereto and incorporated herein.
2. Women- and Minoritv-Owned Businesses (W/MBE): The Subrecipient will use
its best efforts to afford small businesses, minority business enterprises, and
women's business enterprises the maximum practicable opportunity to participate in
the performance of this contract. As used in this contract, the terms "small business"
means a business that meets the criteria set forth in section 3(a) of the Small
Business Act, as amended (15 U.S.C. 632), and "minority and women's business
enterprise" means a business at least fifty-one (51) percent owned and controlled by
minority group members or women. For the purpose of this definition, "minority
group members" are Afro-Americans, Spanish-speaking, Spanish surnamed or
Spanish -heritage Americans, Asian -Americans, and American Indians. The
Subrecipient may rely on written representations by businesses regarding their
status as minority and female business enterprises in lieu of an independent
investigation.
3. Access to 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 Grantee,
HUD or its agent, or other authorized Federal officials for purposes of investigation
to ascertain compliance with the rules, regulations and provisions stated herein.
4. Notifications: The Subrecipient will send to each labor union or representative of
workers with which it has a collective bargaining agreement or other contract or
understanding, a notice, to be provided by the agency contracting officer, advising
the labor union or worker's representative of the Subrecipient's commitments
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hereunder, and shall post copies of the notice in conspicuous places available to
employees and applicants for employment.
5. Equal Employment Opportunity and Affirmative Action (EEO/AA)
Statement: The Subrecipient will, in all solicitations or advertisements for
employees placed by or on behalf of the Subrecipient, state that it is an Equal
Opportunity or Affirmative Action employer.
6. Subcontract Provisions: The Subrecipient will include the provisions of
Paragraphs X.A, Civil Rights, and B, Affirmative Action, in every subcontract or
purchase order, specifically or by reference, so that such provisions will be binding
upon each of its own subrecipients or subcontractors.
C. Employment Restrictions
1. Prohibited Activity: The Subrecipient is prohibited from using funds provided
herein or personnel employed in the administration of the program for: political
activities; inherently religious activities; lobbying; political patronage; and nepotism
activities.
2. Labor Standards: The Subrecipient agrees to comply with the requirements of the
Secretary of Labor in accordance with the Davis -Bacon Act as amended, the
provisions of Contract Work Hours and Safety Standards Act (40 U.S.C. 327 et seq.)
and all other applicable Federal, state and local laws and regulations pertaining to
labor standards insofar as those acts apply to the performance of this Agreement.
The Subrecipient agrees to comply with the Copeland Anti -Kick Back Act (18 U.S.C.
874 et seq.) and its implementing regulations of the U.S. Department of Labor at 29
CFR Part 5. The Subrecipient shall maintain documentation that demonstrates
compliance with hour and wage requirements of this part. Such documentation shall
be made available to the Grantee for review upon request.
The Subrecipient agrees that, except with respect to the rehabilitation or
construction of residential property containing less than eight (8) units, all
contractors engaged under contracts in excess of $2,000.00 for construction,
renovation or repair work financed in whole or in part with assistance provided under
this contract, shall comply with Federal requirements adopted by the Grantee
pertaining to such contracts and with the applicable requirements of the regulations
of the Department of Labor, under 29 CFR Parts 1, 3, 5 and 7 governing the
payment of wages and ratio of apprentices and trainees to journey workers;
provided that, if wage rates higher than those required under the regulations are
imposed by state or local law, nothing hereunder is intended to relieve the
Subrecipient of its obligation, if any, to require payment of the higher wage. The
Subrecipient shall cause or require to be inserted in full, in all such contracts subject
to such regulations, provisions meeting the requirements of this paragraph.
3. "Section 3" Clause
a. Compliance: Compliance with the provisions of Section 3 of the HUD Act of
1968, as amended, and as implemented by the regulations set forth in 24 CFR
135, and all applicable rules and orders issued hereunder prior to the execution
of this contract, shall be a condition of the Federal financial assistance provided
under this contract and binding upon the Grantee, the Subrecipient and any of
the Subrecipient's subrecipients and subcontractors. Failure to fulfill these
requirements shall subject the Grantee, the Subrecipient and any of the
Subrecipient's subrecipients and subcontractors, their successors and assigns, to
those sanctions specified by the Agreement through which Federal assistance is
provided. The Subrecipient certifies and agrees that no contractual or other
disability exists that would prevent compliance with these requirements.
The Subrecipient further agrees to comply with these "Section 3" requirements
and to include the following language in all subcontracts executed under this
Agreement:
"The work to be performed under this Agreement is a project
assisted under a program providing direct Federal financial
Subrecipient Agreement
Page 9 of 14
assistance from HUD and is subject to the requirements of Section
3 of the Housing and Urban Development Act of 1968, as
amended (12 U.S.C. 1701). Section 3 requires that to the
greatest extent feasible opportunities for training and
employment be given to low- and very low-income residents of
the project area, and that contracts for work in connection with
the project be awarded to business concerns that provide
economic opportunities for low- and very low-income persons
residing in the metropolitan area in which the project is located."
The Subrecipient further agrees to ensure that opportunities for training and
employment arising in connection with a housing rehabilitation (including
reduction and abatement of lead -based paint hazards), housing construction, or
other public construction project are given to low- and very low-income persons
residing within the metropolitan area in which the CDBG-funded project is
located; where feasible, priority should be given to low- and very low-income
persons within the service area of the project or the neighborhood in which the
project is located, and to low- and very low-income participants in other HUD
programs; and award contracts for work undertaken in connection with a
housing rehabilitation (including reduction and abatement of lead -based paint
hazards), housing construction, or other public construction project to business
concerns that provide economic opportunities for low- and very low-income
persons residing within the metropolitan area in which the CDBG-funded project
is located; where feasible, priority should be given to business concerns that
provide economic opportunities to low- and very low-income residents within the
service area or the neighborhood in which the project is located, and to low- and
very low-income participants in other HUD programs.
The Subrecipient certifies and agrees that no contractual or other legal
incapacity exists that would prevent compliance with these requirements.
b. Notifications: The Subrecipient agrees to send to each labor organization or
representative of workers with which it has a collective bargaining agreement
or other contract or understanding, if any, a notice advising said labor
organization or worker's representative of its commitments under this Section
3 clause and shall post copies of the notice in conspicuous places available to
employees and applicants for employment or training.
c. Subcontracts: The Subrecipient will include this Section 3 clause in every
subcontract and will take appropriate action pursuant to the subcontract upon
a finding that the subcontractor is in violation of regulations issued by the
grantor agency. The Subrecipient will not subcontract with any entity where it
has notice or knowledge that the latter has been found in violation of
regulations under 24 CFR Part 135 and will not let any subcontract unless the
entity has first provided it with a preliminary statement of ability to comply
with the requirements of these regulations.
D. Conduct
1. Assignability: The Subrecipient shall not assign or transfer any interest in this
Agreement without the prior written consent of the Grantee thereto; provided,
however, that claims for money due or to become due to the Subrecipient from
the Grantee under this contract may be assigned to a bank, trust company, or
other financial institution without such approval. Notice of any such assignment or
transfer shall be furnished promptly to the Grantee.
2. Subcontracts:
a. Approvals: The Subrecipient shall not enter into any subcontracts with any
agency or individual in the performance of this contract without the written
consent of the Grantee prior to the execution of such agreement.
b. Monitoring: The Subrecipient will monitor all subcontracted services on a
regular basis to assure contract compliance. Results of monitoring efforts shall
Subrecipient Agreement
Page 10 of 14
be summarized in written reports and supported with documented evidence of
follow-up actions taken to correct areas of noncompliance.
c. Content: The Subrecipient shall cause all of the provisions of this contract in
its entirety to be included in and made a part of any subcontract executed in
the performance of this Agreement.
d. Selection Process: The Subrecipient shall undertake to insure that all
subcontracts let in the performance of this Agreement shall be awarded on a
fair and open competition basis in accordance with applicable procurement
requirements. Executed copies of all subcontracts shall be forwarded to the
Grantee along with documentation concerning the selection process.
3. Hatch Act: The Subrecipient agrees that no funds provided, nor personnel
employed under this Agreement, shall be in any way or to any extent engaged in
the conduct of political activities in violation of Chapter 15 of Title V of the U.S.C.
4. 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:
a. 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.
b. 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.
c. 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 Grantee, the Subrecipient, or any designated public
agency.
5. Lobbying: The Subrecipient hereby certifies that:
a. 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;
b. 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 an 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
Subrecipient Agreement
Page 11of14
c. 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:
d. 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.
6. Copyright: If this contract results in any copyrightable material or inventions, the
Grantee and/or grantor agency reserves the right to royalty -free, non-exclusive
and irrevocable license to reproduce, publish or otherwise use and to authorize
others to use, the work or materials for governmental purposes.
7. Religious Activities: The Subrecipient agrees that funds provided under this
Agreement will not be utilized for inherently religious activities prohibited by 24
CFR 570.200(j), such as worship, religious instruction, or proselytization.
X. ENVIRONMENTAL CONDITIONS
A. Air and Water: The Subrecipient agrees to comply with the following requirements
insofar as they apply to the performance of this Agreement:
• Clean Air Act, 42 U.S.C. , 7401, et seq.;
• 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;
• Environmental Protection Agency (EPA) regulations pursuant to 40 CFR Part 50, as
amended.
B. 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).
C. 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 -Based 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.
D. 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.
Subrecipient Agreement
Page 12 of 14
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.
XI. 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.
XII. 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.
XIII. WAIVER
The Grantee'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 Grantee to
exercise or enforce any right or provision shall not constitute a waiver of such right or
provision.
XIV. INTERPRETATION OF THE AGREEMENT
The interpretation, validity, and enforcement of the Agreement shall be governed by and
construed under the laws of the State of California. The Agreement does not limit any other
rights or remedies available to the Grantee. The SUB -RECIPIENT shall be responsible for
complying with all local, state, and federal laws whether or not said laws are expressly stated
or referred to herein. Should any provision herein be found or deemed to be invalid, the
Agreement shall be construed as not containing such revision, and all other provisions which
are otherwise lawful shall remain in full force and effect, and to this end the provisions of this
Agreement are severable.
XV. ATTORNEY'S FEES
In the event any legal action or proceeding is commenced to interpret or enforce the terms
of, or obligations arising out of, this Agreement, or to recover damages for the breach thereof,
the party prevailing in any such action or proceeding shall be entitled to recover from the non -
prevailing party all reasonable attorney's fees, costs, and expenses incurred by the prevailing
party.
XVI. ENTIRE AGREEMENT
This agreement constitutes the entire agreement and the attachments referenced below
between the Grantee 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 Grantee and the Subrecipient with respect to this
Agreement.
ATTACHMENTS
Exhibit A -Scope of Services
Exhibit B-Budget
Exhibit C-Board of Directors and Bylaws
Exhibit D-Technical Assistance Materials
Exhibit E-Affirmative Action Policy
Exhibit F-Insurance
Subrecipient Agreement
Page 13 of 14
IN WITNESS WHEREOF, the Parties have executed this contract as of the date first written above.
City of National City
Trauma Intervention Programs of San
Diego County, Inc.
on Morrison Mandy Atkissio
Mayor, City of National City
APPROVED AS TO FORM
George Eiser III
City Attorney
ATTEST
a
Michael Dalla
City Clerk
Executive Director
Subrecipient Agreement
Page 11 of 11
EXHIBIT A
SCOPE OF SERVICES
1. The Trauma Intervention Program/Crisis Intervention Team consists of the following
activities:
AI
)ascription'
Citizen volunteers provide immediate support to emotionally traumatized citizens of
National City after suffering a tragic event. Fire, Police, and medics personnel calls are
placed to TIP, whenever assistance is needed.
1. Staff Salaries for Crisis Team Manager who oversees volunteers.
2. Insurance Bill for liability for volunteers.
3. Training and resource materials volunteers.
ff and time commitments to be allocated to activity listed above.
`Name'anti `
"`Hours Allocated
5 t a nber Title
Elly Harris, Crisis Team Manager
28 Hours
3. Billing Method: Monthly Quarterly X
4. List the type of supporting documentation to be provided:
Timesheets
Bills
Receipts
5. List the major/key activity milestones:
Major Activity
Milestones
Month
1
2
3
4
5
6
7
8
9
10
11
12
Provide Program Services
X
X
X
X
X
X
X
X
X
X
X
X
EXHIBIT B
BUDGET
2009-10
Agency Name: Trauma Intervention Program
•
Description
CDBG
BUDGET
OTHER
RESOURCES
TOTAL
BUDGET
1) Personnel (Direct labor)
$5,000
2) Insurance
$1,000
3) Training and Resource Material
$2,000
5) Sub Total for Direct Costs
$8,000
6) Indirect Costs (Overhead)
-
TOTAL
$
8,000
$ -
1 $
Exhibit C
Board of Directors
By -Laws
Board of Directors
Page 1 of 3
Programs Le SerOses
Board of Directors
Lt. Joe Young, President
Oceanside Police Department
Joe Young has been in law enforcement for 23 years. He is currently assigned to the Inv(
Division managing the Vice/Narcotics and Gang Units Joe also oversees the police depa
Homeland Security and disaster preparedness programs. Lt Young holds a Bachelor's dE
Southern Illinois University in Workforce Education and is near completion of a Master's d
Education.. Joe lives in Oceanside with his wife Jennifer and their three children. Joe's h
spending time with his family, friends, and playing golf.
Cindy Roark, Board Member
National Advisory Board, Mothers Against Drunk Driving
Past Chairman, MADD National Board
Mrs. Cindy Roark has been a proactive grass roots volunteer for MADD since 1984, holdii
positions on the local San Diego board and an officer on the executive committee on the
Board. She developed victim services programs, subject based support groups, speaker
worked to strengthen DUI legislation nation wide, expand diversity outreach, volunteer rec
developed youth programs, among others. She serves as a race official for Race Across
continental non-stop cycling event. She has completed the TIP volunteer training prograrr
to Michael, has an adult son, Patrick Michael, and daughter-in-law Lori. Their 18 year olc
was killed by a drink driver in 1984 and their adult daughter Pamela Roark -Moore died of
2000.
Ken Matsumoto, Board Member
Division Chief
Oceanside Fire Department
Ken Matsumoto has been with the Oceanside Fire Department for over 28 years and hold
Division Chief as the Department's Fire Training Officer. In addition to his current assignrr
the City CERT (Community Emergency Response Team) program, is involved with disast
and coordinates the department's participation in the Oceanside High School's "First Res'
program.
Outside the department, Ken is involved in several rescue training programs as a State Fi
http://www.tipsandiego.orglBoardDirectorsOl.htm 5/25/2010
Board of Directors Page 2 of 3
curriculum developer and as a Senior Instructor. He also holds positions as a Task Force
Incident Support Team Overhead Management team member for FEMA's Urban Search
program. Through this work Ken has responded to help in several search and rescue ope
Northridge Earthquake, Atlanta Summer Olympics, Hurricanes Frances, Katrina, Rita, Gu
North Dakota Floods.
He is a native North County resident and now resides in Cardiff with his wife Diane.
Debbie Fountain, Treasurer
Director of Housing and Redevelopment, City of Carlsbad
Debbie has worked in the public sector for nearly 21 years. Her goal is to work in an envi,
provides needed services to the public, but in a creative and exciting manner. Debbie ha:
Community Development Block Grants, HOME Program, transportation programs, redev€
programs, affordable housing programs, and other programs and projects providing public
local government level. Debbie has earned both a Bachelor and Masters Degree in Publi,
from San Diego State University.
Jim Schroder, Secretary
Independent Business Owner
Mr Schroder was born in San Diego and has resided in Oceanside for the majority of his I
earned a degree in Economics and Business Management from Chapman University. Ac
and restaurant business for 43 years, he has been on the board of directors of numerous
including Oceanside Chamber of Commerce, California Lodging Industry Association, Oct
Oceanside Economic Development Commission, and KOCT Television. He has also bee
Governor for Best Western International Hotels for the San Diego, Baja California, and ME
Don Goddard, Board Member
Don Goddard started with TIP by graduating from it's Training Academy in January 2006 <
monthly calls that year. For the first quarter of 2007, Don was a Team Leader for the Pom
team, and between January 2007 and July 2008 he was the scheduler for the North Coun
Today he continues his TIP service as a Board Member. Don is certified by both the the
Logistics Engineers and Project Management Institute and holds a Master's degrees in be
and Traditional Oriental Medicine (Cum Laude).
Trauma Intervention Programs of San Diego County, Inc.
2560 Orion Way Carlsbad, CA 92010 760-931-2104
http://www.tipsandiego.org/BoardDirectorsOl.htm 5/25/2010
Board of Directors Page 3 of 3
This web site designed and maintained by Chuck Cannova. For questions regarding this site, contact
chuck.cannova@gmail.com. gmal.com. For questions regarding TIP, contact tipsandiego@sbeglobal.net.
http://www.tipsandiego.org/BoardDirectorsOl.htm 5/25/2010
EXHIBIT C
BYLAWS OF
TRAUMA INTERVENTION PROGRAMS OF SAN DIEGO COUNTY, INC.
A California Public Benefit Corporation
ARTICLE 1: Name, Office
Section 1.01 - Name of the Corporation
The name of this Corporation shall be TRAUMA INTERVENTION PROGRAMS OF SAN DIEGO
COUNTY, INC. (hereinafter referred to as the "Corporation").
Section 1.02 — Principal Office
The principal executive office for the transaction of the business of the Corporation is located in the State of
California, County of San Diego.
The Board of Directors (hereinafter referred to as the "BOD") may change the principal office from one
location to another. Any change of this location shall be noted by the Secretary on these Bylaws.opposite
this section, or this section may be amended to state the new location.
Section 1.03 — Other Offices
The ROD or their designee may at any time establish branch or subordinate offices at any place or places
where the Corporation is qualified to do business.
ARTICLE 2: Purpose
Section 2.01 — Purpose
The general purpose of this Corporation is to ensure that victims of traumatic events receive the emotional
and practical support they need immediately following the traumatic occurrence.
Section 2.02 — Nonpartisan Activities
This Corporation has been formed under the California Corporation Law for the purpose described herein at
Article 2, Section 2.01, and it shall be nonprofit and nonpartisan. No substantial part of the activities of the
Corporation shall consist of the publication or dissemination of materials with the purpose of attempting to
influence legislation, and the Corporation shall not participate or intervene in any political campaign on
behalf of any candidate for public office or for or against any cause or measure being submitted to the people
for a vote.
The Corporation shall not, except in an insubstantial degree, engage in any activities or exercise any powers
that are not in furtherance of the purpose described above.
Trauma Intervention Programs
Bylaws
ARTICLE 3: Membership and Meetings
Section 3.01 — Voting Members of the Corporation
2
Voting members shall consist of the members of the BOD of the Corporation. Effective July 1,• 1996 and
thereafter, no voting member shall be an active program volunteer.
Section 3.02 Honorary Members
Any individual or organization that subscribes to the purposes and basic policies of the Corporation and
whose admission will contribute to the Corporation's ability to carry out its charitable and educational
purposes may become an honorary member of the Corporation.
Section 3.03 — Application for Membership to the Board of Directors
Applications for membership to the BOD shall be submitted by the Executive Director or the BOD of the
Corporation on a written form prescribed and approved by the BOD. The Executive Director shall transmit
such applications for consideration to the BOD who shall evaluate such applications in order to determine
the applicant's eligibility for membership. Membership shall be conferred upon the applicant by a simple
majority of the votes cast at a regular or special meeting of the BOD or by a simple vote though a written
ballot emailed to the members at the direction of the BOD.
Section 3.04 — Application for Honorary and Advisory Membership
Honorary and advisory membership shall be conferred upon the individual by a simple majority of the votes
cast at a regular or special meeting of the BOD or by email vote.
Section 3.05 Rights of Directors
Each member of the Corporation shall be entitled to one vote on each matter submitted to a vote at the
meeting of the BOD, except to the extent that the voting rights are limited or denied by the Articles of
Incorporation. No member shall be entitled to any dividend or any part of the income of the Corporation or
to share in the distribution of the corporate assets upon the dissolution of the Corporation.
Section 3.06 — Rights of Honorary and Advisory Members
I-Ionorary and advisory members shall have all the rights and privileges of this Corporation except that they
shall not vote or hold office. No honorary member shall be entitled to any dividend or any part of the
income of the Corporation or to share in the distribution of the corporate assets upon the dissolution of the
Corporation.
Trauma Intervention Programs
Bylaws 3
Section 3.07 — Resignation of Directors, Honorary, & Advisory Members
Any BOD member or honorary member or advisory member may resign from the Corporation by delivering
a written resignation to the President, Secretary, or Executive Director of the Corporation.
Section 3.08 — Termination of Honorary Membership
Any honorary and advisory member may be removed with or without cause at any time by the affirmative
vote of a majority of the members of the Corporation present at a meeting of the BOD_ This section may be
amended or repealed only by a vote of a majority of all members of the Corporation at a meeting of the
BOD.
Section 3.09 — Annual Meeting of the Board of Directors
There shall be an annual meeting each year of the BOD of this Corporation, to be held in the County of San
Diego, State of California. The annual meeting will serve as an annual BOD evaluation to determine the
action and direction of the Corporation toward meeting it's mission and goals.
Section 3.10 — Regular Meetings
The BOD members shall meet at a time and place determined by the BOD, with a minimum of three (3)
meetings held per year.
Section 3.11 — Cancellation of Meetings
The Executive Director, with concurrence of a majority of the members of the BOD, may cancel meetings,
or change the date, time or place of meetings under special circumstances.
Section 3.12 — Adjournment
A majority of the members present, whether or not continuing a quorum, may adjourn any meeting of the
BOD to another time or place.
Section 3.13 — Volunteer Liaison to the Board of Directors
Each geographical volunteer team will have the opportunity to appoint a volunteer liaison to act as a non-
voting member of the board and report back to the other TIP volunteers as to the current BOD activities.
ARTICLE 4 — Board of Directors
Section 4.01 — Powers
(a) The activities, affairs and property of the Corporation shall be managed, directed and controlled, and its
Trauma Intervention Programs
Bylaws 4
powers executed by, and vested in, the BOD or their duly appointed representative.
(b) Select and remove the Executive Director of the Corporation; prescribe any powers and duties for
him/her that are consistent with the law, with the Articles of Incorporation, and with the Bylaws; and fix the
compensation.
(c) Adopt, make and use a corporate seal; prescribes foinis of membership certificates; and alter the form of
the seal and certificate.
(d) Borrow money and incur indebtedness on behalf of the Corporation and cause to be executed and
delivered for the Corporation's purposes, in the corporate name, promissory notes, bonds, debentures, deeds
of trust, mortgages, pledges, hypothecation and other evidence of debt and securities.
Section 4.02 — Number, Election, Term
The BOD shall consist of at least five (5) persons who are elected for two year terms. All terms shall expire
in the month of June with one-half of the terms expiring in the even numbered years and one-half the terms
expiring in the odd numbered years. Elections of the members shall be held in June of each year with the
term beginning in July.
Section 4.03 — Removal
A BOD member may be removed with cause at any time by the affirmative vote of majority of the members
of the Corporation present at a noticed meeting of the BOD, the notice of which shall have specified the
proposed removal. This section may be amended or repealed only by vote of a majority of all members of
the Corporation at a meeting of the BOD. A pattern of five (5) or more absences may result in their removal
from the BOD. A member for personal reasons may request a leave of absence subject to approval of the
BOD.
Section 4.04 — Vacancies
Whenever the number of BOD members shall for any reason be less than the authorized number, the vacancy
may be filled by a majority of the remaining members, though Tess than a quorum, or by sole remaining
member.
Section 4.05 — Quorum
The quorum for the transaction of business at any properly noticed meeting of the BOD shall consist of a
minimum of three (3) members of which two (2) must be Officers of the BOD.Section 4.06 — Special
Meeting of the Board of Directors
Special meeting of the BOD may be called by the President or Vice President and must be called by either of
them on the written request of any three (3) members or a petition signed by 20% of the members of the
Trauma Intervention Programs
Bylaws 5
Corporation.
Section 4.07 — Notice of Meeting
Notice of all meetings of the BOD, except as herein otherwise provided, shall be given by mailing or
emailing the same at least five (5) days before the meeting to the usual business or residence address of the
members but such notice may be waived by any member. Each such notice shall state the general business
to be transacted, the day, time and place of such meeting and in the case of special meetings, and by whose
request it was called. Regular meetings of the BOD may be held without notice at such time and place as
shall be determined by the member. Any business may be transacted at any regularly called meeting of the
BOD.
Section 4.08 — Action by Board of Directors without a Meeting
Any action required or permitted to be taken by the BOD may be taken without a meeting if all rnembers
shall individually or collectively consent in writing to the action, including email. The written consent or
consents shall be filed with the minutes of the proceedings of the BOD, and the action taken shall have the
same force and effect as a unanimous vote of the members.
Section 4.09 — Compensation/Reimbursements
The members and Officers of the Corporation shall serve as such without salary, but the BOD may authorize
reimbursements for reasonable expenses incurred by the members or Officers in the performance of their
duties.
Section 4.10 — Contracts with Board of Directors
No member or Officer of the Corporation shall be interested, directly or indirectly, in any contract relating to
the operations conducted by it, nor in any contract for furnishing services to it, unless (i) such contract shall
he authorized by the entire BOD majority and voting at a meeting at which the presence of such member is
not necessary to constitute a quorum and the vote of such member is not necessary for such authorization;
and (ii) the facts and nature of such interest shall have been fully disclosed or shown to the members of the
BOD present at the meeting at which such contract is so authorized.
Section 4.11 — Board Member Responsibilities
The responsibilities of the Board of Directors will include:
(a) Serve as a "Roving Ambassador" for the Corporation, to promote the Corporation wherever opportunity
arises.
(b) Be willing to allow the Corporation to identify him or her as a Board member on corporate letterhead,
web site and event programs.
Trauma Intervention Programs
Bylaws
6
(c) Provide moral support to the staff of the Corporation, in addition to leads, contacts or introductions that
will be helpful in fundraising, volunteer recruitment, and/or program expansion.
(d) Attend the annual Advisory Board meeting, annual fundraising events, volunteer continuing education
meetings, and the other activities of the Corporation as designated by the BOD.
(e) Participate as an active committee member in support of the annual Heroes on Scene fundraising event
and attend the event.
(f) Recruit other appropriate Board members.
(g) Provide annual contributions to the Corporation through fundraising efforts or other means.
(h) Support the Executive Director in securing grants, fundraising, and individual and corporate
contributions.
(i) Attend monthly BOD meetings and one special annual BOD meeting.
Section 4.12 - Conflict of Interest
Any member of the board who has a financial, personal, or official interest in. or conflict (or
appearance of a conflict) with any matter pending before the Board, of such nature that it
prevents or may prevent that member from acting on the matter in an impartial manner, will
offer to the Board to voluntarily excuse himiherself and will vacate his seat and refrain from
discussion and voting on said item.
ARTICLE 5: Advisory Board
Section 5.01 — Advisory Board
The BOD and the Executive Director shall work together to recruit an Advisory Board. The purpose of this
board will be to advise and support the BOD and Executive Director on issues which affect the Corporation.
The Advisory Board will consist of members of the community who will enhance the mission and goals of
the Corporation. The Advisory Board will not be required to meet more than once annually. There shall be
no fixed term for members of the board. There shall be no minimum or maximum number of members. The
Advisory Board members may serve on committees of the BOD, and be involved in many aspects of the
Corporation, including event planning, legal issues, volunteer recruitment, publicity and fundraising.
Section 5.02 — Advisory Board Member Responsibilities
The responsibilities of the Advisory Board will include to:
(a) Serve as a "Roving Ambassador" for the Corporation, to promote the Corporation wherever opportunity
arises.
Trauma Intervention Programs
Bylaws
7
(b) Be willing to allow the Corporation to identify him or her as an Advisory Board member on corporate
letterhead, web site and event programs.
(c) Provide the staff of the Corporation with leads, contacts or introductions that will be helpful in
fundraising and/or program expansion.
(d) Attend annual Advisory Board meetings.
(e) Support the annual Heroes on Scene event.
(f) Assist in recruiting other appropriate Advisory Board members.
ARTICLE 6: Officers
Section 6.01 — Titles and Qualifications
The Officers of the BOD shall consist of a President, Vice President, Secretary, 'Creasurer and such other
Officers as the BOD may from time to time designate.
Section 6.02 — Duties of Officers
(a) President
The President of the BOD shall preside at all meetings of the BOD of the Corporation and shall have
such other powers and duties not consistent with the Bylaws as may be assigned from time to time by
the BOD.
(b) Vice President
The Vice President of the BOD shall possess the powers and duties of the President of the BOD in
such case as he or she is absent or disabled.
(c) Secretary
The Secretary shall have the general powers and duties usually vested in the office of Secretary of a
Corporation and shall have such powers and duties not consistent with these Bylaws as may be
assigned him or her from time to time by the BOD or the President including the powers and duties
to he (i) be custodian of all records, documents and the seal of the Corporation which are to be kept
in the principal executive office of the Corporation; (ii) affix the Corporate Seal to any instrument
requiring it and to attest the same by his or her signature when authorized by the BOD or when such
instrument shall first have been signed by the President or the Vice President or other duly
authorized officer or agent; (iii) keep the minutes of the BOD meetings and other committee
meetings, as applicable, of the Corporation to be recorded in one or more books provided for that
purpose, with the time and place of the holding of such meetings, how they were called and
Trauma Intervention Programs
Bylaws
8
authorized, the notice given thereof, the names of those present and the proceedings thereof indicated
in the record; (iv) provided that proper notices are given in accordance with the provisions of these
Bylaws.
(d) Treasurer
The Treasurer shall be responsible for all funds and securities of the Corporation and shall have the
general powers and duties usually vested in the office of Treasurer of a Corporation and shall have
such powers and duties not consistent with these Bylaws as may be assigned to him or her from time
to time by the BOD or the President, including the powers and duties to (i) care for, receive and give
receipt monies due and payable to the Corporation; (ii) deposit all monies received in the name of the
Corporation in such banks, trust companies or other depositories as from time to time may be
designated by the Board of Directors; (iii) have charge of the disbursement of the monies of the
Corporation in accordance with the directions of the BOD or the President; (iv) enter or cause to be
entered regularly in the books to be kept by the Treasurer or under his or her direction for that
purpose a complete and correct account of all monies received and disbursed by the Corporation; (v)
render a statement of the financial accounts of the Corporation to the Board of Directors at such
times as may be requested; (vi) exhibit the books of account of the Corporation and all securities,
vouchers, papers on and documents of the Corporation in his or her custody to any member or
designee of the Board of Directors upon request; (vii) submit a full financial report to the members
of the Corporation at the annual membership meeting.
Section 6.03 — Election of Officers
Officers shall be elected by the BOD, at any time, and each Officer shall hold office until he or she resigns,
is removed or is otherwise disqualified to serve, or until his or her successor shall be elected and qualified,
whichever occurs first.
Section 6.04 — Term of Office
All Officers shall be elected in June of each year and serve a term of one year or until their successors are
elected and qualified.
Section 6.05 — Resignation
Any Officer may resign from the office at any time by delivering a written resignation to the President, the
Vice President or the Secretary. The acceptance of any such resignation, unless required by the terms
thereof, shall not be necessary to make the same effective.
Section 6.06- Removal
Any Officer may be removed at any time, with cause, by majority vote of the entirety of the members at a
duly held meeting of the BOD. Proper notice specifying the proposed removal shall be given prior to any
Trauma Intervention Programs
Bylaws 9
meeting of the BOD at which such removal shall be considered.
Section 6.07- Vacancies
Any vacancy in an office may be filled for the unexpired portion of the term by majority vote of the BOD.
Section 6.08 - Records
There shall be maintained at the principal executive office of the Corporation all financial books and records
of account, all minutes of the BOD meetings and other committee meetings of the Corporation, and list of
members, and copies of all other material, corporate records, books, documents and contracts. All such
books, records, minutes, lists, documents and contracts shall be made available for inspection at any
reasonable time during the usual business hours by any members of the Corporation, or duly authorized
representative thereof, for any lawful and proper purpose. Upon leaving office each Officer, or duly
authorized representative thereof, of the Corporation shall turn over to his or her successor or to the
President in good order, such corporate monies, books, records, minutes, lists, documents, contracts or other
property of the Corporation as have been in the custody of such officer of and during his or her term in
office.
Section 6.09 - Committees
The BOD from time to time may establish other committees or auxiliaries whose membership will consist of
voting members and/or honorary or advisory members of the Corporation as designated by the BOD which
shall have such duties and the members of which shall hold office for such periods as the BOD from time to
time determine. The rules of procedures of such committee shall be determined from time to time by the
BOD, and by respective committee members. All committees and committee members serve at the pleasure
of the BOD.
Section 6.10 - Executive Committee
The Executive Committee shall consist of the Officers of the BOD and may elect to hold special meetings
outside of the regular scheduled meetings in order to provide a decision for the Corporation in times of
urgency. Officers will then inform the BOD of the meeting purpose and outcome at the next regular meeting
of the BOD.
ARTICLE 7: Records and Reports
Section 7.01 - Maintenance and Inspection of Articles and Bylaws
The Corporation shall keep at its principal executive office the original or a copy of the Articles and Bylaws
as amended to date, which shall be open to inspection.
Section 7.02 - Maintenance and Inspection of Other Corporate Records
Trauma Intervention Programs
Bylaws 10
The accounting books, records and minutes of proceedings of the BOD and other committees of the
Corporation shall be kept at such place or places designated by the BOD or, in the absence of such
designation, at the principal executive office of the Corporation. The minutes shall be kept in written or
typed form, and the accounting books and records shall be kept either in written or typed form or in any other
form capable of being converted into written, typed or printed form.
Section 7.03 — Inspection by Board of Directors
Every member of the BOD shall have the absolute right at any reasonable time to inspect all books, records
and documents of every kind and the physical properties of the Corporation and each of its subsidiary
Corporations. This inspection by a member may be made in person or by an agent or attorney, and the right
of inspection includes the right to copy and make extracts of documents.
Section 7.04 — Annual Report
The President of the Corporation or his/her designee will cause to be sent each year to the Board of Directors
an annual report of the Corporation's activities. This report will encompass all information required by
California Corporations Code 6321 (*) as amended to date.
Section 7.05 — Annual Audit
The Corporation shall hire an independent auditor to perform an annual audit of the finances of the
Corporation and provide a written report to the BOD.
ARTICLE 8: Deposits, Checks, Loan Contracts
Section 8.01 — Deposit of Funds
All funds of the Corporation not otherwise employed shall be deposited in such banks, trust companies or
other reliable depositories as the BOD from time to time may determine.
Section 8.02 — Checks, Etc.
All checks, drafts, endorsements, notes and evidences of indebtedness of the Corporation shall be signed by
such Officers or agents of the Corporation and in such manner as the BOD from time to time may determine.
Endorsements for deposits to the credit of the Corporation shall be made in such manner as the BOD from
time to time may determine.
Section 8.03 — Loans
No loans or advances shall be contracted on behalf of the Corporation, and no note or other evidence of
indebtedness shall be issued in its name, unless and except as authorized by a vote of the BOD. Any such
Trauma Intervention Programs
Bylaws
11
authorization shall relate to specific transactions, and may include authorization to pledge, and security for
loans or advances so authorized, any and all securities and other personal property at any time held by the
Corporation.
Section 704 Contracts
The President, or any other Officer or agent specially authorized by the BOD, may in the name of and on
behalf of the Corporation, enter into those contracts or execute and deliver those instruments that arc
specifically authorized by the BOD. Without the express and specific authorization of the BOD, no officer
or other agent of the Corporation may enter into any contract or execution and deliver any instrument in the
name of and on behalf of the Corporation.
ARTICLE 9: Dedication of Assets
Section 9.01 Dedication of Assets
The properties and assets of this nonprofit Corporation are irrevocably dedicated to the fulfillment of the
objectives and purposes of this Corporation as set forth in Article 2, Section 2.01 hereof. No part of the net
earnings, properties or assets of this Corporation, on dissolution or otherwise, shall inure to the exclusive
benefit of any private person or individual, or any member of this Corporation except in fulfillment of said
objectives and purposes. On liquidation or dissolution, all properties and assets and obligations shall be
distributed pursuant to the nonprofit provisions of the California Corporation Code then in effect.
ARTICLE 10: Indemnification of Members and Officers
Section 10.01 — Indemnification
Any person (and heirs, executors and administrators of such person) made or threatened to be made a party
to any action, suit or proceeding by reason of the fact that he or she is or was a member or Officer of the
Corporation shall be indemnified by the Corporation against any and all liability and the reasonable
expenses, including attorneys' fees and disbursements incurred by him or her (or by his or her heirs,
executors or administrators) in connection with the defense or settlement of such action, suit or proceedings,
or in connection with any appearance therein, except in relation to matters as to which it shall be adjudged in
such action, suit or proceeding that such member or Officer is liable for negligence or misconduct in the
performance of his or her duties. Such right of indemnification shall not be deemed exclusive of any other
rights to which such Director or officer (or such heirs, executors or administrators) may be entitled apart
from this Article.
Section 10.02 — Insurance or Other Indemnification
The BOD shall have the power to (i) purchase and maintain, at the Corporation's expense, insurance on the
behalf of the Corporation and on behalf of others to the extent that power to do so have been or may be
granted by statute, and (ii) give other indemnification to the extent permitted by law.
Trauma Intervention Programs
Bylaws
ARTICLE 11: Amendment of Bylaws
12
Section 11.01 — Amendment of Bylaws
Except as otherwise provided herein, and subject to the power of the BOD to amend or repeal the Bylaws,
these Bylaws may be altered, amended or repealed and new Bylaws may be adopted by an affirmative vote of
a majority of the member of the BOD present at any regular or special meeting, a quorum being assembled,
provided that written notice of such meeting, setting forth in detail the proposed Bylaw revisions with
explanations therefore, be given not less than five (5) days prior to such meeting.
ARTICLE 12: Miscellaneous
Section 12.01 — Fiscal Year
The fiscal year of the Corporation shall begin on July 1 of each year and shall end on June 30.
Section 12.02 — Construction
Whenever the context so requires, the masculine shall include the feminine and neuter, and the singular shall
include the plural, and conversely. If any of the portion of these Bylaws shall be invalid or inoperative, then
so far as is reasonable and possible:
(a) The remainder of these Bylaws shall be considered valid and operative, and
(b) Effect shall be given to the intent manifested by the portion held invalid or inoperative.
Section 12.03 — Program Modifications
Any and all program modifications shall require the approval, by means of an affirmative vote, of two-thirds
(2/3) of the members present at any regular or special meeting of the BOD, a quorum being assembled.
These Bylaws of the Corporation are hereby adopted with amendments made to date, on this date.
Chris Saunders, President Date
Witness
UPDATED 5.14.07
Date
Trauma Intervention Programs
Bylaws 13
(')California Corporations Code
Section 6321
6321. (a) Except as provided in subdivision (c), (d), or (/), the board shall cause an annual report to be sent to the members not later than 120 days after
the close of the corporation's fiscal year. Unless otherwise provided by the articles or bylaws and if approved by the board of directors, that report and
any accompanying material sent pursuant to this section may be sent by electronic trarumissi'an by the corporation (Section 20). That report shall contain
in appropriate detail the following:
(1) The assets and liabilities, including the trust funds. of the Corporation as of the end of the fiscal year
(2) The principal changes in assets and liabilities, including trust funds, during the fiscal year
(3) The revenue or receipts of the Corporation, both unrestricted and restricted to particular purposes for the fiscal year.
(4) The expenses or disbursements of the Corporation, for both general and restricted purposes, during the fiscal year
(5) Any information required by Section 6322_
(b) The report required by subdivision (a) shall be accompanied by any report thereon of independent accountants, or, if there is no such report. the
certificate of an authorized Officer of the corporation thut such statements were prepared without audit from the books and records of the Corporation.
(c) Subdivision (a) does not apply to any Corporation which receives less than twenty-five thousand dollars (S25,000) in gross revenues or receipts
during the fiscal year.
(d) Where a Corporation has provided, pursuant to Section 5510, for regular meetings ofinembers less often than annually, then the report required by
subdivision (a) need be made to members only with the frequency with which regular membership meetings are required, unless the articles or bylaws
require a report more often.
(e) Subdivisions (c) and (d) notwithstanding, a report with the information required by subdivision (a) shall be furnished annually to:
(1) All directors of the Corporation; and
(2) Any member who requests it in writing.
09 A Corporation which in writing solicits contributions from 500 or more persons need not send the report otherwise required by subdivision (a) if it
does all of the following:
(i) Includes with any written material used to solicit contributions a written statement that its latest annual report will be mailed upon request and that
such request may be sent to the Corporation at a name and address which is set forth in the statement.
The term "annual report" as used in this subdivision refers to the report required by subdivision (a).
(ii) Promptly malls a copy of its latest annual report to any person who requests a copy thereof, and
(in) Causes its annual report to be published not later than 120 days after the close of its fiscal year in a newspaper of general circulation in the county
in which its principal executive office is located_
EXIBIT D
TECHNICAL ASSISTANCE MATERIALS
The Sub -recipient attended the Community Development Block Grant (CDBG)
Technical Assistance Non -Profit Workshop held on June 28, 2007, and received the
following items:
1. Playing by the Rules, A Handbook for CDBG Sub -recipients on Administrative
Systems (if not previously provided)
2. CFR Title 24- Housing and Urban Development, CDBG Regulations (if not
previously provided)
3. OMB A-122
4. Quarterly/Annual Performance Reporting Form (updated format)
5. Compliance and Performing Monitoring Tool
6. Expenditure Reimbursement Claim Form (updated format)
7. Qualifying Beneficiary Intake Data Form (updated format)
The workshop and reference documents will assist the Sub -recipient with new U.S
Department of Housing and Urban Development and City of National City reporting
requirements.
EXHIBIT E
AFFIRMATIVE ACTION POLICY
1. Provision of Program Services
a. SUB -RECIPIENT shall not, on the grounds of race, religion, color, national origin,
sex, sexual preference, or handicap, exclude any person from participation in,
deny any person the benefits of, or subject any person to discrimination under
any program or activity funded in whole or in part with CDBG funds.
b. SUB -RECIPIENT shall not under any program or activity funded in whole or in
part with CDBG funds, on the grounds of race, religion, color, national origin,
sex, sexual preference, or handicap:
1) Deny any facilities, services, financial aid or other benefits
provided under the program or activity; or
2) Provide any facilities, services, financial aid, or other benefits
which are different or are provided in a different form from that
provided to others under the program or activity; or
3) Subject to segregated or separate treatment in any facility in, or
in any matter of process related to receipt of any service or
benefit under the program or activity; or
4) Restrict in any way access to, or in the enjoyment of any
advantage or privilege enjoyed by others in connection with
facilities, services, financial aid, or other benefits under the
program or activity; or
5) Treat an individual differently from others in determining whether
the individual satisfies any admission, enrollment, eligibility,
membership, or other requirement or condition which the
individual must meet in order to be provided any facilities,
services, or other benefits provided under the program or
activity; or
6) Deny any opportunity to participate in a program or activity as an
employee.
c. SUB -RECIPIENT may not utilize criteria or methods of administration which have
the effect of subjecting individuals to discrimination on the basis of race,
religion, color, national origin, sex, sexual preference, or handicap, or have the
effect of defeating or substantially impairing accomplishment of the objectives of
the program or activity with respect to individuals of a particular race, religion,
color, national origin, sex, sexual preference or handicap.
d. SUB -RECIPIENT, in determining the site or location of housing or facilities
provided in whole or in part with CDBG funds, may riot make selections of such
site or location which have the effect of excluding individuals from, denying
them the benefits of, or subjecting them to discrimination on the grounds of
race, color, national origin, or sex, or which have the purpose or effect of
defeating or substantially impairing the accomplishment of the objectives of the
Civil Rights Act of 1964 and amendments thereto:
e. In administering a program or activity funded in whole or in part with CDBG
funds regarding which the SUB -RECIPIENT has previously discriminated against
persons on the grounds of race, religion, color, national origin, sex, sexual
preference or handicap, the SUB -RECIPIENT must take affirmative action to
overcome the effects of prior discrimination.
f. Even in the absence of such prior discrimination, a SUB -RECIPIENT in
administering a program or activity funded in whole or in part with CDBG funds
should take affirmative action to overcome the effects of conditions which would
otherwise result in limiting participation by persons of a particular race, color,
national origin, or sex. Where previous discriminatory practice or usage tends,
on the grounds of race, religion, color, national origin, sex, sexual preference, or
handicap, to exclude individuals from participation in, to deny them the benefits
of, or to subject them to discrimination under any program or activity to which
CDBG funding applies, the SUB -RECIPIENT has an obligation to take reasonable
action to remove or overcome the consequences of the prior discriminatory
practice or usage, and to accomplish the purpose of the Civil Rights Act of 1964.
g. A SUB -RECIPIENT shall not be prohibited by this part from taking any eligible
action to ameliorate an imbalance in services or facilities provided to any
geographic area or specific group of persons within its jurisdiction where the
purpose of such action is to overcome prior discriminatory practice or usage.
h. Notwithstanding anything to the contrary in Sections 3. 1. (a. through h.),
nothing contained herein shall be construed to prohibit any SUB -RECIPIENT
from maintaining or constructing separate living facilities or rest -room facilities
for the different sexes. Furthermore, selectivity on. the basis of sex is not
prohibited when institutional or custodial services can properly be performed
only by a member of the same sex as the recipients of the services.
2. Employment Discrimination
a. SUB -RECIPIENT shall not discriminate against any employee or application for
employment because of race, color, religion, sex, national origin, age, or
handicap. SUB -RECIPIENT shall take affirmative action to insure that applicants
are employed, and that employees are treated during employment, without
regard to their race, color, religion, sex, national origin, age, or handicap. Such
action shall include, but not be limited to, the following: employment,
upgrading, demotion, or transfer, recruitment or recruitment advertising, layoff
or termination, rate -of -pay or other forms of compensation and selection for
training including apprenticeship. SUB -RECIPIENT agrees to post in conspicuous
places, available to employees and applicants for employment, notices setting
forth the provisions of this non-discrimination clause.
b. SUB -RECIPIENT shall, in all solicitations or advertisements for employees placed
by or on behalf of SUB -RECIPIENT, state that all qualified applications will
receive consideration for employment without regard to race, color, religion,
sex, national origin, age, or handicap.
c. SUB -RECIPIENT shall send to each labor union or representative of workers with
which it has a collective bargaining agreement or other contract or
understanding, a notice to be provided by the CDC's contracting officers,
advising the labor union or workers' representative of SUB -RECIPIENT'S
commitments under Section 202 of Executive Order No. 11246 of September
24, 1965, and shall post copies of the notices in conspicuous places available to
employees and applicants for employment.
d. SUB -RECIPIENT shall comply with all provisions of Executive Order 11246 of
September 24, 1965, and of the rules, regulations, and relevant orders of the
Secretary of Labor..
e. SUB -RECIPIENT shall furnish to the CDC all information and reports required by
Executive Order No. 11246 of September 24, 1965, and by the related rules,
regulations, and orders.
f. In the event of SUB -RECIPIENT'S failure to comply with any rules, regulations,
or orders required to be complied with pursuant to this Agreement, the CDC
may cancel, terminate, or suspend in whole or in part its performance and SUB -
RECIPIENT may be declared ineligible for further government contracts in
accordance with procedures authorized in Executive Order No. 11246 of
September 24, 1965, and such other sanctions as may be imposed and
remedies invoked as provided in Executive Order No. 11246 of September 24,
1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise
provided by law.
g. SUB -RECIPIENT shall include the provisions of Section II. J. 2. (a. through f.),
"Affirmative Action Policy," paragraphs (1) through (6) in every subcontract or
purchase order unless exempted by rules, regulations, or order of the Secretary
of Labor issued pursuant to Section 204 of Executive Order No. 11246 of
September 24, 1965, so that such provisions will be binding upon each
subcontractor or vendor. SUB -RECIPIENT shall take such action with respect to
any subcontract or purchase order as the CDC may direct as a means of
enforcing such provisions including sanctions for non-compliance; provided,
however, that in the event SUB -RECIPIENT becomes involved in, or is
threatened with, litigation with a subcontractor or vendor as a result of such
direction by the CDC, SUB -RECIPIENT may request the United States to enter
into such litigation to protect the interests of the United States.
h. SUB -RECIPIENT shall not discriminate on the basis of age in violation of any
provision of the Age Discrimination Act of 1975 (42 U.S.C. 6101 et seq.) or with
respect to any otherwise qualified handicapped individual as provided in Section
504 of the Rehabilitation Act of 1973 (29 U.S.C. 794). SUB -RECIPIENT shall
also provide ready access to and use of all CDBG fund -assisted buildings to
physically handicapped persons in compliance with the standards established in
the Architectural Barriers Act of 1968 (42 U.S.C. 4151 et seq.).
3. Remedies: In the event of SUB -RECIPIENT'S failure to comply with any rules,
regulations, or orders required to be complied with pursuant to this Agreement, the
CDC may cancel, terminate, or suspend in whole or in part its performance and SUB -
RECIPIENT may be declared Ineligible for further government contracts and any such
other sanctions as may be imposed and remedies invoked as provided by law.
Exhibit F
Insurance Requirements
ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID SW
TRAUM02
DATE IMMDO/YYYY)
05/17/10
PRODUCER
G. S. Levine Insurance
Services, Inc.
10505 Sorrento Valley Rd. #200
San Diego CA 92121
Phone: 858-481-6692 Fax: 858-481-7953
THIS CERTIFICATE IS ISSUED AS A MATTER OF
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND,
ALTER THE COVERAGE AFFORDED BY THE POLICIES
NFORMATION
EXTEND OR
BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Trauma Intervention Programs
of San Diego County, Inc.
2560 Orion Way
Carlsbad CA 92008
INSURERA Philadelphia Insurance Co
INSURER E:
INSORERc
INSURERD
INSURER E
THE POLICIES
ANY REQUIREMENT,
MAY PERTAIN,
POLICIES.
BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
BEEN REDUCED BY PAID CLAIMS. ` `"
OF INSURANCE LISTED BELOW HAVE
TERM OR CONDITION OF ANY
THE INSURANCE AFFORDED BY
AGGREGATE LIMITS SHOWN MAY HAVE
TNSR
LIR
ADM.
NERD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM,DDIYYI
POLICY EXPIRATION
DATE (MMNOIYYY)
LIMITS
A
X
GENERAL
LIABILITY
COMMERCIAL GLNLRAtL1MMI,
PHPK507961
12/15/09
12/15/10
EACII OCCURRENCE
$ 1,000,000
X
UAMAL.E TO REV I ED
PREMISES E.eoccurence)
$ 100,000
X CLWMS MADE J OCCUR
MED DP (Any one person)
$ 5,000
PERSONAL &ADV INA'P"
$ 1, 000, 000
GEN
GENERAL AGGREGATE
$ 3,000,000
L AGGREGATE LIMIT APPLIES PLR'.
PRODUCTS- COMP/OP AOG
$ 3 000,000
7 POLICY -1 PF C F LUC
A
X
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AVT DS
SCHEDULED AUTOS
HIRED AUTOS
NDN-OWNED AUTOS
PHPK507961
12/15/09
12/15/10
COMBINED SINGLE LIMIT
(Ea accident)
$ 1 , 000 , 000
BODILY MJUHT
(Per person)
$
X
EODILY INJURY
(Per accident
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAOE
LIABIBTY
ANY AL TO
AUTO ONLY - LA ACCIDENT
$
iOTHERTNAN EA ACC
$
AUTO ONLY AGG
$
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
DEDUCTIBLE
RETENTION $
$
$
WORMERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PPOPRIFTOR/PARTNER/EXECUTIVT
OFrICCRIMEMRFR EXCLUDED?
I' yes, descobe under
SPECIAL PROVISIONS below
I WC STATLL OTH-
TORV LIMITS FP
LL EACH ACCIDENT
$
E L DISEASE EA EMPLOYEE
$
E.L. DISEASE - POLICY OMIT
$
OTHER
DESCRIPTION OF OPERATIONS !LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
RE All Operations
The City of National City, its elected officials, officers, agents and
employees are named Additional Insured per the attached endorsement.
*10 Days Notice of Cancellation Applies for Nonpayment of Premium.
CANCELLATION
C ITYNA5
City of National City
City Attorney's Office
1243 National City Blvd.
National City CA 91950
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 * DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY VINO UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AU RAZED REPRES ATIVE
ACORD 25 (2001/08)
PI-GLD-HS (04/07)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY DELUXE ENDORSEMENT:
HUMAN SERVICES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE
It is understood and agreed that the following extensions only apply in the event that no other specific coverage for
the indicated loss exposure is provided under this policy_ If such specific coverage applies. the terms, conditions and
limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on
this endorsement. The following is a summary of the Limits of Insurance and additional coverages provided by this
endorsement. For complete details on specific coverages, consult the policy contract wording.
Coverage Applicable
Limit of Insurance
Page #
Damage to Premises Rented to You
$1,000,000
2
Extended Property Damage
included
2
Non -Owned Watercraft
Less than 58 feet
2
Medical Payments
$20,000
2
Medical Payments — Extended Reporting Period
3 years
3
Athletic Activities
Amended
3
Supplementary Payments — Bail Bonds
$2,500
3
Supplementary Payment— Loss of Earnings
$500 per day
3
Employee Indemnification Defense Coverage for Employee
$25,000
3
Additional Insured - Medical Directors and Administrators
Included
3
Additional Insured — Managers and Supervisors
Included
3
Additional Insured — Broadened Named Insured
Included
3
Additional Insured — Funding Source
Included
4
Additional Insured — Home Care Providers
Included
4
Additional Insured — Managers. Landlords, or Lessors of Premises
Included
4
Additional Insured - Lessor of Leased Equipment —Automatic Status
When Required in Lease Agreement With You
Included
4
Additional Insured — Grantor of Permits
Included
4
Limited Rental Lease Agreement Contractual Liability
$50,000 limit
5
Damage to Property You Own, Rent, or Occupy
$30,000 limit
5
Transfer of Rights of Recovery Against Others To Us
Clarification
5
Duties in the Event of Occurrence, Claim or Suit
Included
5
Unintentional Failure to Disclose Hazards
Included
5
Liberalization
Included
6
Bodily Injury — includes Mental Anguish
Included
6
Personal and Advertising Injury —includes Abuse of Process,
Discrimination
Included
6
Key and Lock Replacement — Janitorial Services Client Coverage
$5,000 limit
6
Page 1 of 7
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI-GLD-HS (04/07)
A. Damage to Premises Rented to You
1. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the
word "fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire protective
systems" where it appears in:
a. The last paragraph of SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND
PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions;
b. SECTION III - LIMITS OF INSURANCE, Paragraph 6.;
c. SECTION V — DEFINITIONS, Paragraph 9.a.
2. If damage by fire to premises rented to you is not otherwise excluded from this Coverage Part, the
words "Fire insurance" are changed to "insurance for fire, lightning, explosion, smoke, or leakage
from automatic fire protective systems" where it appears in:
a. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other
Insurance, Paragraph b. Excess Insurance
3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the
greater of:
a. $1,000,000; or
b. The amount shown in the Declarations as the Damage to Premises Rented to You Limit.
This is the most we will pay for all damage proximately caused by the same event, whether such
damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective
systems or any combination thereof.
B. Extended "Property Damage"
SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, Subsection 2_ Exclusions, Paragraph a is deleted end replaced by the following:
a. Expected or Intended Injury
"Bodily Injury" or "Property Damage" expected or intended from the standpoint of the insured.
This exclusion does riot apply to "bodily injury" or "property damage" resulting from the use of
reasonable force to protect persons or property.
C. Non -Owned Watercraft
SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is amended to read as follows:
(2) A watercraft you do not own that is:
(a) Less than 58 feet long; and
(b) Not being used to carry persons or property for a charge;
This provision applies to any person, who with your consent, either uses or is responsible for the
use of a watercraft. This insurance is excess over any other valid and collectible insurance
available to the insured whether primary, excess or contingent.
D. Medical Payments - Limit Increased to $20,000. Extended Reporting Period
Page 2 of 7
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI-GLD-HS (04/07)
If COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part:
1. The Medical Expense Limit is changed subject to all of the terms of SECTION III - LIMITS OF
INSURANCE to the greater of:
a. $20,000; or
b, The Medical Expense Limit shown in the Declarations of this Coverage Part.
2. COVERAGE C MEDICAL PAYMENTS, Subsection 1. Insuring Agreement, the second part of
Paragraph a. is amended to read
provided that:
(2) The expenses are incurred and reported to us within three years of the date of the accident;
E. Athletic Activities
SECTION I — COVERAGES, COVERAGE C MEDICAL PAYMENTS, Subsection 2. Exclusions,
Paragraph e. Athletic Activities is deleted and replaced with the following:
e. Athletic Activities
To a person injured while taking part in athletics.
F. Supplementary Payments
Under the SUPPLEMENTARY PAYMENTS - COVERAGE A AND B provision, Items 1.b. and 1.d.
are amended as follows:
1. The limit for the cost of bail bonds is changed from $250 to $2,500; and
2. The limit for loss of earnings is changed from $250 a day to $500 a day.
G. Employee Indemnification Defense Coverage
Under the SUPPLEMENTARY PAYMENTS - COVERAGES A AND B provision, the following is
added:
3. We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding
The most we will pay for any "employee" who is alleged to be directly involved in a criminal
proceeding is $25,000 regardless of the numbers of "employees", claims or "suits" brought or
persons or organizations making claims or bringing "suits".
H. SECTION 11 - WHO IS AN INSURED is amended as follows:
1. If coverage for newly acquired or formed organizations is not otherwise excluded from this
Coverage Part, Paragraph 3.a. is changed to read:
a. Coverage under this provision is afforded until the end of the policy period.
2_ Each of the following is also an insured:
a. Medical Directors and Administrators - Your medical directors and administrators, but only
while acting within the scope of and during the course of their duties as such. Such duties do
not include the furnishing or failure to furnish professional services of any physician or
psychiatrist in the treatment of a patient.
Page 3 of 7
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI-GLD-HS (04/07)
b. Managers and Supervisors - If you are an organization other than a partnership or joint
venture, your managers and supervisors are also insureds, but only with respect to their duties
as your managers and supervisors.
c. Broadened Named Insured - Any organization and subsidiary thereof which you control and
actively manage on the effective date of this Coverage Part. However, coverage does not
apply to any organization or subsidiary not named in the Declarations es Named Insured, if they
are also insured under another similar policy, but for its termination or the exhaustion of its limits
of insurance.
d. Funding Source - Any person or organization with respect to their liability arising out of:
(1) Their financial control of you; or
(2) Premises they own, maintain or control while you lease or occupy these premises.
This insurance does riot apply to structural alterations, new construction and demolition
operations performed by or for that person or organization.
e. Home Care Providers - At the first Named Insured's option, any person or organization under
your direct supervision and control while providing for you private home respite or foster home
care for the developmentally disabled.
f. Managers, Landlords, or Lessors of Premises - Any person or organization with respect to
their liability arising out of the ownership, maintenance or use of that part of the premises
leased or rented to you subject to the following additional exclusions:
g.
This insurance does not apply to:
(1) Any "occurrence" which takes place after you cease to be a tenant in that premises.
(2) Structural alterations, new construction or demolition operations performed by or on
behalf of that person or organization.
Lessor of Leased Equipment — Automatic Status When Required in Lease Agreement
With You — Any person or organization from whom you lease equipment when you and such
person or organization have agreed in writing in a contract or agreement that such person or
organization is to be added as an additional insured on your policy. Such person or
organization is an insured only with respect to liability for "bodily injury", "property damage"
or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation
or use of equipment leased to you by such person or organization.
A person's or organization's status as an additional insured under this endorsement ends when
their contract or agreement with you for such leased equipment ends.
With respect to the insurance afforded to these additional insureds, this insurance does not
apply to any "occurrence" which takes place after the equipment lease expires.
h. Grantors of Permits — Any state or political subdivision granting you a permit in connection
with your premises subject to the following additional provision:
(1) This insurance applies only with respect to the following hazards for which the state or
political subdivision has issued a permit in connection with the premises you own, rent or
control and to which this insurance applies:
(a)The existence, maintenance, repair, construction, erection, or removal of advertising
signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees,
hoist away openings, sidewalk vaults, street banners or decorations and similar
exposures; or
Page4of7
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI-GLD-HS (04/07)
(b) The construction, erection, or removal of elevators; or
(c) The ownership, maintenance, or use of any elevators covered by this insurance.
I. Limited Rental Lease Agreement Contractual Liability
The following is added to SECTION I — COVERAGES. COVERAGE A. BODILY INJURY AND
PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions, Paragraph b. Contractual Liability:
(3) Based on the named insured's request at the time of claim, we agree to indemnify the named
insured for their liability assumed in a contract or agreement regarding the rental or lease of a
premises on behalf of their client, up to $50,000. This coverage extension only applies to rental
lease agreements. This coverage is excess over any renter's liability insurance of the client.
J. Damage to Property You Own, Rent or Occupy
SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, Subsection 2. Exclusions, Paragraphj_ Damage to Property, Item (1) is deleted in its
entirety and replaced with the following:
(1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any
other person, organization or entity, for repair, replacement, enhancement, restoration or
maintenance of such property for any reason, including prevention of injury to a person or
damage to another's property, unless the damage to property is caused by your client, up to a
$30,000 limit. A client is defined as a person under your direct care and supervision.
K. Transfer of Rights of Recovery Against Others To Us
As a clarification, the following is added to SECTION IV — COMMERCIAL GENERAL LIABLITY
CONDITIONS, Paragraph 8. Transfer of Rights of Recovery Against Others To Us:
Therefore, the insured can waive the insurer's Rights of Recovery prior to the occurrence of a loss,
provided the waiver is made in a written contract.
L. Duties in the Event of Occurrence, Claim or Suit
1. The requirement in Paragraph 2.a. of SECTION IV - COMMERCIAL GENERAL LIABILITY
CONDITIONS that you must see to it that we are notified as soon as practicable of an "occurrence"
or an offense, applies only when the "occurrence" or offense is known to:
a. You, if you are an individual;
b. A partner, if you are a partnership; or
c. An executive officer or insurance manager, if you are a corporation.
2. The requirement in Paragraph 2.b. of SECTION IV — COMMERCIAL GENERAL LIABILITY
CONDITIONS that you must see to it that we receive notice of a claim or "suit' as soon as
practicable will not be considered breached unless the breach occurs after such claim or "suit" is
known to:
a. You, if you are an individual;
b. A partner, if you are a partnership; or
c. An executive officer or insurance manager, if you are a corporation.
Page 5 of 7
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI-GLD-HS (04/07)
M. Unintentional Failure To Disclose Hazards
It is agreed that, based on our reliance on your representations as to existing hazards, if you should
unintentionally fail to disclose all such hazards prior to the beginning of the policy period of this
Coverage Part, we shall not deny coverage under this Coverage Part because of such failure.
N. Liberalization
If we revise this endorsement to provide more coverage without additional premium charge, we will
automatically provide the additional coverage to all endorsement holders as of the day the revision is
effective in your state.
O. Bodily Injury - Mental Anguish
SECTION V — DEFINITIONS, Paragraph 3. is changed to read:
"Bodily Injury":
a. Means bodily injury, sickness or disease sustained by a person, and includes mental anguish
resulting from any of these; and
b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any
time.
P. Personal and Advertising Injury — Abuse of Process, Discrimination
If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise
excluded from this Coverage Part, the definition of "personal and advertising injury" is amended as
follows:
1. SECTION V — DEFINITIONS, Paragraph 14.b. is revised to read:
b. Malicious prosecution or abuse of process;
2. SECTION V — DEFINITIONS, Paragraph 14. is amended to include the following:
"Personal and advertising injury" also means discrimination based on race, color, religion, sex,
age or national origin, except when:
(1) Done intentionally by or at the direction of, or with the knowledge or consent of:
(a) Any insured; or
(b) Any executive officer, director, stockholder, partner or member of the insured; or
(2) Directly or indirectly related to the employment, former or prospective employment,
termination of employment, or application for employment of any person or persons by an
insured; or
(3) Directly or indirectly related to the sale, rental, lease or sublease or prospective sales, rental,
lease or sub -lease of any room, dwelling or premises by or at the direction of any insured; or
(4) Insurance for such discrimination is prohibited by or held in violation of law, public policy,
legislation, court decision or administrative ruling.
The above does not apply to fines or penalties imposed because of discrimination.
The fallowing additional coverage is added to A. COVERAGE 4_ ADDITIONAL COVERAGES:
Page 6 of 7
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
PI-GLD-HS (04/07)
Q. Key and Lock Replacement — Janitorial Services Client Coverage
1. We will pay for the cost to replace keys and locks at the "clients" premises due to theft or other
loss to keys entrusted to you by your "client", up to a $5,000 limit per occurrence/$5,000 policy
aggregate.
2. We will not pay for loss or damage resulting from theft or any other dishonest or criminal act that
you or any of your partners, members, officers, "employees", "managers", directors, trustees,
authorized representatives or any one to whom you entrust the keys of a "client" for any purpose
commit, whether acting alone or in collusion with other persons.
3. The following, when used on this coverage, are defined as follows:
a. "Client" means an individual, company or organization with whom you have a written contract or
work order for your services for a described premises and have billed for your services.
b. "Employee"
1. Any natural person:
a. While in your service or for 30 days after termination of service;
b. Who you compensate directly by salary, wages or commissions; and
c. Who you have the right to direct and control while performing services for you; or
2. Any natural person who is fumished temporarily to you:
a. To substitute for a permanent "employee" as defined in Paragraph 1. above, who is
on leave; or
b. To meet seasonal or short-term workload conditions;
while that person is subject to your direction and control and performing services for you.
3. "Employee" does not mean:
a. Any agent, broker, person leased to you by a labor leasing firm, factor, commission
merchant, consignee, independent contractor or representative of the same general
character; or
b, Any "manager", director or trustee except while performing acts coming within the
scope of the usual duties of an "employee".
c. "Manager" means a person serving in a directorial capacity for a limited liability company.
Page 7 of 7
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
STATE
COMPENSATION
INSURANCE
FUND
IN REPLY REFER TO:
1429032-09
WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY
INSURANCE POLICY
STATE COMPENSATION INSURANCE FUND
Forms and Endorsements Applicable List Policy
FORM NUMBER FORM DESCRIPTION
10963A ANNUAL RATING ENDORSEMENT
10217 2089 -ENDORSEMENT AGREEMENT -
STATUTORY ACCOUNTING PRINCIPLES - BILL RECEIVABLE
10217 2437 -ENDORSEMENT AGREEMENT -
MEDICAL PROVIDER NETWORK ENDORSEMENT
10217 2559 -ENDORSEMENT AGREEMENT -
TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION
10217 3015 -ENDORSEMENT AGREEMENT -
EXECUTIVE OFFICERS - MINIMUM/MAXIMUM LIMITS
10610 POLICY HOLDER NOTICE
1275 Market Street • San Francisco, CA 94103-1410
Mailing Address: P.O. Box 420807 • San Francisco, CA 94142-0807
HOME OFFICE SAN FRANCISCO
ANNUAL RATING ENDORSEMENT
STATE
MPENSATION
INN SCE E
SUURRAANNC
IT IS AGREED THAT THE CLASSIFICATIONS AND RATES PER $100 OF REMUNERATION APPEARING
IN THE CONTINUOUS POLICY ISSUED TO THIS EMPLOYER ARE AMENDED AS SHOWN BELOW.
FUN D
HERE ARE YOUR NEW RATES FOR THE PERIOD INDICATED. IF YOUR NAME OR ADDRESS SHOULD
BE CORRECTED OR IF INSURANCE IS NOT NEEDED FOR NEXT YEAR, PLEASE TELL US.
CONTINUOUS POLICY 1429032-09
IMPORTANT THIS IS NOT A BILL
SEND NO MONEY UNLESS STATEMENT IS ENCLOSED
THE RATING PERIOD BEGINS AND ENDS AT 12:01AM
PACIFIC STANDARD TIME
TIP OF SAN DIEGO COUNTY, INC.
2560 ORION WAY
CARLSBAD, CALIF 92010
NAME OF EMPLOYER -
RATING PERIOD 8-01-09 TO 8-01-10
DEPOSIT PREMIUM
MINIMUM PREMIUM
PREMIUM ADJUSTMENT PERIOD
TRAUMA INTERVENTION PROGRAMS OF
SAN DIEGO CNTY, INC. (A NON-PROFIT CORP)
(A NON-PROFIT CORP.)
CODE NO. PRINCIPAL WORK AND RATES EFFECTIVE FROM 08-01-09 TO 08-01-10
$773.00
$200.00
SEMI-ANNUAL
R SD
INTERIM
PREMIUM BASE BILLING
BASIS RATE RATE*
8742-1 SALESPERSONS --OUTSIDE. 91654 1.39 1.25
8810-1 CLERICAL OFFICE EMPLOYEES--N.O.C. 1.15 1.04
********BUREAU NOTE INFORMATION********
FEIN 330317893
FEIN 330492484
FEIN 953778272
FEIN 956004793
TOTAL ESTIMATED ANNUAL PREMIUM $1,147
r.,TTlTmt.ncTr_)FT1 Awn IRSUED AT SAN FRANCISCO . JULY 14, 2009 POLICY L PAGE 1 OF
HOME OFFICE SAN FRANCISCO
ANNUAL RATING ENDORSEMENT
STATE
COMPENSATION
I N S U R A N C E
IT IS AGREED THAT THE CLASSIFICATIONS AND RATES PER $100 OF REMUNERATION APPEARING
IN THE CONTINUOUS POLICY ISSUED TO THIS EMPLOYER ARE AMENDED AS SHOWN BELOW.
FUND
HERE ARE YOUR NEW RATES FOR THE PERIOD INDICATED. IF YOUR NAME OR ADDRESS SHOULD
BE CORRECTED OR IF INSURANCE IS NOT NEEDED FOR NEXT YEAR, PLEASE TELL US.
CONTINUOUS POLICY 1429032-09
IMPORTANT THIS IS NOT A BILL
SEND NO MONEY UNLESS STATEMENT IS ENCLOSED
THE RATING PERIOD BEGINS AND ENDS AT 12:O1AM
PACIFIC STANDARD TIME
RATING PERIOD 8-01-09 TO 8-01-10
INTERIM BILLING RATES WILL BE USED ON PAYROLL REPORTS. THEY TAKE INTO ACCOUNT
RATING PLAN CREDITS (OR DEBITS) WHICH WILL APPLY AT FINAL BILLING AND AN
ESTIMATE OF YOUR PREMIUM DISCOUNT AS DETAILED BELOW.
RATING PLAN CREDITS (DEBITS) EFFECTIVE FROM 08-01-09 TO 08-01-10
RATING PLAN MODIFIER
ESTIMATED PREMIUM DISCOUNT MODIFIER
COMPOSITE FACTOR APPLIED TO BASE RATES TO DERIVE
INTERIM BILLING RATES
0.90000
1.00000
0.90000
•.....:co'c..............:c9c•.icicicicdc::icdcxicic:..c*ic?cdcdc$dc:c:.k:cdc.c;::c'c*4c:'.. * **** c9c.c.,:ro;:.,c•.•.x:...;cm...c****.,..,...•,.c
is
PREMIUM DISCOUNT SCHEDULE EFFECTIVE FROM 08-01-09 TO 08-01-10
ESTIMATED MODIFIED PREMIUM IS DISCOUNTED ACCORDING TO THE FOLLOWING SCHEDULE:
FIRST ABOVE
*
*
$5,000 $5,000
0.0% 11.6%
is
*
**************'tick******is** *********do is***do************* `*k*.....c **..*..*************
THE ESTIMATED PREMIUM DISCOUNT IS BASED ON AN ESTIMATE OF YOUR PAYROLL. ACTUAL
PREMIUM DISCOUNT APPLIED AT FINAL BILLING WILL BE BASED ON THE ACTUAL PAYROLL
REPORTED ON YOUR POLICY AND SUBJECT TO AUDIT.
.nttumcocTam n ANfl ISST W.I] AT SAN FRANCISCO
JULY 14. 2009 POLICY L PAGE 2 OF
STATE
HOME OFFICE SAN FRANCISCO
ANNUAL RATING ENDORSEMENT
COMPENSATION
INSURANCE
FUND
IT IS AGREED THAT THE CLASSIFICATIONS AND RATES PER $100 OF REMUNERATION APPEARING
IN THE CONTINUOUS POLICY ISSUED TO THIS EMPLOYER ARE AMENDED AS SHOWN BELOW.
CONTINUOUS POLICY 1429032-09
IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT YOUR LOCAL STATE FUND OFFICE BELOW:
CSC - POLICY AT FAIRFIELD
5251 BUSINESS CENTER DRIVE
FAIRFIELD , CA 94585
(877) 405-4545
Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions
agreements or limitations of the Policy other than as herein stated.
When countersigned by a duly authorized officer or representative of the State Compensation Insurance
Fund, these declarations shall be valid and form part of the Policy.
(c174JYQD
AUTHORIZED REPRESENTATIVE PRESIDENT
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO JULY 14, 2009 POLICY L PAGE 3 OF
STATE
COMPENSATION
INSURANCE
FUND
ENDORSEMENT AGREEMENT
STATUTORY ACCOUNTING PRINCIPLES
BILL RECEIVABLE
1429032-09
RENEWAL
SD
HOME OFFICE
SANFRANCISCO EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M. PAGE 1 OF 1
ALL EFFECTIVE DATES ARE
AT 12:01 AM PACIFIC
STANDARD TIME OR THE
TIME INDICATED AT
PACIFIC STANDARD TIME
TIP OF SAN DIEGO COUNTY, INC.
2560 ORION WAY
CARLSBAD, CA 92010
ANY CONTRADICTION BETWEEN THE POLICY AND THIS ENDORSEMENT
WILL BE CONTROLLED BY THIS ENDORSEMENT.
IT IS AGREED THAT THIS ENDORSEMENT AMENDS SECTION D. OF
PART FIVE OF THE POLICY.
YOUR POLICY HAS BEEN WRITTEN ON SEMI-ANNUAL ADJUSTMENT
PERIOD. YOU WILL PAY ALL PREMIUM WHEN DUE.
PAYROLL REPORTS AND PREMIUM ARE DUE WITHIN 10 DAYS (TEN)
AFTER THE LAST DAY OF THE REPORTING PERIOD.
PAYMENT OF OUTSTANDING PREMIUM IS DUE WITHIN 10 DAYS (TEN)
FROM THE BILL DATE.
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:
HORIZED REPRESENTATIV
JULY 14, 2009
PRESIDENT
2089
ENDORSEMENT AGREEMENT
STATE
COMPENSATION
INSURANCE
FUND
MEDICAL PROVIDER NETWORK
1429032-09
RENEWAL
SD
HOME OFFICE
SAN FRANCISCO EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M. PAGE 1 OF 3
ALL EFFECTIVE DATES ARE
AT 12:01 AM PACIFIC
STANDARD TIME OR THE
TIME INDICATED AT
PACIFIC STANDARD TIME
TIP OF SAN DIEGO COUNTY, INC.
2560 ORION WAY
CARLSBAD, CA 92010
ANY CONTRADICTION BETWEEN THE POLICY AND THIS ENDORSEMENT
WILL BE CONTROLLED BY THIS ENDORSEMENT.
THE STATE COMPENSATION INSURANCE FUND MEDICAL PROVIDER
NETWORK IS ESTABLISHED IN ACCORDANCE WITH CALIFORNIA LABOR
CODE 4600 ET SEQ AND APPROVED BY THE CALIFORNIA DIVISION OF
WORKERS' COMPENSATION ADMINISTRATIVE DIRECTOR. THE INTENT
OF THE 2004 LEGISLATION REQUIRING THE ESTABLISHMENT OF THE
MEDICAL PROVIDER NETWORK IS INCREASED EMPLOYER CONTROL OVER
THE COSTS OF TREATING EMPLOYEE WORK RELATED INJURIES AND
DISEASE.
PART FOUR OF THE POLICY, YOUR DUTIES IF INJURY OCCURS, IS
AMENDED AS FOLLOWS:
IT IS AGREED THAT THE POLICYHOLDER SHALL REFER ALL WORK
RELATED INJURIES OR DISEASE TO THE STATE COMPENSATION
INSURANCE FUND MEDICAL PROVIDER NETWORK AT THE TIME OF AN
OCCUPATIONAL INJURY OR UPON KNOWLEDGE OF AN OCCUPATIONAL
INJURY OR DISEASE.
IT IS FURTHER AGREED THAT WHEN AN EMPLOYEE NOTIFIES THE
POLICYHOLDER OF AN OCCUPATIONAL INJURY OR FILES A CLAIM FOR
WORKERS' COMPENSATION WITH, THE POLICYHOLDER, THE POLICY-
HOLDER SHALL ARRANGE AN INITIAL MEDICAL EVALUATION AND
BEGIN TREATMENT WITHIN THE MEDICAL PROVIDER NETWORK. THE
POLICYHOLDER SHALL NOTIFY THE EMPLOYEE OF HIS OR HER RIGHT
CONTINUED
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:
at I-afRI7F1l PFPRFSFNTATIV
JULY 14, 2009
PRESIDENT
2437
ENDORSEMENT AGREEMENT
STATE
COMPENSATION
INSURANCE
FUND
MEDICAL PROVIDER NETWORK
1429032-09
RENEWAL
SD
HOME OFFICE
SAN FRANCISCO EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M. PAGE 2 OF 3
ALL EFFECTIVE DATES ARE
AT 12:01 AM PACIFIC
STANDARD TIME OR THE
TIME INDICATED AT
PACIFIC STANDARD TIME
TIP OF SAN DIEGO COUNTY, INC.
2560 ORION WAY
CARLSBAD, CA 92010
CONTINUED.
TO BE TREATED BY A PHYSICIAN OF HIS OR HER CHOICE FROM
WITHIN THE MEDICAL PROVIDER NETWORK AFTER THE FIRST VISIT.
THE POLICYHOLDER SHALL NOTIFY EMPLOYEE OF THE METHOD BY
WHICH THE LIST OF PARTICIPATING PROVIDERS MAY BE ACCESSED
BY EMPLOYEES.
IT IS FURTHER AGREED THAT IF AN INJURED EMPLOYEE DISPUTES
EITHER THE DIAGNOSIS OR THE TREATMENT PRESCRIBED BY THE
TREATING PHYSICIAN, THE EMPLOYEE MAY SEEK THE OPINION OF
ANOTHER PHYSICIAN WITHIN THE MEDICAL PROVIDER NETWORK. IF
THE INJURED EMPLOYEE DISPUTES THE DIAGNOSIS OR TREATMENT
PRESCRIBED BY THE SECOND PHYSICIAN, THE EMPLOYEE MAY SEEK
THE OPINION OF A THIRD PHYSICIAN WITHIN THE MEDICAL
PROVIDER NETWORK.
IT IS FURTHER AGREED THAT THIS ENDORSEMENT IN NO WAY
AFFECTS THE RIGHTS OF AN INJURED WORKER TO PREDESIGNATE A
PHYSICIAN. AN EMPLOYEE MUST FILE WRITTEN NOTICE OF THE
PREDESIGNATION WITH THE EMPLOYER PRIOR TO THE DATE OF
INJURY. THE NOTICE MUST INCLUDE THE PHYSICIAN'S SIGNATURE
OF AGREEMENT TO THE PREDESIGNATION, AND THE FOLLOWING
CONDITIONS MUST APPLY:
THE PHYSICIAN IS THE EMPLOYEE'S REGULAR PHYSICIAN.
THE PHYSICIAN IS THE EMPLOYEE'S PRIMARY CARE PROVIDER WHO
HAS PREVIOUSLY DIRECTED THE MEDICAL TREATMENT OF THE
CONTINUED
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:
HORIZED REPRESENTATIV
JULY 14, 2009
PRESIDENT
2437
STATE
COMPENSATION
INSURANCE
FUND
HOME OFFICE
SAN FRANCISCO
ALL EFFECTIVE DATES ARE
AT 12:01 AM PACIFIC
STANDARD TIME OR THE
TIME INDICATED AT
PACIFIC STANDARD TIME
ENDORSEMENT AGREEMENT
MEDICAL PROVIDER NETWORK
1429032-09
RENEWAL
SD
EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M. PAGE 3 OF 3
TIP OF SAN DIEGO COUNTY, INC.
2560 ORION WAY
CARLSBAD, CA 92010
CONTINUED.
EMPLOYEE AND RETAINS RECORDS OF THE TREATMENT AND MEDICAL
HISTORY.
THE EMPLOYER PROVIDES THE STAFF WITH NONOCCUPATIONAL GROUP
HEALTH COVERAGE IN A HEALTH-CARE SERVICE PLAN (SUCH AS AN
HMO/PPO PROGRAM).
OR
THE EMPLOYER PROVIDES NONOCCUPATIONAL HEALTH COVERAGE IN A
GROUP HEALTH PLAN OR A GROUP HEALTH INSURANCE POLICY, PER
LABOR CODE 4616.7.
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, ' AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:
HORIZED REPRESENTATIV
JULY 14, 2009
PRESIDENT
2437
STATE
COMPENSATION
INSURANCE
FUND
HOME OFFICE
SAN FRANCISCO
ALL EFFECTIVE DATES ARE
AT 12:01 AM PACIFIC
STANDARD TIME OR THE
TIME INDICATED AT
PACIFIC STANDARD TIME
ENDORSEMENT AGREEMENT
TERRORISM RISK INSURANCE PROGRAM
REAUTHORIZATION ACT
1429032-09
RENEWAL
SD
EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M. PAGE 1 OF 4
TO AUGUST 1, 2010 AT 12.01 A.M.
TIP OF SAN DIEGO COUNTY, INC.
2560 ORION WAY
CARLSBAD, CA 92010
THIS ENDORSEMENT ADDRESSES THE REQUIREMENTS OF THE
TERRORISM RISK INSURANCE ACT OF 2002 AS AMENDED AND
EXTENDED BY THE TERRORISM RISK INSURANCE PROGRAM
REAUTHORIZATION ACT OF 2007.
DEFINITIONS
THE DEFINITIONS PROVIDED IN THIS ENDORSEMENT ARE BASED ON
AND HAVE THE SAME MEANING AS THE DEFINITIONS IN THE ACT.
IF WORDS OR PHRASES NOT DEFINED IN THIS ENDORSEMENT ARE
DEFINED IN THE ACT, THE DEFINITIONS IN THE ACT WILL APPLY.
"ACT" MEANS THE TERRORISM RISK INSURANCE ACT OF 2002,
WHICH TOOK EFFECT ON NOVEMBER 26, 2002, AND ANY AMENDMENTS
RESULTING FROM THE TERRORISM RISK INSURANCE PROGRAM
REAUTHORIZATION ACT OF 2007.
"ACT OF TERRORISM" MEANS ANY ACT THAT IS CERTIFIED BY THE
SECRETARY OF THE TREASURY, IN CONCURRENCE WITH THE
SECRETARY OF STATE, AND THE ATTORNEY GENERAL OF THE UNITED
STATES AS MEETING ALL OF THE FOLLOWING REQUIREMENTS:
A. THE ACT IS AN ACT OF TERRORISM.
B. THE ACT IS VIOLENT OR DANGEROUS TO HUMAN LIFE,
PROPERTY OR INFRASTRUCTURE.
C. THE ACT RESULTED IN DAMAGE WITHIN THE UNITED STATES,
OR OUTSIDE OF THE UNITED STATES IN THE CASE OF THE
PREMISES OF UNITED STATES MISSIONS OR CERTAIN AIR
CONTINUED
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:
HORIZED REPRESENTATIV
JULY 14, 2009
PRESIDENT
C./
2559
STATE
COMPENSATION
INSURANCE
FUND
HOME OFFICE
SAN FRANCISCO
ALL EFFECTIVE DATES ARE
AT 12:01 AM PACIFIC
STANDARD TIME OR THE
TIME INDICATED AT
PACIFIC STANDARD TIME
ENDORSEMENT AGREEMENT
TERRORISM RISK INSURANCE PROGRAM
REAUTHORIZATION ACT
EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M.
TO AUGUST 1, 2010 AT 12.01 A.M.
TIP OF SAN DIEGO COUNTY, INC.
2560 ORION WAY
CARLSBAD, CA 92010
CONTINUED.
CARRIERS OR VESSELS.
D. THE ACT HAS BEEN COMMITTED BY AN INDIVIDUAL OR
INDIVIDUALS AS PART OF AN EFFORT TO COERCE THE
CIVILIAN POPULATION OF THE UNITED STATES OR TO
INFLUENCE THE POLICY OR AFFECT THE CONDUCT OF THE
UNITED STATES GOVERNMENT BY COERCION.
1429032-09
RENEWAL
SD
PAGE 2 OF 4
"INSURED LOSS" MEANS ANY LOSS RESULTING FROM AN ACT OF
TERRORISM (INCLUDING AN ACT OF WAR, IN THE CASE OF WORKERS
COMPENSATION) THAT IS COVERED BY PRIMARY OR EXCESS
PROPERTY AND CASUALTY INSURANCE ISSUED BY AN INSURER IF
THE LOSS OCCURS IN THE UNITED STATES OR AT THE PREMISES OF
UNITED STATES MISSIONS OR TO CERTAIN AIR CARRIERS OR
VESSELS.
"INSURER DEDUCTIBLE" MEANS, FOR THE PERIOD BEGINNING
JANUARY 1, 2008, AND ENDING ON DECEMBER 31, 2014, AN
AMOUNT EQUAL TO 20% OF OUR DIRECT EARNED PREMIUMS, OVER
THE CALENDAR YEAR IMMEDIATELY PRECEDING THE APPLICABLE
PROGRAM YEAR.
"PROGRAM YEAR" REFERS TO EACH CALENDAR YEAR BETWEEN
JANUARY 1, 2008 AND DECEMBER 31, 2014 AS APPLICABLE.
LIMITATION OF LIABILITY
THE ACT LIMITS OUR LIABILITY TO YOU UNDER THIS POLICY. IF
CONTINUED
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:
HORIZED REPRESENTATIV
JULY 14, 2009
PRESIDENT
2559
STATE
COMPENSATION
INSURANCE
FUND
HOME OFFICE
SAN FRANCISCO
ALL EFFECTIVE DATES ARE
AT 12:01 AM PACIFIC
STANDARD TIME OR THE
TIME INDICATED AT
PACIFIC STANDARD TIME
ENDORSEMENT AGREEMENT
TERRORISM RISK INSURANCE PROGRAM
REAUTHORIZATION ACT
EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M.
TO AUGUST 1, 2010 AT 12.01
TIP OF SAN DIEGO COUNTY, INC.
2560 ORION WAY
CARLSBAD, CA 92010
CONTINUED.
A.M.
1429032-09
RENEWAL
SD
PAGE 3 OF 4
AGGREGATE INSURED LOSSES EXCEED $100,000,000,000 IN A
PROGRAM YEAR AND IF WE HAVE MET OUR INSURER DEDUCTIBLE, WE
ARE NOT LIABLE FOR THE PAYMENT OF ANY PORTION OF THE
AMOUNT OF INSURED LOSSES THAT EXCEEDS $100,000,000,000;
AND FOR AGGREGATE INSURED LOSSES UP TO $100,000,000,000,
WE WILL PAY ONLY A PRO RATA SHARE OF SUCH INSURED LOSSES
AS DETERMINED BY THE SECRETARY OF THE TREASURY.
POLICYHOLDER DISCLOSURE NOTICE
1. INSURED LOSSES WOULD BE PARTIALLY REIMBURSED BY THE
UNITED STATES GOVERNMENT. IF THE AGGREGATE INDUSTRY
INSURED LOSSES EXCEEDS $100,000,000 IN A PROGRAM
YEAR, THE UNITED STATES GOVERNMENT WOULD PAY 85% OF
OUR INSURED LOSSES THAT EXCEED OUR INSURER DEDUCTIBLE.
2. NOTWITHSTANDING ITEM 1 ABOVE, THE UNITED STATES
GOVERNMENT WILL NOT MAKE ANY PAYMENT UNDER THE ACT
FOR ANY PORTION OF INSURED LOSSES THAT EXCEED
$100,000,000,000.
3. THE PREMIUM CHARGED FOR THE COVERAGE FOR INSURED
LOSSES UNDER THIS POLICY IS INCLUDED IN THE AMOUNTS
SHOWN IN ITEM 4 OF THE INFORMATION PAGE OR IN THE
SCHEDULE IN THE TERRORISM PREMIUM ENDORSEMENT-
CALIFORNIA (WC 04 04 16), ATTACHED TO THIS POLICY.
THIS ENDORSEMENT CHANGES THE POLICY TO WHICH IT IS
ATTACHED AND IS EFFECTIVE ON THE DATE ISSUED UNLESS
CONTINUED
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:
HORIZED REPRESENTATIV
JULY 14, 2009
PRESIDENT
2559
STATE
COMPENSATION
INSURANCE
FUND
HOME OFFICE
SAN FRANCISCO
ENDORSEMENT AGREEMENT
TERRORISM RISK INSURANCE PROGRAM
REAUTHORIZATION ACT
1429032-09
RENEWAL
SD
EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M. PAGE 4 OF 4
ALL EFFECTIVE DATES ARE TO AUGUST 1, 2010 AT 12.01 A.M.
AT 12:01 AM PACIFIC
STANDARD TIME OR THE
TIME INDICATED AT
PACIFIC STANDARD TIME
TIP OF SAN DIEGO COUNTY, INC.
2560 ORION WAY
CARLSBAD, CA 92010
CONTINUED.
OTHERWISE STATED.
WC 04 01 04
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:
HORIZED REPRESENTATIV
JULY 14, 2009
PRESIDENT
2559
ENDORSEMENT AGREEMENT
STATE
COMPENSATION
INSURANCE
FUND
EXECUTIVE OFFICERS
MINIMUM/MAXIMUM LIMITS
1429032-09
RENEWAL
SD
HOME OFFICE
SAN FRANCISCO EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M. PAGE 1 OF 1
ALL EFFECTIVE DATES ARE
AT 12:01 AM PACIFIC
STANDARD TIME OR THE
TIME INDICATED AT
PACIFIC STANDARD TIME
TIP OF SAN DIEGO COUNTY, INC.
2560 ORION WAY
CARLSBAD, CA 92010
ANY CONTRADICTION BETWEEN THE POLICY AND THIS ENDORSEMENT
WILL BE CONTROLLED BY THIS ENDORSEMENT.
IT IS AGREED THAT UNLESS OTHERWISE EXCLUDED BY ENDORSEMENT
THE ACTUAL REMUNERATION EARNED BY EACH EXECUTIVE OFFICER
DURING THE POLICY PERIOD SHALL BE USED AS THE BASIS OF
PREMIUM, SUBJECT TO
THE MINIMUM AMOUNT OF $ 36,400 PER ANNUM
AND THE MAXIMUM AMOUNT OF $
94,900 PER ANNUM
AS SPECIFIED IN THE CALIFORNIA WORKERS' COMPENSATION
UNIFORM STATISTICAL REPORTING PLAN, FOR WORKERS'
COMPENSATION INSURANCE IN EFFECT DURING THE POLICY PERIOD.
NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENDORSEMENT.
COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:
HORIZED REPRESENTATIV
JULY 14, 2009
PRESIDENT
3015
1429032-09
Dear Policyholder:
These endorsements amend and are part of your policy.
Please keep them with your documents for future reference.
If you have any questions concerning these endorsements,
Please contact your local State Fund office.
POLICYHOLDER NOTICE
Page 1 of 2
STATE
COMPENSATION
INSURANCE
FUND
YOUR RIGHT TO RATING AND DIVIDEND INFORMATION
PN 04 99 01B (Ed. 03-03)
TIP OF SAN DIEGO COUNTY, INC.
2560 ORION WAY
CARLSBAD, CALIF 92010
POLICY NO. 1429032-09
NR SD
1. RATING AND CLAIMS INFORMATION. Pursuant to Section 11752.6 of the California Insurance
Code, upon written request, you are entitled to information relating to loss experience, claims, class-
ification assignments, and policy contracts, as well as rating plans, rating systems, manual rules, or
other information impacting your premium that is maintained in the records of the Workers' Compen-
sation Insurance Rating Bureau of California ("WCIRB"), a rating organization licensed by the California
Insurance Commissioner. Requests for policyholder information should be forwarded to: WCIRB,
525 Market Street, Suite 800, San Francisco, California 94105-2716, Attention: Custodian of
Records. The Custodian of Records can be reached by telephone at 1-888-229-2472, and the fax
number is 415-778-7272.
Pursuant to Sections 3761 and 3762 of the California Labor Code, you are also entitled to receive
information in our claim files that affects your premium.
2. POLICYHOLDER OMBUDSMAN. Pursuant to California Insurance Code Sections 11752.6 (g) and
(h) (1), a policyholder ombudsman is available at the WCIRB to assist you in obtaining and evaluating
the information referenced above. The ombudsman may advise you on any dispute with us, the WCIRB,
or on an appeal to the Insurance Commissioner pursuant to Section 11737 of the Insurance Code.
The address of the policyholder ombudsman is WCIRB, 525 Market Street, Suite 800, San Francisco,
California 94105-2716, Attention: Policyholder Ombudsman. The policyholder ombudsman can be
reached by telephone at 415-777-0777 and by fax at 415-778-7007.
3. CALIFORNIA DEPARTMENT OF INSURANCE. Information and assistance on policy questions can
be obtained from the Department of Insurance Consumer HOTLINE, 1-800-927-HELP (4357).
4. STATISTICAL REPORTING. For claims covered under this policy, we will estimate the ultimate
cost of unsettled claims for statistical purposes eighteen months after the policy becomes effective
and will report those estimates to the WCIRB no later than twenty months after the effective date
of the policy. The cost of any settled claims will also be reported at that time. At twelve-month
intervals thereafter, we will update and report to the WCIRB the estimated cost of any unsettled
claims and the actual final cost of any claims settled in the interim. The amounts we report will be
used by the WCIRB to compute your experience modification if you are eligible for experience
rating.
5. DIVIDEND CALCULATION. If this is a participating policy (a policy on which a dividend may be
paid), upon payment or non-payment of a dividend, we shall provide a written explanation to you
that sets forth the basis of the dividend calculation. The explanation will be in clear, understandable
language and will express the dividend as a dollar amount and as a percentage of the earned premium
for the policy year on which the dividend is calculated.
SCIF 10610 (Rev. 04-07)
Page 2 of 2
POLICY NO. 1429032-09
NR SD
6. DISPUTING OUR ACTIONS. Pursuant to Insurance Code Section 11753.1 (b), you may request,
in writing, that we reconsider a change in a classification assignment that results in an increased pre-
mium. You may also request, in writing, that we review the manner in which our rating system has
been applied in connection with the insurance afforded or offered you pursuant to Insurance Code
Section 11737 (f). Written requests that we reconsider or review our actions should be forwarded
to: State Compensation Insurance Fund, Attention: Manager, Customer Assistance Program,
5860 Owens Drive, Pleasanton, CA 94568, Telephone: (925) 460-6530, Fax: (925) 460-6633.
7. DISPUTING THE ACTIONS OF THE WCIRB. If you have been aggrieved by any decision, action,
or omission to act of the WCIRB, you may request, in writing, that the WCIRB reconsider its decision,
action, or omission to act pursuant to Insurance Code Section 11753.1 (a). You may also request, in
writing, that the WCIRB review the manner in which its rating system has been applied in connection
with the insurance afforded or offered you pursuant to Insurance Code Section 11737 (f). Written
requests for reconsideration or requests for review regarding the actions of the WCIRB should be
forwarded to: WCIRB, 525 Market Street, Suite 800, San Francisco, California 94105-2716,
Attention: Complaints and Reconsiderations. The WCIRB's telephone number is 1-888-229-2472, and
the fax number is 415-371-5204.
8. APPEAL TO THE INSURANCE COMMISSIONER. After you send your written request for policyholder
information, reconsideration, or review of the manner in which the rating system has been applied in
connection with the insurance afforded or offered you, we, or the WCIRB, have 30 days to provide
you written notice indicating whether or not your written request will be reviewed. If we, or the
WCIRB, agree to review your request, we, or the WCIRB, must conduct the review and issue a decision
grantingor rejecting your request within 60 days after sending you the written notice granting review.
If we, or the WCIRB, decline to review your request, or if you are dissatisfied with the decision upon
review, or if your request is rejected or not acted upon, you may appeal to the Insurance Commissioner
pursuant to the provisions of Insurance Code Sections 11752.6(c), 11753.1(a) and (b), or 1 1737(f) and
Title 10, California Code of Regulations, Section 2509.40 et seq. You must make your appeal within 30
days after we, or the WCIRB, send you the notice denying review of your request or the decision upon
review. If no written decision regarding your request for policyholder information, reconsideration, or
review is sent, your appeal must be filed within 120 days after you sent your request to us, or the
WCIRB. The filing address for all appeals to the Commissioner is:
Administrative Hearing Bureau
California Department of Insurance
45 Fremont Street, 22nd Floor
San Francisco, California 94105
The Insurance Commissioner will hold a hearing upon your appeal and may either affirm, modify, or
reverse our action or that of the WCIRB.
This notice does not change the policy to which it is attached.
RESOLUTION 2009 — 87
RESOLUTION OF THE CITY COUNCIL
OF THE CITY OF NATIONAL CITY
AUTHORIZING THE SUBMITTAL OF THE 2009/2010
ANNUAL ACTION PLAN FOR THE COMMUNITY DEVELOPMENT
BLOCK GRANT (CDBG) AND HOME INVESTMENT PARTNERSHIP
(HOME) PROGRAMS TO THE U.S. DEPARTMENT OF
HOUSING AND URBAN DEVELOPMENT (HUD)
WHEREAS, as an entitlement community, the City of National City administers
the Community Development Block Grant (CDBG) and the Home Investment Partnership Act
(HOME) Program for the Federal Government under the United States Department of Housing
and Urban Development (HUD); and
WHEREAS, HUD requires that all CDBG and HOME Program entitlement
communities, such as the City of National City, hold Public Hearings to solicit input on a the
Annual Action Plan; and
WHEREAS, the City Council of the City of National City conducted a duly
advertised public hearing on January 20, 2009; March 3, 2009; March 17, 2009; and April 21,
2009; and
WHEREAS, the Annual Action Plan addresses the housing and community
development needs assessed in the City's 5-Year Consolidated Plan for FY's 2005-06 through
2009-10, adopted by the City Council in May 2005. The Annual Action Plan, attached hereto as
Exhibit "A," includes a listing of projects/activities to be undertaken in Fiscal Year 2009-2010
utilizing CDBG and HOME funds; and
WHEREAS, HUD has not released the final formula annual allocation and an
estimate for the total allocation is used to calculate funding allocations for both the CDBG and
HOME programs based on information provided by the National Association of Housing and
Redevelopment Officials.
NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of
National City hereby approves and authorizes the submission of the FY 2008-2009 Annual
Action Plan for the expenditure of said funds to the U.S. Department of Housing and Urban
Development (HUD).
BE IT FURTHER RESOLVED, that the City of National City will adjust the grant
amounts once the final formula allocation is released by HUD as follows:
A. If the final allocation is greater than the estimated amount for the CDBG and
HOME Programs, then all activities will share a proportional increase in funding with the
exception of Activity No. 8 Fire Apparatus Lease Payment No. 5 of 5, which will remain as stated
as it is a fixed payment amount.
B. If the final allocation is less than the estimated amount for the CDBG and HOME
Programs, then all activities will share a proportional decrease in funding with the exception of
Activity No. 8 Fire Apparatus Lease Payment No. 5 of 5 and any activity at or below $20,000 for
which the funding will remain as stated.
Resolution No. 2009 — 87
Page 2
April 21, 2009
In the event a change in funding, whether an increase or decrease, is greater
than 5% the allocation will be brought forth to the City Council for review.
PASSED and ADOPTED this 21st day of April, 2009.
on Morrison, Mayor
ATTEST:
/1
Mi ael R. Della / ity Clerk
APPROVED AS TO FORM:
George H. Eiser, III
City Attorney
FISCAL YEAR 2009-2010
COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROGRAM
(Page 1 of 2)
FY 2009- 2010 CDBG ESTIMATED PROGRAM ENTITLEMENT
$1,107,495
AGENCY NAME
ACTIVITY NAME
NUMBER TO
BENEFIT FROM
THE ACTIVITY
CDBG
FUNDING
REQUEST
PUBLIC SERVICE ACTIVITIES
1
City of National City -
Public Library
National City Public Library
Literacy Services
220 Individuals
$47,250
2
City of National City -
Community Services
Department
At Risk Youth After -school
Program "Supreme Teens"
100 Individuals
$20,000
3
City of National City -
Community Services
Department
Tiny Tots
30 Individuals
$29,337
4
City of National City -
Police Department
Homeless Outreach Program and
Enforcement
250 Individuals
$41,537
5
PASACAT
The Philippines Through Music
and Dance
2,755
Individuals
$10,000
6
South Bay Community
Services
National City Police Department
Juvenile Diversion Program
55 Individuals
$10,000
7
Trauma Intervention
Programs of San Diego
County, Inc.
Crisis Intervention Team
799 Households
$8,000
TOTAL FOR PUBLIC SERVICE ACTIVITIES
166,124
PRIOR YEAR COMMITMENTS TO PHYSICAL IMPROVEMENT ACTIVITIES
Public Facility Improvement Activities
8 City of National City - Fire
Department
Fire Apparatus Lease Payment 5 of 1 Fire Apparatus
5 / Equipment
TOTAL PRIOR YEAR COMMITMENTS
$84,906
$84,906
PHYSICAL IMPROVEMENT ACTIVITIES
Rehabilitation and Repair Activities
9
Christmas in July *
National City
Home Repair Program
10 Households
$110,000
10
City of National City-
Community Development
Department
Granger Hall Preservation and
Heritage Tourism Planning
1 Historic
Restoration
(14,474
Households)
$25,000
11
National City Living History
Farm Preserve
Stein Farm Community Use
Planning
1 Community
Facility
$40,000
Public Facility Improvement Activities
12
Council of Philippine
American Organizations of
San Diego County, Inc.
COPAO Building Renovation Project
1 Public Facility
Improvement
$15,000
13
City of National City -
EngineeringDepartment
Soccer Field
Public
Infrastructure
Improvements
$79,466
Resolution No. 2009-87
Page 1 of 3
EXHIBIT "A"
FISCAL YEAR 2009-2010
COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) PROGRAM
(Page 2 of 2)
TAB
#
AGENCY NAME
ACTIVITY NAME
NUMBER TO
BENEFIT FROM
THE ACTIVITY
CDBG
FUNDING
REQUEST
Public Infrastructure Improvement Activities
14
City of National City -
Engineering Department
Miscellaneous Concrete
Improvements
Public
Infrastructure
Improvements
$100,000
15
City of National City -
Engineering Department
Miscellaneous Storm Drain
Improvements
Public
Infrastructure
Improvements
$125,500
16
City of National City -
Engineering Department
ADA Master Plan
Public
Infrastructure
Improvements
$140,000
TOTAL NEW PHYSICAL IMPROVEMENT ACTIVITIES
$634,966
CDBG PROGRAM ADMINISTRATION
17
City of National City -
Community Services
Department
Neighborhood Council Program
n/a
$105,000
18
The Fair Housing Council of
San Diego
Fair Housing and Tenant -Landlord
Education Services
n/a
$38,000
19
City of National City -
Community Development
Department
CDBG Program Administration
n/a
$78,499
TOTAL FOR PROGRAM ADMINISTRATION
$221,499
Resolution No_ 2009-87 Page 2 of 3 EXHIBIT "A"
FISCAL YEAR 2009-2010
HOME INVESTMENT PARTNERSHIPS ACT (HOME) PROGRAM
(Page 1 of 1)
FY 2009- 2010 HOME PROGRAM ESTIMATED ENTITLEMENT
$645,850
AGENCY NAME
ACTIVITY NAME
NUMBER TO
BENEFIT
FROM
THE ACTIVITY
HOME
FUNDING
REQUEST
AFFORDABLE HOUSING ACTIVITIES
1
City of National City -
Community
Development
Department
First Time Homebuyer Program
10 Households
$360,000
2
City of National City -
Community
Development
Department
Rehabilitation Program
8 Households
$124,387
3
City of National City -
Community
Development
Department
Community Housing
Development Organization Set -
Aside
n/a
$96,878
4
City of National City -
Community
Development
Department
HOME Program Administration
n/a
$64,585
TOTAL HOME ACTIVITIES AND ADMINISTRATION
$645,850
Resolution No. 2009-87
Page 3 of 3 EXHIBIT "A"
Passed and adopted by the Council of the City of National City, California, on April 21,
2009 by the following vote, to -wit:
Ayes: Councilmembers Morrison, Parra, Sotelo-Solis, Van Deventer, Zarate.
Nays: None.
Absent: None.
Abstain: None.
AUTHENTICATED BY: RON MORRISON
Mayor of the City of National City, California
MICHAEL R. DALLA
City Clerk of the City of National City, California
By:
Deputy
I HEREBY CERTIFY that the above and foregoing is a full, true and correct copy of
RESOLUTION NO. 2009-87 of the City of National City, California, passed and adopted
by the Council of said City on April 21, 2009.
4
City (clerk of the City of National City, California
By:
Deputy
City of National City, California
COUNCIL AGENDA STATEMENT
`.+MEETING DATE April 21, 2009
AGENDA ITEM NO. 22
(TEM TITLE RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY
APPROVING THE FISCAL YEAR (FY) 2009-2010 ANNUAL ACTION PLAN FOR THE COMMUNITY
DEVELOPMENT BLOCK GRANT (CDBG) AND HOME INVESTMENT PARTNERSHIP ACT (HOME)
PROGRAMS
PREPARED BY
Carlos Aguirre c
(Ext. 4391)
�`
DEPARTMENT Community Development Dep.
Housing and Grants Division
EXPLANATION
Upon the conclusion of Public Hearing No.4, the City Council will consider the adoption of the
attached resolution approving the FY 2009-2010 Annual Action Plan.
The Annual Action Plan (AAP) addresses the housing and community development needs assessed in
the City's 5-Year Consolidated Plan for FY's 2005-06 through 2009-10, adopted by the City Council in
May 2005. The AAP includes a listing of all proposed projects/activities to be undertaken in FY 2008-
2009 (July 1, 2008 - June 30, 2009) utilizing CDBG and HOME program funding.
Environmental Review J N/A
Financial Statement Approved By.
The estimated amount of funding available for FY 2009-2010 for each program is as follows:
r Community Development Block Grant - $1,107,495 Account No. 3O%-0es0-34418
Home Investment Partnership Program $645,850 Sos-eoea -
STAFF RECOMMENDATION
Adopt attached resolution.
BOARD / COMMISSION RECOMMENDATION
Not applicable to this report.
ATTACHMENTS ( Listed Below) Resolution No.
Attachment 1: Summary of FY 2009-2010 CDBG and HOME Program Funding Recommendations
A-200 (9/99)
OFFICE OF THE CITY CLERK
1243 National City Blvd.
National City, California 91950
Michael R. Dalia, CMC - City Clerk
619-336-4228 phone • 619-336-4229 fax
July 12, 2010
Ms. Mandy Atkission
Trauma Intervention Programs of San Diego County
2560 Orion Way
Carlsbad, CA 92010
Dear Ms. Atkission,
On July 8th, 2010, a Subrecipient Agreement was entered between the City of
National City and Trauma Intervention Programs of San Diego County, Inc.
We are enclosing for your records a fully executed original agreement.
Sincerely,
Esther Clemente
Deputy City Clerk
Enclosure
cc: Housing & Grants Dept.