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Home My WebLink About2010 CON Trauma Intervention Programs of San Diego County - CDBG 10-11 Sub-RecipientSUBRECIPIENT 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 /9 7k day of A () trf/ST , 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 1st day of July, 2010 and end on the 30`h day of June of 2011 in the case of Public Services and in the case of Capital Improvements end on June 30, 2012. 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 and incorporated herein. Both the Grantee and the Subrecipient must approve any amendments to the budget in writing. Subrecipient Agreemenr Page 1 of 14 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 : I '�° SUbreciiprielnt 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.net 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 arise out of the Subrecipient's performance or nonperformance of the services or subject matter called for in this Agreement. Subrecipient Agreement Page 2 of 14 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. 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 Subrecipient Agreement Page 3of' 14 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 Subrecipient 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 Subrecipient has violated the terms and conditions of this Agreement, the Subrecipient 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, 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 Subrecipient Agreement Page 4 of 14 notice to the other party thirty (30) days prior to the effective date of any termination, in whole or part, for convenience. VII. ADMINISTRATIVE REOUIREMENTS 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 involveany 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. 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 Subrecipient Agreement Page 5 of 14 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," "E," and "F" 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. 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. Subrecipient Agreement Page 6 of 14 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 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 Subrecipient Agreement Page 7 of 14 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"E", attached hereto and incorporated herein. 2. Women- and Minority -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 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 Subrecipient Agreement Page 8 of' 14 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 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 Subrecipient Agreement Page 9 of 14 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 be summarized in written reports and supported with documented evidence of follow-up actions taken to correct areas of noncompliance. Subrecipient Agreement Page 10 of 14 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 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 Subrecipient Agreement Page I 1 of 14 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. 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. Subrecipient Agreement Page 12 of 4 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. Ro Morrison J 0 (4/212-, Mayor, City of National City Mandy Atkission Executive Director '•'OVED AS TO FORM IS Claudia G. City Attorne� ATTES Michael Dalla City Clerk Subrecipient .Agreement Page 14 of 14 EXHIBIT A SCOPE OF SERVICES 1. The Trauma Intervention Program (TIP) consists of the followin activities: Overall Project foal tei.iittany additional goals or objectives on another page.) g Citizen Volunteers will provide immediate support to approximately 250 individual emotionally traumatized citizens of National City after suffering a tragic event. Police, Fire and medical personnel will request TIP volunteers whenever assistance is needed Objective ##1 Respond within 20 minutes to approximately 5 emergency scenes per month to provide resources, emotional support to traumatized citizens. Help individuals with contacting loved ones, making funeral arrangements, and informing these individuals of bereavement services available to them locally Qbject➢ve,f#2 Assist 35-40 emergency responders monthly, by relieving them the responsibility of caring for emotionally traumatized individuals and allowing them to return to service quicker. Objective # Hold a TIP training academy and train 10-15 individuals to respond to TIP calls and provide the above services. Obijective #4 2. The following lists the staff and time commitments to be allocated to activity Listed above. Hours Allocated Staff Member ne and Titte EIIyHarris, Crisis Team Manager 28 hours/week 3. Billing Method: Monthly Quarterly x 4. List the type of supporting documentation to be provided: Timesheets, statements, receipts 5. List the major/key activity milestones: Major Activity Milestones Month 1 2 3 4 5 6 7 8 9 10 11 12 Program Implementation X X X X X X X X X X X X Provide Program Services X X X X X X X X X X X X EXHIBIT B BUDGET 2010-11 Agency Name: Trauma Intervention Program (TIP) Activity Name: Crisis Intervention Description CDBG BUDGET OTHER RESOURCES TOTAL BUDGET 1) Personnel (Direct labor) Crisis Team Manager 5,000.00 18,920.00 23,920.00 2) Fringe Benefits 3) Travel 4) Supplies and Materials Training/Supplies 1,500.00 2,000.00 3,500.00 Resources 500.00 3,500.00 4,000.00 5) Sub Total for Direct Costs 6) Indirect Costs (Overhead) Liability Insurance 1,000.00 5,000.00 6,000.00 TOTAL $ 8,000 $ 29,420 I $ 37,420 Exhibit C Board of Directors By -Laws TRAIJMA INTERVENTION PROGRAMS OF SAN DIEGO COUNTY, INC. BOARD OF DIRECTORS 2009-2010 Lt. Joe Young, President Oceanside Police Department Cindy Roark Former President, Mothers Against Drunk Driving Past Chairman, National Board of Mothers Against Drunk Driving (MADD) Debbie Fountain, Treasurer City of Carlsbad Director of Housing and Redevelopment Jim Schroder, Secretary Independent Business Owner Chief David Burk Fire Chief, City of La Mesa Don Goddard Professor of Systems Engineering Management Defense Acquisition University BYLAWS OF TRAUMA INTERVENTION PROGRAMS OF; SAN DIEGO COUNTY, INC. A California Public Benefit Corporation ARTICLE I: Name, Office Section 1.01— Name of the Corporation The name of this Corporation shall be TRAUMA INTE1i.VENTIONPROGRAMS 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 BOD 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 2 ARTICLE 3: Membership a:nd Meetings Section 3.01— Voting Members of the Corporation 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 ablity 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 si-all be contented 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 Membersh; 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 dividends 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 Honorary and advisory members shall have all the rights and privileges off 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, Honoray, & 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 Execui ve 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 annTial 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 HOD, 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 forms 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 maybe removed with cause at any time by the affirmative vote of maj ority 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 less 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 shai11 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 ratted 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 ofDirectors without a Meeting Any action required or permitted to be taken by the BOD may be taken without a meeting, if all members 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 taker. 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 BOI) may authorize reimbursements for reasonable expenses incurred by the members or Officers in the perfomnance 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) smclm contract shall be 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 Trotter in an impartial manner, will offer to the Board to voluntarily excuse him/herself 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 tire 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 ofrnembers. 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 letterhead, web site and event programs. (c) Provide the staff of the Corporation 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 identify him or her as an Advisory Board mei mlber on corporate with leads, contacts or introductions that wiill be helpful in Section 6.01— Titles and Qualifications The Officers of the BOD shall consist of a President, Vice President„ Secretary, Treasurer and such other Officers as the BOD may from time to time designate. Section 6.02 — Duties of Officers (a) President The President of 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 Bylaaws as may be assigned him or her from time to time by the BOD or the President including the powers and duties to be (i) be custodian of all records, documents and the seal of the Corporation whiclh 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 Mira 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 ion 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 time 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 (Erection 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 cf 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 eachOfficer shall hold office until hhe 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 Once 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„ oir 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 memberslmip 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 Comrnittee The Executive Committee shall consist of the Officers of the BOD and may elect to hold special meetings outside of the regular s.cheduled 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 Bylaw 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 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 air 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 shallhire 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, tmust 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 manrer 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 anther 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 7.04 — 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 are 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 contractor 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— Indemnifieatio;i 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 ary appearance therein, except in relation to matters as to which iit 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 12 ARTICLE 11: Amendment of Bylaws Section 11. 01— Amendment of Bylaws Except as otherwise provided herein, and subject to the power of the BOD to amend oar repeal the Bylaws, these Bylaws may be altered, amended or repealed and new; Bylaws maybe 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) day:: 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 lfune 30. Section 12.02 — Construction Whenever the context so requires, the masculine shall include the feminine and neuter, aind 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, andl (b) Effect shall be given to the intent manifested by the pontion 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 amiandments made to date, on this date. Chris Saunders, President Date Witness Date UPDATED 5.14.07 Trauma Intervention Programs Bylaws 13 (*)California Corporations Code Section 6321 6321. (a) Except as provided in subdivision (c), Id), or (J), the board shall cause an annual report to be sent to the members mot later than 120 days after the close of the corporation's fiscal year. Unless otherwise provided by the articles or bylaws wad ifapproved by the board mfdireclors, that report and any accompanying material sera pursuant to this section may be sent by electronic transmission by the corporation (Section 20). That report shall contain in appropriate detail the following: (I) The assets and liabilities, including the trust funds, of the Corporation as of the alai of thefiscal year. (2) The principal changes in assets and liabilities, including trust finds, during the fiscal year. (3) The revenue or receipts of the Corporation, both unrestricted and restricted to particular purposes, for the fiscal'yeter. (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, orr, ifrthere is no such report, the certificate of an authorized Officer of the corporation that such statements were prepared withoue auditfrom the books and records of the Corporation. (c) Subdivision (a) does not apply to any Corporation which receives less than twenty-five thaewand dollars ($25,0009 in gross revenues or receipts during the fiscal year. (d) Where a Corporation has provided pursuant to Section 5510, for regular meetinge ofinem&iers less often than annuall}v, then the report required by subdivision (a) need be made to members only with the frequency with which regular membershy'p meetings are required, unless the articles or bylaws require a report more often. (e) Subdivisions (c) and (d) notwithstanding, a report with the information required by subdivision (a) shall be furnia$ied annually to: (1) All directors of the Corporation; and (2) Any member who requests i1 in writing. (J) A Corporation which in writing solicits contributions from 500 or more persons need not seivd the report otherwise uequ0red 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 last annual report will be minded upon request and that such request may be sent to the Corporation at a name and address which is set forth as the statement. The term "annual report" as used in this subdivision refers to the report required by a ubdivisioan (a). (it) Promptly mails a copy of its latest annual report to any person who requests a cony thereof, and (*Causes its annual report to be published not later than 120 days after the close of its fiscalyear in a newspaper ofgenemal circulation in the county in which its principal executive office is located. EXHIBIT D TECHNICAL ASSISTANCE MATERIALS The Sub -recipient attended the Community Development Block Grant (CDBG) Technical Assistance Non -Profit Workshop held on May 26, 2010 and received the following items: 1. Playing by the Rules, A Handbook for CDBG Sub -recipients on Administrative Systems 2. OMB Circular No. A-122: Cost Principals for Non -Profit Organizations 3. Quarterly/Annual Performance Reporting Form (updated format) 4. A Comprehensive Compliance and Performance Monitoring Checklist 5. Expenditure Reimbursement Claim Form (updated format) 6. Qualifying Beneficiary Intake Data Form (updated format) 7. Sample Sub -recipient Agreement and Exhibits (Scope of Services, Budget, Board of Directors and By-laws, Affirmative Action Policy and Insurance Requirements) 8. Orientation on meeting CDBG National Objectives The workshop and reference documents will assist the Sub -recipient to understand U.S Department of Housing and Urban Development and City of National City rules, regulations, and reporting requirements. The Grantee also reviewed CDBG regulations under Title 24 and the CDBG webpage on the HUD website: http://www. hud.gov/offices/cpd/commu nitydevelopment/programs/entitlement EXHIBIT E AFFIRMATIVE ACTION POLICY 1. Provision of Program Services a. Subrecipient 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. Subrecipient 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. Subrecipient 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. Subrecipient, in determining the site or location of housing or facilities provided in whole or in part with CDBG funds, may not 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 Subrecipient has previously discriminated against persons on the grounds of race, religion, color, national origin, sex, sexual preference or handicap, the Subrecipient must take affirmative action to overcome the effects of prior discrimination. f. Even in the absence of such prior discrimination, a Subrecipient 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 Subrecipient 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 Subrecipient 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 J. 1. (a. through h.), nothing contained herein shall be construed to prohibit any Subrecipient 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. Subrecipient shall not discriminate against any employee or application for employment because of race, color, religion, sex, national origin, age, or handicap. Subrecipient 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. Subrecipient agrees to post in conspicuous places, available to employees and applicants for employment, notices setting forth the provisions of this non-discrimination clause. b. Subrecipient shall, in all solicitations or advertisements for employees placed by or on behalf of Subrecipient, state that all qualified applications will receive consideration for employment without regard to race, color, religion, sex, national origin, age, or handicap. c. Subrecipient 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 Subrecipient'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. Subrecipient 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. Subrecipient 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 Subrecipient'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 Subrecipient 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• Subrecipient 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. Subrecipient 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 Subrecipient becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the CDC, Subrecipient may request the United States to enter into such litigation to protect the interests of the United States. h. Subrecipient 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). Subrecipient 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 Subrecipient'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 Subrecipient 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 PRODUCER G. S. Levine Insurance Services, Inc. 10505 Sorrento Valley Rd. #200 San Diego CA 92121 Phone: 858-481-8692 Fax: 858-481-7953 INSURED Trauma Intervention Programs of San Diego County, Inc. 2560 Orion Way Carlsbad CA 92008 OP ID sw TRAUM02 DATE (MMIDDIYYYYI 05/17/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF NFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INCIIPFPA Philadelphia Insurance Co NENRFR H NAIC # INSURER C HSUPER D. DISURFR F COVERAGES THE ANY MAY POLICIES. POLICIES REQUIREMENT, PERTAIN, ADD -IL NSRD AGGREGATE OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MRNDD/YY) DATE (MMNDnY] UMITS A X GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY PHPK507961 12/15/09 12/15/10 EACH OCCURRENCE 51, 000, 000 DAMAGE TD FEN TEU PFEMIKS(Ea oceurenc=) 5100,000 X C_AIMSMADE OCCUR MEDEXP(Anyoneperson, $ 5,000 GEN PERSONAL T.ADV INJURY GLILLHALAGGRLGAIL L$1,000,000 $ 3,000,000 LAGUHEGA-EMVII APPLIESPER. POLICY FRET LOC PRODUCTS- OOMP/OPAGC S 3,000,000 A X AUTOMOBILE }A' X LIABILITY ANT AUTO AL_ OIMNED AUTOS ACHEDU_ED AUTOS .TIRED AUTOS NOn-LIVENED AUTOS PHPK507961 12/15/09 12/15/10 FT-MHINFD SIN, FI MIT (Eaaaiderrt] 51,000,000 S'1H11 YINII IRY \PS person) $ i_IIIIIVmu, de n :Per a:ddenC 'ROPERTI DAMAGE ,Pe-nsdentr $ GARAGE UABLITY AIJY AUTO AUTO ONLY • EA ACCIDENT A OTHER THAN FAA AT, AUTO ONLY. AGG 5 $ EXCESSNMERELLA LIABILITY CCC JP 1 CLAIMS MADE DEDLCT BLE RETENTION 5 EACH OCCUPRENCE 5 AGGREGATE 5 $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER'EXECUTNE OFFICERIMEMBER EXCLUDED? Byes, desenbe under SPECIAL RIPCNISIDNS LeIow C MJ- OE H- I L TNRV L.MIiS EP E L EACH ACCIDENT $ EL DISEASE • EA EMPLO"EE $ E.L. DISEASE POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS i 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. CERTIFICATE HOLDER CANCELLATION CITYNAS City of National City City Attorney's Office 1243 National City Blvd. National City CA 91950 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURERWILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KING UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AU RIZED REPRES ATIVE ACORD 25 (2001/08) © ACORD CORPORATION 1988 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 — Horne 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 and 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 not 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 h. 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 II - 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 (D41D7) 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 as 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 not 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 an 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 Page 4 of 7 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 ownersnip, 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 S50,000. 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, Paragraph j. 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 tc: 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 following 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 ' cents 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 ary 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 furnished 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 420907 • San Francisco, CA 94142-0807 STATE COMPENSATION INSURANCE FUND HOME OFFICE SAN FRANCISCO ANNUAL RATING ENDORSEMENT 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. 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 I5 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 RATING PERIOD 8-01-09 TO 8-01-10 DEPOSIT PREMIUM MINIMUM PREMIUM PREMIUM ADJUSTMENT PERIOD NAME OF EMPLOYER- 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.Q.C. 1.15 1.04 ********BUREAU NOTE INFORMATION******** FEIN 330317893 FEIN 330492484 FEIN 953778272 FEIN 956004793 TOTAL ESTIMATED ANNUAL PREMIUM $1,147 COUNTERSIGNED AND ISSUED AT SAN FRANCISCO o„CC,JULY 14, 2009 POLICY L PAGE 1 OF STATE COMPENSATION INSURANCE FUND HOME OFFICE SAN FRANCISCO ANNUAL RATING ENDORSEMENT 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. HERE ARE YOUR NEW RATES FOR THE PERIOD INDICATED. IF YOUR NAME OR ADDRESS SHOULD BE CORRECTED OR IF INSURANCE IS NOT NEEDED FOR NFXT 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:OIAM 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 * r l l* r r r *.�**J * 4 r J J r� r.*J. r-* r. **********�*** **:'C***:r i. .. .. .. .. .: ...,„;,:...xxxiro'c it it it is is i:k,.,...,.,c..n.xrcit.. is do ic;k is �'rdc:: do do is :. :. .... is o'r:...:: i<>. dca v is • i< PREMIUM DISCOUNT SCHEDULE EFFECTIVE FROM 08-01-09 TO 08-01-10 * ESTIMATED MODIFIED PREMIUM IS DISCOUNTED ACCORDING TO THE FOLLOWING SCHEDULE: of FIRST ABOVE i< $5,000 $5,000 0.0% 11.67, J <<.,** r r r,J****ic***-,:.:.:'c****dc'c****::icici***Aeiricicitiri:;:i...........iciciciricici:icicic,.icicicic** :tdr x is it it is ,c :. :. ;. .. ,. .Firx;: :. .. . " �:':�:. :. 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. ;OUNTERSIGNED AND ISSUED AT SAN FRANCISCO ,_,JULY 14, 2009 POLICY L PAGE 2 OF STATE COMPENSATION INSURANCE FUND HOME OFFICE SAN FRANCISCO ANNUAL RATING ENDORSEMENT IT IS AGREED THAT THE CLASSIFICATIONS AND RATES PER VICO 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. dt12j- 17146 AUTHORIZED REPRESENTATIVE PRESIDENT COUNTERSIGNED AND ISSUED AT SAN FRANCISCO JULY 14, 2009 POLICY L PAGE 3 OF nnm cr.o.a Ineevn loot/ lf(.1, 1 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 RE 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 STATE COMPENSATION INSURANCE FUND ENDORSEMENT AGREEMENT 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 Al 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: JULY 14, 2009 HORIZED REPRESENTATIV& \ 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 2 OF 3 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: ORIZED REPRESENTATIV JULY 14, 2009 PRESIDENT 2437 STATE COMPENSATION INSURANCE FUND ENDORSEMENT AGREEMENT MEDICAL PROVIDER NETWORK 1429032-09 RENEWAL SD HOME OFFICE SAN FRANCISCO EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M. PAGE 3 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. 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 HM0/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 ENDORSEMENT AGREEMENT TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT HOME OFFICE SAN FRANCISCO EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M. ALL EFFECTIVE DATES ARE TO AUGUST 1, 2010 AT 12.01 A.M. AT 1201 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME 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. 1429032-09 RENEWAL SD PAGE 1 OF 4 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: JULY 14, 2009 HORIZED REPRESENTATIV 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 1429032-09 RENEWAL SD EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M. PAGE 2 OF 4 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. "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 ENDORSEMENT AGREEMENT 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 TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT 1429032-09 RENEWAL SD EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M. PAGE 3 OF 4 TO AUGUST 1, 2010 AT 12.01 A.M. TIP OF SAN DIEGO COUNTY, INC. 2560 ORION WAY CARLSBAD, CA 92010 CONTINUED. 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: JULY 14, 2009 HORIZED REPRESENTATIV PRESIDENT 2559 STATE COMPENSATION INSURANCE FUND ENDORSEMENT AGREEMENT TERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT 1429032-09 RENEWAL SD HOME OFFICE SAN FRANCISCO EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M. PAGE 4 OF 4 TO AUGUST 1, 2010 AT 12.01 A.M. 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. 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 EXECUTIVE OFFICERS COMPENSATION MINIMUM/MAXIMUM LIMITS 1429032-09 INSURANCE FUND RENEWAL SD HOME OFFICE SAN FRANCISCO EFFECTIVE AUGUST 1, 2009 AT 12.01 A.M. PAGE 1 OF 1 STATE 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. STATE COMPENSATION INSURANCE FUND POLICYHOLDER NOTICE 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 Page 1 of 2 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 lg) 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 fRev. 04-071 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 affordedor 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 granting or 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 1 1752.6(c), 1 1753.1(a) and lb), 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 2010 — 88 RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY AUTHORIZING THE REALLOCATION OF $236,080 IN UNEXPENDED COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) ENTITLEMENT FUNDS, AND AUTHORIZING THE SUBMISSION OF THE 2010/2015 FIVE YEAR CONSOLIDATED PLAN AND THE 2010/2011 ANNUAL ACTION PLAN TO THE UNITED STATES 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 Partnerships 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 at least two Public Hearings and a 30-day public comment period to solicit input on the draft Five -Year Consolidated Plan, Annual Action Plan, and for the reallocation of entitlement funds; and WHEREAS, the City Council of the City of National City conducted a duly advertised public hearing on March 16, 2010 and May 4, 2010 to receive input from the public; and WHEREAS, the City placed the draft Five Year Consolidated Plan, the Annual Action Plan, and the intent to reallocate CDBG funds for a duly advertised 30-day public comment period on the City's website and in various City locations from March 29, 2010 to April 28, 2010; and WHEREAS, the City will incorporate any comment received during the 30-day public comment period in the final submission of said Plans; and WHEREAS, staff recommends the reallocation of unused CDBG funds, attached hereto as Exhibit "A," to supplement the funding of CDBG and HOME Program activities listed in the FY 2010-2011 Annual Action Plan, attached hereto as Exhibit "B;" and WHEREAS, the FY 2011-2015 Five -Year Consolidated Plan outlines the City's housing and non -housing community development needs and priorities over the next five years; and WHEREAS, the Annual Action Plan for FY 2010-2011 outlines how the City of National City plans to expend $1,188,660 in CDBG, and $636,617 in HOME Program funds to meet the needs and priorities established in the Five -Year Consolidated Plan; and WHEREAS, in accordance with the federal regulations at 24 CFR, Part 91, the City of National City is required to prepare and submit a Five -Year Consolidated Plan and Annual Action Plan for its Housing and Community Development Programs. NOW, THEREFORE, BE IT RESOLVED, that the City Council of the City of National City hereby authorizes the reallocation of $236,080 in CBDG funds toward activities included in the FY 2010-2011 Annual Action Plan. Resolution No. 2010 — 88 Page 2 BE IT FURTHER RESOLVED, that the City Council of the City of National City authorizes the submission of FY 2011-2015 Five Year Consolidated Plan and the FY 2010-2011 Annual Action Plan for the expenditure of said funds to the U.S. Department of Housing and Urban Development (HUD). PASSED and ADOPTED this 4th day of ;y, 2010. ATTEST: ch el R. DallaitC APPROVED AS TO FORM: George H. Piser, 1I1 City Attorney Ron Morrison, Mayor Mi Clerk Exhibit A Final Reallocation to FY2010-2011 from Previous Year CDBG Activities HUD IDIS Fiscal Activity Year Number Activity Name 2 302 Re nstalfat on of S et hts 2001 335 Reinstallation of Sreet Lights* 2004 446 .Code Enforcement =Fhlot Pro rarn 2004 489 Street Lights 2005 491 # friusrng luspectton Pmgrar i 2005 497 Fire Apparatus -Radios and Equipment 517 Haustng Inspection �roran 538 National City Library Literacy Services 540 Housing Inspection>Program 2007 541 Code Enforcement 2007 $44 Mtseelfanec us Storrrt Dramfrnprove ertt 2007 545 Beck Fire Truck 2007 2008 2f3f�8' 2008 2tfLtf3 2008 2009 548 Rescue f quilxrtent 554 Neighborhood Councils Program 557 Communtty Food Bank 558 Tiny Tots 562 1"iat onal City Library Literacy- Services 566 Seagraves Fire Truck -Fifth Payment 582 Christmas m Ju y Clean Up 583 Community Food Bank- Walk in Cooler Reallocable Total Funded Drawn Amount Funds 50,OQ000 42320'80 50,000.00 35,000.00 50,000 00 43,354 l4 25,000.00 ti8,938'34 62:115.25 47,000.00 40,161.05 75 000 00 31950 50 47 250.00 44,447.79 1!20:928 98 4243544 120, 928.97 100,188.13 50000J00 78,453.00 78,452.88 2,000 00 1,922 87 103,232.00 100,530.89 10,000 00 2,880;53 24,736.50 22,953.05 47,250 (0 44,871 37 60,116-00 60,115.56 50,000.00 42,931.00 13,000.00 TOTAL AMOUNT FOR REALLOCATION FOR FISCAL YEAR 2010-2011 7,t8(1'fJO::' 15,000.0.0 0,058 46 _' 25,000.00 6,823 09'' 6,838.95 31>1 050 2,802.21 78493 54 20,740.84 72A 56 0.12 2,701.11 7,119 47 1,783.4.5 2,378:63 0.44 13,000.00 236,079.50 Page 1 of 1 Fiscal Year 2010-2011 National City CDBG and HOME Final Allocation Exhibit B FY 20 .11.2011yCDBG Program Entitlement of.$1,188,660, ti�re of,$236080 from previous year CDBG funds reallocation 1,424,740.00 1T CDBG PUBLIC SERVICES 1 Burn Institute Senior Fire & Burn Prevention Program/ Smoke Alarm Installation Program $ 8,000.00 2 Community Youth Athletic Center Champs For Life Youth Diversion Program $ 10,000.00 3 City of National City Community Services Department At Risk Youth Afterschool Program "Supreme Teens" $ 20,000.00 4 City of National City Community Services Department Learn to Swim $ 10,023.00 5 City of National City Community Services Department Tiny Tots $ 29,337.00 6 City of National City Public Library National City Public Library Literacy Services $ 49,600.00 7 Meals -on -Wheels Greater San Diego, Inc. Meals -on -Wheels National City $ 10,000.00 8 South Bay Community Services National City Police Department Support Services - Juvenile Diversion Program $ 20,000.00 $ 8,000.00 9 Trauma Intervention Programs of San Diego County, Inc. Crisis Intervention Team Total Public Service Activities $ ' 164,960.00 CDBG CODE ENFORCEMENT, ECONOMIC DEVELOPMENT, HOUSING REHABILITATION, INTERIM ASSISTANCE, • PUBLIC FACILITY AND INFRASTRUCTURE IMPROVEMENTS ' Code Enforcement $ 94,000.00 10 City of National City- Community Development Department National City Housing Inspection Program $ 94,000.00 Economic Development $ 35,000.00 11 Southwestern Community College District (SCCD) Small Business Development & International Trade Center (SBDITC) National City Economic Development Funds Program $ 35,000.00 Housing Rehabilitation $ 66,908.00 12 Environmental Health Coalition Making National City's "Healthy Homes" Energy Efficient $ 66,908.00 Interim Assistance $ 30,000.00 13 Christmas in July * National City City Clean -Ups $ 30,000.00 Public Facility Improvements $ 538,925.00 14 City of National City- Development Soccer Field at El Toyon Park $ 238,925.00 15 International Community Foundation National City School Gardens and Urban Agriculture Initiative $ 50,000.00 16 La Maestra Clinic -National City La Maestra Dental Clinic, National City $ 25,000.00 17 National City Living History Farm Structural Engineering Report for the Preservation of the Stein Farm Barn $ 25,000.00 18 Sweetwater High Joint -Use Athletic Field Sweetwater Union High School District $ 200,000.00 Public Infrastructure Improvements $ 275,000.00 19 City of National City -Development ADA Park Improvements $ 75,000.00 20 City of National City -Development Upgrade Substandard Pedestrian Ramps, Sidewalk, Curb, and Gutters $ 200,000.00 Tota of Non -Public Service Activities $ 1,039,833.00 Page 1 of 2 Exhibit B CDAHMAND'i4DMiNISTRA BG � INOTIQNiI Planning $ 26,339.00 21 Boys & Girls Club of Inland North Boys & Girls Club Expansion Site Feasibility Study $ 11,339.00 22 City of National City- Community Neighborhood Councils Program $ 15,000.00 Administration $ 193,608.00. 23 Fair Housing Council of San Diego Fair Housing and Tenant -Landlord Education Services $ 38,000.00 24 City of National City - Community Development Department CDBG Program Administration $ 155,608.00 Total Planning and Administration $ 219,947.00 FY 2010=201.1 HOME` Investment Partnerships. (HOME) Program +Entitlement .: 4 "' 8 : `$ 7 00 1 City of National City - Community First Time Homebuyer Program ..636E $ 296,989.00 2 City of National City- Community National City Community Housing Rehabilitation Program $ 148,645.00 3 Community HousingWorks CHDO Predevelopment Loan for Paradise Creek Affordable Housing Project $ 9,549.00 4 Community HousingWorks CHDO Set -aside Development Loan for Paradise Creek Affordable Housing Project $ 85,943.00 5 Community HousingWorks CHDO Operating Assistance to Community HousingWorks for Paradise Creek Affordable Housing Project $ 31,830.00 6 City of National City - Community Development Department HOME Program Administration $ 63,661.00 Total HOME Program $ 636,617.00 Page 2 of 2 Passed and adopted by the Council of the City of National City, California, on May 4, 2010 by the following vote, to -wit: Ayes: Councilmembers Morrison, 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. 2010-88 of the City of National City, California, passed and adopted by the Council of said City on May 4, 2010. City Clerk of the City of ation al City, California By: Deputy CITY OF NATIONAL CITY, CALIFORNIA COUNCIL AGENDA STATEMENT ✓ tio6-\-q �03 -`1 -! MEETING DATE: May 4, 2010 AGENDA ITEM NO. 16 rTEM TITLE: Resolution of the City Council of the City of National City authorizing the reallocation of $236,080 in unexpended Community Development Block Grant (CDBG) entitlement funds, and authorizing the submission of the 2010-2015 Five -Year Consolidated Plan and the 2010-2011 Annual Action Plan to the United States Department of Housing and Urban Development (HUD). (Community Development, Housing and Grants) PREPARED BY: Carlos J. Aguirree: DEPARTMENT: Community Development PHONE: (619) 336-4391 APPROVED BY: EXPLANATION: The City has prepared a draft Fiscal Year 2011-2015 Consolidated Plan and Fiscal Year 2010-2011 Annual Action Plan. The Five Year Plan outlines the City's housing and non -housing community development needs and priorities over the next five years. The Consolidated Annual Action Plan for FY 2010-2011 outlines how the City plans to expend $1,188,660 in federal Community Development Block Grant funds (CDBG) and $636,617 in HOME Investment Partnerships (HOME) Program funds. In addition to the funding sources noted above, the City will also reallocate $236,080 of CDBG funds that remain from previous year activities. In accordance with the federal regulations at 24 CFR, Part 91, the City of National City is required to prepare and submit a Five -Year Consolidated Plan and Annual Action Plan for its Housing and Community Development Programs. In order to obtain the views of residents, public agencies, and other interested parties, the City of National City placed its proposed FY 2011-2015 Five -Year Consolidated Plan and Annual Action Plan for FY 2010-2011 for public comment on the City website and on public display at various National City locations beginning on Monday, March 29, 2010 and ending April 28, 2010. No public comments have been received to date. The purpose of the final public hearing held before consideration of the resolution is to review any comments received during the 30-day public review and comment period. In addition, interested persons and community groups will be provided with one last opportunity to share their thoughts and comments regarding these plans. All comments received will be incorporated into the final plan that will be submitted to HUD, no later than May 15, 2010. Following the 'blic hearing, after all public comment has been considered, the City will take final action on the Five Year Consolidated Plan and ,,nnual Action Plan by adopting the resolution. _ FINANCIAL STATEMENT: ACCOUNT NO. APPROVED: APPROVED: Finance MIS The City received $1,188,660 in CDBG Program and $636,617 in HOME Program allocations for FY2011. The City is also reallocating $236,080 from previously funded CDBG activities that will carryover to FY2011 listed activities. ENVIRONMENTAL REVIEW: Not applicable. ORDINANCE: INTRODUCTION: FINAL ADOPTION: STAFF RECOMMENDATION: Adopt the resolution. BOARD / COMMISSION RECOMMENDATION: Not applicable to this report. ATTACHMENTS: Q,Eso\4v-'o\ No. ao\o - %% OFFICE OF THE CITY CLERK 1243 National City Blvd. National City, California 91950 Michael R. Dalla, CMC - City Clerk 619-336-4228 phone • 619-336-4229 fax TRAUMA INTERVENTION PROGRAMS OF SAN DIEGO COUNTY, INC. Resolution No. 2010-88 CDBG 2010 - 2011 Trauma Intervention Program / Crisis Intervention Team Carlos Aguirre (Housing & Grants) Forwarded Copy of Agreement to Subrecipient