12-154 Human Services Grant Funds City/Non-Profit Contract (Catholic Charities) Long Term Care Ombudsman Program Long Term Care Ombudsman Program
HUMAN SERVICE GRANT FUNDS pt7 S`7
CITY/NON-PRO''FIT CONTRACT
THIS Contract is entered into between the CITY OF CUPERTINO, a political
subdivision.of the State of California (hereinafter "CITY"), and
3 7) ( CATHOLIC CHARITIES
a non-profit corporation (hereinafter "CORPORATION"). The allocation of funds
pursuant to this Contract will be a grant. CITY approved the allocation and
disbursement of Human Service Grant fund (hereinafter "Grant") to CORPORATION
on May 1, 2012.
WITNESSETH
WHEREAS, CITY has reserved a portion of its General Fund to be used on
activities that benefit Cupertino's residents; and,
WHEREAS, CITY has agreed to the use by CORPORATION of a portion of
CITY'S Human Service Grant budget for the Project as described below to be operated
within CITY and will benefit low and very low-income households;
NOW, THEREFORE, the parties agree as follows;
I. PROJECT
CITY agrees to allocate a portion of its current Human Service Grant budget to
CORPORATION, being the sum of Five Thousand Dollars and No Cents ($5,000.00)
for the purpose of implementing the CORPORATION'S project (hereinafter "Project"),
as more particularly described in numerous exhibits marked as noted herein, attached
to this Contract, incorporated by this reference, as though fully set forth, as follows:
Exhibit "A" (Project Description), Exhibit "B" (Project Work Plan), Exhibit "C"
(Proposed Implementation Time Schedule), Exhibit "D" (Project Budget), Exhibit "E"
(Certifications), Exhibit "F" (Assurances), and Exhibit "G" (Indemnity and Insurance
Requirements).
II. TERM
A. The purpose of this Contract is for the CITY to disburse Grant funds for eligible
activities. Unless amended prior to its expiration, the term of this Contract for
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disbursement purposes will begin on July 1, 2012 and will end on June 30, 2013 unless
terminated earlier pursuant to Section VI or Section VII of this Contract.
B. The term of the expenditure by CORPORATION of the allocation provided for
herein will begin on July 1, 2012 and terminate on the earliest of the following dates as
set forth herein: June 30, 2013, or later date per amendment to this Contract; or upon the
termination date established pursuant to Section VI or Section VII of this Contract.
III. SECOND YEAR RENEWAL OPTIONS
The term of this Contract may be extended by an amendment to disburse the CITY'S
Grant funds authorized by City Council for the fiscal year subsequent to the initial term
of this Contract, contingent on the following requirements and process:
A. Authorization by CITY to expend funds for the purposes of this Contract;
B. CITY'S appropriation of funds for this Project effective until Tune 30, 2014;
C. CORPORATION'S satisfactory performance, as determined by the CITY, of all
it's obligations as stated in this Contract for the period Tuly 1, 2012 through Tune
30, 2013;
D. Submission to CITY of Proof of Insurance for the period Tuly 1, 2013 through
Tune 30, 2014.
IV. OBLIGATIONS OF CORPORATION
A. Organization of CORPORATION. CORPORATION will:
1. Provide CITY with copies of the following documents, evidencing
filing with the appropriate governmental agency:
a) Its Articles of Incorporation under the laws of the State of
California;
b) A copy of the current Bylaws of CORPORATION;
c) Documentation of its Internal Revenue Service non-profit status;
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d) Names and addresses of the current Board of Directors of
CORPORATION; and,
e) An adopted copy of CORPORATION'S personnel policies and
procedures.
2. During the Contract term, immediately report any changes,
subsequent to the date of this Contract, in CORPORATION'S Articles of
Incorporation, Bylaws, Board of Directors, personnel policies and procedures,
or tax exempt status to DIRECTOR.
3. Maintain no member of its Board of Directors as a paid employee,
agent, independent contractor, or subcontractor under this Contract.
4. Open to the public, meetings of its Board of Directors, if required by
California's open meeting laws, except meetings, or portions thereof, dealing
with personnel or litigation matters or as otherwise provided by law.
5. Keep minutes of all its regular and special meetings.
6. Comply with all provisions of California and Federal Non-Profit
Corporation Laws.
B. Program Performance by CORPORATION. CORPORATION shall:
1. Conduct the PROJECT within the City of Cupertino, for the purpose
of benefiting low and very low-income households.
2. File quarterly reports as required by CITY on the type and number of
services rendered through the operation of the PROJECT, and a description of
the beneficiaries of these services, and which reports will evaluate the manner in
which the PROJECT is achieving its objectives and goals according to the
standards established by CITY. The progress reports will be due ten days after
the close of each reporting period and must cover the three months immediately
preceding the date on which the report is filed.
3. Coordinate its services with other existing organizations providing
similar services in order to foster community cooperation and to avoid
unnecessary duplication of services.
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4. Seek out and apply for other sources of revenue in support of its
operation or services from local, state, federal and private sources and, in the
event of receipt of such award, inform CITY within ten days.
5. Include an acknowledgement of CITY funding and support on
CORPORATION stationery and on all appropriate project-related publicity and
publications using words to the effect: "funded in whole or in part by the City of
Cupertino General Funds."
C. Fiscal Responsibilities of CORPORATION. CORPORATION will:
1. Appoint and submit the name of a fiscal agent who will be responsible
for the financial and accounting activities of CORPORATION, including the
receipt and disbursement of CORPORATION funds. The CITY must
immediately be notified in writing of the appointment of any new fiscal agent
and that agent's name.
2. If the term of this Contract:.s extended by an amendment for a second
fiscal year, submit a satisfactory Audit within 150 days of CORPORATION's
fiscal year encompassed by the first year of this Contract.
3. Document all PROJECT costs by maintaining records in accordance
with Section III, Paragraph D below.
4. Submit to the CITY,based on an agreed upon schedule, a request for
payment, together with all supporting documentation. Invoices requesting
disbursements submitted after the expiration of the Contract will be honored
only for eligible charges incurred during the Contract term. All invoices must be
submitted by the Contract expiration date or within such other time period
specified by the CITY for this Contract term. Funds not disbursed will be
returned to the City for future reallocation.
5. Certify current and continuous insurance coverage, subject to CITY
approval and in accordance with requirements as outlined in Exhibit G,
"Indemnity and Insurance Requirements."
6. Items 1) through 6) above are express conditions precedent to
disbursement of any CITY funding and failure to comply with these conditions
will, at discretion of CITY, result in suspension of funding or termination of this
Contract.
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7. If CORPORATION does not use Grant funds in accordance with the
requirements of this Contract; CORPORATION is liable for repayment of all
disallowed costs. Disallowed costs may be identified through audits, monitoring
or other sources. CORPORATION is required to respond to any adverse
findings, which may lead to disallowed costs subject to provisions of OMB
Circular A-122, "Cost Principles for Non-Profit Organizations."
D. Establishment and Maintenance of Records. CORPORATION shall:
1. Maintain complete and accurate records of all its transactions
including, but not limited to, contracts, invoices, time cards, cash receipts,
vouchers, canceled checks, bank statements, client statistical records, personnel,
property and all other pertinent records sufficient to reflect properly (a) all direct
and indirect costs of whatever nature claimed to have been incurred or
anticipated to be incurred to perform this Contract or to operate the PROJECT,
and (b) all other matters covered by this Contract.
2. Maintain client data demonstrating client eligibility for services
provided for the Project. Such data will include, but not be limited to, client
name, address, income level or other basis for determining eligibility, and
description of service provided. Such information will be made available to
CITY monitors for review upon request.
E. Preservation of Records. CORPORATION will preserve and make available its
records:
1. Until five years following date of final payment of this contract, or
2. For such longer period, if any as is required by applicable law; or
3. If this Contract is completely or partially terminated, the records
relating to the work terminated will be preserved and made available for a
period of five years from the date of termination.
F. Examination of Records and Facilities. At any time during normal business
hours, and as often as may be deemed necessary, CORPORATION agrees that the CITY,
and/or any duly authorized representatives may until expiration of (a) five years after
final payment under this Contract, (b) five years from the date of termination of this
Contract, or (c) such longer period as may be described by applicable law, have access
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to and the right to examine its plants, offices and facilities used in the performance of
this Contract or the operation of the PROJECT, and all its records with respect to the
PROJECT and all matters covered by this Contract. CORPORATION also agrees that
CITY or any duly authorized representatives will have the right to audit, examine, and
make excerpts or transactions of and from, such records and to make audits of all
contracts and subcontracts, invoices, payrolls, records of personnel, conditions of
employment, materials and all other data relating to the PROJECT and matters covered
by this Contract. CORPORATION will be notified in advance that an audit will be
conducted. CORPORATION will be required to respond to any audit findings, and
have the responses included in the final audit report. The cost of any such audit will be
borne by CITY.
G. Compliance with Law. CORPORATION will become familiar and comply with
and cause all its subcontractors, independent contractors, and employees, if any, to
become familiar and comply with all applicable federal, state and local laws,
ordinances, codes, regulations and decrees.
H. Suspension and Termination. Suspension or termination of this Contract may
occur if the CORPORATION materially fails to comply with any term of the award, and
that the award may be terminated for convenience.
I. Reversion of Assets. Upon expiration or termination of this Contract, the
CORPORATION will transfer to the CITY any Human Service Grant funds on hand at
the time of expiration and any accounts receivable attributable to the use of funds.
IV. OBLIGATIONS OF CITY
A. Method of Payment. During the term of this Contract, CITY shall disburse Grant
funds to CORPORATION on a reimbursement basis unless otherwise provided herein
for all allowable costs and expenses incurred in connection with the PROJECT, not to
exceed the total sum of Five Thousand Dollars and No Cents ($5,000.00). CITY may, at
any time in its absolute discretion, elect to suspend or terminate payment to
CORPORATION, in whole or in part, pursuant to this Contract based on
CORPORATION'S non-compliance, including, but not limited to, incomplete
documentation of expenses, failure to substantially meet goals and objectives as
required in Exhibit B, ("Project Work Plan"), failure to submit adequate progress
reports as required herein or other incidents of non-compliance as described in Section
VI, Paragraph B of this Contract or based on the refusal by CORPORATION to accept
any additional conditions that may be imposed by City at any time.
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V. PROGRAM COORDINATION
A. CITY. The CITY Executive will assign a single DIRECTOR for CITY who will
render overall supervision of the progress and performance of this Contract by CITY.
All services agreed to be performed by CITY will be at the overall direction of the
DIRECTOR.
B. CORPORATION. As of the date hereof, CORPORATION has designated
Gregory Kepferle to serve as EXECUTIVE DIRECTOR and to assume overall
responsibility for the progress and execution of this Contract. The CITY will be
immediately notified in writing of the appointment of a new EXECUTIVE DIRECTOR.
C. NOTICES. All notices or other correspondence required or contemplated by this
Contract shall be sent to the parties at the following addresses:
CITY: Attention: Vera Gil
Housing Services Division
Community Development Department
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014
CORPORATION: Gregory Kepferle
Executive Director
Catholic Charities of Santa Clara County
Corporation
2625 Zanker Road, Suite 200
Address of Corporation
San Jose, CA 95134
City, State, ZIP
All notices will either be hand delivered or sent by United States mail, registered or
certified, postage prepaid. Notices given in such a manner will be deemed received
when hand delivered or seventy-two (72) hours after deposit in the United States mail.
Any party may change his or her address for the purpose of this section by giving five
days written notice of such change to the other party in the manner provided in this
section.
VI. CONTRACT COMPLIANCE
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A. Monitoring and Evaluation of Services. Evaluation and monitoring of the
PROJECT performance is the mutual responsibility of both CITY and CORPORATION.
CORPORATION must furnish all data, statements, records, information and reports
necessary for DIRECTOR to monitor, review and evaluate the performance of the
PROJECT and its components. CITY will have the right to request the services of an
outside agent to assist in any such evaluation. Such services shall be paid for by CITY.
B. Contract Noncompliance. If CORPORATION fails to comply with any
provision of this Contract; CITY will have the right to require corrective action to
enforce compliance with such provision as well as the right to suspend or terminate this
Contract. Examples of noncompliance include, but are not limited to:
1. If CORPORATION (with or without knowledge) has made any material
misrepresentation of any nature with respect to any information or data
furnished to CITY in connection with the PROJECT.
2. If there is pending litigation with respect to the performance by
CORPORATION if any of its duties or obligations under this Contract, which
may materially jeopardize or adversely affect the undertaking of or the carrying
out of the PROJECT.
3. If CORPORATION has taken any action pertaining to the PROJECT, which
action required CITY approval, and such approval was not obtained.
4. If CORPORATION is in default under any provision of this Contract.
5. If CORPORATION makes illegal use of CITY funds.
6. If CORPORATION submits to CITY any report which is incorrect or
incomplete in any material respect.
7. If CORPORATION fails to meet the stated objectives in Exhibit B ("Project
Work Plan").
C. Corrective Action Procedure. CITY, in its absolute discretion and in lieu of
immediately terminating this Contract upon occurrence or discovery of noncompliance
by CORPORATION pursuant to this Contract, will have the right to give
CORPORATION notice of CITY'S intention to consider corrective action to enforce
compliance. Such notice must indicate the nature of the non-compliance and the
procedure whereby CORPORATION will have the opportunity to participate in
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formulating any corrective action recommendation. CITY will have the right to require
the presence of CORPORATION'S officer(s) and EXECUTIVE DIRECTOR at any
hearing or meeting called for the purpose of considering corrective action.
In the event that CORPORATION does not implement the corrective action
recommendations in accordance with the corrective action timetable, CITY may
suspend payments hereunder or terminate this Contract as set forth in Section VII
below.
VII. TERMINATION
A. Termination for Cause. CITY may terminate this Contract by providing written
notice to CORPORATION, for any of the following reasons: uncorrected Contract non-
compliance as defined in Section VI, Paragraph B; CORPORATION is in bankruptcy or
receivership; a member of the CORPORATION'S Board of Directors or the executive
director is found to have committed fraud or; there is reliable evidence that
CORPORATION is unable to complete the Project as described in the attached Exhibits.
The date of termination will be as specified in the notice.
B. Termination for Convenience. In addition to the CITY'S right to terminate for
cause set forth in Section VI, either CITY or CORPORATION may suspend or terminate
this Contract for any reason by giving thirty (30) days prior written notice to the other
party. Upon receipt of such notice, performance of the services hereunder will be
immediately discontinued.
C. In the event that this Contract is terminated, CORPORATON may be required to
return funds to the CITY.
D. Upon termination of this Contract, CORPORATION must immediately provide
CITY access to all documents, records, payro:[1, minutes of meetings, correspondence
and all other data pertaining to Grant made to CORPORATION pursuant to this
Contract.
VIII. PROGRAM INCOME
Income generated by the Project, is considered Program Income. CORPORATION will
annually report all program income generated by activities carried out with grant funds
made available under this Contract. By way of further limitations, CORPORATION
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
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program income balance on hand. All unused program income shall be returned to the
CITY at the end of the Contract period.
IX. INDEPENDENT CONTRACTOR
This is a Contract by and between independent contractors and is not intended and will
not be construed to create the relationship of agent, servant, employee, partnership,
joint venture or association between CORPORATION and CITY. CORPORATION,
including its officers, employees, agents or independent contractors or subcontractors,
shall not have any claim under this Contract or otherwise against CITY for any Social
Security, Worker's Compensation, or employee benefits extended to employees of
CITY.
X. ASSIGNABILITY
A. None of the work or services to be performed hereunder will be assigned,
delegated or subcontracted to third parties without the prior written approval of CITY.
Copies of all third party contracts shall be submitted to CITY at least ten days prior to
the proposed effective date. In the event CITY approves of any such assignment,
delegation or sub-contract, the subcontractors, assignees or delegates shall be deemed
to be employees of CORPORATION, and CORPORATION will be responsible for their
performance and any liabilities attaching to their actions or omissions.
B. This Contract may not be assumed nor assigned to another CORPORATION,
person, partnership or any other entity without the prior written approval of CITY.
XI. DISCLOSURE OF CONFIDENTIAL CLIENT INFORMATION
CITY and CORPORATION agree to maintain the confidentiality of any information
regarding applicants for services offered by the PROJECT pursuant to this Contract or
their immediate families which may be obtained through application forms, interviews,
tests, reports from public agencies or counselors, or any other source. Without the
written permission of the applicant, such information will be divulged only as
necessary for purposes related to the performance or evaluation of the services and
work to be provided pursuant to this Contract, and then only to persons having
responsibilities under this Contract, including those furnishing services under the
PROJECT through approved subcontracts.
XII. HOLD HARMLESS
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In addition to the indemnity obligations set forth in Exhibit G, "Indemnity and
Insurance Requirements," CORPORATION will indemnify and hold harmless the
CITY, its employees, agents, and officials, members of boards and commissions, from
any and all claims, actions, suits, charges and judgments whatsoever, with respect to
any damages, including attorney's fees and court costs, arising out of the failure of the
CORPORATION's Project to comply with applicable laws, ordinances, codes,
regulations and decrees, including without limitation those set forth in Exhibit E,
"Certifications."
XIII. WAIVER OF RIGHTS AND REMEDIES
In no event will any payment by CITY constitute or be construed to be a waiver by
CITY of any breach of the covenants or conditions of this Contract or any default which
may then exist on the part of CORPORATION, and the making of any such payment
while any such breach or default will in no way impair or prejudice any right or remedy
available to CITY with respect touch breach or default. In no event will payment to
CORPORATION by CITY in any way constitute a waiver by CITY of its rights to
recover from CORPORATION the amount of money paid to CORPORATION on any
item, which is not eligible for payment under the PROJECT or this Contract.
XIV. NON-DISCRIMINATION
CORPORATION will comply with all applicable Federal, State and local laws and
regulations including the City of Cupertino's policies concerning nondiscrimination
and equal opportunity in contracting. Such laws include but are not limited to the
following: Title VII of the Civil Rights Act of 1964 as amended; Americans with
Disabilities Act of 1990; The Rehabilitation Act of 1973 (Sections 503 and 504); California
Fair Employment and Housing Act (Government Code
sections 12900 et seq.); and California Labor Code sections 1101 and 1102.
CORPORATION will not discriminate against any subcontractor, employee, or
applicant for employment because of age, race, color, national origin, ancestry, religion,
sex/gender, sexual orientation, mental disability, physical disability, medical condition,
political beliefs, organizational affiliations, or marital status in the recruitment, selection
for training including apprenticeship, hiring, employment, utilization, promotion,
layoff, rates of pay or other forms of compensation. Nor shall CORPORATION
discriminate in provision of services provided in this Contract because of age, race,
color, national origin, ancestry, religion, sex/gender, sexual orientation, mental
disability, physical disability, medical condition, political beliefs, organizational
affiliations, or marital status.
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This non-discrimination provision must be included in CORPORATION's contracts
with sub-contractors and vendors when utilizing the grant funds disbursed for this
project.
XV. AMENDMENTS
Other than the amendment related to a second year renewal option as stated in Article
III. above, amendments to the terms or conditions of this Contract must be requested in
writing by a duly authorized representative of the party desiring such amendments,
and any such amendment shall be effective only upon the mutual agreement in writing
of the parties hereto. Amendments will not invalidate this Contract, nor relieve or
release the CITY or the CORPORATION from its obligations under this Contract.
XVI. INTEGRATED DOCUMENT
This Contract contains the entire Agreement between CITY and CORPORATION with
respect to the subject matter hereof. No written or oral Agreements with any officer,
agent or employee of CITY prior to execution of this Agreement shall affect or modify
any of the terms of obligations contained in any documents comprising this Agreement.
XVII. MISCELLANEOUS
A. The captions and section headings used in this Contract are for convenience of
reference only, and the words contained herein will, in no way, be held to explain,
modify, amplify or aid in the interpretation, construction or meaning of the provisions
of this Contract.
B. All Exhibits attached hereto and referred to in this Contract are incorporated
herein by this reference as if set forth fully herein. Exhibits are as follows: Exhibit "A"
(PROJECT Description), Exhibit "B" (PROJECT Work Plan), Exhibit "C" (Proposed
Implementation Time Schedule), Exhibit "D" (Project Budget), Exhibit "E"
(Certifications), Exhibit "F" (Assurances), Exhibit "G" (Indemnity and Insurance
Requirements), Exhibit "H" (Loan Agreement) if applicable, and Exhibit "I"
(Contracting Principles Documents).
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C. The persons signing below are duly authorized to execute this Contract.
IN WITNESS WHEREOF, the parties have executed this Contract the day and year
above written.
AGENCY: Catholic Charities of Santa Clara CITY OF CUPERTINO:
County
By: Gregory Kepferle By:
(print name)
/211 3 2 _ C_ (1
Executive llihriector u Date David Brandt Date
City Manager
APPROVED AS TO FORM AND ATTEST:
LEGALITY:
1 C7707 lo //3 �� hrt u A al■
Carol Korade Date Grace Schmidt Date
firCity Attorney City Clerk
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EXHIBIT A
PROGRAM DESCRIPTION
Agency Name: Catholic Charities of Santa Clara County DUNS: 11974590
Executive Director: Project Manager: Project#(For Office Use Only)
Gregory Kepferle Wanda Hale
Street Address: City: State: Zip Code:
2625 Zanker Road, Suite 200 San Jose CA 95134-2107
Telephone number: Fax Number: Project Manager E-mail
1-408-944-0567 1-408-944-0776 Address:
Whale @catholiccharitiesscc.org
Name of Project/Program:
Long Term Care Ombudsman Program
Project/Program Location:
26 25 Zanker Road, Suite 200,San Jose, CA 95134-2107
Delivering services at Cupertino licensed long term care facilities.
Project Description:
Please describe the project with as many details as possible. Include general information, such as the
number of units, number of Cu•ertino residents that will be served, services that will be provided, etc.
The Long Term Care Ombudsman Program is authorized by the federal Older Americans Act, as
well as state's Older Californian Act to advocate for the rights of seniors and disabled residents in
long term care facilities.
The main function of the Ombudsman Program is to investigate and endeavor to resolve
complaints made by or on behalf of residents related to issues of quality of care and abuse. The
mission of the Long Term Care Ombudsman Program is to enhance the quality of life and care
for residents in long term care facilities. The Ombudsman Program promotes the interest, well
being and rights of Cupertino's long term care facility residents. Ombudsmen help residents and
their families and friends understand and exercise the rights they are guaranteed by law,both at
the federal and state level.
Long Term Care Ombudsmen are advocates for the more than 200 residents living in Cupertino
long term care facilities that serve low income residents. Ombudsman work to resolve problems
of an individual resident and to bring about changes at the local, state and national level to
improve care. Ombudsmen regularly visit long term care facilities, monitor conditions and care,
and provide a voice for those unable to speak for themselves. The Program will demonstrate and
maintain a regular, ongoing visibility to these residents through the presence of trained and
certified Ombudsmen. As independent advocates, certified Ombudsmen will provide community
contact through unannounced regular visitation to long term care facilities. Ombudsmen regularly
visit Cupertino long term care facilities to be accessible to residents and observe actual or
potential problems first hand. Ombudsmen have responsibility for individual as well as systemic
problem resolution. Ombudsmen address the root cause of individual and/or systemic problems
and fundamentally change the way people and systems work. Regular visits provide residents
with the opportunity to develop personal and confidential relationships and create an environment
for registering complaints. Ombudsmen wild identify, receive, investigate, and resolve
complaints, including violations of personal rights and allegations of elder abuse for primarily
elderly and/or disabled residents in Cupertino's licensed long term care facilities.
The Program will accomplish our goals by conducting a minimum of 48 unannounced site visits
to licensed Cupertino long term care facilities during which we will make contact with a
minimum of 224 unduplicated residents. A minimum of 16 complaints will be identified,
received, investigated and resolved as a result of the regular presence of a long term care
Ombudsman.
EXHIBIT B
CITY OF CUPERTINO CDBG PROGRAM
PERFORMANCE MEASUREMENTS
FY 2012/2013
AGENCY NAME: Catholic Charities of Santa Clara County DATE PREPARED: December 17, 2012
PROJECT NAME: Long Term Care Ombudsman Program
HUD Natonal Objectives 4
❑ Low/Mod Income
❑ Area Benefit(LMA)
El Limited Clientele(LMC)
❑ Housing (LMH)
Objectives Outcomes Performance Benchmarks or Beneficiaries for Each
(Use Specific Indicator Quarter(Quantify When Possible)
Numerical Data 1st 2nd 3rd 4th TOTAL
When Possible)
-
The Program will conduct a minimum of 48 224 Unduplicated ❑ Housing Units
unannounced site visits to licensed Cupertino long term
resident contacts Eri People S 46 5C 54J 22r
care facilities during which we will make contact with a 0 Households
minimum of 224 unduplicated residents ❑ Public Facilities
The Program will accomplish our goals by conducting 48 site visits to ❑ Housing Units 12 12 12 12 48
a minimum of 48 unannounced site visits to licensed Cupertino licensed Ed People
Cupertino long term care facilities long term care 0 Households
facilities. ❑ Public Facilities
A minimum of 16 complaints will be identified, 16 complaints ❑ Housing Units 4 4 4 4 16
received, investigated and resolved as a result of the received from or on ® People
regular presence of a long term care Ombudsman. behalf of residents 0 Households
❑ Public Facilities
EXHIBIT C
Proposed Implementation Time Schedule
Fiscal Year 2012- 13
Agency Name: Catholic Charities of Santa Clara County Date: December 17, 2012
Project Name: Long Term Care Ombudsman Program
Specific Activities Jul -Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
103 11 11 11 11 11 11 11 11 11 11 11
Unduplicated Resident Contacts
4 4 4 4 4 4 4 4 4 4 4 4
Site Visits
2 2 2 2 1 1 1 1 1 1 1 1
Complaint Investigations
EXHIBIT D
ANNUAL BUDGET
FOR GRANT AMOUNT ONLY
FY 2012/2013
Agency Name: Catholic Charities of Santa Clara County Date Prepared: December 17, 2012
Project Name: Long Term Care Ombudsman Program
CATEGORIES $ AMOUNT
SALARIES: $5,000
Personnel
Taxes and Benefits
OFFICE EXPENSE:
Rent
Telephone/Fax
Office Supplies
Equipment Maintenance/Repair
PROJECT EXPENSES:
Accounting Services
Auditing Fees
Insurance
Davis Bacon Compliance
Fair Housing Testing
PROJECT CONSTRUCTION:
Appraisal
Engineering Services
Architectural/Design
Acquisition costs
Construction costs/rehab
TOTAL: $5,000
EXHIBIT E
BASIC INSURANCE AND BOND REQUIREMENTS FOR
NON-PROFIT CONTRACTS
Definition of Contractor: The "Contractor" as the word is used herein is the party contracting
with the City of Cupertino for the direct distribution of CDBG funds. If your organization will
be contracting for construction work (such as general contractors building rental apartments) to
undertake a Program (as defined in this Non-Profit/City Contract) then the requirements set forth
herein shall be complied with by the party contracted with for construction work protecting both
the non-profit and the City.
Indemnity
The Contractor shall indemnify, defend, and hold harmless the City of Santa Clara (hereinafter
"City"), its officers, agents and employees from any loss, liability, claim, injury or damage
arising out of, or in connection with performance of this Contract by Contractor and/or its
agents, employees or subcontractors, excepting only loss, injury or damage caused solely by the
acts or omissions of personnel employed by the City. It is the intent of the parties to this Contract
to provide the broadest possible coverage for the City. The Contractor shall reimburse the City
for all costs, attorneys' fees, expenses and liabilities incurred with respect to any litigation in
which the Contractor is obligated to indemnify, defend and hold harmless the City under this
Contract.
Insurance
Without limiting the Contractor's indemnification of the City, the Contractor shall provide and
maintain at its own expense, during the term of this Contract, or as may be further required
herein, the following insurance coverages and provisions:
A. Evidence of Coverage
Prior to commencement of this Contract, the Contractor shall provide on the City's own form or a
form approved by the City's Insurance Manager an original plus one copy of a Certificate of
Insurance certifying that coverage as required herein has been obtained and remains in force for
the period required by this Contract. The contract number and project name must be stated
on the Certificate of Insurance. The City's Special Endorsement form shall accompany the
certificate. Individual endorsements executed by the insurance carrier may be substituted for the
City's Special Endorsement form if they provide the coverage as required. In addition, a certified
copy of the policy or policies shall be provided by the Contractor upon request.
This verification of coverage shall be sent to the address as shown on the City's Certificate of
Insurance form and to the Housing and Community Development Program at the address set
forth in this Contract at Section VI. PROGRAM COORDINATION, Paragraph C., NOTICES.
The Contractor shall not issue a Notice to Proceed with the work under this Contract until it has
obtained all insurance required and such insurance has been approved by the City. This approval
of insurance shall neither relieve nor decrease the liability of the Contractor.
EXHIBIT E-NON-PROFITS 1 REVISED 6/8/95
B. Notice of Cancellation of Reduction of Coverage
All policies shall contain a special provision for thirty (30) days prior written notice of any
cancellation or reduction in coverage to be sent to the Community Development Department,
10300 Torre Avenue, Cupertino, CA 95014.
C. Qualifying Insurers
All policies shall be issued by 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, unless otherwise approved by the City's Insurance Manager.
D. Insurance Required
1. Comprehensive General Liability Insurance - for bodily injury (including death) and
property damage which provides limits of not less than one million dollars ($1,000,000)
combined single limit(CSL) per occurrence.
OR
2. Commercial General Liability Insurance - for bodily injury (including death) and
property damage which provides limits as follows:
a. General limit per occurrence- $1,000,000
b. General limit aggregate- $2,000,000
c. Products/Completed Operations- $1,000,000 aggregate
d. Personal Injury limit- $1,000,000
If coverage is provided under a Commercial General Liability Insurance form, the carrier
shall provide the City Insurance Manager with a quarterly report of the amount of
aggregate limits expended to that date. If over 50% of the aggregate limits have been paid
or reserved, the City may require additional coverage to be purchased by the Contractor
to restore the required limits.
3. For either type of insurance, coverage shall include:
a. Premises and Operations
b. Products/Completed Operations with limits of one million dollars ($1,000,000)
per occurrence/ aggregate to be maintained for two (2) years following
acceptance of the work by the City.
c. Contractual Liability expressly including liability assumed under this Contract.
EXHIBIT E-NON-PROFITS 2 REVISED 6/8/95
d. Personal Injury liability.
e. Independent Contractors' (Protective) liability.
f. Severability of Interest clause providing that the coverage applies separately to
each insured except with respect to the limits of liability.
4. For either type of insurance, coverage shall include the following endorsements, copies
of which shall be provided to the City:
a. Additional Insured Endorsement:
Such insurance as is afforded by this policy shall also apply to the City of
Cupertino, and members of the City Council, and the officers, agents and
employees of the City of Cupertino, individually and collectively, as additional
insureds.
b. Primary Insurance Endorsement:
Such insurance as is afforded by the additional insured endorsement shall apply as
primary insurance, and other insurance maintained by the City of Cupertino, its
officers, agents, and employees shall be excess only and not contributing with
insurance provided under this policy.
c. Notice of Cancellation or Change of Coverage Endorsement:
This policy may not be cancelled nor the coverage reduced by the Company
without 30 days prior written notice of such cancellation or reduction in coverage
to the City of Cupertino at the address shown on the Certificate of Insurance.
d. Contractual Liability Endorsement:
This policy shall apply to liability assumed by the insured under written contract
with the City of Cupertino.
e. Personal Injury Endorsement:
The provisions of this policy shall provide Personal Injury coverage.
f. Severability of Interest Endorsement:
The insurance afforded by this policy shall apply separately to each insured that is
seeking coverage or against whom a claim is made or a suit is brought, except
with respect to the Company's limit of liability.
EXHIBIT E-NON-PROFITS 3 REVISED 6/8/95
5. Comprehensive Automobile Liability Insurance for bodily injury (including death) and
property damage which provides total limits of not less than one million dollars
($1,000,000) combined single limit per occurrence applicable to all owned, non-owned
and hired vehicles.
6. Worker's Compensation and Employer's Liability Insurance for:
a. Statutory California Workers' Compensation coverage including a broad form all-
states endorsement.
b. Employer's Liability coverage for not less than one million dollars ($1,000,000)
per occurrence for all employees engaged in services or operations under this
Contract.
c. Inclusion of the City and its governing board(s), officers, representatives, agents,
and employees as additional insureds, or a waiver of subrogation.
7. Professional Errors and Omissions Liability Insurance
This type of insurance should be provided by persons/entities you contract with to
provide you with professional services.
a. Limits of not less than one million dollars ($1,000,000).
b. If this policy contains a self retention limit, it shall not be greater than ten
thousand dollars ($10,000)per occurrence/event.
c. This coverage shall be maintained for a minimum of two (2) years following
termination of this Contract.
The City must first approve any exceptions to the above requirements.
8. Bond Requirements
Fidelity Bond - Before receiving compensation under this Contract, Contractor will
furnish City with evidence that all officials, employees, and agents handling or having
access to funds received or disbursed under this Contract, or authorized to sign or
countersign checks, are covered by a BLANKET FIDELITY BOND in an amount of
AT LEAST fifteen percent (15%) of the maximum financial obligation of the City cited
herein. If such bond is cancelled or reduced, Contractor will notify City immediately, and
City may withhold further payment to Contractor until proper coverage has been
obtained. Failure to give such notice may be cause for termination of this Contract, at the
option of the City.
9. Special Provisions
EXHIBIT E-NON-PROFITS 4 REVISED 6/8/95
The following provisions shall apply to this Contract:
a. The foregoing requirements as to the types and limits of insurance coverage to be
maintained by the Contractor and any approval of said insurance by the City or its
insurance consultant(s) are not intended to and shall not in any manner limit or
qualify the liabilities and obligations otherwise assumed by the Contractor
pursuant to this Contract, including but not limited to the provisions concerning
indemnification.
b. The City acknowledges that some insurance requirements contained in this
Contract may be fulfilled by self-insurance on the part of the Contractor.
However, this shall not in any way limit liabilities assumed by the Contractor
under this Contract. The City shall approve any self-insurance in writing.
c. The City reserves the right to withhold payments to the Contractor in the event of
material noncompliance with the insurance requirements outlined above.
d. If the Contractor fails to maintain such insurance as is called for herein, the City
must order the Contractor to immediately suspend work at Contractor's expense
until a new policy of insurance is in effect.
EXHIBIT E-NON-PROFITS 5 REVISED 6/8/95
ADDENDUM TO EXHIBIT "E"
BASIC INSURANCE AND BOND REQUIREMENTS
FOR CONSTRUCTION PROJECTS USING CITY FUNDS
If your organization will be contracting for construction work (such as general contractors
building rental apartments) to undertake a Program (as defined in this Non-Profit/City Contract)
then the requirements set forth in this Addendum to Exhibit "E" shall be complied with by the
party contracted with for construction work protecting both the non-profit and the City.
Indemnity
The General Contractor (hereinafter referred to as "General") shall indemnify, defend, and hold
harmless the City of Cupertino (hereinafter "City"), its officers, agents and employees, and the
Contractor, it's officers, agents and employees from any loss, liability, claim, injury or damage
arising out of, or in connection with performance of this Contract by General and/or its agents,
employees or subcontractors, excepting only loss, injury or damage caused solely by the acts or
omissions of personnel employed by the City or the Contractor. It is the intent of the parties to
this Contract to provide the broadest possible coverage for the City and the Contractor. The
General shall reimburse the City and the Contractor for all costs, attorneys' fees, expenses and
liabilities incurred with respect to any litigation in which the General is obligated to indemnify,
defend and hold harmless the City and the Contractor under this Contract.
Insurance
Without limiting the General's indemnification of the City and the Contractor, the General shall
provide and maintain at its own expense, during the term of this Contract, or as may be further
required herein, the following insurance coverages and provisions:
A. Evidence of Coverage
Prior to commencement of this Contract, the General shall provide an original plus one copy of a
Certificate of Insurance certifying that coverage as required herein has been obtained and
remains in force for the period required by this Contract. The contract number and project name
must be stated on the Certificate of Insurance. Individual endorsements executed by the
insurance carrier shall accompany the Certificate.
This verification of coverage shall be sent to the Contractor at the address stated below and to
the Community Development Department, 10300 Torre Avenue, Cupertino, CA 95014. The
Contractor shall not issue a Notice to Proceed with the work under this Contract until it has
obtained all insurance required and such insurance has been approved by the Contractor and final
approval by the City. This approval of insurance shall neither relieve nor decrease the liability of
the Contractor.
B. Notice of Cancellation or Reduction of Coverage
EXHIBIT E-NON-PROFITS 6 REVISED 6/8/95
All policies shall contain a special provision for thirty (30) days prior written notice of any
cancellation or reduction in coverage to be sent to the Community Development Department as
stated above, and the Contractor at the following address:
Catholic Charities of Santa Clara County
Contractor's Name
2625 Zanker Road
Street Address
San Jose, CA 95134-2107
City, State, Zip
C. Qualifying Insurers
1. All policies shall be issued by 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, unless otherwise approved by the City.
2. Surety coverage (including bid, performance and payment bonds) shall be required as
follows:
a. For projects in excess of$100,000:
1. Either a California Admit?:ed Surety OR a current Treasury Listed Surety
(Federal Register); and either a current A.M. Best A IV rated Surety OR a
current Standard and Poor:; (S&P) rating of A;
2. An admitted surety insurer which complies with the provisions of the
Code of Civil Procedure, Section 995.660*;
OR
3. In lieu of 1 & 2, a company of equal financial size and stability that is
approved by the City's Insurance/Risk Manager.
b. For projects between $25,000 and not exceeding $100,000:
1. A California Admitted Surety and either a current A.M. Best B rated
Surety OR a current Standard and Poors (S&P) rating of B B;
OR
2. An admitted surety insurer which complies with the provisions of the
Code of Civil Procedure, Section 995.660*;
* California Code of Civil Procedure Section 995.660 in summary, states that an admitted surety must provide: 1)the
original, or a certified copy of instrument authorizing the person who executed the bond to do so; 2)a certified copy of
the Certificate of Authority issued by the Insurance Commissioner; 3)a certificate from City Clerk of Santa Clara City
that Certificate of Authority has not been surrendered, revoked, canceled, annulled or suspended; 4) a financial
statement showing the assets and liabilities of the insurer at the end of the quarter calendar year, prior to 30 days
next preceding the date of the execution of the bond.
EXHIBIT E-NON-PROFITS 7 REVISED 6/8/95
OR
3. In lieu of 1 & 2, a company of equal financial size and stability that is
approved by the City's Insurance/Risk Manager.
D. Insurance Required
1. Comprehensive General Liability Insurance - for bodily injury (including death) and
property damage which provides limits of not less than one million dollars ($1,000,000)
combined single limit(CSL) per occurrence.
OR
2. Commercial General Liability Insurance - for bodily injury(including death) and
property damage which provides limits as follows:
a. General limit per occurrence - $1,000,000
b. General limit aggregate- $2,000,000
c. Products/Completed Operations- $1,000,000 aggregate
d. Personal Injury limit- $1,000,000
If coverage is provided under a Commercial General Liability Insurance form, the carrier
shall provide the City Insurance Manager with a quarterly report of the amount of
aggregate limits expended to that date. If over 50% of the aggregate limits have been paid
or reserved, the City may require additional coverage to be purchased by the General to
restore the required limits.
3. For either type of insurance, coverage shall include:
a. Premises and Operations
b. Products/Completed Operations with limits of one million dollars ($1,000,000)
per occurrence/aggregate to be maintained for two (2) years following acceptance
of the work by the City.
c. Contractual Liability expressly including liability assumed under this Contract.
d. Personal Injury liability.
e. Independent Contractors' (Protective) liability
f. Severability of Interest clause providing that the coverage applies separately to
each insured except with respect to the limits of liability.
4. For either type of insurance, coverage shall include the following endorsements, copies
of which shall be provided to the City and the Contractor:
EXHIBIT E-NON-PROFITS 8 REVISED 6/8/95
a. Additional Insured Endorsement:
Insurance afforded by this policy shall also apply to the City of Cupertino and
Contractor as additional insureds.
b. Primary Insurance Endorsement:
Insurance afforded by the additional insured endorsement shall apply as primary
insurance, and other insurance maintained by the City of Cupertino and the
Contractor shall be excess only and not contributing with insurance provided
under this policy.
c. Notice of Cancellation or Change of Coverage Endorsement:
This policy may not be canceled nor the coverage reduced by the Company
without 30 days prior written notice of such cancellation or reduction in coverage
to the City of Cupertino CDBG Program, and the Contractor at the addresses set
forth on page 10 of this Addendum.
d. Severability of Interest Endorsement:
The insurance afforded by this policy shall apply separately to each insured who
is seeking coverage or against whom a claim is made or a suit is brought, except
with respect to the Company's limit of liability.
5. Comprehensive Automobile Liability Insurance for bodily injury (including death) and
property damage which provides total limits of not less than one million dollars
($1,000,000) combined single limit per occurrence applicable to all owned, non-owned
and hired vehicles.
6. Worker's Compensation and Employer's Liability Insurance for:
a. Statutory California Workers' Compensation coverage including a broad form all-
states endorsement.
b. Employer's Liability coverage for not less than one million dollars ($1,000,000)
per occurrence for all employees engaged in services or operations under this
Contract.
7. Work and Materials Insurance (including but not limited to Builder's Risk, Course of
Construction, Installation Floater or similar first party property insurance for covering the
interest of the Contractor and the City) shall be provided by the Contractor.
The Contractor's coverage shall provide the following:
EXHIBIT E-NON-PROFITS 9 REVISED 6/8/95
a. Coverage shall be provided on an "all-risk" basis.
b. Coverage shall be provided on the work and materials which are the subject of
this Contract, whether in process or manufacture or finished, including "in
transit" coverage to the final agreed upon destination of delivery, and including
loading and unloading operations, and such coverage shall be in force until the
work and materials are accepted by the City.
c. City and non-profit shall be named as additional insured as its interests may
appear at the time of loss.
d. Coverage shall be in an amount no less than the full replacement value of the
property at the time of loss.
e. The deductible shall not exceed $1,000 per occurrence unless otherwise approved
by the City and shall be borne by the Contractor.
f. If the construction contractor fails to maintain such insurance as is called for
herein, the City shall have cause to terminate this Contract in accordance with
Section V, paragraph B.
8. Bond Requirements
The following bond requirements apply:
a. Contract Bonds - Prior to execution of the Contract, Contractor shall file with the
City on the approved forms, the two surety bonds in the amounts and for the
purposes noted below, duly executed by a reputable surety company satisfactory
to City, and Contractor shall pay all premiums and costs thereof and incidental
thereto. Both Contractor and the sureties shall sign each bond.
b. The "payment bond for public works" shall be in an amount of one
hundred percent (100%) of the Contract price, as determined from the prices in
the bid form, and shall insure to the benefit of persons performing labor or
furnishing materials in connection with the work of the proposed Contract. This
bond shall be maintained in full force and effect until all work under the Contract
is completed and accepted by the City, and until all claims for materials and labor
have been paid.
c. The "performance bond" shall be in an amount of one hundred percent (100%) of
the Contract price as determined from the prices in the bid form. and shall insure
the faithful performance by Contractor of all work under the Contract. It shall also
insure the replacing of, or making acceptable, any defective materials or faulty
workmanship.
EXHIBIT E-NON-PROFITS 10 REVISED 6/8/95
Should any surety or sureties be deemed unsatisfactory at any time by the City
notice will be given Contractor to that effect, and Contractor shall forthwith
substitute a new surety or sureties satisfactory to the City. No further payment
shall be deemed due or will be made under the Contract until the new sureties
qualify and are accepted by the City.
All alterations, time extensions, extra and additional work, and other changes
authorized by the Specifications, or any part of the Contract, may be made
without securing consent of the surety or sureties on the contract bonds.
9. Special Provisions
The following provisions shall apply to this Contract:
a. The foregoing requirements as to the types and limits of insurance coverage
to be maintained by the General and any approval of said insurance by the City or
the Contractor are not intended to and shall not in any manner limit or qualify the
liabilities and obligations otherwise assumed by the General pursuant to this
Contract, including but not limited to the provisions concerning indemnification.
b. The Contractor reserves the right to withhold payments to the General in the
event of material noncompliance with the insurance requirements outlined above.
c. The Contractor shall notify the City Community Development Department
promptly of all losses or claims over $25,000 resulting from work performed
under this contract, or any products/completed operations loss or claim against the
contractor resulting from any of the contractor's work.
EXHIBIT E-NON-PROFITS 11 REVISED 6/8/95
EXHIBIT F
ASSURANCES
CORPORATION hereby assures and certifies that it will comply with all regulations,policies,
guidelines and requirements applicable to the acceptance and use of Federal funds for this Federally-
assisted program and will be responsible for implementing and complying with all relevant future
changes to Federal Regulations or OMB Circulars. Specifically CORPORATION gives assurances and
certifies with respect to the PROGRAM that it is in compliance with the following Regulations as
defined by 24 CFR, Part 570, Subpart J; 24 CFR, Part 570, Subpart K; and will be conducted and
administered in conformity with"Public Law 88.352 and Public Law 90-284.
1. 570.601. Public Law 88-352 and Public Law 90-284; affirmatively furthering fair housing;
Executive Order 11063, as amended by Executive Order 12259 addresses discrimination. HUD
regulations implementing Executive Order 11063 are contained in 24 CFR, Part 107.
2. 570.602. Section 109 of the Act addresses discrimination.
3. 570.603. Labor Standards.
4. 570.604. Environmental Standards.
5. 570.605. National Flood Insurance Program.
6. 570.606. Relocation, Displacement and Acquisition.
7. 570.607. Employment and Contracting Opportunities.
8. 570.608. Lead-Based Paint.
9. 570.609. Use of Debarred, Suspended, or Ineligible Contractors or Subrecipients.
10. 570.610. Uniform Administrative Requirement and Cost Principles. The CITY, its
Subrecipients, agencies or instrumentalities, shall comply with the policies, guidelines, and
requirements of 24 CFR Part 85 (Common Rule), and OMB Circulars A-110 (Grants and
Agreements with Non-Profit Organizations), A-122 (Cost Principles for Non-Profits), A-128
(Audits of State and Local Governments-implemented at 24 CFR, Part 24), and A-133 (Audits
of Institutions of Higher Education and Other son-Profit Institutions), as applicable, as they
relate to the acceptance and use of Federal funds under this part. The applicable sections of 24
CFR, Part 85 and OMB Circular A-100 are set forth at 570.502.
11. 570.611. Conflict of Interest.
12. 570.612. Executive Order 12372 allows States to establish its own process for review and
comment on proposed Federal financial assistance programs, specifically the use of CDBG
funds for the construction or planning of water or sewer facilities.
EXHIBIT F-ASSURANCES 1 REVISED 11/15/00