14-089 General Fund Human Service Grants (HSG) Program City/Non-Profit Contract-Catholic Charities of Santa Clara County OFFICE OF THE CITY CLERK
CITY HALL
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
TELEPHONE:(408)777-3223•FAX: (408)777-3366
WEBSITE:www.cupertino.org
CUPERTINO
June 25, 2015
Catholic Charities of Santa Clara County
Attention: Wanda Hale
2625 Zanker Road, Suite 200
San Jose, CA 95134
Re: General Fund Human Service Grants (HSG) Program City/Bon-Profit Contract
Enclosed is a fully executed original copy of your agreement with the City of Cupertino.
If you have any questions or need additional information, please contact the Planning
Department at (408) 777-3308.
Sincerely,
Andrea Sanders
Senior Office Assistant
cc: Planning
Enclosure
FIRST AMENDMENT
TO GENERAL FUND HUMAN SERVICE GRANTS (HSG) PROGRAM
CITY/NON-PROFIT CONTRACT
(Services Only)
The First Amendment to Contract is entered into between CATHOLIC CHARITIES OF
SANTA CLARA COUNTY (CORPORATION) and the CITY OF CUPERTINO (CITY)to
amend the General Fund Human Service Grants (HSG) Program Contract(CONTRACT) dated
July 1,2014.
WITNESSETH
WHEREAS, CITY has reserved a portion of its HSG funds 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 HSG
budget for the Program as described below to be operated within CITY and will benefit low and
very low-income households;
THEREFORE, the parties agree as follows:
1. Section I, entitled"Project," is revised to read as follows:
For the period of July 1, 2014 to June 30, 2015, CITY agreed to allocate a portion of its HSG
budget to CORPORATION, being the sum of Six Thousand Five Hundred Dollars and No
Cents ($6,500.00) for the purpose of implementing the CORPORATION'S project(hereinafter "
Project"), as more particularly described in Exhibits A-E.
For the period of lite-FTsUl6 CITY agrees to allocate a portion of its current
HSG budget to CORPORATION as a subrecipient in the sum of
Six Thousand Five Hundred Dollars and No Cents°'( 6. 0"Q) for the purpose of
implementing the CORPORATION'S project, as more particularly described in Exhibits A-E as
noted herein, attached to this First Amendment.
The total allocation for July 1, 2014 through June 30, 2016 shall not exceed Thirteen Thousand
Dollars and No Cents ($13,000.00).
2. Section 11, "Term," is amended to read as follows, the purpose of this Contract is for the CITY to
disburse HSG funds for eligible activities. Unless amended prior to its expiration, the term of this
Contract for disbursement.purposes will begin on July 1, 2015 and will end on June 30, 2016,
unless terminated earlier pursuant to Section VI or Section VII of the Contract.
3. The following Exhibits to the Contract are hereby added to read as shown in the attachments to
this Amendment:
1. Exhibit A: Program Description;
2. Exhibit B: Program Work Plan;
Page 1 of 1 1
FY 2015-16 General Fund Human Service Grants (HSG) City/Non-Profit Contract Amendment
3. Exhibit C: Proposed Implementation Timeline Schedule;
4. Exhibit D: Program Budget;
5. Exhibit E: Basic Insurance and Bond Requirements For Non-Profit Contracts
4. All terms, covenants and conditions stated in the CONTRACT, which are not herein amended,
remain in full force and effect.
IN WITNESS WHEREOF, the parties have executed this First Amendment effective on the.later
date shown below.
AGENCY: CITY OF CUPERTINO, a municipal
Catholic Charities of Santa Clara County corporation:
y: Q � LC By: �'l V
3
(print name) (print name)
Margaret Williams Date David Brandt Date
Chief Administrative and Financial Officer City Manager
APPROVED AS TO FORM AND ATTEST:
LEGALITY:
W4�A
Carol Korade Date Grace Schmidt Date
Ci Attorney City Clerk
EXPENDITURE DISTRIBUTION
n• 1
ACCOUNT NUMBER AMOUNT
100-72-712-700-702
PO# � �_ A(0/ 5E0- "C 6[ s0od
Original Contract: $6,500.00
Total: A 3/ L
Page 2 of 11
FY 2015-16 General Fund Human Service Grants (HSG) City/Non-Profit Contract Amendment
EXHIBIT A
PROGRAM DESCRIPTION
Agency Name: DUNS#:
Catholic Charities of Santa Clara County Not Applicable(Only for CDBG)
Chief Financial Officer: Project Manager: Project#(For Office Use Only)
Margaret Williams Wanda Hale HSG-2015-1
Street Address: City: State: Zip Code:
2625 Zanker Road, Suite 200 San Jose California 95134
Telephone number: Fax Number: Project Manager E-mail Address:
408.325.5269 408.944.0776 Whale@catholiccharitiesscc.org
Name of Project/Program:
Long-Tenn Care Ombudsman
Project/Program Location:
City-Wide
Project Description:
The Long Term Care Ombudsman Program (LTCOP) 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 LTCOP
promotes the interest,well being and rights of long term care facility residents. Long Term Care(LTC)
Ombudsmen protect and help improve the quality of care and life for the frailest of our senior and disabled
population.
The main function of the LTCOP 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 LTCOP is to enhance the
quality of life and care for residents in long term care facilities by promoting the interest,well being and
rights of residents in long term care facilities in Cupertino. LTC 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.As independent advocates, certified LTC Ombudsmen work to
resolve problems of an individual resident and to bring about changes by creating ongoing visibility through
regular unannounced visits to long term care facilities,by monitoring conditions and care, and providing a
voice for those unable to speak for themselves. LTC Ombudsmen regularly visit Cupertino long term care
facilities to be accessible to residents and observe actual or potential problems first hand. LTC Ombudsmen
have responsibility for individual as well as systemic problem resolution by addressing the root cause of
individual and/or systemic problems that can fundamentally change the way people and systems work.
Regular visits provide residents with the opportunity to develop personal and confidential relationships and
create a secure environment for registering complaints. LTC Ombudsmen will identify,receive, investigate,
and resolve complaints, including violations of personal rights and allegations of elder abuse for primarily
elderly and/or disabled residents in licensed long tenn care facilities in Cupertino.
Certified LTC Ombudsmen provide services with respect for human dignity and the individuality of the
resident unrestricted by considerations of age, social or economic status,personal characteristic or lifestyle.
Regular contact with residents helps to build trust,visibility and clarity of purpose,making residents more
likely to express their concerns that might not otherwise surface.
The LTCOP will accomplish our goals by conducting a minimum of 48 unannounced site visits to licensed
Cupertino long tern 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 LTC Ombudsman. In addition,through the response to all consumer telephone
inquiries the LTCOP will partner with residents,their families, and long term care facilities to address issues
to improve the quality of life of the residents in the facilities.
Page 3 of 11
FY 2015-16 General Fund Human Service Grants(HSG) City/Non-Profit Contract Amendment
EXHIBIT B
PROGRAM WORK PLAN
FY 2015/16
AGENCY NAME: Catholic Charities of Santa Clara County
PROGRAM NAME: Long-Term Care Ombudsman
Benchmarks for Each Quarter
Objectives
1st 2nd 3rd 4th TOTAL
Unannounced Site Visits to 6 Cupertino 12 12 12 12 48
Long-Term Care (LTC) Facilities
Unduplicated Contacts w/LTC Residents 56 56 1 56 56 224
Investigate and Resolve Complaints 4 4 4 4 16
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FY 2015-16 General Fund Human Service Grants (HSG) City/Non-Profit Contract Amendment
EXHIBIT C
PROPOSED IMPLEMENTATION TIMELINE SCHEDULE
FY 2015/16
AGENCY NAME: Catholic Charities of Santa Clara County
PROGRM NAME: Long-Term Care Ombudsman
Activity Number & Description:
#1.Unannounced site visits to 6 targeted Cupertino Long-Term Care(LTC)Facilities
#2.Unduplicated contacts for LTC residents
#3. Investigate and resolve complaints
R, a
30,
1 4 4 4 4 4 4 4 4 4 4 4 4 48
2 18 18 18 18 18 18 18 18 18 18 18 26 224
3 1 1 1 1 1 1 1 1 1 1 1 5 16
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FY 2015-16 General Fund Human Service Grants (HSG) City/Non-Profit Contract Amendment
EXHIBIT D
PROGRAM BUGET
FY 2015/16
Agency Name: Catholic Charities of Santa Clara County
Project Name: Long-Term Care Ombudsman
Proposed Project Expenses FY 2015/16
Salaries/Benefits/Payroll/Taxes $6,500
Office Supplies $0
Communication $0
Publications/Printing/Advertising $0
Travel $0
Rent/Lease/Mortgage $0
Utilities $0
Insurance $0
Equipment Rental/Maintenance $0
udit/Legal/Professional Services $0
Direct Services (Funding for specific service such as a meal, ride) $0
Contracted Services $0
Other $0
Total Expenses $6,500
Page 6 of 11
FY 2015-16 General Fund Human Service Grants (HSG) City/Non-Profit Contract Amendment
EXHIBIT E
BASIC INSURANCE AND BOND REQUIREMENTS FOR
NON-PROFIT CONTRACTS
Definition of Contractor: The "Contractor" as the word is used in this Exhibit E is the party
contracting with the City of Cupertino for the direct distribution of HSG funds.
Indemni
The Contractor shall indemnify, defend, and hold harmless the City of Cupertino (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 Community Development Department 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.
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.
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FY 2015-16 General Fund Human Service Grants(HSG) City/Non-Profit Contract Amendment
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 assumdd 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.
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FY 2015-16 General Fund Human Service Grants(HSG)City/Non-Profit Contract Amendment
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.
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.
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FY 2015-16 General Fund Human Service Grants (HSG) City/Non-Profit Contract Amendment
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
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.
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FY 2015-16 General Fund Human Service Grants (HSG) City/Non-Profit Contract Amendment
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.
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FY 2015-16 General Fund Human Service Grants (HSG) City/Non-Profit Contract Amendment
OFFICE OF THE CITY CLERK
CITY HALL
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255
TELEPHONE: (408)777-3223• FAX: (408)777-3366
C U P E RT I N O WEBSITE:www.cupertino.org
June 5, 2014
Catholic Charities of Santa Clara County
2625 Zanker Road, Suite 200
San Jose, CA 95134
Re: General Fund Human Service Grants Program
A fully executed copy of the agreement for consultant services with the City of
Cupertino is enclosed. If you have any questions or need additional information, please
contact the Community Development Department at (408) 777-3308.
Sincerely,
Andrea Sanders
Senior Office Assistant
City Clerk's Office
Enclosure
cc: Community Development
GENERAL FUND HUMAN SERVICE GRANTS (HSG) PROGRAM
CITY/NON-PROFIT CONTRACT
S-
Services Only)
( y) P
THIS General Fund Human Services Grants (HSG) Program City/Non-Profit Contract
(the "Contract") is entered into between the CITY OF CUPERTINO, a political subdivision of
the S o 7a; nia (hereinafter "CITY"), and.
�3
ATHOLIC CHARTIES OF SANTA CLARA COUNTY
a non-profit public benefit corporation (hereinafter"CORPORATION"). The allocation of fiends
pursuant to this Contract will be a(g an" t. CITY approved the allocation and disbursement of
General Fund Human Service Grdnts (HSG) funds (hereinafter "Grant") to CORPORATION on
April 15, 2014. ----------
WITNESSETH
WHEREAS, CITY has reserved a portion of its HSG funds 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
HSG budget for the Program 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. PROGRAM
CITY agrees to allocate a portion of its current HSG budget to CORPORATION, being
the sum of Six Thousand Five Hundred Dollars and No Cents ($6,500.00) for the purpose of
implementing the CORPORATION'S program (hereinafter"Program"), 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" (Program Description),
Exhibit "B" (Program Work Plan), Exhibit "C" (Proposed Implementation Time Schedule),
Exhibit "D" (Program Budget), and Exhibit"E" {Insurance and Bond Requirements).
II. T1ERM
A. The purpose of this Contract is for the CITY to disburse HSG funds for eligible activities.
Unless amended prior to its expiration, the term of this Contract for disbursement purposes will
begin on July 1, 2014 and will end on June 30, 2015 unless terminated earlier pursuant to
Section VII or Section VIII of this Contract.
B. The term of the expenditure by CORPORATION of the allocation provided for herein
will begin on July 1, 2014 and terminate on the earliest of the following dates as set forth herein:
June 30, 2015, or later date per amendment to this Contract; or upon the tei->nination date
established pursuant to Section VII or Section VIII of this Contract.
Page 1 of 21
FY 2014-15 General Fund Human Service Grants(HSG)City/Non-Profit 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 Program;
C. CORPORATION'S satisfactory performance, as detennined by the CITY, of all it's
obligations as stated in this Contract;
D. Submission to CITY of Proof of Insurance.
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;
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.
Page 2 of 21
FY 2014-15 General Fund Human Service Grants(HSG)City/Non-Profit Contract
6. Comply with all provisions of California and Federal Non-Profit Corporation
Laws.
7. Provide to the CITY a copy of a resolution authorizing the
CORPORATION's execution of this Contract. The CORPORATION hereby warrants to
the CITY that this Contract is a legal, valid, and binding obligation of the
CORPORATION enforceable in accordance with its terms, and that the execution and
delivery of this Contract and the performance of the CORPORATION's obligations have
been duly authorized by the CORPORATION.
B. Program Performance by CORPORATION. CORPORATION shall:
1. Conduct the PROGRAM 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 PROGRAM, and a description of the beneficiaries
of these services, and which reports will evaluate the manner in which the PROGRAM 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.
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 program-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 is 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.
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FY 2014-15 General Fund Human Service Grants(HSG)City/Non-Profit Contract
3. Document all PROGRAM 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 E, "Insurance and Bond
Requirements."
6. Items 1) through 5) 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 germination of this Contract.
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 PROGRAM, and (b) all other matters covered by this Contract.
2. Maintain client data demonstrating client eligibility for services provided for
the Program. 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
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FY 2014-15 General Fund Human Service Grants(HSG)City/Non-Profit Contract
3. If this Contract is completely or partially tenninated, 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 tennination of this Contract, or (c) such longer period as
may be described by applicable law, have access to and the right to examine its plants, offices
and facilities used in the performance of this Contract or the operation of the PROGRAM, and
all its records with respect to the PROGRAM 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 PROGRAM 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 HSG funds on hand at the time of expiration and
any accounts receivable attributable to the use of Rinds.
V. OBLIGATION'S OF CITY
A. Method of Payment. During the term of this Contract, CITY shall disburse HSG fiends to
CORPORATION on a reimbursement basis unless otherwise provided herein for all allowable
costs and expenses incurred in connection with the PROGRAM, not to exceed the total sum of
Six Thousand Five Hundred Dollars ($6,500.001. CITY may, at any tirne 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, (`'Program Work Plan"), failure to submit adequate progress
reports as required herein or other incidents of non.-compliance as described in Section VII,
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 to ensure compliance with the
terms of this Contract.
Page 5 of 21
FY 2014-15 General Pond HUrnan Service Grants(HSG)City/Non-Profit Contract
VI. 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 Margaret
Williams to serve as CHIEF ADMINISTRATIVE AND FINANCIAL OFFICER 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: City of Cupertino
Attn: Senior.-Housing Planner
10300 Torre Avenue
Cupertino, California 95014
CORPORATION: Catholic Charities of Santa Clara County
Attn: Executive Director
2625 Zanker Road, Suite 200
San Jose, California 95134
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.
VII. CONTRACT COMPLIANCE
A. Monitoring and Evaluation of Services. Evaluation and monitoring of the PROGRAM
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 PROGRAM 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 PROGRAM.
Page 6 of 21
FY 2014-15 General Fund I-luman Service Grants MSG)City/Non-Profit Contract
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 PROGRAM.
3. If CORPORATION has taken any action pertaining to the PROGRAM, 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 ("Program 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 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 VIII below.
VIII. TERA11 NATION
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 VII, 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
Program 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 VII, 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.
Page 7 of'21
FY 2014-I5 General Fund Human Service Grants(HSG)City/Non-Profit Contract
D. Upon termination of this Contract. CORPORATION must immediately provide CITY
access to all documents, records, payroll, minutes of meetings, correspondence and all other data
pertaining to Grant made to CORPORATION plursuant to this Contract.
IX. PROGRAM INCOME
Income generated by the Program, 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 arty such program income balance on hand. All
unused program income shall be returned to the CITY at the end of the Contract period.
X. 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 LSocial Security, Worker's Compensation, or
employee benefits extended to employees of CITY.
XI. ASSIGNABILITY
CITY is entering into this Contract based on the experience, skill, and ability to perform of the
CORPORATION. The CORPORATION recognizes that its qualifications and identify are of
particular concern to the CITY in view of the CITY's interest in providing services to lower
income persons and the CITY's reliance on the unique qualifications of the CORPORATION.
Consequently, this Contract may not be assigned to another CORPORATION, person,
partnership or any other entity without the prior written approval of CITY. None of the work or
services to be performed hereunder may be assigned, delegated or subcontracted to third parties
without the prior written approval of CITY, which the CITY may withhold in its sole discretion.
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 CORPORATION shall remain fully liable for
all obligations and requirements under this Contract, including the performance and any
liabilities attaching to the assignees' actions or omissions.
Page 8 of 21
FY 2014-15 General Fund Human Service Grants(FISG)City/Non-Profit Contract
XII. CLIENT INFORMATION
CORPORATION agrees to maintain client records consistent with applicable laws regarding
personal privacy and obligations of confidentiality. .
XIII. MOLD HARMLESS
In addition to the indemnity obligations set forth in Exhibit E, "Insurance and Bond
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 Program to comply with
applicable laws, ordinances, codes, regulations and decrees, including without limitation those
set forth in Exhibit E, "Certifications."
XIV. 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 rel.nedy 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 PROGRAM or this
Contract.
XV. NON-DISCIR.IMINATION
CORPORATION will comply with all applicably, .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 cif 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.
This non-discrimination provision must be included in CORPORATION's contracts with sub-
contractors and vendors when utilizing the grant fiends disbursed for this program.
Page 9 of 21
FY 2014-15 General Fund Human Service Grants(FISG)City/Non-Profit Contract
XVI. AMENDMENTS
Other than the amendment related to a second year renewal option as stated in Section 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. _
XVII. INTEGRA'T'ED 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 Contract shall affect or modify any of the terms of obligations
contained in any documents comprising this Contract.
XVIII. MISCELLANEOUS
A. Headings. 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. Exhibits. 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"
(PROGRAM Description), Exhibit "B" (PROGRA.M Work Plan), Exhibit "C" (Proposed
Implementation Time Schedule), Exhibit "D" (Program Budget), and Exhibit "E" (Insurance and
Bond Requirements).
C. Conflict of Interest. In accordance with Government Code Section 1090 and the Political
Reform Act, Government Code Section 87100 et seq., except for approved eligible
administrative or personnel costs, no person who its an employee, agent, consultant, officer, or
any immediate family member of such person, or any elected or appointed official of the CITY
who exercises or has exercised any functions or responsibilities with respect to the activities
funded by this Contract or who is in a position to participate in a decision-making process, may
obtain a personal or financial interest or benefit from the activity, or have an interest in any
contract, subcontract or agreement with respect thereto, or the proceeds thereunder, during, or at
any time after, such person's tenure. The CORPORATION shall exercise due diligence to ensure
that the prohibition in this section is followed.
Further, no person who is a director, officer, partner, trustee or employee or consultant of the
CORPORATION, or immediate family member of any of the preceding, shall make or
participate in a decision, made by the CITY or a CITY board, commission or committee, if it is
reasonably foreseeable that the decision will have a material effect on any source of income,
investment or interest in real property of that person or the CORPORATION.
Interpretation of this section shall be governed by the definitions and provisions used in the
Political Reform Act, Goverrunent Code Section 8 7100 et sue., its implementing regulations
manual and codes, and Government Code Section 1090.
Page 10 of.'21
FY 2014-15 General Fund 1-luman Service Grants(FISG)City/Non-Profit Contract
D. Interpretation. Each party to this Contract has had an opportunity to review the Contract,
confer with legal counsel regarding the meaning of the Contract, and negotiate revisions to the
Contract. Accordingly, neither party shall rely upon Civil Code Section 1654 in order to interpret
any uncertainty in the meaning of the Contract.
E. Third-Party Beneficiary. There shall be no third party beneficiaries to this Contract.
F. Choice of Law and Venue. This Contract shall be governed by and construed in
accordance with California law. Venue shall be Santa Clara County.
G. Severability. If any term of this Contract is held by a court of competent jurisdiction to be
invalid, void or unenforceable, the remainder of the provisions shall continue in full force and
effect unless the rights and obligations of the parties have been materially altered or abridged by
such invalidation, voiding or unenforceability.
Page 11 of 21
FY 2014-15 General Fund Fluman Service Grants(I-ISG)City/Non-Profit Contract
IN WITNESS WHEREOF,the parties have executed this Contract the day and year above written. The parties
signing below hereby warrant that they are duly authorized to execute this Contract.
AGENCY: CITY OF CUPERTINO, a municipal
Catholic Charities of Santa Clara County corporation:
By: By: JI` ��
(print name) (print name)
S
Margaret Williams Date David Brandt
Date
Chief Administrative and Financial Officer City Manager
APPROVED AS TO FORM AND ATTEST:
LEGALITY:
.Carol Korade Date race Sc 'dt Date
City Attorney City Clerk
EXPENDITURE DISTRIBUTION
ACCOUNT NUMBER AMOUNT
110-7406-7102 ✓
Original Contract: $6,1500.00
Total: $6;.500.00
If fD
� �
Page 12 of'21
FY 2014-15 General Fund Human Service Grants(HSG)City/Non-Profit Contract
EXHIBIT A
PROGRAM DESCRIPTION
Agency Name: DUNS#:
Catholic Charities of Santa Clara Cou ty Not Applicable(Only for CDBG)
Chief Financial Officer: Project Manager: Project#(For Office Use Only)
Margaret Williams Wanda Hale _ HSG 2014-1
Street Address: City: State: Zip Code:
2625 Zanker Road, Suite 200 San Jose _ California 95134
Telephone number: Fax Number: Project Manager E-mail Address:
408.325.5269 408.944.0776 Whale@ catholiccharitiesscc.org
Name of Project/Prograrn:
Long-Term Care Ombudsman
Project/Program Location:
City-Wide
Project Description:
The Long Term Care Ombudsman Program (LTCOP) 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 investiio;ate and endeavor to resolve complaints made by or on
behalf of residents related to issues of quality of care and abuse. The LTCOP prornotes the interest, well being and
rights of long term care facility residents. Long Term Care (LTC)Ombudsmen protect and help improve the quality
of care and life for the frailest of our senior and disabled population.
The main function of the LTCOP 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 LTCOP is to enhance the quality of life
and care for residents in long term care facilities by promoting the interest, well being and rights of residents in long
term care facilities in Cupertino. LTC 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 Tenn Care Ombudsmen are advocates for the more than 200 residents living in Cupertino long term care
facilities that serve low income residents. As independent advocates, certified LTC Ombudsmen work to resolve
problems of an individual resident and to bring about changes by creating ongoing visibility through regular
unannounced visits to long term care facilities, by monitoring conditions and care, and providing a voice for those
unable to speak for themselves. LTC Ombudsmen regularly visit Cupertino long term care facilities to be accessible
to residents and observe actual or potential problems first hand. LTC Ombudsmen have responsibility for individual
as well as systemic problem resolution by addressing the root cause of individual and/or systemic problems that can
fundamentally change the way people and systems work. Regular visits provide residents with the opportunity to
develop personal and confidential relationships and create a secure environment for registering complaints. LTC
Ombudsmen will identify, receive, investigate, and resolve complaints, including violations of personal rights and
allegations of elder abuse for primarily elderly and/or disabled residents in licensed long term care facilities in
Cupertino.
Certified LTC Ombudsmen provide services with respect for human dignity and the individuality of the resident
unrestricted by considerations of age, social or economic status, personal characteristic or lifestyle. Regular contact
with residents helps to build trust, visibility and clarity of purpose, making residents more likely to express their
concerns that might not otherwise surface.
The LTCOP 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 i,vith 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 LTC Ombudsman.In addition, through the response to all consumer telephone inquiries the LTCOP will partner
with residents, their families, and long term care facilities to address issues to improve the quality of life of the
residents in the facilities.
Page 1.3 of 21
FY 2014-15 General Fund Fluman Service Grants(I-ISG)City/Non-Profit Contract
EXH1131T B
PROGRAM WORK PLAN
FY 2014/15
AGENCY NAME: Catholic Charities of Santa Clara County
PROGRAM NAME: Long-Term Care Ombudsman
Benchmarks for Each Quarter
Objectives
:l St 2nd 3rd 4 t TOTAL
Unannounced Site Visits to 6 Cupertino 2 12 12 12 48
Long Term Care (LTC) Facilities
Unduplicated Contacts w/LTC Residents 56 56 56 56 224
Investigate and Resolve Complaints l 4 4 4 16
Page 14 of 21
FY 2014-15 General Fund Human Service Grants(FiSG)City/Non-Profit Contract
EXHIBIT C
PROPOSED IMPLEMENTATION TIMELINE SCHEDULE
FY 201.4/15
AGENCY NAME: Catholic Charities of Santa Clara County
PROGRM NAME-. Long-Tenn Care Ombudsman
Activity Number& Description:
#1. Unannounced site visits to 6 targeted Cupertino Long- Ferm Care(LTC) Facilities
#2. Unduplicated contacts for LTC residents
#3. Investigate and resolve complaints
6ta I
aW- -re
...... . :Jul u g.--, eOct,
p O ' :Nov ec.
21t
1 4 4 4 4 4 4 4 4 4 4 4 4 48
2 18 18 18 18 18 :18 18 18 18 18 18 26 224
3 1 1 1 1 1 11 1 1 -1 1 1 5 16
Page 15 of 21
FY 2014-15 General Fund FlUrnan Service Grants(IISG)City/Non-Profit Contract
EXHIBIT D
PROGRAM BUDGET
FY 2014/15
Agency Name: Catholic Charities of Santa Clara County
Project Name: Long-Term Care Ombudsman
Proposed Project Expenses _ FY 2014/15
Salaries/Benefits/Payroll/Taxes _ $6,50
Office Supplies _ $
Communication $
Publications/Printing/Advertising $
Travel $
Rent/Lease/Mortgage _ $
Utilities $
Insurance $
Equipment Rental/Maintenance _ $
Audit/Legal/Professional Services $
Direct Services (Funding for specific service such as a meal, ride) $
Contracted Services _ $0
Other $
Total Expenses X67500
Page 16 o F 21
FY 2014-15 General Fund Human Service Grants(IISG)City/Non-Profit Contract
EXHIBIT E
BASIC INSURANCE AND BOND REQUIREMENTS FOR
NON-PROFIT CONTRACTS
Definition of Contractor: The "Contractor" as the word is used in this Exhibit E is the party
contracting with the City of Cupertino for the direct distribution of HSG funds.
Indemnity
The Contractor shall indemnify, defend, and hold harmless the City of Cupertino (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 previsions:
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 th(-, address as shown on the City's Certificate of
Insurance form and to the Community Development Department 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.
B. Notice of Cancellation of Reduction of Coverav�e
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 9501.4.
Page 17 of 2 l
FY 2014-15 General Fund 1-11.1man Service Grants(HSG)City/Non-Profit Contract
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 Insuratnce - 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 inctuding 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.
Page 1.8 of 21
FY 2014-17 General Fund Human Service Grants(HSG)City/Non-Profit Contract
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 policcy shall apply separately to each insured that is
seeking coverage or against whorl a claim is made or a suit is brought, except
with respect to the Company's limit of liability.
5. Comprehensive Automobile Liabilit. Ins_ta:rance 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 Uability Insurance for:
a. Statutory California Workers' Compensation coverage including a broad form all-
states endorsement.
Page 19 of 2 l
FY 2014-15 General Fund Human Service Grants(HSG)City/Non-Profit Contract
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
tennination 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 jmaximum financial obligation of the City cited
herein. If such bond is cancelled or reducc,cl, 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
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 airy 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.
Page 20 ol-21
FY 2014-15 General Fund Human Service Grants(HSG)City/Non-Profit Contract
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.
Page 21 of 21
FY 2014-15 General Fund Human Service Grants(FISG)City/Non-Profit Contract