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CS Multi-Cultural Senior Activities 2018DEPARTMENT OF HEALTH AND HUMAN SERVICES ~.-.-.~~-········· .. ················ .. ··· .. ········S·Q·C.I.A.L. ... S . .E.R.V.l.C .. E.S ........................................................................ . Grant Nash Colfax, MD DIRECTOR Kari Beuerman HHS ASSISTANT DIRECTOR SOCIAL SERVICES Lee Pullen DIVISION DIRECTOR Aging and Adult Services l 0 North San Pedro Raad Suite 1023 San Rafael, CA 94903 415 473 7118 T 415 473 7042 F 415 473 3232 TTY www.marinhhs.org/aging- adult-services Promoling ond prolecling health, well·being, self•sufficiency, and sofely of all in Marin July 13, 2018 Carol Jacobs-Courtz, Sr. Recreation Supervisor City of San Rafael Community Services Department 618 B Street San Rafael, CA 94901 Dear Carol, Enclosed, please find one copy of the fully executed contract for Fiscal Year 2018-2019 with the County of Marin, Department of Health and Human Services and the City of San Rafael to provide Multi-Cultural Senior Activities in the amount of $10,000. We look forward to working with you in the future to coordinate community- based services for older adults in Marin County, and we appreciate the additional resources that your agency provides for the operation of this important service for older adults. Sincerely, Gary Lara Administrative Asst. II encl, CAO Contract Log# / f -0/ o COUNTY OF MARIN PROFESSIONAL SERVICES CONTRACT 2012 -Edition 1 Dept. Contract Log # __ THIS CONTRACT is made and entered into this 1st day of July, 2018, by and between the COUNTY OF MARIN, hereinafter referred to as "County" and City of San Rafael, hereinafter referred to as "Contractor.• RECITALS: WHEREAS, County desires to retain a person or firm to provide the following service: Multi-Cultural Senior Center Activities; and WHEREAS, Contractor warrants that it is qualified and competent to render the aforesaid services; NOW, THEREFORE, for and in consideration of the Contract made, and the payments to be made by County, the parties agree to the following: 1. SCOPE OF SERVICES: Contractor agrees to provide all of the services described in Exhibit A attached hereto and by this reference made a part hereof. 2. FURNISHED SERVICES: The County agrees to: A. Guarantee access to and make provisions for the Contractor to enter upon public and private lands as required to perform their work. 8. Make available all pertinent data and records for review. C. Provide general bid and Contract forms and special provisions format when needed. 3. FEES AND PAYMENT SCHEDULE: The fees and payment schedule for furnishing services under this Contract shall be based on the rate schedule which is attached hereto as Exhibit B and by this reference incorporated herein. Said fees shall remain in effect for the entire term of the Contract. Contractor shall provide County with his/her/its Federal Tax I.D. number prior to submitting the first invoice. 4. MAXIMUM COST TO COUNTY: In no event will the cost to County for the services to be provided herein exceed the maximum sum of $10,000 including direct non-salary expenses. As set forth in section 14 of this Contract, should the funding source for this Contract be reduced, Contractor agrees that this maximum cost to County may be amended by written notice from County to reflect that reduction. 5. TIME OF CONTRACT: This Contract shall commence on July 1, 2018, and shall terminate on June 30, 2019. Certificate(s) of Insurance must be current on day Contract commences and if scheduled to lapse prior to termination date, must be automatically updated before final payment may be made to Contractor. The final invoice must be submitted within 30 days of completion of the stated scope of services. 6. INSURANCE: Commercial General Liability: The Contractor shall maintain a commercial general liability insurance policy in the amount of $1,000,000 ($2,000,000 aggregate). The County shall be named as an additional insured on the commercial general liability policy. Commercial Automobile Liability: Where the services to be provided under this Contract involve or require the use of any type of vehicle by Contractor, Contractor shall provide comprehensive business or commercial automobile liability coverage, including non-owned and hired automobile liability, in the amount of $1,000,000.00. 1 Workers' Compensation: The Contractor acknowledges the State of California requires every employer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of the Labor Code. If Contractor has employees, a copy of the certificate evidencing such insurance, a letter of self-insurance, or a copy of the Certificate of Consent to Self-Insure shall be provided to County prior to commencement of work. Errors and Omissions, Professional Liability or Malpractice Insurance. Contractor may be required to carry errors and omissions, professional liability or malpractice insurance. All policies shall remain in force through the life of this Contract and shall be payable on a "per occurrence" basis unless County specifically consents to a "claims made" basis. The insurer shall supply County adequate proof of insurance and/or a certificate of insurance evidencing coverages and limits prior to commencement of work . Should any of the required insurance policies in this Contract be cancelled or non-renewed, it is the Contractor's duty to notify the County immediately upon receipt of the notice of cancellation or non-renewal. If Contractor does not carry a required insurance coverage and/or does not meet the required limits, the coverage limits and deductibles shall be set forth on a waiver, Exhibit C, attached hereto. Failure to provide and maintain the insurance required by this Contract will constitute a material breach of this Contract. In addition to any other available remedies, County may suspend payment to the Contractor for any services provided during any time that insurance was not in effect and until such time as the Contractor provides adequate evidence that Contractor has obtained the required coverage . 7. ANTI DISCRIMINATION AND ANTI HARASSMENT: Contractor and/or any subcontractor shall not unlawfully discriminate against or harass any individual including, but not limited to, any employee or volunteer of the County of Marin based on race, color, religion, nationality, sex, sexual orientation, age or condition of disability. Contractor and/or any subcontractor understands and agrees that Contractor and/or any subcontractor is bound by and will comply with the anti discrimination and anti harassment mandates of all Federal, State and local statutes, regulations and ordinances including, but not limited to, County of Marin Personnel Management Regulation (PMR) 21. 8. SUBCONTRACTING: The Contractor shall not subcontract nor assign any portion of the work required by this Contract without prior written approval of the County except for any subcontract work identified herein. If Contractor hires a subcontractor under this Contract, Contractor shall require subcontractor to provide and maintain insurance coverage(s) identical to what is required of Contractor under this Contract and shall require subcontractor to name Contractor and County of Marin as an additional insured under this Contract for general liability. It shall be Contractor's responsibility to collect and maintain current evidence of insurance provided by its subcontractors and shall forward to the County evidence of same. 9. ASSIGNMENT: The rights, responsibilities and duties under this Contract are personal to the Contractor and may not be transferred or assigned without the express prior written consent of the County. 10. LICENSING AND PERMITS: The Contractor shall maintain the appropriate licenses throughout the life of this Contract. Contractor shall also obtain any and all permits which might be required by the work to be performed herein. 11. BOOKS OF RECORD AND AUDIT PROVISION: Contractor shall maintain on a current basis complete books and records relating to this Contract. Such records shall include, but not be limited to, documents supporting all bids, all income and all expenditures. The books and records shall be original entry books with a general ledger itemizing all debits and credits for the work on this Contract. In addition, Contractor shall maintain detailed payroll records including all subsistence, travel and field expenses, and canceled checks, receipts and invoices for all items. These documents and records shall be retained for at least five years from the completion of this Contract. Contractor will permit County to audit all books, accounts or records relating to this Contract or all books, accounts or records of any business entities controlled by Contractor who participated in this Contract in any way. Any audit may be conducted on Contractor's premises or, at County's option, Contractor shall provide all books and records within a maximum of fifteen (15) days upon receipt of written notice from County. Contractor shall refund any monies erroneously charged. 2 12. WORK PRODUCT/PRE-EXISTING WORK PRODUCT OF CONTRACTOR: Any and all work product resulting from this Contract is commissioned by the County of Marin as a work for hire. The County of Marin shall be considered, for all purposes, the author of the work product and shall have all rights of authorship to the work, including, but not limited to, the exclusive right to use, publish, reproduce, copy and make derivative use of, the work product or otherwise grant others limited rights to use the work product. To the extent Contractor incorporates into the work product any pre-existing work product owned by Contractor, Contractor hereby acknowledges and agrees that ownership of such work product shall be transferred to the County of Marin . 13. TERMINATION: A If the Contractor fails to provide in any manner the services required under this Contract or otherwise fails to comply with the terms of this Contract or violates any ordinance, regulation or other law which applies to its performance herein, the County may terminate this Contract by giving five (5) calendar days written notice to the party involved. B. The Contractor shall be excused for failure to perform services herein if such services are prevented by acts of God, strikes, labor disputes or other forces over which the Contractor has no control. C. Either party hereto may terminate this Contract for any reason by giving thirty (30) calendar days written notice to the other parties . Notice of termination shall be by written notice to the other parties and be sent by registered mail. D. In the event of termination not the fault of the Contractor, the Contractor shall be paid for services performed to the date of termination in accordance with the terms of this Contract so long as proof of required insurance is provided for the periods covered in the Contract or Amendment(s). 14. APPROPRIATIONS: The County's performance and obligation to pay under this Contract is contingent upon an annual appropriation by the Marin County Board of Supervisors, the State of California or other third party. Should the funds not be appropriated County may terminate this Contract with respect to those payments for which such funds are not appropriated . County will give Contractor thirty (30) days' written notice of such termination. All obligations of County to make payments after the termination date will cease. Where the funding source for this Contract is contingent upon an annual appropriation or grant from the Marin County Board of Supervisors, the State of California or other third party, County's performance and obligation to pay under this Contract is limited by the availability of those funds. Should the funding source for this Contract be eliminated or reduced, upon written notice to Contractor, County may reduce the Maximum Cost to County identified in section 4 to reflect that elimination or reduction. 15. RELATIONSHIP BETWEEN THE PARTIES: It is expressly understood that in the performance of the services herein, the Contractor, and the agents and employees thereof, shall act in an independent capacity and as an independent Contractor and not as officers, employees or agents of the County. Contractor shall be solely responsible to pay all required taxes, including but not limited to, all withholding social security, and workers' compensation. 16. AMENDMENT: This Contract may be amended or modified only by written Contract of all parties. 17. ASSIGNMENT OF PERSONNEL: The Contractor shall not substitute any personnel for those specifically named in its proposal unless personnel with substantially equal or better qualifications and experience are provided, acceptable to County, as is evidenced in writing. 18. JURISDICTION AND VENUE: This Contract shall be construed in accordance with the laws of the State of California and the parties hereto agree that venue shall be in Marin County, California. 3 19. INDEMNIFICATION: Contractor agrees to indemnify, defend, and hold County, its employees, officers, and agents, harmless from any and all liabilities including, but not limited to, litigation costs and attorney's fees arising from any and all claims and losses to anyone who may be injured or damaged by reason of Contractor's negligence, recklessness or willful misconduct in the performance of this Contract. 20. COMPLIANCE WITH APPLICABLE LAWS: The Contractor shall comply with any and all Federal, State and local laws and resolutions : including, but not limited to the County of Marin Nuclear Free Zone, Living Wage Ordinance, and Board of Supervisors Resolution #2005-97 prohibiting the off-shoring of professional services involving employee/retiree medical and financial data affecting services covered by this Contract. Copies of any of the above-referenced local laws and resolutions may be secured from the Contract Manager referenced in section 21. In addition, the following NOTICES may apply: 1. Pursuant to California Franchise Tax Board regulations, County will automatically withhold 7% from all payments made to vendors who are non-residents of California. 2. Contractor agrees to meet all applicable program access and physical accessibility requirements under State and Federal laws as may apply to services, programs or activities for the benefit of the public. 3. For Contracts involving any State or Federal grant funds, Exhibit D must be attached. Exhibit D shall consist of the printout results obtained by search of the System for Award Management at www.sam.gov. Exhibit D -Debarment Certification By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below. 4 • The certification in this clause is a material representation of fact relied upon by County. • The Contractor shall provide immediate written notice to County if at any time the Contractor learns that its certification was erroneous or has become erroneous by reason of changed circumstances . • Contractor certifies that none of its principals, affiliates , agents , representatives or contractors are excluded, disqualified or ineligible for the award of contracts by any Federal agency and Contractor further certifies to the best of its knowledge and belief, that it and its principals: • Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal Department or Agency; • Have not been convicted within the preceding three-years of any of the offenses listed in 2 CFR 180.B00(a) or had a civil judgment rendered against it for one of those offenses within that time period ; • Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or Local) with commission of any of the offenses listed in 2 CFR 180.B00(a); • Have not had one or more public transactions (Federal, State, or Local) terminated within the preceding three-years for cause or default. • The Contractor agrees by signing this Contract that it will not knowingly enter into any subcontract or covered transaction with a person who is proposed for debarment, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction. • The Contractor to this Contract and any subcontractor will provide a debarment certification that includes the debarment clause as noted in preceding bullets above , without modification. 21. NOTICES: This Contract shall be managed and administered on County's behalf by the Department Contract Manager named below. All invoices shall be submitted and approved by this Department and all notices shall be given to County at the following location: Contract Manager: Lee Pullen, Director, Aging and Adult Services Dept./Location: Department of Health and Human Services Division of Social Services, Aging & Adult Services Telephone No.: (415) 473-7118 Notices shall be given to Contractor at the following address(es): Contractor: Address: Telephone No.: Contractor: Address: Telephone No.: Jim Schutz, City Manager City of San Rafael 1400 5th Avenue San Rafael, CA 94901 (415) 485-3070 22. ACKNOWLEDGEMENT OF EXHIBITS: EXHIBIT A. EXHIBITS. EXHIBITC. EXHIBITD. EXHIBITE. OTHER REQUIRED EXHIBITS (HHS USE ONLY) IX! Check applicable Exhibits [81 Scope of Services [81 Fees and Payment • Insurance Reduction/Waiver [81 Contractor's Debarment Certification • Subcontractor's Debarment Certification [81 Exhibit G: Audits/Non-Discrimination [81 Exhibit K: Aging & Adults Programs ~ Exhibit K1: Terms & Conditions CONTRACTOR'S INITIALS --f . s . 5 -S· --rs -r-s. IN WITNESS WHEREOF, the parties have executed this Contract on the date first above written. CONTR By: --4--,,-~~--..1e~-=----=:......+------ Name: ~~:,...:;=!,....C>d...l,..__.,..:::::\-_____ _ Title: -~:::ttK:-:'.!::::l.d::-.i!~L,__----- APPROVED BY COUNTY OF MARIN: By~ County Administrator ,.,.;,.u•••h•iaillaiim.mu,wim1mQ&iiim1mm.miiiilhim1iliiiiii1,1~i1m,mu~m;.mm111mmm,iiii,Ullllmmmmm11t,mumm,m.m,mmmtiim,;m~1,1tdlmm11 COUNTY COUNSEL REVIEW AND APPROVAL (required If template content has been modified) County Counsel: _________________ Date: _______________ _ 5 EXHIBIT "A" SCOPE OF SERVICES MARIN COUNTY DEPARTMENT OF HEAL TH & HUMAN SERVICES DIVISION OF SOCIAL SERVICES AGING AND ADULT SERVICES July 1, 2018 -June 30, 2019 Provider: City of San Rafael Program Name: Multicultural Senior Center Activities Program Goal: Arrange or provide organized art, educational health, recreational, social and volunteer opportunities for persons 60 years and older in order to promote their wellness and enhance their quality of life. Performance Objectives: At least 80% of clients will report "high" to "very high" satisfaction with the program. Program Definition: Services designed to enable older individuals to attain and/or maintain physical and mental well-being such as recreation, music, creative arts, physical activity, education, leadership development and other supportive services not covered under other service categories. Development and provision of new volunteer opportunities and services and creation of additional services and programs to remedy gaps and deficiencies in existing services. Entertainment costs such as tickets to shows or sporting events, meals, lodging, rentals, transportation and gratuities are not allowable. Minimum Units of Service Required Units of service: hours Minimum number of hours: 1,000 Contract Award: $10,000 Geographic Area/Persons to be served: Marin County Service Provider shall have the capacity to conduct and comply, at a minimum, to the following: Cooperate with Aging and Adult Services in the annual monitoring of the funded program, including monitoring for compliance with program, fiscal, and regulatory requirements and standards. Perform the activities in the agency's bid/proposal in response to the Request for Proposal for the contracted service, as negotiated and approved by Aging and Adult Services. In the event the service levels specified in the bid/proposal are not attained, Aging and Adult Service will be permitted to reduce the contractor's budget. The scope of service outlined in this exhibit reflects the service level agreed upon between Aging and Adult Services and the contractor. Agree not to use contract funds to pay the salary or expenses of any individual who is engaging in activities designed to influence legislation or appropriations pending before the Congress. Submit a detailed program budget within 15 days of receiving the budget template provided by the County. The program budget must be submitted prior to issuance of the County Contract. 6 All required elements in the budget including, but not limited to, the agency's matches, project income, and in- kind contributions must be identified. Indirect costs are limited to a maximum indirect cash cost of 10% of the direct cash cost, less Capital Equipment. The program match for Ill B supportive services is 10%. Contractor must show proof of meeting match cash or in-kind match by documenting on the program budget as described above and on monthly invoices. Monthly invoice data must be submitted to Aging and Adult Services no later than the 10th day of the month for the prior month. Each monthly invoice must include documentation to support the expenditures claimed for payment. There must also be supporting documentation for all monthly Match Cash, Match In-Kind, Non-match Cash, and Non-Match In-Kind, program income claiming. The invoice request for funds must be accompanied by supporting documentation before payment. During the fiscal year an in-depth fiscal monitoring will be performed. At this time the County will verify expenditures, revenue, and match, and general ledger items for selected samples among other documentation. After the end of the fiscal year a contract resolution will be conducted where expenditures, payments, and match for the full fiscal year are verified via independent single audit, contractor general ledger, or both. The omission or lack of supporting documentation may result in contract noncompliance and/or nonpayment. Submit monthly service unit data report by the 1 oth day of the month for the prior month. Enter data directly in the Get Care/CARS in order to comply with the California Department of Aging, National Aging Program Information System and Aging and Adult Services reporting requirements. Offer opportunity for clients to make voluntary confidential contributions to the agency for services received. Contribution request must include the following information: there is no obligation to contribute; contributions are voluntary; and service will not be denied based on ability to make contributions. Maintain a Client Grievance Policy and Procedure that is approved by Aging and Adult Services prior to being put into use. Policy must have specific timelines for every level of the grievance. Revise the Policy as necessary after the annual program monitoring to be in compliance with the requirements of the California Department of Aging. Notify all clients of the grievance process. Provider's Client Grievance Policy and Procedure must be posted in a visible area accessible to clients and distributed at time of intake. Provide a copy of Client Grievance Policy and Procedure to all clients who are homebound. On an annual basis, agency staff that handle personal, sensitive, or confidential information must complete a Security Awareness training conducted by the California Department of Aging. This can be completed online. Maintain a log of attendees and completion certificates for those staff attending. All publications and written materials developed by the program must include the following statement: "Funding for this program, at least in part, is made available by the Older Americans Act, administered locally by the Marin Department of Health and Human Services, Aging and Adult Services." Attend all mandatory contractors' meetings scheduled by the Aging and Adult Services. Maintain an updated organizational emergency/disaster preparedness or continuity of operations plan. Minority Service Priority [pursuant to Older Americans Act Sec.306. (a)(5)(A)(ii)] Provider must prioritize services to low income minority individuals. In order to satisfy the service needs of this population, the provider will give priority to minority persons when hiring new staff or recruiting new volunteers. Services to lesbian, gay, bisexual, and transgender older adults: [pursuant to the Older Californians Equity and Protection Act (AB 2920)]: Provider must ensure that programs and services are available to all older adults regardless of sexual orientation and gender identity. 7 Service priority for frail, homebound or isolated elderly 45CFR1321.69 Persons age 60 or over who are frail, homebound because of illness or incapacitating disability, or otherwise isolated, shall be given priority in the delivery of services. Program evaluations to be conducted annually using template provided by Aging and Adult Services. Program Specific Requirements: Provide programs and activities targeting the population of low-income older adults including minorities and limited English -proficient residents focusing on recreation, health, nutrition and education Publicize programs and events to older adults, service providers, and community agencies in Central Marin Maintain volunteer sign-in sheets to track the number of volunteers, volunteer hours, staff time working on activities, staff supervising staff or volunteers working on activities 8 EXHIBIT "B" FEES AND PAYMENT SCHEDULE B.1. BASE CONTRACT FEE: COUNTY shall pay CONTRACTOR during the term of this contract (July 1, 2018 through June 30, 2019). Contractor shall submit requests for payment. No costs incurred by CONTRACTOR prior to the effective date of the contract should be included in the invoices, nor paid by the COUNTY. B.2. CONSIDERATIONS: In no event shall total compensation paid to Contractor under this provision exceed $10,000 without a written amendment to this Agreement, approved by the County of Marin. Said sum to be payable as follows: subject to the availability of funds, compliance with insurance requirements as hereinafter provided, and completion of the contract services to County's satisfaction. Payment amount will be based upon receipt of contractor's financial statement and request for funds, as expended. Payment will be made following County's receipt of a timely, accurate and accepted invoice to be submitted no later than the 1 oth of the following month. 9 EXHIBIT "G" AUDITS, NON-DISCRIMINATION 1. AUDITS/RECORDS: 1.1 Contractor shall maintain books, records, files, documents and other evidence directly pertinent to all work under this Agreement in accordance with accepted professional practices and accounting procedures and according to statutory agreements for the applicable time mandated, and in no case less than seven (7) years after the termination of the Agreement. County, or any of its duly authorized representatives, shall have access to such books, records, files, documents and other evidence for purposes of inspection, evaluation, audit or copying. Contractor will furnish County a certified copy of an Audit Report from an independent CPA firm by October 31, for the report covering the County's fiscal year that ended the previous June 30. The Audit Report will cover the County's fiscal year and include the independent CPA firm's review of each program operated by Contractor, with review of both expenditures and revenues for each program. 1.2 Contractor will provide County with a letter from the chair of the Contractor's Board of Directors certifying that the Board of Directors has reviewed the Audit Report. 2. NON-DISCRIMINATION IN THE PROVISION OF SERVICES: 2.1 Contractor and/or any permitted subcontractor shall not unlawfully discriminate against any individual based upon race, religious creed, color, national origin, ancestry, medical condition, marital status, sex, sexual orientation, age or condition of disability. Contractor and/or any permitted subcontractor understands and agrees that Contractor and/or any permitted subcontractor is bound by and will comply with the nondiscrimination mandates of all Federal, State and local statutes, regulations and ordinances. In the performance of the terms of this Agreement, Contractor shall not discriminate against any employee or applicant for employment, or against any applicant for or beneficiary of services, because of race, sex, sexual orientation, HIV status, color, religion, ancestry, national origin, age, disability, or any other unlawful basis. 2.2 Contractor shall take affirmative action to ensure that applicants are employed and that employees are treated fairly during employment without regard to their race, sex, sexual orientation, HIV status, color, religion, ancestry, national origin, age, or disability. Such action shall include, but not be limited to, employment, upgrading, demotion or transfer, recruitment or recruitment advertising, lay-off or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship. Contractor shall post in conspicuous places, available to employees and applicants for employment, notices setting forth Fair Employment Practices outlined in this section. Contractor shall permit access to its records of employment, employment advertisements, application forms, and other pertinent data and records by the State Fair Employment Practice Commission, or any other agency of the State of California designated by the awarding authority, for the purpose of investigation to ascertain compliance with the Fair Employment Practices section of this Agreement. 2.3 Contractor shall develop and implement policies and procedures to ensure that all services provided under this Agreement are rendered in a manner that conforms to all local, State and federal non-discrimination statutes, regulations and ordinances, including but not limited to race, gender, national origin, disability or medical condition such as a diagnosis of Acquired Immune Deficiency Syndrome (AIDS), or upon testing positive for Human Immunodeficiency Virus (HIV), or all other applicable nondiscrimination provisions. Contractor shall ensure that its staff is adequately trained regarding these non-discrimination provisions, policies and procedures, including those that involve specific disease-related problems, issues and special recovery needs . 10 3. Disaster Plan: 3.1 Contractor shall have in place, and shall provide to the County, its plan for the referral and/or treatment of clients in the case of a disaster. 4. Drug-Free Workplace Requirements: 4.1 Contractor will comply with the requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free workplace by taking the following actions: Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations. Establish a Drug-Free Awareness Program to inform employees about: The danger of drug abuse in the workplace The person's or organization's policy of maintaining a drug-free workplace Any available counseling, rehabilitation and employee assistance programs, and, Penalities that may be imposed upon employees for drug abuse violations 11 EXHIBIT "K" AGING AND ADULT SERVICES PROGRAMS 1. Contractor's Compliance with Provisions of State Contract Contractor acknowledges that this Agreement is a subcontract to an Agreement between the County and the State (hereinafter "State Contracr). The State Contract requires that the County contractually obligate any of its subcontractors to also comply with the terms and conditions of the State Contract. Contractor hereby agrees to comply with the terms and conditions of the State Contract, a copy of which is attached hereto as Exhibit K-1. In addition, funds available under this Contract are depending upon funding from the state. Lack of funding from the State will result in termination of this Agreement. In the event the State Contract requires the County to notify the State of a breach of privacy and/or security of personally identifiable information (hereinafter "PII") and/or protected health information (hereinafter "PHI"), Contractor shall immediately upon discovery of a breach of privacy and/or security of PII and/or PHI by Contractor, notify County of such breach by telephone and email or facsimile. Contractor further agrees that it shall notify County of any such breaches prior to the time the County is required to notify the State pursuant to the State Contract. In the event the State Contract requires the County to pay any costs associated with a breach of privacy and/or security of PII and/or PHI, including but not limited to the costs of notification, Contractor shall pay on Count's behalf any and all such costs arising out of a breach of privacy and/or security of PII and/or PHI by Contractor. 12 EXHIBIT "K.1" STATE OF CALIFORNIA AREA PLAN TERMS AND CONDITIONS AND TITLE V TERMS AND CONDITIONS Contractor will comply with the requirements of the California Department of Aging Area Plan Terms and Conditions (AP Scope of Work: Exhibits A, B, D and E) from the Area Agency on Aging (PSA 5) or if applicable, a copy of the Title V Terms and Conditions (TV Scope of Work: Exhibits A, B, D and E). By signing below, the contract administrator at the office of the Area Agency on Aging confirms this document has been delivered with the contract package. The Area Agency on Aging will maintain a hard copy of the Area Plan (AP) Terms and Conditions and Title V (TV) Terms and Conditions in the office of the Area Agency on Aging's State Contract folder. Copies of the Area Plan (AP) Terms and Conditions and Title V (TV) Terms and Conditions are also maintained at the Board of Supervisor's Office. This is to confirm the Area Plan Terms and Conditions or Title V Terms and Conditions have been sent to the provider as part of the contract. Due to the size of the document, a copy is not being made for each contract file. A hard copy and electronic copy are available in the program office at the Area Agency on Aging. 13 CALIFORNIA JOINT POWERS RISK MANAGEMENT AUTHORITY Accredit,d v,irb E:x:cellence from the California Association of Joint Powers Authorities Certificate Holder and Additional Covered Party: CERTIFICATE OF COVERAGE County of Marin Health and Human Services 1 O N. San Pedro Road, Suite 1023 San Rafael, CA 94903 Attn: Gary Lara This certifies that the coverage Described herein has been issued to: City of San Rafael Description of Activity: County of Marin Professional Services Contract July 1, 201 B to provide Multicultural Senior Center Activities Date(s) of Activity: 07-01-2018 to 06-30-2019 Location of Activity: Al Bora Community Center 50 Canal Street San Rafael, CA Entity Providing Coverage Excess Coverage Certificate Expiration Date California Joint Powers Risk Management Authority $500,000 June 30, 2019 excess of $500,000 The following coverage is in effect and is provided through participation in a risk sharing joint powers authority: general liability and automobile liability pooled self-insurance, as defined in the Memorandum of Coverage on file with the entity and which will be made available upon request. The coverage being provided is limited to the activity and the time period indicated herein and is subject to all the terms, conditions and exclusions of the Memorandum of Coverage of the California Joint Powers Risk Management Authority. Pursuant to Section II, subsection B, relating to the definition of a covered party, the certificate holder named herein is only an additional covered party for covered claims arising out of the activity described herein and is subject to the limits stated herein. Coverage is in effect at this time and will not be cancelled, limited or allowed to expire at a date other than that indicated herein except upon 30 days written notice to the certificate holder. 07-01-2018 David J. Clovis, ARM, General Manager Name and Title (Print or type) Certificate Number: 2018-2019-COC1932 FormC 3201 Doolan Road, Suite 285 • Livermore, CA 94551 • Phone (925) 837-0667 • FAX (925) 290-1543 Office of the City Attorney Robert F . Epstein, City Attorney Lisa A. Goldfien, Assistant City Attorney Lauren M. Monson, Deputy City Attorney II Phone: (415) 485-3080 Fax: (415) 485--3109 Email: city.attomey@cityofsanrafael.org June 12, 2018 County of Marin Dept. of Health and Human Services Division of Social Services Aging & Adult Services Attention: Gary Lara ION. San Pedro Road, Suite 1023 San Rafael, CA 94903 Re: City of San Rafael Self-Insurance, Multicultural Senior Activities 2018-2019 Dear Mr. Lara: The City of San Rafael, as permitted under State law, is self-insured for general liability, including automobile liability, for the first $500,000. Accordingly, the City does not have a commercially issued general liability insurance policy. Additional insurance for the coverage required by your contract is provided by a public entity excess liability pool in which the City participates. The pool, the California Joint Powers Risk Management Authority (CJPRMA) provides the City's coverage in excess of $500,000 under a Memorandum of Coverage. Since CJPRMA 's 2018-19 program year begins on July I, and the agreement between the City and Marin County runs from July I, 2018 to June 30, 2019, a Certificate of Coverage will be issued on June 25 th and forwarded to you showing the County of Marin as an additional insured. With respect to Worker's Compensation liability, the City is self-insured for the first $1,000,000 and has a separate excess liability policy from Safety National Casualty Corporation, as detailed on the enclosed copy of the City of San Rafael's Certificate for Specific Excess Workers' Compensation and Employers' Liability Insurance. An updated certificate for 2018-19 for excess Workers' Compensation and Employers' Liability Insurance will be forwarded to you after it is issued. Because it is a local governmental agency existing in the State of California and because it is entitled to self-insure under the Government Code, the City assumes that this letter will satisfy the insurance requirements of the Agreement between the County of Marin and the City of San Rafael, for the arrangement or provision of Multicultural Senior Center Activities. Please call the City Attorney's Office at 485-3080 should you have any questions regarding insurance. Enclosure VC7i"* LISA A. GOLDFIEN Assistant City Attorney cc: Susan Andrade-Wax, Community Services Director Carol Jacobs-Courtz, Program Director/Older Adult Services CITY OF SAN RAFAEL 1400 FIFTH AVrnUE. SAN RAFAEL. CALIFORNlt>. 94901 CITYOFSANRAFAEL.ORG Gary 0. Phillips, Mayor• John Gamblin, Vice Mayor• Kate Colin, Councilmember • Maribeth Bushey. Councilmember • Andrew Cuyugan McCullough, Councllmember A membi:r of the Toido M,1nne Group CERTIFICATE OF INSURANCE 1832 Schuetz Road St Louis, MO 63146-3540 Telephone (888) 995-5300 (314) 995-5300 Fax(314)995-3843 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY LISTED BELOW. NAME AND ADDRESS OF CERTIFICATE HOLDER: California Department of Industrial Relations Ms. Jamie L. Meyers Office of Self-Insurance Plans 11050 Olson Drive Suite 230 Rancho Cordova, CA 95670-5600 This is to certify that the policy of insurance listed below has been issued to the insured named below and is in force at this time. Notwithstanding any requirement, term or condition of any contract or any other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions and conditions of such policy. Should any of the policy described herein be canceled before expiration date thereof the CORPORATION will endeavor to mail sixty (60) days written notice to the above named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the CORPORATION . NAME INSURED EMPLOYER: ADDRESS: POLICY NUMBER: TYPE OF INSURANCE: LOCATION(S): POLICY LIABILITY PERIOD: POLICY PAYROLL REPORTING PERIOD: CITY OF SAN RAFAEL 1400 FIFTH AVENUE, SAN RAFAEL, CA 94901 SP 4054929 Specific Excess Workers' Compensation and Employers' Liability Insurance CALIFORNIA July 01, 2016 through July 01, 2018 July 01, 2017 through July 01, 2018 Self-Insured Retention Per Occurrence Maximum Limit of Indemnity Per Occurrence $1,000,000 Statutory $2,000,000 Employers' Liability Maximum Limit of Indemnity Per Occurrence and Aggregate SAFETY NATIONAL CASUALTY CORPORATION ~ ~ By: Seth A. Smith Senior Vice President Workers' Compensation Underwriting Date: July 18, 2017 SAFETY NATIONAL CASUAL TY CORPORATION EXCESS WORKERS COMPENSATION INSURANCE BINDER NAME INSURED EMPLOYER: ADDRESS: POLICY NUMBER: CITY OF SAN RAFAEL 1400 FIFTH AVENUE, SAN RAFAEL, CA 94901 SP4059040 TYPE OF INSURANCE: LOCATION(S): Specific Excess Workers' Compensation and Employers' Liability Insurance CALIFORNIA POLICY LIABILITY PERIOD: POLICY PAYROLL REPORTING PERIOD: July 01, 2018 through July 01, 2019 July 01, 2018 through July 01, 2019 This is to certify that the above named Insured Employer is covered by Specific Excess Workers' Compensation and Employers' Liability Insurance by the CORPORATION. Self-Insured Retention Per Occurrence Maximum Limit of Indemnity Per Occurrence / Employers' Liability Maximum Limit of Indemnity Per Occurrence and Aggregate $1,000,000 Statutory $2,000,000 Premium Rate $ 0.4473 per $100 of Payroll Minimum Premium for the Liability Period Deposit Premium for the Payroll Reporting Period Commission $162,542 $180,602 15.00 % This binder is effective July 01, 2018 and is subject to all the fonns, tenns and conditions of bound quote number 2733208362, and shall be automatically tenninated and superseded by the Excess Workers• Compensation Agreement and Employers' Liability Insurance Agreement when issued. Issued at St Louis, Missouri, on June 29, 2018. SAFETY NATIONAL CASUAL TY CORPORATION 14-~ By: Seth A. Smith Senior Vice President Workers' Compensation Underwriting 1832 Schuetz Road St. Louis MO 63146-3540 314-995-5300 fax 314-995-3843 SAM Search Results List of records matching your search for : Search Term : city* of san* rafael* Record Status: Active !ENTITY lsAN RAFAEL, CITY OF Status:Active DUNS : 198423832 +4: CAGE Code: 4TB82 DoDAAC: Expiration Date: Feb 15, 2019 Has Active Exclusion?: No Debt Subject to Offset?: No Address: 1400 5TH AVE City: SAN RAFAEL State/Province: CALIFORNIA ZIP Code: 94901-1943 Country: UNITED STATES !ENTITY lsAN RAFAEL, CITY OF Status:Active DUNS : 082447459 +4: CAGE Code: 3ULX3 DoDAAC: Expiration Date: Feb 1, 2019 Has Active Exclusion?: No Debt Subject to Offset?: No Address: 1400 5TH AVE City: SAN RAFAEL State/Province: CALIFORNIA ZIP Code: 94901-1943 Country: UNITED STATES May 11, 2018 12:04 PM https:/lwww.sam.gov/ Page 1 of 1 1 2 3 4 5 6 7 8 9 BUDGET CATOGERY Total salaries .and benefits ·· . ,•i. Totaltravet. _ -' ·· .. ·-. ·: .. .• .• ....... JQtatStaffNolunte.e'r'Training .. Total ·Equlpineilt : '. consuJiants -· _ ... ,. . , . ••.•· TotalOther·Costs . · · ·. : · :. ·. ... ... . . , .. ... . ; .. , , ·-· ., ·.;· · . ... .. .. .. Grand Total Costs BUDGET DETAIL COST ALLOCATION Fiscal Year 18/19 Agency: City of San Rafael Date: ...A3;2o:f 91 1; i 1 'f Service: Hours -----------# Units: 1,000 SUMMARY OF BUDGET, ACTIVITIES, FUNDING BUDGETED AAA County/HH COSTS Grant S Funds* (a) (d) (e) .. 13,880 8,600 0 0 0 0 .. . ... 0 0 0 ~· 0 0 0 -.. 0 0 0 10070 1400 0 .. 23,950 10,000 - "These funds are both County Additional Funding and Sequester HHS Backfill Funding. Project Director Name: __ CAROL JACOBS-COURTZ, Program Director/Older Adult Servies Signature: _____________ _ Match Cash (f) 0 0 0 0 0 3900 3,900 AP,p/\O ~cd ~ L;/13. Ii~ ~d ~ [1111 l'i Contract Amount: 10,000 ---------✓ if Original Budget: X ✓ if Revised Budget: ---- Revision#_: __ _ Match · Non-Match Non-Match Project In-Kind Cash In-Kind Income (g) (hf (i) 0) 0 5,280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2070 0 2600 100 2,070 5,280 2,600 100 4/02 Copy of Copy of 18-19 budget template 1118 and all other excluding C12.xls . ·--... -•·· ···•---•···-·-·····---·--··• .. ·•···-··-··--······-··-~· ... , ......... -.. ~ ·• .. BUDGET DETAIL COST ALLOCATION Fiscal Veal 18/19 Agency: City of San Rafael Contract Amount: _.....:.,:10:.,,00=0=------- ✓ ff Original Budget: X Date: April 13th, 2018 Service: Multlcullunil Senior Center Activities ✓ ff Revised Budget: # of Units: 1,000 Revision#: ____ _ TOTAL f\JHDINO SOURCES BUDGETED AAA County/HHS Match Match Non Matching Non-Mats:lllng Project BUDGET COSTS Fundlna Funds• Cash In-Kind Cash In-Kind Income CATOG£RY (1) t•l (r) (al (h) (r) OI (t) PersonMI: P,aoram Dlredar 7,780 2,500 5280 1 ........ steff 5500 5500 Slafl-Memarv Lass Pn>aram 600 600 0 a Total salattt: 13,BBO 8600 0 0 0 5280 0 Bonents 0 Total sallrtH and -fits 13,880 8,600 0 0 0 5,280 0 0 T.-..1· -· 0 0 0 Totalllanl 0 0 0 0 0 0 o . 0 ltaffNotunteer Train Ina 0 0 a 0 0 0 0 Totsl Slal!Nolun1N< Trolnlng 0 0 0 0 0 0 0 0 Eiaul..,;.nt (IN nata 1>11-l 0 0 0 Justlffcatlon (II % of Prooram Dlrectots hours lo manaae & suoervise oroaram Sunnort slaff lo oroaram activfUes at Boro Center for the senior cilizens Slaff from Senior Access will be oresentina 4 worksn<>ns for senior citizens at Boro Center Total Equipment 0 0 0 0 0 0 0 '0 . consattams 0 0 0 Conauttant. 0 .0 0 0 0 0 -0 0 . Otllercosts' -· -. .. ,,, lnclinld Casts (Not to e--a 10%) 0 c,-.t staff..8Df'D Ctnter 2600 su~,. selYfcos, room use 7370 1400 3,900 2070 Ful'ldrnlser-Martachl Concert 100 100 0 Toblothetc-· 10070 1,400 0 3 900 2,070 0 2,600 100 Total-· 23,950 10,000 0 3,900 2,070 5,280 2,600 100 COStl'wUnlt 24 10 0 4 . 2 5 3 0 "These lunGs .,_ bo1h eo.nty Addlllonll Funlllng and Sequ111ar HHS Bacl<IIR Funding . Equipment-ff you are purchasing equipment with AAA funds or County Funds at cost of $500 or more you must contact your county nscaf person to obtain approval and the proper forms. ff this budget Is part of an RFP you wlll not need to get approval for the equipment purchase until the RFP has been awarded. In-kind sun=rt from Albert J . eoro staff & office sucolles Scheduled collaborated event al SR Comm Cenler-Seot. 2018