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CS Multi-Cultural Senior Center Activities Addendum 1l5 -30i a COUNTY OFb1ARIN - FIRST ADDENDUM TO CONTRACT BY AND BETWEEN THE COUNTY OF MARIN AND THE CITY OF SAN RAFAEL 11{IIUII{IUiillliiiLli{IilLH11i� kUU1UtUUliffillltUiUlUUtdtUUiUIU1L�lIUUi�lIDilfl/IUiUiftliiuilittiLi/lUidiAUNiiuUllliUUli�illUULIWUiWUIILIUIWIUIt1UiU11iilUt THIS ADDENDUM is made and entered into the 1ST day of January 2019, by and between the COUNTY OF MARIN, a political subdivision of the State of California (hereinafter referred to as "County") and The City of San Rafael (hereinafter referred to as "Contractor") RECITALS WHEREAS, the County and the Contractor entered into a contract for Multi -Cultural Senior Center Activities dated July 1, 2018 ("Contract'); and WHEREAS, Exhibit A of the contract obligated Contractor to complete services in the amount of $10,000 by June 30, 2019; and WHEREAS, the parties desire to amend the contract to complete services in the amount of $11,200 by June 30, 2019; NOW, THEREFORE, the parties agree to modify Exhibits A and B as set forth below. AGREEMENT 1. Except as otherwise provided herein all terms and conditions of the agreement shall remain in full force and effect. 2. ® Updated Certificate of Insurance(s) attached hereto. 3. Exhibits A and B are hereby amended as follows: See revised scope of services. IN WITNESS WHEREOF, the parties hereto have executed this FIRST Addendum on the day first written above. CONTRACTOR: COUNTY OF MARIN: By cLt-vet Contract9 are Coun y Administrator COUNTY COUNSEL REVIEW AND APPROVAL (required if template content has been modified) County Counsel y -3 --72>2- 1 of 5 EXHIBIT "A" AMENDED MARIN COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF SOCIAL SERVICES AGING AND ADULT SERVICES SCOPE OF 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: Original Contract: $10,000 One -Time Increase 200 Amended Contract Total: $11,200 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 2of5 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. 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 III 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 101h 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 3of5 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. 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: a. 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 b. Publicize programs and events to older adults, service providers, and community agencies in Central Marin c. 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 4of5 EXHIBIT "B" AMENDED FEES AND PAYMENT SCHEDULE B.1. BASE CONTRACT FEE: COUNTY shall pay CONTRACTOR during the term of this contract (January 1, 2019 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 111,200 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 10th of the following month. 5of5 CALIFORNIA JOINT POWERS RISK MANAGEMENT AUTHORITY Accredited witb Excellence from the California Association of Joint Powers Authorities Certificate Holder and Additional Covered Party: CERTIFICATE OF COVERAGE County of Marin Health and Human Services 10 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, 2018 to provide Multicultural Senior Center Activities Date(s) of Activity: 07-01-2018 to 06-30-2019 Location of Activity: Al Boro Community Center 50 Canal Street San Rafael, CA Entity Providing Coverage Excess Coverage Certificate Expiration Date California Joint Powers Risk Management Authority $ 500,000 excess of June 30, 2019 $ 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 8, 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 Date V• Authorized Signa re Certificate Number: 2018-2019-COC1932 David J. Clovis, ARM, General Manager Name and Title (Print or type) 3201 Doolan Road, Suite 285 • Livermore, CA 94551 • Phone (925) 837-0667 e FAX (925) 290-1543 y0 lYwITH Pd` County of Marin Dept. of Health and Human Services Division of Social Services Aging & Adult Services Attention: Gary Lara 10 N. San Pedro Road, Suite 1023 San Rafael, CA 94903 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.attorney@cityofsanrafael.org June 12, 2018 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 1, and the agreement between the City and Marin County runs from July 1, 2018 to June 30, 2019, a Certificate of Coverage will be issued on June 25`h 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. V ry truly yours, , LISA A. GOLDFIEN Assistant City Attorney Enclosure cc: Susan Andrade -Wax, Community Services Director Carol Jacobs-Courtz, Program Director/Older Adult Services CITY Or SAN RAFAEL i 1400 FIFTH AVENUE, SAN . RAFAEL. CALIFORNIA 94961 -f CITYOFSANRAFAEL.ORG Gary O. Phillips, Mayor • John Gamblin. Vice Mayor • Kate Colin, Councilmember • Maribeth Bushey Councilmember • Andrew Cuyugan McCullough, Councilmember A membt-r of thc• Tokio N1 +nnc 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 mad such notice shall impose no obligation or liability of any kind upon the CORPORATION NAME INSURED EMPLOYER: CITY OF SAN RAFAEL ADDRESS: 1400 FIFTH AVENUE. SAN RAFAEL, CA 94901 POLICY NUMBER: SP 4054929 TYPE OF INSURANCE. Specific Excess Workers' Compensation and Employers' Liability Insurance LOCATION(S): CALIFORNIA POLICY LIABILITY PERIOD: July 01, 2016 through July 01, 2018 POLICY PAYROLL REPORTING PERIOD July 01, 2017 through July 01, 2018 Self -Insured Retention Per Occurrence $ 1,000,000 Maximum Limit of Indemnity Per Occurrence Statutory Employers' Liability Maximum Limit of Indemnity Per Occurrence and Aggregate $ 2,000,000 SAFETY NATIONAL CASUALTY CORPORATION !�� Z,45�_:;4 By: Seth A Smith Senior Vice President Workers Compensation Underwriting Date July 18, 2017 SAFETY NATIONAL CASUALTY CORPORATION EXCESS WORKERS COMPENSATION INSURANCE BINDER NAME INSURED EMPLOYER: CITY OF SAN RAFAEL ADDRESS: 1400 FIFTH AVENUE, SAN RAFAEL, CA 94901 POLICY NUMBER: SP 4059040 TYPE OF INSURANCE: Specific Excess Workers' Compensation and Employers' Liability Insurance LOCATION(S): CALIFORNIA POLICY LIABILITY PERIOD: July 01, 2018 through July 01, 2019 POLICY PAYROLL REPORTING PERIOD: 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 $ 1,000,000 Maximum Limit of Indemnity Per Occurrence Statutory Employers' Liability Maximum Limit of Indemnity Per Occurrence and Aggregate $ 2,000,000 Premium Rate $ 0.4473 per $100 of Payroll Minimum Premium for the Liability Period $ 162,542 Deposit Premium for the Payroll Reporting Period $ 180,602 Commission 15.00% This binder is effective July 01, 2018 and is subject to all the forms, terms and conditions of bound quote number 2733208362, and shall be automatically terminated 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 CASUALTY CORPORATION !�� Z,��4 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 January 10, 2019 6:37 PM https://www.sam.gov Page 1 of 1 SAM Search Results List of records matching your search for Search Term : City of San Rafael* Record Status: Active ENTITY SAN RAFAEL, CITY OF Status: Active DUNS: 198423832 +4: CAGE Code: 4TB82 DoDAAC: Expiration Date: 02/15/2019 Has Active Exclusion?: No Debt Subject to Offset?: No Address: 1400 5TH AVE City: SAN RAFAEL ZIP Code: 94901-1943 State/Province: CALIFORNIA Country: UNITED STATES ENTITY SAN RAFAEL, CITY OF Status: Active DUNS: 082447459 +4: CAGE Code: 3ULX3 DoDAAC: Expiration Date: 02/01/2019 Has Active Exclusion?: No Debt Subject to Offset?: No Address: 1400 5TH AVE City: SAN RAFAEL ZIP Code: 94901-1943 State/Province: CALIFORNIA Country: UNITED STATES January 10, 2019 6:37 PM https://www.sam.gov Page 1 of 1 LL O O N U Q c N coU 0 4MO c M N N L U � -0(D 7 O V O r 0 C C7 Z 5 Z LL N W H F- U Q H W C9 m LL 0 Q T- N M d' 0 0 r- O O 0 0 0 0 0 0 U O O) O O U j � C 0 0 0 0 0 0CU O a coo Y N N C ' O C Z CD 0000co o +V CN N CU �i L LON f0 c (� O Z 0 0 o o o o O U fa Y N N C 0 0 0 0 0 0 O U L O cu U M CDO co O O O o 0 0 m m 2 en :3 LL O U O O O O 00 O a C) O d N 0 -p 0 O O o o Cco o ao 0 LO of W U)r Cf) C) .-- N ca QO U � m c w 'ea C d O t� O (D t4 N O H m U -W 40 C V ra C cd H FO- 1-O f -O 1-O (9 T- N M d' 0 0 r- O O U O y m L OLL d CLd u $ y w c O C d O o L u u 0 T a � e « d e Ea u Cr N d � d E$ T O p E o `o r. o o 0 d h 01 `oa N d O d U C A C d C y O 9 > c LL - L d u c d d LL n U m a c n o m = y O a Y d N o. d Q � n o$ � �3a c OE p E — L C FyF C d C ° c o m `m Q a ` O � � a � o -d O ` J A a o O m d !h N O O o o. c c O. 2 E e d O. ._ y C .� MLU O y N N U O E o awm 'c o O N O N � d y E w L y N d O p d U — ee U p, o E u c V d 0c ^0 E y c m W H m y U 7 E d o o LL' cn o `o m c o; L � y N d t o v a a d o Q E o o a 13 O ,`o_ E m o mtn: y E c d y p d a o U a a O a N c Y U u o(nV1 mp a o O o O O c o 0 no " E d O Y d � 0 o a 0 o 0 o eo c La u c Y c N N c — Z Inm m m o o 0 0 o v) c t _ N N N (my � U ► o z o o O O O O o N W a ^ rZ u 0: Y L O N cc N N O 5 N zt o 0 0 0 0 0 0 0 0 O« N . d Ol rn N m t•7 m c i Z U LL N O O O O O O O O O x 'y S a G O l U 0 0 0 0 ec 0 0 0 0 0 0 0 0 c IL = m m m ao� 0 I -u] Oo m O O Om O m m0 m coon 0 a m m m m o o coca coon O O o o o m o O o a Oml N J W N F N W 000"' HjI- U m 0 0 E « « o m pC y d F m u d y O U S 0 EL a m p o U Q U o y U O y OA ~ 7 m C Z O d 10 '� � d_rt J m C y d y m O n V p o y F' W y 0 E N N > 7 C do C C w y d d 7 o C7 p o o vi d a m Z H E w> > p o d a f' C Q d L 0 « d«` O m 0 O .": 7 O « O C O C d O .r7 v>>> C _OU p 0 0 o m U d d V1 fn F H 1- F N H W 10 U U 0 C UJ (n LL F U O y m L OLL d CLd u $ y w c O C d O o L u u 0 T a � e « d e Ea u Cr N d � d E$ T O p E o `o r. o o 0 d h 01 `oa N d O d U C A C d C y O 9 > c LL - L d u c d d LL n U m a c n o m = y O a Y d N o. d Q � n o$ � �3a c OE p E — L C FyF C d C ° c o m `m Q a ` O � � a � o -d O ` J A a o O m d !h N O O o o. c c O. 2 E e d O. ._ y C .� MLU O