Family Services Association-2019-362019-36
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INDEPENDENT CONTRACTOR AGREEMENT
FOR FISCAL YEAR 2019-2020
THIS AGREEMENT is made and entered into as of this 29th day of October 2019,
and between the City of Grand Terrace, a municipal corporation (hereinafter "Ci
and Family Services Association (hereinafter "FSA"), a California non -pi
Corporation.
RECITALS
WHEREAS, City participates in the federally funded Community Development Bloc
Grant (CDBG) program as a cooperative city in the County Consortium, and receive
annual CDBG funding through the County of San Bernardino, hereinafter referred to a
County.
WHEREAS, the City submitted an application for CDBG funds for fiscal year 2019-202C
to fund a Senior Center Coordinator provided by FSA to meet the City's goal to alloy+
seniors to have a safe and healthy place to continue to be nourished and stay actiVE
within their community. The position(s) would be responsible for the daily operation o
the Center, including opening and closing the Center, scheduling of classes
educational counseling, coordinating with the Senior transportation bus driver
coordinating with vendors for programs, and also working with the senior boarc
members.
WHEREAS, FSA and the City entered into an agreement, approved by the City Counci
on June 27, 2017, for FSA to provide the Senior Services Coordinator.
WHEREAS, FSA has expressed an interest in providing a senior nutrition meal prog
for low -and -moderate income seniors in the City of Grand Terrace.
WHEREAS, FSA desires to participate in the CDBG program and represents to C
that it is qualified by reason of experience, preparation, organization, staffing, a
facilities to provide a senior nutrition meal program.
WHEREAS, On April 16, 2019, the County Board of Supervisors approved the 20111
2020 Consolidated Plan update and 2019-20, Action Plan; and, as part of that pla
allocated TWENTY FIVE THOUSAND DOLLARS ($25,000.00) in CDBG funds to th
City to fund a senior services employee to staff the Grand Terrace Senior Center an
TEN THOUSAND DOLLARS ($10,000.00) for the provision of a "Senior Congregat
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and Mobile Meal Program", in accordance with Exhibit "B", Scope of
incorporated herein.
WHEREAS, on October 29, 2019, the City agreed to accept, but has not yet received
Community Development Block Grant funding from the County of San Bernardino
("County") in the amount of TWENTY FIVE THOUSAND DOLLARS ($35,000.00) for th(
purpose of contracting with FSA for the time period of July 1, 2019 to June 30, 2020 an(
for the provision of a "Senior Center Coordinator' and "Senior Congregate and Mobil(
Meal Program", in accordance with Exhibits "A" and "B", Scope of Services
incorporated herein.
WHEREAS, FSA will complete performance of the services described in Exhibits "A'
and "B, Scope of Services, which is incorporated herein by this Agreement, for the time
period of July 1, 2019 to June 30, 2020.
WHEREAS, in order for the City to receive reimbursement in the amount of THI
FIVE THOUSAND DOLLARS ($35,000.00) of CDBG funds, as described above,
the County of San Bernardino, the County requires City to submit an Agreei
between the City and FSA to the County.
WHEREAS, the parties enter into this agreement to allow City to comply with
County's CDBG funding requirements.
NOW THEREFORE, in consideration of the mutual promises contained herein, the
of Grand Terrace and FSA hereby agree as follows:
AGREEMENT
Section 1: Services.
A. City and FSA mutually agree that payment of FSA for performance of the
services more specifically described in Exhibits "A" and "B", Scope o-
Services, incorporated herein by this reference, ("Services") shall be in the
maximum amount of THIRTY FIVE THOUSAND DOLLARS ($35,000.00;
in Community Development Block Grant ("CDBG") funds reimbursed tc
the City from the County related to the services as described by Exhibi.
"A" and "B", Scope of Services, incorporated herein.
B. City hereby agrees to reimburse FSA, in a maximum amount of THIRT)
FIVE THOUSAND DOLLARS ($35,000.00), for staffing costs, mileage
equipment, for FSA to administer the "Senior Center Coordinato
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Program", in accordance with Exhibit "A" and "B", Scope of Services,
incorporated herein.
C. Prior to City's reimbursement to FSA, FSA shall deliver receipts for a
eligible expenditures to the City. Expenditure reports shall be documente
with "audit ready" supportive evidence of each expenditure and proof c
payment. Reimbursements shall be limited to the total approved, properl
documented expenditures. All reimbursement requests must be submitte
no later than 30 days after the expiration of this Agreement. Requesl
received after said 30-day period shall be considered non -compliant an
not eligible for reimbursement under the terms of this Agreement. FS,
shall submit a final request for reimbursement for the program year n
later than July 31, 2020. Any balance remaining on this project after th,,
date will be reprogrammed
D. FSA shall further submit to the City a completed County of San Bemar
Department of Economic and Community Development Monthly Prog
Progress and Direct Benefit Report and a completed Benefic
Qualification Statement, attached herein as Exhibit C reflecting prog
activity for the term wherein Services were performed.
Section 2. Independent Contractor. It is the express intention an(
understanding of the parties hereto that FSA will act as an independen
contractor and not an employee or agent of City. Nothing in this Agreement shal
be interpreted or construed as creating or establishing a relationship of employe
or employee between FSA and City. Both parties acknowledge that FSA is not ai
employee for State tax, Federal tax, or any other purpose.
Section 3. Term. The term of this Agreement shall be one (1) year startin
July 1, 2019 and ending June 30, 2020.
Section 4. Termination. City shall have the right to terminate this Agreemei
with or without cause, upon twenty (20) days prior written notice to FSA. C
shall have no liability for any claims or damages resulting to FSA as a result
any exercise by City of its right to terminate this Agreement.
Section 5. Compliance with Laws and Reaulations. FSA shall comply
all applicable federal, state and local laws, regulations and ordinances.
executing this Agreement, FSA hereby certifies that it will adhere to and cor
with the following as they may be applicable to a subrecipient of funds grai
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pursuant to the Housing and Community Development Act of 1974, as amend
(the "Act"):
A. The Housing and Community Development Act of 1974, as amended, a
the regulations issued thereto;
B. Section 3 of the Housing and Urban Development Act of 1968,
amended;
C. Executive Order 11246, as amended by Executive Orders 11375 an(
12086, and implementing regulations at 41 CFR Chapter 60;
D. Executive Order 11063, as amended by Executive Order 12259, an(
implementing regulations at 24 CFR Part 107;
E. Section 504 of the Rehabilitation Act of 1973 (PL 93-112), as amended
and implementing regulations;
F. The Age Discrimination Act of 1975 (PL 94-135), as amended, an(
implementing regulations;
G. The relocation requirements of Title II and the acquisition requirements
Title III of the Uniform Relocation Assistance and Real Prope
Acquisitions Policies Act of 1970, and the implementing regulations at
CFR Part 42;
H. The labor standard requirements as set forth in 24 CFR Part 570, Subpa
K and I -IUD regulations issued to implement such requirements;
I. Executive Order 11988 relating to the evaluation of flood hazards an
Executive Order 11288 relating to the prevention, control and abatemel
of water pollution;
J. The flood insurance purchase requirements of Section 102(a) of the Floc
Disaster Protection Act of 1973 (PL 93-234);
K. The regulations, policies, guidelines and requirements of 24 CFR Part 8
"Common Rule," OMB Circular Nos. A-87, A-21, A-110, A-122 and A-13
as they relate to the acceptance and use of federal funds under th
federally -assigned program;
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L. Title VI of the Civil Rights Act of 1964 (PL 88-352) and implementi
regulations issued at 24 CFR Part I;
M. Title VIII of the Civil Rights Act of 1968 (PL-90-284) as amended; and
N. The lead based paint requirements of 24 CFR Part 35 issued pursuant
the Lead -based Paint Poisoning Prevention Act (42 USC 4801, et seq.);
O. Uniform Administration Requirements pursuant to 24 CFR 570.502.
P. The FSA shall carry out its activity pursuant to this Agreement
compliance with all federal laws and regulations described in Subpart K
Title 24 of the Code of Federal Regulations, except that:
1. FSA does not assume the City's or County's environmental
responsibilities described at §570.604; and
2. FSA does not assume the City's or County's responsibility
initiating the review process under the provisions of 24 CFR
52.
Q. All Uniform Administrative Requirements pursuant to 24 CFR 570.502.
Section 6. Federal Requirements. FSA shall comply with the provisions
the Act and any amendments thereto and the federal regulations and guidelir
now or hereafter enacted pursuant to the Act. More particularly, FSA is to com
with those regulations found in 24 CFR 570, Part 84 and Part 85. FSA is
comply with OMB Circular Nos. A-110, A-87. A-122, and A-133 as applicable,
they relate to the acceptance and use of federal funds under this Agreement.
Section 7. Program Income. FSA, who is a subrecipient as defined i
Section 570.500 (c), shall not retain any program income as defined in Sectio
570.500 of Title 24 of the Federal Code of Regulations.
Section 8. Insurance. Without limiting or diminishing FSA'S obligations tc
defend, indemnify, or hold the City harmless, FSA shall procure and maintain o
cause to be maintained, at its sole cost and expense, the following insuranc(
coverage's during the term of the Agreement.
A. Workers' Compensation:
LW
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If FSA has employees as defined by the State of California, FSA shal
maintain statutory Workers' Compensation Insurance (Coverage A) a-
prescribed by the laws of the State of California. Policy shall include Employers
Liability (Coverage B) including Occupational Disease with limits not less than
$1,000,000 per person per accident. The policy shall be endorsed to waive
subrogation in favor of THE CITY OF GRAND TERRACE or the GRAN[
TERRACE SENIOR CENTER.
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B. Commercial General Liability:
Commercial General Liability insurance coverage, including but not limitec
to, premises liability, contractual liability, products and completed operation:
liability, personal and advertising injury, and cross liability coverage, coverinc
claims which may arise from or out of FSA'S performance of its obligatior
hereunder. Policy shall name the GRAND TERRACE SENIOR CENTER, it:
Agencies, Districts, Special Districts, and Department, their respective directors
officers, employees, elected or appointed officials, agents or representatives a=.
Additional Insureds. Policy's limit of liability shall not be less than $1,000,000 pei
occurrence combined single limit. If such insurance contains a general aggregate
limit, it shall apply separately to this agreement or be no less than two (2) time:
the occurrence limit.
C. Vehicle Liability:
If vehicles or mobile equipment are used in the performance of the
obligations under this Agreement, then FSA shall maintain liability insurance for
all owned, non -owned or hired vehicles so use in any amount not less than
$1,000,000 per occurrence combined single limit. If such insurance contains a
general aggregate limit, it shall apply separately to this agreement or be no less
than two (2) times the occurrence limit. Policy shall name the GRAND TERRACE
SENIOR CENTER, its Agencies, Districts, Special Districts, and Departments,
their respective directors, officers, employees, elected or appointed officials,
agents or representatives as Additional Insureds.
D. General Insurance Provisions — All Lines:
1. Any insurance carrier providing insurance coverage hereunder shal
be admitted to the State of California and have a A M BEST ratinc
of not less than A: VIII (A:S) unless such requirements are waived
in writing, by the City Attorney. If the City Attorney waives
requirement for a particular insurer such waiver is only valid for tha
specific insurer and only for one policy term.
2. FSA shall cause FSA'S insurance carrier(s) to furnish the City w
either 1) a properly executed original Certificate(s) of Insurance a
certified original copies of Endorsements effecting coverage
required herein, and 2) if requested to do so orally or in writing
the City, provide original Certified copies of policies including
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Endorsements and all attachments thereto, showing suc
insurance is in full force and effect. Further, said Certificate(s) an
policies of insurance shall contain the covenant of the insuranc
carriers(s) that thirty (30) days written notice shall be given to th
City prior to any material modification, cancellation, expiration c
reduction in coverage of such insurance. In the event of a materi<
modification, cancellation, expiration, or reduction in coverage, thi
Agreement shall terminate forthwith, unless the City receives, pric
to such effective date, another properly executed original Certificat
of Insurance and original copies of endorsements or certifie
original policies, including all endorsements and attachment
thereto evidencing coverage's set forth herein and the insuranc
required herein is in full force and effect. FSA shall not commenc
operations until the City has been furnished original Certificate(s) c
Insurance and certified original copies of endorsements and
requested, certified original policies of insurance including a
endorsements and any and all other attachments as required in thi
Section. An individual authorized by the insurance carrier to do s
on its behalf shall sign the original endorsements for each polic
and the Certificate of Insurance.
3. If, during the term of this Agreement or any extension thereof, ther
is a material change in the scope of services; or, there is a materi<
change in the equipment to be used in the performance of th
scope of work which will add additional exposures (such as the us
of) aircraft, watercraft, cranes, etc.); or, the term of this Agreemen
including any extensions thereof, exceeds five (5) years the Cit
reserves the right to adjust the types of insurance required unde
this Agreement and the monetary limits of liability for the insuranc
coverage's currently required herein, if; in the City Attorney'
reasonable judgment, the amount or type of insurance carried b
the sponsor has become inadequate.
4. FSA shall pass down the insurance obligations contained herein
all tiers of subcontractors working under this Agreement.
5. The insurance requirements contained in this Agreement may
met with a program(s) of self-insurance acceptable to the City.
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6. FSA agrees to notify City of any claim by a third party of an
incident or event that may give rise to claim arising from th
performance of this Agreement.
Section 9. HUD Indemnity. FSA shall defend, indemnify, and hold harmles
the County of San Bernardino and City against any liability, claims, losses
demands, and actions incurred by the County of San Bernardino and City as
result of the determination by HUD or its successor that activities undertaken b
FSA under the program(s) fail to comply with any laws, regulations or policie
applicable thereto or that any funds billed by and disbursed to FSA under thi
Contract were improperly expended. Notwithstanding the late execution of thi
Agreement, this indemnity shall survive and extend beyond the term c
termination of this Agreement.
Section 10. Indemnity. FSA shall defend, indemnify, and hold harmless the
County of San Bernardino and the City, its elected officials, officers, employee;
and agents from and against any and all actions, damages, losses, causes c
action and liability imposed or claimed relating to the injury or death of an,
person or damage to any property, including attorney's fees, costs, and othe
legal expenses, arising directly or indirectly from any act or omission of FSA it
performing services hereunder. Notwithstanding the late execution of this
Agreement, this indemnity shall survive and extend beyond the term o
termination of this Agreement.
Section 11. Prohibition Against Conflicts of Interest.
A. FSA and its assigns, employees, agents, consultants, officers and electe
and appointed officials shall become familiar with and shall comply wi-
the CDBG regulations prohibiting conflicts of interest contained in 24 CIF
570.611, by this reference incorporated herein.
B. FSA understands and agrees that no waiver or exception can be grantec
to the prohibition against conflict of interest except upon written approva
HUD pursuant to 24 CFR 570.611(d). Any request by FSA for and
exception shall first be reviewed by CITY to determine whether sucr
request is appropriate for submission to HUD.
C. Prior to any funding under this Agreement, FSA shall provide CITY with
list of all employees, agents, consultants, officers and elected ai
appointed officials who are in a position to participate in a decision-makii
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process, exercise any functions or responsibilities, or gain insic
information with respect to the CDBG activities funded under th
Agreement. FSA shall also promptly disclose to CITY any potenti
conflict, including even the appearance of conflict, that may arise wi.
respect to the CDBG activities funded under this agreement.
D. Any violation of this section shall be deemed a material breach of thi
Agreement, and the Agreement shall be ground for immediate terminatioi
by the City.
Section 12. Religious Activities. Under federal regulations, CDBG assistan
may not be used for inherently religious activities or provided to primal
religious entities for any activities including secular activities. FSA shall adhere
the restrictions set forth in 24 CFR 570.2000), by this reference is incorporat
herein.
Section 13. Lobbying. FSA certifies to the best of it knowledge and belief
that:
A. No federally appropriated funds have been paid or will be paid, by or or
behalf of the undersigned, to any person for influencing or attempting tr
influence an officer or employee of any agency, a member of Congress
an officer or employee of Congress, or an employee of a member o
Congress in connection with the awarding of any federal contract, the
making of any federal grant, the making of any federal loan, the enterinc
into of any cooperative agreement, and the extension, continuation
renewal, amendment, or modification of any federal contract, grant, loan
or cooperative agreement.
B. If any funds other than federally appropriated funds have been paid or wil
be paid to any person for influencing or attempting to influence an office
to employee of any agency, a member of Congress, an officer o
employee of Congress, or an employee of a member of Congress it
connection with this federal contract, grant, loan, or cooperativ{
agreement, the undersigned shall complete and submit Standard Form
LLL, "Disclosure Form to Report Lobbying," in accordance with i
instructions.
C. The undersigned shall require that the language of this certification
included in the award document for all subawards at all tier (incluc
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subcontracts, subgrants, and contracts under grants, loans, an
cooperative agreements) and that all subrecipients shall certify an
disclose accordingly. This certification is a material representation of fal
upon which reliance was placed when this transaction was made c
entered into.
Section 14. Entire Agreement/Modification. This Agreement represents th
entire Agreement of the parties hereto as to the matters contained herein. An
modification of this Agreement will be effective only if it is in writing and signed b
the parties hereto.
Section 15. Assignment. This Agreement shall not be assigned without th
prior written consent of City. Any assignment, or attempted assignment, withot
such prior consent, shall be null and void and, at the option of City, result in th
immediate termination of this Agreement.
Section 16. Attorney's Fees and Governing Law. In the event any action is
commenced to enforce or interpret the terms or conditions of the Agreement the
prevailing party shall, in addition to any costs or other relief, be entitled to recove
its reasonable attorney's fees. This Agreement and any dispute arising hereunde
shall be governed by and interpreted in accordance with the laws of the State c
California. This Agreement shall be construed as a whole according to its fai
language and common meaning to achieve the objectives and purposed of the
parties hereto, and the rule of construction to the effect that ambiguities are to bE
resolved against the drafting party shall not be employed in interpreting thi
Agreement, all parties having been represented by counsel in the negotiation an(
preparation hereof.
Section 17. Jurisdiction and Venue. Any action at law or in equity arisinc
under this Agreement or brought by a party hereto for the purpose of enforcing
construing or determining the validity of any provision of this Agreement shall be
filed in a court of competent jurisdiction in the County of San Bernardino, State o
California, and the parties hereto waive all provisions of law providing for the
filing, removal or change of venue to any other court or jurisdiction.
Section 18. Program Reporting. FSA agrees to prepare and submit financial
program progress, and other reports as required by HUD or the County of Sar
Bernardino and/or City accounts as are considered necessary by HUD or the
County of San Bernardino and/or City to assure proper accounting for al
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Contract funds. All FSA records, with the exception of confidential clie
information, shall be made available to representatives of the County of SE
Bernardino and/or City and the appropriate federal agencies. FSA is required
submit data necessary to complete the Annual Grantee Performance Report
accordance with HUD regulations in the format and at the time designated by tt
Community Development Director or his/her designee. By the 30th of eat
month, FSA shall submit a completed "Monthly Program Progress Report." F.E.
shall also provide the Monthly Direct Benefit Report and Beneficiary Qualificatic
Statement information included as Exhibit "C", as necessary for completion of tt
Annual Grantee Performance Report.
Section 19. Applicability of Agreement. In consideration of the intent of t
parties to memorialize the parties understanding of the terms of their agreeme
all uses of the present tense shall be interpreted to apply to the term of t
Agreement. With the exceptions of Sections 9, 10, 11, and any other section
this Agreement expressly stating otherwise, which obligations shall not termina
the terms and conditions of this Agreement shall only apply during the term
this Agreement.
Section 20. Waiver. Failure by a party to insist upon the strict performance
any of the provisions of this Agreement by the other party, or the failure by
party to exercise its rights upon the default of the other party, shall not constitu
a waiver of such party's right to insist and demand strict compliance by the oth
party with the terms of this Agreement thereafter.
Section 21. Severability. Each section and provision of this Agreement
severable from each other provision, and if any provision or part thereof
declared invalid, the remaining provisions shall nevertheless remain in full for
and effect.
Section 22. Counterparts. This Agreement may be signed by the differE
parties hereto in counterparts, each of which shall be an original but all of whi
together shall constitute one and the same agreement.
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CITY OF GRAND TERRACE
G. HaloDu y
City Manager
FAMILY SERVICES ASSOCIATION
Jticdith Wood,
esident & CEO
APPROVED AS TO FORM:
Adrian R. Guerra
City Attorney
ATTEST:
Debra L. Thomas
City Clerk
Date
Date
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EXHIBIT A
SENIOR CONGREGATE AND MOBILE MEAL PROGRAM
SERVICES:
For program year 2019-2020 the City of Grand Terrace will contract with Family
Services Association (FSA) to provide, Senior Congregate and Mobile Meal Program
and a Senior Services Coordinator. The Senior Congregate and Mobile Meal Program
will serve congregate meals, to low -and moderate -income seniors and home delivered
meals to seniors who are homebound by reason of illness, incapacity, disability, and
lack of transportation, residing in the City of Grand Terrace. Approximately 140 seniors
will have increase access to nutritional meals programs. The Senior Services
Coordinator will manage the Senior programs at the Grand Terrace Senior Center,
which include, but are not limited to: social activities, educational classes, exercise
classes, arts & crafts classes, health insurance counseling, home energy assistance,
fresh produce program, health screenings, game nights, karaoke and transportation.
The Senior Services Coordinator will serve approximately 170 low -and moderate -
income seniors in the City of Grand Terrace.
UNITS OF SERVICE:
Units of Service shall be reported on Monthly Program Progress/Direct Benefit Report,
Exhibit 4, Part 1, monthly. Each senior attending a Senior Service Program activity, one
meal counts as an activity, provided by the Family Service Association, shall count as 1
unit of service.
TIME OF PERFORMANCE: July 1, 2019 through June 30, 2020
PROGRAM PARTICIPANT PERFORMANCE STANDARDS:
CDB Activity: Senior Congregate and Mobile Meal Program and Senior Service
Coordinator Program Activities.
Measurable Outcome: Approximately 140 seniors will have increased access to
nutritional meal programs. Approximately 170 seniors from the Grand Terrace Area will
receive Coordinate Senior Center Services.
In addition to units of service, the City of Grand Terrace will report unduplicated client
counts on the Monthly Program Progress/Direct Benefit Report, Exhibit 4, Part II.
OPERATIONS:
The FSA Senior Congregate Meal Program and the Coordinated Senior Services will be
operated at the Grand Terrace Senior Center, located at 22627 Grand Terrace Rd.,
Grand Terrace, the FSA Mobile Meal Program will operate as meals delivered to home
bound seniors that reside in the City of Grand Terrace. The FSA administration office is
locate at 21250 Box Springs Rd., Suite 212, Moreno Valley, CA 92557.
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ATTACHMENT A- REQUEST TO INITIATE PROJECT/ACTIVITY
PROJECT/CASE NUMBER: GTER-19-2-05A/2992 DATE OF ORIGINAL ISSUE: 7/1/2019
CFDA No: 14.218 ORIGINAL: X REVISION No.:
TARGET AREA: City of Grand Terrace DATE OF REVISION:
WBSE CODE: 50.60.0116.09
Pursuant to the terms of the Delegate Agency Agreement between Community Development and Housing (CDH), and the City
of Grand Terrace, effective 7/1/2015, CDH hereby requests that the following project/activity be initiated. There will be no
changes in Project/Activity Title, Activity Budget (Attachment A) or in the Activity Description (Attachment B) without written
approval of the Director of Community Development and Housing/Supervising CDH Analyst.
PROJECT/ACTIVITY TITLE: Grand Terrace: Family Service Association - Senior Meals and Coordinator Services
ACTIVITY LOCATION: Grand Terrace Senior Center, 22627 Grand Terrace Rd., Grand Terrace, CA 92313
TOTAL PROJECT FUNDING: $35,000
CITY CDBG ALLOCATION RELEASED: $35,000
CITY CDBG FUNDS PROJECTED TO BE EXPENDED AS OF 6/30/2019: $0
DATE OF RELEASE OF FUNDS: 7/1/2019
SCHEDULE OF CDBG ALLOCATION:
Year 1-40 Year 41 Year 42 Year 43
(75-2015) (2015-16) (2016-17) (2017-18)
$0 $0 $0 $0
BALANCE OF FUNDS AVAILABLE: $35,000
Year 44
Year 45
Year 46 TOTAL OF
B19UC060503
(2018-19)
(2019-20)
(2020-21) 46 YEARS
$0
$35,000
$0 $35,000
MAINTENANCE AND OPERATION BUDGET/AGREEMENT: City of Grand Terrace
OTHER PERTINENT INFORMATION: City certifies all requests for reimbursement from CDH contain proof of payment, all
supporting documentation for costs incurred and a Monthly Program Progress Report.
ACCEPTANCE OF REQUEST TO INITIATE PROJECT/ACTIVITY
I hereby acknowledge the receipt of the Request to Initiate the above Project/Activity and agree to implement the activity
described in Attachment B (Project/Activity Description) in accordance with the above Allocation and Balance of Funds
Available subject to necessary approvals of the Board of Supervisors. The proposed budget for this project is as follows:
CONSULTANT SERVICES:
$0
CONTRACT SERVICES:
$0
PERSONNEL EXPENSES:
$25,000
CONSUMABLE SUPPLIES:
$10,000
SPACE RENT: $0
RENT/LEASE OR PURCHASE OF
EQUIPMENT: $0
OTHER: $0
TOTAL CITY CDBG ALLOCATION AVAILABLE: $35,000
IMPLEMENTING CITY: CITY OF GRAND TERRACE
SIGNATURE:
COUNTY OF SAN BERNARDINO
Gary Hallen ire or of Community Development and Housing/
Bryan A erso , Supervising Community Development and Housing Analyst
DATE:
T
TITLE:
� 7
DATE
ATTACHMENT B - PROJECT/ACTIVITY DESCRIPTION
PROJECT/CASE NUMBER: GTER-19-2-OSA/2992 DATE OF ORIGINAL ISSUE: 7/1/2019
CFDA No.: 14.218 ORIGINAL: X REVISION No.:
TARGET AREA: City of Grand Terrace DATE OF REVISION:
PROJECT/ACTIVITY TITLE: Grand Terrace: Family Service Association - Senior Meals and Coordinator Services
ACTIVITY LOCATION: Grand Terrace Senior Center, 22627 Grand Terrace Rd., Grand Terrace, CA 92313
TIME OF PERFORMANCE: July 1, 2019 through June 30, 2020
SUSPENSION AND DEBARMENT: By entering this Contract, the City of Grand Terrace certifies that the Family Services Association, including its
principals, is not suspended or debarred from participating in federally funded contracts and sub -awards. The City may research the agency's
status online at the System for Award Management (SAM) website https://www.sam.gov/portal/public/SAM/
ACTIVITY DESCRIPTION: The City of Grand Terrace will contract with Family Service Association to provide a Senior Nutrition Program and a Senior
Services Program Coordinator. The Nutrition Program will include: congregate meals and meals delivered to home bound seniors. The Senior
Servicces Program Coordinator will manage the senior services and programs which include: social activities, educational classes, exercise classes,
arts & crafts classes, health insurance counseling, health screenings, home energy assistance counseling, fresh produce program, game nights,
karaoke and transportation. All services will be provided at the Grand Terrace Senior Center. San Bernardino County Department of Community
Development and Housing, herein after referred to as CDH, will reimburse the City ofGrand Terrace in the amount not to exceed the "CDBG
Allocation Released" on the Attachment A for the services necessary to implement this program. Federal, state, county and city rules and
regulations will apply.
Family Service Assiciation (FSA) shall sign a contract with the City of Grand Terrace addressing the scope of service and the terms and conditions.
The contract shall remain in effect during the period that the services are provided for which CDBG funds will be requested for reimbursement.
The contract with FSA shall comply with requirements listed in 24 CFR 570.503 including: Agreements with Subrecipients; Statement of Work;
Records and Reports; Program Income; Uniform Administrative Requirements; Other Program Requirements; Conditions for Religious
Organizations; Suspension and Termination; Reversion of Assets; and Exhibits 3(a) & 3(b)1 of 2 and 2 of 2.
In addition, City of Grand Terrace shall comply with all applicable regulations listed in the City -County Delegate Agency Agreement, No.14-406,
Attachment C, Section IV. City shall maintain monthly program reports and records on the services provided. CDBG funds cannot be used for
entertainment, gifts or fund-raising activities. Reimbursement expenditures must be appropriately documented. City shall comply with conflict of
interest provisions and shall not exclude any person from funded programs on the grounds of race, sex, creed, color, religion or national origin.
CDBG funds cannot be used to replace other local or state monies to fund essential services typically offered by the City. The City shall certify the
eligible use of CDBG funds on Certification of CDBG Funded New or Expanded Service, Exhibit 5. This program is available to low- and moderate -
income persons and requires documentation that at least 51% of the persons served are from income qualifying households. In order to
document that 51% of the persons served are from income qualifying households, a Beneficiary Qualification Statement, Exhibit 3(a), must be
completed for each person that participates in the program. A Spanish version of the Beneficiary Qualification Statement, Exhibit 3(b), can be
completed for Spanish speakers who prefer it, however, the County cannot guarantee the accuracy of the translation and CDH cannot be held
responsible for any errors. The Beneficiary Qualification Statement will then be used to complete and submit the Monthly Program
Progress/Direct Benefit Report, Exhibit 4, to CDH. The Monthly Program Progress/Direct Benefit Reports must be submitted to CDH for each
month that CDBG reimbursement is requested. It is anticipated that a monthly average of approximately 160 meals will be served at the
congregate senior nutrition program and approximately 325 meals per month will be delivered to home bound seniors, for a total of
approximately 140 seniors served for the 2019-20 year. Also, an approximately 170 persons will participate in the Senior Services Coordination
Program. A "Unit of Service" is defined as each person attending an outreach and/or program activity, in a given month. The number of persons
times the total number of program activities per month will reflect the total units of service which results in the measureable outcome. The
measurable outcome will be recorded on Part I: Monthly Program Progress Report, Exhibit 4, and the number of unduplicated first-time persons
who participated in the program during the fiscal year will be recorded on Part II: Direct Benefit Report, Exhibit 4.
The City of Grand Terrace understands that reimbursements received from the County for which no measurable outcome is achieved may
subsequently be required to be repaid by the City (using non-federal funds) to County. Measurable outcomes are defined as providing benefits
to low- to moderate -income individuals, families, organizations, and communities and are derived from the project or program. Examples
include: construction completed resulting in improved access to services/public facilities/park & recreation/street improvements, etc.
The City of Grand Terrace will submit a final request for reimbursement for the program year no later than July 15, 2020. Note: After July 31,
2020, any balance remaining in this project will be reprogrammed.
IMPLEMENTING CITY: CITY OF GRAND TERRACE
SIGNATURE:
COUNTY OF SAN BERNARDINO
Gary Hallen, D' a or of Community Development and Housing/
Bryan And so , Supervising Community Development and Housing Analyst
DATE:
TITLE:
/-d�L9
DATE
COUNTY OF SAN BERNARDINO COMMUNITY DEVELOPMENT AND HOUSING
Project/ Activity Title: PROJECT/CASE NUMBER:
Grand Terrace: Family Service Association - Senior Meals GTER-19-2-OSA/2992
and Coordinator Services
Name/Address of Contract Agency: Date of Issue:
Family Services Association X Original: Beginning 7/1/2019
21250 Box Springs Rd., Suite, 212, Moreno Valley, Amendment No.:
CA 92557
PROJECT/ACTIVITY DESCRIPTION
SERVICES :
For program year 2019-2020 the City of Grand Terrace will contract with Family Service Association (FSA) to
provide, Senior Congregate and Mobile Meal Program and a Senior Services Coordinator. The Senior
Congregate and Mobile Meal Program will serve congregate meals, to low -and moderate -income seniors
and home delivered meals to seniors who are homebound by reason of illness, incapacity, disability, and
lack of transportation, residing in the City of Grand Terrace. Approximately 140 seniors will have increased
access to nutritional meals programs. The Senior Services Coordinator will manage the Senior programs at
the Grand Terrace Senior Center, which include, but are not limited to: social activities, educational classes,
exercise classes, arts & crafts classes, health insurance counseling, home energy assistance counseling, fresh
produce program, health screenings, game nights, karaoke and transportation. The Senior Services
Coordinator will serve approximately 170 low -and moderate -income seniors in the City of Grand Terrace.
UNITS OF SERVICE:
Units of Service shall be reported on Monthly Program Progress/Direct Benefit Report, Exhibit 4, Part I,
monthly. Each senior attending a Senior Service Program activity, one meal counts as an activity, provided
by the Family Service Association, shall count as 1 unit of service.
TIME OF PERFORMANCE: July 1, 2019 through June 30, 2020
PROGRAM PARTICIPANT PERFORMANCE STANDARDS:
CDBG Activity: Senior Congregate and Mobile Meal Program and Senior Service Coordinator Program
activities.
Measurable Outcome: Approximately 140 seniors will have increased access to nutritional meal programs.
Approximately 170 seniors from the Grand Terrace Area will receive Coordinated Senior Center Services.
In addition to units of service, the City of Grand Terrace will report unduplicated client counts on the
Monthly Program Progress/Direct Benefit Report, Exhibit 4, Part II.
OPERATIONS:
The FSA Senior Congregate Meal Program and the Coordinated Senior Services will be operated at the
Grand Terrace Senior Center, located at 22627 Grand Terrace Rd., Grand Terrace, the FSA Mobile Meal
Program will operate as meals delivered to home bound seniors that reside in the City of Grand Terrace.
The FSA administration office is located at 21250 Box Springs Rd., Suite 212, Moreno Valley, CA 92557.
Exhibit 1 Page 1 of 1
COUNTY OF SAN BERNARDINO COMMUNITY DEVELOPMENT AND HOUSING
Proiect/ Activity Title: PROJECT/CASE NUMBER:
Grand Terrace: Family Service Association - Senior Meals GTER-19-2-05A/2992
and Coordinator Services
Name/Address of Contract Agency: Date of Issue:
Family Services Association X Original: Beginning 7/1/2019
21250 Box Springs Rd., Suite, 212, Moreno Valley, Amendment No.:
CA 92557
BUDGET SUMMARY
A. Budget Items
Projected Expenses
Personnel
$1,408,623
Consultant/Contract Services (Auditing, Accounting or Payroll Services)
$25,052
Travel
$0
Space Rent
$34,602
Consumable Supplies
$1,165,476
Rental, Lease, or Purchase of Equipment
$0
Insurance
$65,306
Other (Utilities, Land -line Phones, Cellular Phones, Internet Service, Postal
Services, Security Clearances, Approved Subsidies/Scholarships,
Administrative and Indirect Costs)
$496,308
Total Budget:
$3,195,367
B. Sources of Funding
Amount of Revenue
i. Federal Funding: Older Americans Act Title III
$1,947,057
2. State Funding: Older Americans Act Title III
$331,604
3. County Funding: Older Americans Act Title III
$483,619
4. Private Funding: Individual Donations
$398,087
5. *Grand Terrace CDBG Share
$35,000
Total Sources of FundIng:1
$3,195,367
*Proiect Allocation: $35,000 (Allocated dollars can only be expended in the Personnel or Consumable
Supplies (food) categories listed under subsection A of Budget Summary above.)
Time of Performance: July 1, 2019 through June 30, 2020
Special Instructions or Restrictions:
For programs with multiple funding sources, administrative and indirect costs charged to this grant must be
determined using the City of Grand Terrace's approved Cost Allocation Plan.
The current standard Internal Revenue Service mileage allowance will be used for reimbursement of
authorized costs associated with vehicle operation under this contract.
City of Grand Terrace will submit a final request for reimbursement for the program year no later than July
31, 2020. After July 31, 2020, any balance remaining in this project will be reprogrammed.
Exhibit 2 Page 1 of 1
COUNTY OF SAN BERNARDINO COMMUNITY DEVELOPMENT AND HOUSING
Proiect/ Activity Title: PROJECT/CASE NUMBER:
Grand Terrace: Family Service Association - Senior GTER-19-2-05A/2992
Meals and Coordinator Services
Name/Address of Contract Agency: Date of Issue:
Family Services Association X Original: Beginning 7/1/2019
21250 Box Springs Rd., Suite, 212, Moreno Valley, CA Amendment No.:
92557
BENEFICIARY QUALIFICATION STATEMENT
This form has the purpose of providing information needed to qualify the use of federal Community Development Block
Grant (CDBG) funds for the project/activity described above. This statement must be completed and signed by the
person (or legal guardian of the person) requesting to receive benefits from the described project/activity. Only one
statement per person, per fiscal year is required (Fiscal Year begins July 1 and ends June 30).
Please answer each of the following questions.
1. This question helps you determine the size of your household. For this question a household is a group of related or
unrelated persons occupying the same house with at least one member being the head of the household. Renters,
roomers, or borders cannot be included as household members.
How many persons are in your household?
2. This question asks if you are from a low- and moderate -income household. For this question, a list of the EXTREMELY
LOW-INCOME, VERY LOW-INCOME and LOW-INCOME categories* are presented below. Please add up the combined
gross annual income of all persons in your household from all sources of income. In the blanks provided, write (yes) or
(no) if your combined gross annual income is equal to or less than the, EXTREMELY LOW-INCOME, VERY LOW-
INCOME, or LOW -INCOME -amount for the number of persons in your household.
YES/NO
EXTREMELY LOW-INCOME
VERY LOW-INCOME
LOW-INCOME
Number of Persons in Your Household
1
2
3 4
5
6
7
8
VERY LOW-INCOME
LIMIT ($)
23,600
27,000
30,350 33,700
36,400
39,100
41,800
44,500
EXTREMELY LOW-INCOME
LIMIT ($)
14,150
16,460
20,780 25,100
29,420
33,740
38,060
42,380
LOW-INCOME LIMIT ($)
37,750
43,150
48,550 53,900
58,250
62,550
66,850
71,150
* Taken from FY 2018 Income Limits Summary: https://www.huduser-gov/aortal/datasetslillil2018/2018summarv.odn
Exhibit 3(a) Page 1 of 2
COUNTY OF SAN BERNARDINO COMMUNITY DEVELOPMENT AND HOUSING
Proiect/ Activitv Title: PROJECT/CASE NUMBER:
Grand Terrace: Family Service Association - GTER-19-2-05A/2992
Senior Meals and Coordinator Services
Name/Address of Contract Agency: Date of Issue:
Family Services Association X Original: Beginning 7/1/2019
21250 Box Springs Rd., Suite, 212, Moreno Valley, CA 92557 Amendment No.:
3. Please indicate how you identify yourself by checking only one of the following choices:
White
Hispanic
F7
Non -Hispanic
Black/African American
E-1
a
American Indian/Alaskan Native
Asian
FI
Native Hawaiian/Other Pacific Islander
7
American Indian/Alaskan Native & White
F
Asian & White
a
Black/African American & White
American Indian/Alaskan Native & Black/African American
a
Balance/Other
a
a
4. Please check whether you belong to a Female Headed Household:
71YES
EDNO
5. Please describe the condition that would qualify you as being considered in one of the following
presumed low- and moderate -income categories: abused child, battered spouse, elderly person, homeless
person, disabled adult, illiterate person, or migrant farm worker:
(Description)
ACKNOWLEDGMENT AND DISCLAIMER
I CERTIFY UNDER PENALTY OF PERJURY THAT INCOME AND HOUSEHOLD STATEMENTS
MADE ON THIS FORM ARE TRUE.
NAME:
ADDRESS:
DATE:
CITY: ZIP:
SIGNATURE: PHONE:
The information you provide on this form is for Community Development Block Grant (CDBG) program
purposes only and will be kept confidential.
Exhibit 3(a) Page 2 of 2
COUNTY OF SAN BERNARDINO COMMUNITY DEVELOPMENT AND HOUSING
Proiect/ Activity Title: PROJECT/CASE NUMBER:
Grand Terrace: Family Service Association - GTER-19-2-05A/2992
Senior Meals and Coordinator Services
Name/Address of Contract Agency: Date of Issue:
Family Services Association X Original: Beginning 7/1/2019
21250 Box Springs Rd., Suite, 212, Moreno Valley, CA 9255 Amendment No.:
ARACION DE LA CALIFICACION DEL BENEFICIARIO
Esta forma tiene el proposito de proporcionar la informacibn necesaria para calificar el use de los fondos
federales del bloque del desarrollo de la comunidad (CDBG) para el proyecto/actividad descrito arriba. Esta
declaracion se debe Ilenar y firmar por la persona (o la tutela legal de la persona) que solicita para recibir
beneficios del proyecto/actividad descrito. Solamente una declaracion por persona, por an"o se requiere.
Conteste por favor a cada una de las preguntas siguientes.
1. Esta pregunta le ayuda a determinar el tamaflo de su casa. En esta pregunta un hogar es un grupo de
personas relacionadas o sin relacion que ocupan la misma casa por to menos con un miembro que es la
cabeza de la casa. Los inquilinos no se pueden incluir como miembros de la casa.
ZCuantas personas viven en su casa?
2. Esta pregunta explica si usted es de un hogar de ingresos bajos y moderados. Para esta pregunta, la lista
de categorfas de INGRESOS-ESTREMADO BAJOS, INGRESO-BAJOS *se presenta abajo. Sume por favor para
arriba los ingresos brutos anuales combinados de todas las personas en su hogar y de todas las fuentes de
los ingresos. En el espacio en blanco, escriba (sf) o (no) si su ingreso anual grueso combinado es igual o
menos que la cantidad de INGRESOS-ESTREMADO BAJOS, INGRESOS-MUY BAJOS, INGRESO-BAJOS para el
numero de personas en su casa.
SVNo
INGRESOS-ESTREMADO BAJOS
INGRESOS-MUY BAJOS
INGRESO-BAJOS
Numero de Personas en su Hogar
1 2 3 4 5 6 7 8
INGRESOS-MUY BAJOS ($)
23,600 27,000 30,350 33,700 36,400 39,100 41,800 44,500
INGRESOS-ESTREMADO
BAJOS ($) 14,150 16,460 20,780 25,100 29,420 33,740 38,060 42,380
INGRESO-BAJOS ($) 37,750 43,150 48,550 53,900 58,250 62,550 66,850
* Tornado de FY 2018 Resu men Urnites de Ingresos: httos: /WWW.huduser. w/portal datasets it 112018 2018summa ry.odn
Exhibit 3(b) Page 1 of 2
COUNTY OF SAN BERNARDINO COMMUNITY DEVELOPMENT AND HOUSING
Proiect/ Activity Title: PROJECT/CASE NUMBER:
Grand Terrace: Family Service Association - GTER-19-2-05A/2992
Senior Meals and Coordinator Services
Name/Address of Contract Agency: Date of Issue:
Family Services Association X Original: Beginning 7/1/2019
21250 Box Springs Rd., Suite, 212, Moreno Valley, CA 92557 Amendment No.:
3. Indique por favor c6mo se identifica usted, marcando solamente una de las opciones siguientes:
Hispano
No-Hispano
Blanco
Negro/Afro Americano
Indio Americano/Nativo de Alaska
a
Asiatico
a
Nativo Hawaiano/Otra Isla del Pacifico
a
Indio Americano/Nativo de Alaska & Blanco
Asiatico & Blanco
a
Negro/Afro Americano & Blanco
a
Indio Americano/Nativo de Alaska & Negro/Afro Americano
Balance/Otro
4. Marque por favor si usted pertenece a un hogar encabezado femenino:
=Si
=No
5. Describa por favor la condici6n que le calificaria como siendo considerado en una de las categorias de
presumidos ingresos bajos y moderados siguientes: nin"o abusado, esposo estropeado, persona mayor,
persona sin hogar, adulto incapacitado, persona analfabeta, o trabajador migratorio de granja:
(Description)
RECONOCIMIENTO Y NEGACION
CERTIFICO BAJO PENA DE PERJURIO QUE LAS DECLARACIONES HECHAS EN ESTA FORMA,
ACERCA DE LOS INGRESOS Y DE LAS CUENTAS DE LA CASA SON VERDADERAS.
NOMBRE: FECHA
DOMICILIO: CIUDAD :
FIRMA:
TELEFONO :
CODIGO :
La Informaci6n que usted proporciona en esta forma es para los prop6sitos del programa de fondos del
bloque del desarrollo de la comunidad (CDBG) solamente y serd mantenida confidencial.
Exhibit 3(b) Page 2 of 2
COUNTY OF SAN BERNARDINO COMMUNITY DEVELOPMENT AND HOUSING
Proiect/ Activity Title: PROJECT/CASE NUMBER:
Grand Terrace: Family Service Association - Senior Meals and GTER-19-2-05A/2992
Coordinator Services
Name/Address of Contract Agency: Date of Issue:
Family Services Association X Original: Beginning 7/1/2019
21250 Box Springs Rd., Suite, 212, Moreno Valley, CA 92557 Amendment No.:
MONTHLY PROGRAM PROGRESS AND DIRECT BENEFIT REPORT For the Month of , 20
PART I: MONTHLY PROGRAM PROGRESS REPORT
A. Units of Service Provided and Description
In the space provided under each type of service listed below, summarize what your program has accomplished during this month. Include
location, number of persons served, services/benefits provided, and a description of the clients served. Also report the number of "Units of
Service" provided, as defined in the Project/Activity Description (Exhibit 1 of the agreement). Attach additional pages if needed.
1.
2.
3.
Type of Service:
Anticipated Units of Service
Coordinated Senior Services Program activities:
Goal/Mo.: 155 Actual/Mo.:
Each senior participating in an activity counts a
one unit of service.
Senior Meals Provided at the Senior Center
Goal/Mo.: 325 Actual/Mo. :
Each senior receiving a meal counts a one unit of service.
Senior Meals Delivered to Home Bound Seniors
Goal/Mo.: 160 Actual/Mo.
Each senior receiving a meal counts a one unit of service.
B. Monthly Beneficiary Count (may include individual persons or households previously counted during this
grant/program year) Total number of beneficiaries (clients/participants) served this month (choose 1 category only):
Number of Persons OR Number of Households
PART II: DIRECT BENEFIT REPORT
Direct Benefit Statistics (Unduplicated first-time client counts since start of contract; taken from Beneficiary
Qualification Statement forms)
Enter the number of first-time program beneficiaries directly assisted this month (check one box)
Count only as: ❑ Individual Persons or ❑ Households
Extremely Low -Income: + Very Low -Income: + Low -Income:
= All Beneficiaries:
Non- Non -
Racial Identity Categories Hispanic Hispanic Hispanic Hispanic
(a) (b) (c) (d)
White American Indian/Alaskan Native & White
Black/African American Asian & White
American Indian/Alaskan Native Black/African American & White
Asian Amer. Indian/Alaskan Native & African Amer.
Native Hawaiian/Other Pacific Islander Balance/Other
Total of Racial Identity Categories: Add columns (a)+(b)+(c)+(d) from above. Match to "All Beneficiaries" total above:
Female Headed Households:
Signed: Title: Date:
Printed Name: Telephone No./Ext:
Exhibit 4 Page 1 of 1
COUNTY OF SAN BERNARDINO COMMUNITY DEVELOPMENT AND HOUSING
Proiect/ Activity Title: PROJECT/CASE NUMBER:
Grand Terrace: Family Service Association - GTER-19-2-05A/2992
Senior Meals and Coordinator Services
Name/Address of Contract Agencv:
Family Services Association
Date of Issue.
X Original: Beginning 7/1/2019
21250 Box Springs Rd., Suite, 212, Moreno Amendment No.:
Valley, CA 92557
CERTIFICATION OF CDBG FUNDED NEW OR EXPANDED SERVICE
The City of Grand Terrace certifies that the public service project described in these Attachments A & B and
associated Exhibits is either:
A New Public Service
A new public service is defined as a new service to your community which has not been previously
funded through city funds.
OR
MAn Expanded Service
An expanded public service is defined as a quantifiable increase in the level of an existing service
which has been provided by the grantee or another entity on its behalf through State or local
government funds in the 12 months preceding the CDBG contract year.
Describe the expansion of the public service:
This expanded public service will result in an increase of 5 persons per service above the
level which has been previously provided by or on behalf of the City of Grand Terrace.
OR
® This expanded public service will increase the scope of the service by adding (describe
added or expanded activities) to a public service which has been previously provided by
or on behalf of the City of Grand Terrace
The City of Grand Terrace certifies that the implementing organization:
Is a unit of local government (incorporated city, township, County department or district, community services
district, school district, etc.), or a private non-profit entity incorporated in the State of California with "active"
status; and,
Is conferred tax-exempt status by the Internal Revenue Service, pursuant to Section 501( c )(3) of the Internal
Revenue Code; and,
aIs not suspended or debarred from participating in federally funded contracts and sub awards.
Is registered in the System for Awards management (SAM).
SIGNATURE: DATE:
NAME: G. HA D DUFFEY TITLE: CITY MANAGER
Exhibit 5 Page 1 of 1