M01 CITY COUNCIL MEETING DATE: JANUARY 7, 2014 TITLE: AGREEMENT WITH NETWORK KINECTION, LLC FOR ON- THE - JOB TRAINING DEVELOPMENT SERVICES CITY MANAGER RECOMMENDED ACTION CLERK OF COUNCIL USE ONLY: APPROVED As Recommended As Amended Ordinance on 1" Reading Ordinance on 2nd Reading Implementing Resolution Set Public Hearing For_ CONTINUED TO FILE NUMBER Authorize the City Manager and Clerk of the Council to execute the attached agreement with Network Kinection, LLC in the amount of $ 127, 376 for a one - year period, subject to non - substantive changes approved by the City Manager and City Attorney. DISCUSSION In November 2011, the Department of Labor awarded the City of Santa Ana WORK Center WORK Center) $ 4, 997, 479 to fund its Bridges to Engineering program, which included a multi - agency consortium composed of three community colleges, including Santa Ana College; two non- profits; and three universities, including Cal State Fullerton and UCI. The program, intended to serve 290 students, was created with the purpose of providing academic and peer support to pre - engineering students to assist in acquiring an engineering degree. One of the foundational elements to this program includes an On- The - Job Training ( OJT) component, which has been found to increase the probability of employment when combined with classroom training. The OJT program will subsidize 50% of the new employee' s wages for up to six months to compensate the employer costs associated with training. On October 24, 2013, the WORK Center released a Request for Proposal ( RFP) for organizations to develop OJT training opportunities with local businesses for Bridges to Engineering participants as required by the H -1 B Technical Skills Training grant. Eight proposals were distributed and only two responses were reviewed and evaluated. The evaluation panel consisted of one member each from the California Employment Development Division, Rancho Santiago Community College District, and CDC Small Business Finance. Proposals were reviewed and rated based on the following criteria: past experience, comprehensiveness of services, and reasonable cost. Network Kinection, LLC, which is located in Diamond Bar, was selected. Network Kinection, LLC will be responsible for coordinating the placement of 100 program participants in science, technology, engineering and math ( STEM) related OJT or internship opportunities with private, engineering and other STEM companies. Responsibilities also include structuring training plans, preparing and submitting OJT agreements, internship agreements, and employer reimbursement request documents to the City for review, approval, and processing. 251 - 1
Transcript
M01
CITY COUNCIL MEETING DATE:
JANUARY 7, 2014
TITLE:
AGREEMENT WITH NETWORK
KINECTION, LLC FOR ON- THE -JOB
TRAINING DEVELOPMENT SERVICES
CITY MANAGER
RECOMMENDED ACTION
CLERK OF COUNCIL USE ONLY:
APPROVED
As Recommended
As Amended
Ordinance on 1" ReadingOrdinance on 2nd ReadingImplementing ResolutionSet Public Hearing For_
CONTINUED TO
FILE NUMBER
Authorize the City Manager and Clerk of the Council to execute the attached agreement withNetwork Kinection, LLC in the amount of $ 127, 376 for a one -year period, subject to non -
substantive changes approved by the City Manager and City Attorney.
DISCUSSION
In November 2011, the Department of Labor awarded the City of Santa Ana WORK CenterWORK Center) $ 4, 997, 479 to fund its Bridges to Engineering program, which included a multi -
agency consortium composed of three community colleges, including Santa Ana College; two non- profits; and three universities, including Cal State Fullerton and UCI. The program, intended toserve 290 students, was created with the purpose of providing academic and peer support to pre - engineering students to assist in acquiring an engineering degree. One of the foundational
elements to this program includes an On- The -Job Training ( OJT) component, which has beenfound to increase the probability of employment when combined with classroom training. The OJTprogram will subsidize 50% of the new employee' s wages for up to six months to compensate theemployer costs associated with training.
On October 24, 2013, the WORK Center released a Request for Proposal ( RFP) for organizations
to develop OJT training opportunities with local businesses for Bridges to Engineering participantsas required by the H -1 B Technical Skills Training grant. Eight proposals were distributed and onlytwo responses were reviewed and evaluated. The evaluation panel consisted of one member
each from the California Employment Development Division, Rancho Santiago Community CollegeDistrict, and CDC Small Business Finance. Proposals were reviewed and rated based on the
following criteria: past experience, comprehensiveness of services, and reasonable cost. NetworkKinection, LLC, which is located in Diamond Bar, was selected.
Network Kinection, LLC will be responsible for coordinating the placement of 100 programparticipants in science, technology, engineering and math ( STEM) related OJT or internshipopportunities with private, engineering and other STEM companies. Responsibilities also includestructuring training plans, preparing and submitting OJT agreements, internship agreements, andemployer reimbursement request documents to the City for review, approval, and processing.
251 -1
Agreement — Network Kinection, LLC
January 7, 2014Page 2
FISCAL IMPACT
Funds are available in the H -1 B Visa Program account (no. 13218744- 69137).
APPROVED AS TO FUNDS AND ACCOUNTS:
NaYrc Fong, AIC Francisco Gutierrez
Interim Executive irectoor Executive Director `
Community Devel pment Agency Finance & Management Services Agency
N F /CR/ kg
Exhibit: 1. Agreement
251 -2
EXHIBIT 1
Contract No.
AGREEMENT UNDER THE WORKFORCE INVESTMENT ACT
THIS AGREEMENT, made and entered into this 7a' day of January, 2014, by andbetween the City of Santa Ana, a charter city and municipal corporation duly organized and existingunder the Constitution and laws of the State of California ( "CITY ") and Network Kinection, LLC dbaMikeMarinoff,com ( "CONTRACTOR ").
RECITALS:
A. CITY has been designated a Local Workforce Investment Area ( LWIA) underthe Workforce Investment Act of 1998, Public Law 105 -220 ( "the Act ").
B. The State of California has created the LWIA to administer the Act programs
operated by the State of California pursuant to the Act.
C. As a LWIA, CITY is entitled to receive federal funds to establish programs to
increase training opportunities for unemployed individuals. One goal of California' s WorkforceInvestment System is to provide the opportunities to find retain, or advance their employment.
D. CONTRACTOR is experienced in operating education, occupationaldevelopment and employment programs for economically disadvantaged youths for entry into the labormarket ( "said program ").
E. CONTRACTOR is willing to operate said prograin pursuant to the Act andCalifornia law.
WHEREFORE, for and in consideration of the respective and mutual covenants andpromises hereinafter contained and made, and subject to all the terms and conditions hereof, the parties
hereto do hereby agree as follows:
I.
CONTRACTOR' S OBLIGATIONS
A. CONTRACTOR agrees to provide the following services pursuant to saidprogram, as more specifically set forth in CONTRACTOR'S program narrative contained in " ExhibitA ", attached hereto and by this reference incorporated herein:
Develop On- The -Job Training and internship agreements with local private, engineering andother science, technology, engineering and mathematics ( STEM) companies on behalf of the Santa AnaWORI{ Center to structure work based teaming training opportunities for 100 Bridges -to- EngineeringProgram participants.
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CONTRACTOR' S failure to provide said services may be grounds for CITY to readjustthe level of payment to CONTRACTOR otherwise provided for hereinafter.
B, CONTRACTOR agrees to provide benefits to individuals who participate in theactivities and services funded by this Agreement ( "participants ") in accordance with the standards andrequirements set forth in Workforce Investment Act of 1998, Public Law 105 -220.
C. CONTRACTOR agrees to perform the services set forth herein in a professional, timely and diligent manner.
D. RESERVED
E. CONTRACTOR shall adhere to the Labor Standards described in the Actincluding Section 181 of the Act.
F. CONTRACTOR agrees to comply with the " Complaint Handling Procedures underthe WW', attached hereto as " Exhibit B" and incorporated herein as though fully set forth in 20 CFR
667.200, Subpart F. CONTRACTOR shall advise participants of their rights to file complaints tinderthe Act and the procedures for resolution of any complaints. CITY's procedures for handlingcomplaints alleging a violation of the Act, regulations, grants, or other agreements tinder the Act shall
be followed and any decision of CITY, the State or the federal government relating to the complaintshall be binding and followed by CONTRACTOR. CONTRACTORS who are employers shall operatea grievance system that incorporates CITY's procedures for resolution of complaints relating to theterns and conditions of employment; these procedures shall be approved in writing by CITY,
G. As a condition of this award of financial assistance under the Act to
CONTRACTOR from CITY, CONTRACTOR assures, with respect to operation of all programs or
activities funded with funds provided pursuant to the Act, and all agreements or arrangements to carryout such programs or activities, that it will comply fully with the nondiscrimination and equalopportunity provisions of the Act (Section 188) and compliance with Equal Employment Opportunityprovisions in Executive Order (E.O.) 11246, as amended by E.O. 11375 and supplemented by therequirements of 41 CFR Part 60; the Nontraditional Employment for Women Act of 1991; Title VI ofthe Civil Rights Act of 1964, as amended; section 504 of the Rehabilitation Act of 1973, as amended; the Age Discrimination Act of 1975, as amended; the Americans with Disabilities Act of 1990; and
with all applicable requirements imposed by or pursuant to regulations implementing those laws, including, but not limited to, 29 CFR Part 33 and 37. The United States, the State ofCalifornia andCITY have the right to seek judicial enforcement of this assurance.
H. CONTRACTOR agrees that no participant( s) shall commence training prior to theapproval of funding pursuant to Section 123 of the Act.
I. CONTRACTOR agrees to maintain such records and submit such reports, data and
information, on the form and containing such information, at such times as CITY may request orrequire regarding the performance of CONTRACTOR' S services or activities, costs or other data,
including but not limited to, participants' attendance, payroll records and job duty statements.
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CITY, the State of California and the United States government and /or their
representatives shalt have access for purposes of monitoring, auditing and examining ofCONTRACTOR'S activities, performance, books, documents, papers, and records of CONTRACTORsubcontractors, bookkeepers and accountants, and employees and participants related to this
Agreement. Such agencies or representatives shall also schedule on -site monitoring in their discretion. Monitoring activities may also include, but are not limited to, questioning employees and participants
and entering any premises or onto any site in which any of the services or activities funded hereunderare conducted or in which any of the records of CONTRACTOR are kept. Nothing herein shall beconstrued to require access to any privileged or confidential information as set forth in federal or statelaw,
In the event CONTRACTOR does not make the above - referenced documents available
within the City of Santa Ana, California, CONTRACTOR agrees to pay all necessary and reasonableexpenses incurred by CITY in conducting any audit at the location where said records and books ofaccount are maintained.
All accounting records and evidence pertaining to all costs of CONTRACTOR and alldocuments related to this Agreement shall be kept available at the location where CONTRACTORconducted the program, as well as in the County of Orange, for the duration of this Agreement andthereafter for three ( 3) years after completion of an audit. Records which relate to ( a) complaints,
claims, administrative proceedings or litigation arising out of the performance of this Agreement, or (b) costs and expenses of this Agreement to which CITY, the State of California or the United States
Government take exception, shall be retained beyond the three ( 3) years until resolution of dispositionof such appeals, litigation, claims, or exceptions.
J. Without prejudice to any other section of this Agreement, CONTRACTORshall, where applicable, maintain the confidential nature of information provided to it concerningparticipants in accordance with the requirements of federal and state law. Notwithstanding theforegoing, CONTRACTOR agrees to submit to CITY, the State of California and/ or the United StatesGoverranent or their representatives, all records requested for administrative purposes, includingaudits, examinations, monitoring and verification of records submitted by CONTRACTOR, costsincurred and services rendered hereunder,
K. CONTRACTOR agrees to complete in triplicate, a monthly Invoice/Voucher onCITY's InvoiceNoucher form, showing in detail the amount of money already expended byCONTRACTOR hereunder, as this is a cash reimbursement contract. Accounting records must besupported by such source documentation such as cancelled checks, paid bills, payrolls, time andattendance records, contract and subgrant award documents [ 29 CFR- Subpart C, Section 97.20 ( b)( 6)].
CONTRACTOR agrees to submit the above- stated documents to the WIB Administrative Office, 1000
East Santa Ana Blvd., Suite 200, Santa Ana, California, 92701, by the tenth ( 10th) day of the monthfollowing the month in which CONTRACTOR'S services are performed. Should CONTRACTOR failto deliver said documents to CITY, CITY shall have the option to cancel this Agreement by givingCONTRACTOR ten ( 10) days written notice thereof. CONTRACTOR shall either return to the CITY
excess revenues over costs or use such excess revenues as program income by utilizing such programincome for additional training activities authorized under the Act.
L. CONTRACTOR agrees to expend all funds in accordance with all applicable
federal, state and local laws and regulations. CONTRACTOR also agrees to provide at
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CONTRACTOR' S own expense supplies and other costs of said PROGRAM.
M. CONTRACTOR shall arrange independently for an audit that includes WIAfunds received from CITY, in accordance with the Act, 20 CFR Section 667.200 and OMB Circular A- 133. CONTRACTOR shall submit one original of each required audit report to CITY within (30) daysafter the date received by CONTRACTOR. Should CONTRACTOR fail to comply with theserequirements, CITY may at its option withhold payment of funds, or disallow kinds or suspendadditional grant funds,
N. CONTRACTOR shall not expend funds pursuant to this Agreement to provideservices to any participant where costs of training are paid for by any other person or entity.
O. CONTRACTOR shall comply with the provisions of Circular A -102 of the U.S. Office of Management and Budget ( OMB) and the related " Common Rule" entitled " UniformAdministrative Requirements for Grants and Cooperative Agreements to State and Local Government ", Subpart C, paragraphs 37 and 42, Circular A -128, and all other applicable federal statutes andexecutive orders and their implementing regulations, including regulations at 29 CFR Park 97.
P. CONTRACTOR shall comply with the requirements of federal regulationsfound at 29 CFR 93 which provide that no appropriated funds may be expended by the recipient of afederal contract, grant, loan or cooperative agreement to pay any person for influencing or attemptingto influence an officer or employee of any agency, member of Congress or an officer or employee of amember of Congress in connection with awarding of any federal contract, the making of any federalgrant or loan, entering into any cooperative agreement and the extension, renewal, amendment ormodification of any federal contract, grant, loan or cooperative agreement. CONTRACTOR shall sign
a certification to that effect in a form as set forth in " Exhibit C," attached hereto and by this referenceincorporated herein. CONTRACTOR shall submit said signed certification to CITY prior to
performing any of its obligations under this Agreement and prior to any obligation arising on the partof CITY to pay any sums to CONTRACTOR under the terms and conditions of this Agreement.
Q. CONTRACTOR agrees to provide a drug -free work place and to execute acertification as set forth in "Exhibit D" attached hereto and incorporated herein by this reference.
R. CONTRACTOR, in accordance with the Child Support Compliance Act,
recognizes and acknowledges the importance of child and f<rmily support obligations and shall fullycomply with all state and federal laws relating to child and family support enforcement, including, butnot limited to: disclosure of information and compliance with earnings assignment orders, as providedin Chapter 8 ( commencing with Section 5200) of Part 5 of Division 9 of the state Family Code; and, tothe best of its knowledge is fully complying with the earnings assignment orders of all employees andis providing the names of all new employees to the New Employee Registry maintained by theCalifornia Employment Development Department ( EDD).
S. CONTRACTOR agrees to comply with all applicable provisions of the ACT andthe federal regulations, including but not limited to the regulations found at 20 CFR part 629.
T. CONTRACTOR agrees to provide priority of services for veterans and eligiblespouses pursuant to 20 CFR part 101.0 and the regulations implementing priority of service for veteransand eligible spouses in Department of Labor job training programs under the Jobs for Veterans Act
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published at 73 Fed.Reg. 78132 on December 19, 2008.
H.
CITY' S OBLIGATIONS
A. CITY agrees to pay to CONTRACTOR when, if and to the extent federal fundsare received under the provisions of the Act a sum not to exceed One Hundred Twenty SevenThousand Three Hundred Seventy Six Dollars ($ 127,376.00) for CONTRACTOR' S performance in
accordance with the payment schedule attached hereto as " Exhibit E" during the period of thisAgreement. Said sum shall be paid after CITY receives invoices submitted by CONTRACTOR asprovided hereinabove.
B. CITY agrees to provide for on -site monitoring reviews of said programoperation at least twice annually. In addition, monthly desk -top reviews of pertinent information willbe conducted.
C. CITY has the right to de- obligate the funds hereunder and take such fundingback from CONTRACTOR due to any of the following reasons: ( a) lack of performance byCONTRACTOR; ( b) lack of fiscal accountability of CONTRACTOR; or ( c) decrease in availablefunding.
III.
TIME PERIOD OF AGREEMENT
This Agreement shall commence on January 7, 201.4, and all duties arising under thisAgreement shall have been perfonned by January 6, 2015. The term of this Agreement may beextended by a writing executed by the Executive Director of the Community Development Agency andthe City Attorney.
IV.
INDEPENDENT CONTRACTOR
CONTRACTOR shall, during the entire term of this Agreement, be construed to be anindependent contractor and not an employee of the CITY. This Agreement is not intended nor shall it
be construed to create an employer - employee relationship, ajoint venture relationship, or to allow theCITY to exercise discretion or control over the professional manner in which CONTRACTORperforms the services which are the subject matter of this Agreement; however, the services to beprovided by CONTRACTOR shall be provided in a manner consistent with all applicable standards
and regulations governing such services. CONTRACTOR shall pay all salaries and wages, employer'ssocial security taxes, unemployment insurance and similar taxes relating to employees and shall beresponsible for all applicable withholding taxes.
V.
WORKER' S COMPENSATION AND EMPLOYER' S RIGHTS
A. CONTRACTOR shall use appropriate funds received from CITY to provide
workers' compensation to all those hired by CONTRACTOR under this Agreement.
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B. CONTRACTOR shall have the right to hire, dismiss, or promote its employees
or contract personnel Erred under this Agreement so long as its hiring or dismissal policy or standarddoes not violate Title VII of the Civil Rights Act of 1964, Fair Labor Standards Act of 1938, or anyother applicable law, and CONTRACTOR maintains itself as an Equal Opportunity employer.
VI.
APPLICABLE GUIDELINES
A. The parties hereto agree that CONTRACTOR shall comply with all applicablefederal and state laws and regulations, including, but not limited to the Performance StandardsExhibit A) and general program requirements described in Sections 106 and 141 of the Act (29 USC
Sections 1516 and 1551) and applicable regulations, and the U,S. Department of Labor guidelines and
regulations, including amendments or revisions made during the terms of this Agreement. Saidapplicable laws are hereby incorporated by reference and made as part of this Agreement as thoughfully set forth herein.
B. CONTRACTOR also assures and certifies that:
1. CONTRACTOR shall comply with Title VII of the Civil Rights Act of1964 ( P. L. 83 -354) and in accordance with Title VII of the Act, no person shall, on the grounds of race, color, religion, sex, age, handicap or national origin be excluded from participation in, be denied thebenefits of, or be otherwise subjected to discrimination under this Agreement.
2. CONTRACTOR shall comply with any and all federal laws limiting thepolitical activity of employees hired under this Agreement.
3. CONTRACTOR shall comply with the requirements that no programunder the Act shall involve political activities.
4. RECORD INSPECTION. CONTRACTOR shall provide the U.S.
Department of Labor and the Controller General, by and through any authorized representative, as wellas the WIB Administrative Office, access to and the right to examine all records, books, papers ordocuments relating to the accotnting and use of funds under this Agreement for a three -year periodfrom and after the effective date of this Agreement.
5. No person with responsibilities in the operation of any program under theAct shall discriminate with respect to any program participant or any application for participation insuch program because of race, creed, color, national origin, sex, political affiliation or beliefs.
6. CONTRACTOR shall maintain appropriate standards for health andsafety in work and training situations.
7. CONTRACTOR shall comply with general provisions, assurances, andcertifications attached hereto as " Exhibit F" and incorporated herein.
8. EQUAL OPPORTUNITY. Any literature distributed byCONTRACTOR for the purpose of apprising businesses, , participants, or the general public of itsprograms under this Agreement shall state that its programs are supported by the City of Santa Ana and
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the Santa Ana Workforce Investment Board, and shall state that the program is an " equal opportunityemployer /program" and that " auxiliary aids and services are available upon request to individuals withdisabilities."
9. Based on the population eligible to be served, or likely to be directlyaffected by the WIA program or activity, the services or information may need to be provided in alanguage other than English in order to allow such population to be effectively informed about or ableto participate in the program or activity. Pursuant to 29 CFR 37.35, the Contractor must take
reasonable steps to provide services and information in appropriate languages after considering thescope of the program or activity, and the size and concentration of the population that needs services orinformation in a language other than English.
10. CONTRACTOR certifies that all property, finished or unfinisheddocuments, data, studies and reports prepared or purchased under this Agreement, will be disposed ofin accordance with the direction of the CITY. In addition, any tools and /or equipment furnished to theCONTRACTOR by the CITY and/ or purchased by the CONTRACTOR with funds pursuant to thisAgreement, will be limited to use within the activities outlined in this agreement and will remain theproperty of the United States Government and/or CITY. Upon termination of this Agreement, CONTRACTOR will immediately return such tools and /or equipment to the CITY or dispose of themin accordance with the direction of the CITY.
11. CONTRACTOR certifies that this Agreement does not provide for the
advancement or aid to any religious sect, church or creed, or sectarian purpose nor does it help tosupport or sustain any school, college, university, hospital or other institution controlled by anyreligious creed, church, or sectarian denomination, as specified by Article XVI, Section 5, of theConstitution of the State of California, regarding separation of church and state.
12. PATENT, COPYRIGHTS AND RIGHTS IN DATA. The
CONTRACTOR will disclose to the CITY any invention, written product, computer programdeveloped or data assembled as a result of performance ofwork under this Agreement within seventyfour (74) days of invention, development or assembly. The CITY, State of California, and U.S. Department of Labor will have the right to patent any invention and copyright any written product orcomputer program or data generated by CONTRACTOR. Upon written request, CONTRACTOR will
transfer all pertinent information, specifications and right, title and interest to the designated agency.
13. INVENTIONS, PATENTS AND COPYRIGHTS.
A. Reporting Procedure. If any project produces patentable items, patent rights, processes, or inventions in the course of work under a U.S. Department of Labor (DOL) grant oragreement, the CONTRACTOR shall report the fact promptly and fully to the CITY. The CITY shallreport the fact to the Grant Officer, at the DOL. Unless there is a prior agreement between the CITYand the DOL and its representative on these matters, the DOL shall determine whether to seekprotection on the invention or discovery. The DOL and its representative shall determine how therightsin the invention or discovery, including rights under any patent issued thereon, will be allocatedand administered in order to protect the public interest consistent with the "Governmental PatentPolicy" (President' s Memorandum for Heads of Executive Departments and Agencies, August 23, 1971, and Statement of Government Patent Policy as printed in 36 FR 16889).
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B. Copyright Policy,
1. Unless otherwise provided in the tenns of the grant or agreement, when copyright - able material is developed in the course of or under a DOL Grant or agreement, the author and theCITY which developed the work is free to copyright material or to permit others to do so. The
CONTRACTOR and the Workforce Investment Board (WIB) shall have a royalty -free, nonexclusiveand irrevocable license to reproduce, publish, use and to authorize others to use all copyrightedmaterial.
2. The DOL reserves a royalty -free, nonexclusive, and irrevocable license toreproduce, publish or otherwise use, and to authorize others to use, for Federal Government purposes:
a) The copyright in any work developed under any grant, sub - grant, or contract under a grant orsubgrant; ( b) Any right of copyright to which a grantee, subgrantee or a CONTRACTOR purchasesownership with grant support; and ( c) CONTRACTOR shall comply with the requirements of 29CFR Part 97. 34,
C. nights to Data. The DOL and the CITY shall have unlimited rights to any datafirst procured or delivered under this Agreement.
14. CLEAN AIR / CLEAN WATER ACT. If the grant hereunder
exceeds $ 100, 000, CONTRACTOR must comply with Section 306 of the Clean Air Act [( 42 USC1875( h)]; Section 508 of the Clean Water Act (33 USC. 1368); Executive Order 11738 and
Environmental Protection Agency ( "EPA ") regulations (40 CFR Part 15) as any may now exist or behereafter amended. Under these laws and regulations, the CONTRACTOR assures that:
a) No facility to be utilized in the performance of the proposed grant has been listedon the EPA List ofViolating Facilities;
b) It will notify CITY prior to award of the receipt of any communication from theDirector, Office of Federal Activities, U.S. EPA, indicating that a facility to beutilized for the grant is under consideration to be listed on the EPA List of
Violating Facilities; c) It will notify the CITY and the EPA about any known violation of the above laws
and regulations.
C. CONTRACTOR agrees to adhere to the following STANDARDS OF CONDUCT:
1. General Assurance, Every reasonable course of action will be taken by CONTRACTOR inorder to maintain the integrity of this expenditure ofpublic funds and to avoid favoritism. ThisAgreement will be administered in an impartial manner, free from errors to gain personal, financial
political gain. CONTRACTOR, its officers and employees, in administering this Agreement, willavoid situations which give rise to a suggestion that any decision was influenced by prejudice, bias, special interest or desire for personal gain.
2. Emplovment ofFormer State or CITY Employees, CONTRACTOR will ensure that any ofits employees who were formerly employed by the State of California or CITY, in a position that could
have enabled such individuals to impact policy regarding or implementation of programs covered bythis Agreement, will not be assigned to any part or phase of the activities conducted pursuant to thisAgreement for a period of not less than two ( 2) years following the termination of such employment.
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3. Conducting Business Involving Relatives. No relative by blood, adoption ormarriage of any executive or employee of CONTRACTOR will receive favorable treatment when
considered for enrollment in programs provided by, or employment with, CONTRACTOR.
4. Conducting Business Involving Close personal Friends and Associates. Executives
and employees of CONTRACTOR will be particularly aware of the varying degrees of influence thatcan be exerted by personal friends and associates and, in administering this Agreement, will exercisedue diligence to avoid situations which give rise to an assertion that favorable treatment is beinggranted to friends and associates. When it is in the public interest for CONTRACTOR to conductbusiness with a friend or associate of an executive or employee of CONTRACTOR, an elected officialin the area or a voting or non - voting member of the Workforce Investment Board (WIB), a permanentrecord of the transaction will be retained.
5. Avoidance of Conflict of Economic Interest. No executive or employee of
CONTRACTOR or voting or non - voting member of a WIB, will solicit or accept money or any otherconsideration from a third person, for the performance of an act reimbursed in whole or part byCONTRACTOR or CITY. Supplies, materials, equipment or services purchased with Agreement
funds will be used solely for purposes asserted or allowed under this Agreement. No voting member ofthe WIB will cast a vote on the provision of services or vote on any matter which would provide directfinancial benefit to that member or any business or organization which the member directly represents.
6. Salary and Bonus Limitations. All subrecipients of WIA program funds are required tocomply with federal requirements regarding the limitations on salary and bonus payments inaccordance with Public Law 109 -149, Section 7013.
VII.
HOLD HARMLESS
A. CONTRACTOR shall indemnify and save harmless CITY, its officers, agentsand employees, from and against any and all damages to property or injuries to or death of any personor persons, including property and employees or agents of CITY, and shall defend, indemnify and saveharmless CITY, its officers, agents and employees, from any and all claims, demands, suits, actions orproceedings of any kind or nature, including, but not by way of limitation, workers' compensationclaims, resulting from or arising out of the negligent acts, errors or omission of CONTRACTOR, itsemployees or subcontractors.
B. CONTRACTOR shall indemnify and save hanuless CITY, its officers, agentsand employees, from and against any and all damages to property or injuries to or death of any personor persons, including property and employees or agents of CITY, and shall defend, indemnify and saveharmless CITY, its officers, agents and employees, from and against any and all claims, demands, suits, actions or proceedings therefore, resulting from or arising out of the intentional or malicious acts ofCONTRACTOR, its employees or subcontractors.
C. Both parties to this Agreement shall agree to defend, indemnify, and holdharmless the other party, its officers, agents, employees, and volunteers, from and against all loss, cost, and expense arising out of any liability or claim of liability, sustained or claimed to have beensustained, arising out of activities, or the performance or nonperformance of obligations under this
Agreement, of the indemnifying party, or those of any of its officers, agents, employees, or volunteers.
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The provisions of this Article do not apply to any damage or losses caused solely by the negligence ofthe non - indemnifying party or any of its agents or employees.
VIII.
INSURANCE
1. Commercial General Liability. CONTRACTOR agrees to obtain and keep in forceduring the term of this Agreement a policy of comprehensive commercial public liability insuranceinsuring the State of California, CITY, and CONTRACTOR against any liability for accident, injury ordeath arising out of or in consequence of this Agreement. Such insurance shall be in an amount notless than One Million Dollars ($ 1, 000,000.00) for any injury to or death of any person or persons inany single accident or occurrence. Said policy of comprehensive insurance shall be endorsed to
provide to CITY and to the State of California, Employment Development Department, at least thirty30) days written notice prior to cancellation; name CITY, its officers, agents, employees, and
volunteers, and the State of California, its officers, employees, and volunteers as additional insured; and state that such coverage is primary to any other coverage or self - insurance of the State of Californiaand CITY. Governmental entities may substitute a certificate of self- insurance.
2. Automobile Liability Coverage CONTRACTOR shall also obtain and maintain, during the effective period of this Agreement, broad form automobile liability coverage with a
1, 000,000 limit tmless reduced by CITY, which applies to both owned /leased and non -ownedautomobiles used by CONTRACTOR employees or participants in performance of this Agreement, or, in the event that CITY will not utilize such owned /leased automobiles but intends to requireemployees, participants or other agents to utilize their own automobiles in the performance of this
Agreement, CONTRACTOR shall secure and maintain on file from all such employees, participants, oragents as self - certification of automobile insurance coverage. Governmental entities may substitute acertificate of self - insurance.
3. Workers' Compensation. If CONTRACTOR is an " employer ", as set forth inCalifornia Labor Code Section 3300 et seq., or utilizes participants as " employees," as set forth inCalifornia Labor Code Section 3350 et seq., CONTRACTOR shall obtain and keep in force during theterm of this Agreement full Workers' Compensation insurance coverage .for injuries suffered byparticipants. Said insurance policy shall guarantee CITY at least thirty (30) days written notice ofcancellation or modification. CONTRACTOR shall carrymedical and accident insurance for thoseparticipants not qualifying as " employees" for Worker' s Compensation Coverage, pursuant toCalifornia Labor Code Section 3350, et seq.
4. Equipment Coverage. CONTRACTOR shall purchase a policy or policies ofinsurance covering loss or damage to any and all Equipment provided to or purchased byCONTRACTOR in accordance with this Agreement. Said insurance shall be in the amount of the fullreplacement value thereof, providing protection against the classification of fire, extended coverage,
vandalism, malicious mischief, theft, and special extended perils. Governmental entities maysubstitute a certificate of self- insurance.
5, Proof of Insurance. Certificates and endorsements must be submitted and approved byCITY prior to any work under this Agreement. CONTRACTOR understands that CITY will make no
payments under this Agreement until the required certificates and endorsements have been approved byCITY.
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IX.
CORPORATESTATUS
All corporate CONTRACTORS shall be in good standing, without suspension by theCalifornia Secretary of State, Franchise Tax Board and Internal Revenue Service. Any change incorporate status or suspension shall be reported immediately to CITY.
X.
ASSIGNABILITY
None of the duties of, or work to be performed by, CONTRACTOR under this Agreementshall be subcontracted or assigned to any agency, consultant, or person without the prior writtenconsent of CITY. CONTRACTOR must submit all subcontracts and other agreements that relate tothis Agreement to CITY. No subcontract or assignment shall terminate or alter the legal obligations ofCONTRACTOR under the terms of this Agreement.
XI.
LAWS GOVERNING THIS AGREEMENT
In its performance under this Agreement, CONTRACTOR shall fully comply with therequirements of the following, whether or not otherwise referred to in this Agreement:
1, The Act and all applicable federal statutes, regulations, policies, procedures and directives, including but not limited to, 20 C. F.R. Parts 652 and 660 through 671.
2. All applicable State statutes, regulations, policies, procedures and directives;
3. All applicable CITY policies, procedures and directives;
4. All applicable local ordinances and requirements, including use permits and licensing;
5. Court orders applicable to its operation; and,
6. The terns and conditions of this Agreement.
If any of the foregoing is enacted, amended, or revised, CONTRACTOR will comply withsuch or will notify CITY after enactment or modification that it cannot so comply. CITY maythereupon terminate this Agreement, if necessary.
XII.
EXCLUSIVITY AND AMENDMENT OF AGREEMENT
This Agreement supersedes any and all other agreements, either oral or in writing, between the parties hereto with respect to the employment of CONTRACTOR by CITY, and containsall the covenants and agreements between the parties with respect to such employment. Each party tothis Agreement acknowledges that no representations, inducements, promises or agreements, orally orotherwise, have been made by any party, or anyone acting on behalf of any party, which are not
251- 13 Page 11 of 15
embodied herein, and that no other agreement or amendment hereto shall be affective unless executed
in writing and signed by both CITY and CONTRACTOR.
XIII.
FRAUD
CONTRACTOR shall immediately report to CITY all instances and facts concerningpossible fraud, abuse or criminal activity relating to expenditure or receipt of funds under thisAgreement,
XIV.
CONTINGENCY OF FUNDS
CONTRACTOR acknowledges that approval of and funding for this Agreement iscontingent upon Federal approval, and funds received or obligated from the Department of Labor to
CITY. If such approval of funds is not forthcoming, or is otherwise limited, CITY shall immediatelynotify CONTRACTOR. Within twenty ( 20) days of receipt of such notice, CONTRACTOR shallmodify or cease operations as directed by CITY and negotiate necessary modification to thisAgreement and/or reimbursement of costs incurred hereunder.
XV.
TERMINATION
A. This Agreement may be terminated by either party at its sole discretion, upon thirty ( 30) days written notice to the other party. Notice shall be deemed served on the date of mailing. However, CONTRACTOR may not terminate this Agreement if undue hardship will result to any participant.
B. In the event CONTRACTOR defaults by failing to fulfill all or any of its obligationshereunder, CITY may declare a default and termination of this Agreement by written notice toCONTRACTOR, which default and termination shall be effective on a date stated in the notice which is
to be not less than ten ( 10) days after certified mailing or personal service of such notice, unless suchdefault is cured before the effective date of termination stated in such notice. If terminated for cause,
CITY shall be relieved of further liability or responsibility under this Agreement, or as a result of thetermination thereof, including the payment of money, except for payment for approved expenses incurredfor services satisfactorily and timely performed prior to the mailing or service of the notice of termination, and except for reimbursement of (1) any payments made for services not subsequently performed in atimely and satisfactory manner, and ( 2) costs incurred by CITY in obtaining substitute performance.
XVI.
DISPUTES
Except as otherwise provided in this Agreement, any dispute concealing any questionarising under this Agreement shall be decided by CITY. In such a case CITY shall reduce its decisionto writing and mail or otherwise furnish a copy thereof to CONTRACTOR. The decision of the Cityshall be final and conclusive unless within thirty (30) calendar days from the mailing or delivery ofsuch copy, CITY receives from CONTRACTOR written request to appeal said decision,
Procedures governing the appeal shall be prescribed by CITY and /or the State ofCalifornia in accordance with the Act and all corresponding regulations and OMB circulars. Pending
2 51 - 1 4 Page 12 of 15
final disposition of the appeal, CONTRACTOR shall act in accordance with CITY's decision unlessthe dispute involves a change order,
XVII.
BREACH - SANCTIONS
If, through any cause, CONTRACTOR violates any of the terms and conditions of thisAgreement, and/ or prior agreements whereby grant funds were received by CONTRACTOR pursuantto this Agreement, or if CONTRACTOR reports inaccurately or if any Audit Report makesdisallowances, CONTRACTOR shall promptly remedy its acts or omissions and /or repay CITY allamounts due CITY as a result of CONTRACTOR's violation, For any such failures or violations, CITY shall also have the right at its sole discretion to either: ( 1) discontinue program support until
such time as CONTRACTOR fulfills its obligations or remedies all violations of this agreement or
prior agreements; and/ or ( 2) collect outstanding amounts as determined by CITY due CITY byoffsetting or debiting from current claims or invoices, if after thirty ( 30) days' written noticeCONTRACTOR has failed to repay same or a repayment schedule has not been made; and/ or ( 3) terminate this Agreement by giving written notice to CONTRACTOR of such termination inaccordance the notice provision in Paragraph XVIII herein below.
XVIII.
NOTICES
All notices, reports and correspondence between the parties hereto respecting thisAgreement shall be in writing and deposited in the United States Mail, postage prepaid, addressed asfollows:
CITY: City of Santa AnaManager, WIB Administrative Office
P. O. Box 1988 ( M -73)
Santa Ana, CA 92702
CLERK: Clerk of the City CouncilCity of Santa Ana20 Civic Center Plaza (M -30) P,O. Box 1988
Santa Ana, CA 92702 -1988
Telefacsimile (714) 647 -6956
CONTRACTOR: Network Kinection, LLC
c/ o Mike Marinoff
1142 S. Diamond Bar Blvd #160
Diamond Bar CA, 91765
Telephone: ( 714) 305 -2311
Telefacsimile: ( 714) 549 -8109
2 51 - 1 5 Page 13 of 15
XIX.
MERGER
This Agreement, together with the attachments hereto, expresses the total understandingof the parties. There are no oral understandings of the parties or terms and conditions other than asstated herein.
XX.
VALIDITY
The invalidity in whole or in part of any provision of this Agreement shall not void oraffect the validity of any other provision of this Agreement.
XXI.
MISCELLANEOUS PROVISIONS
a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall
indemnify City fully, including reasonable costs and attorney' s fees, for any injuries or damages to CITYin the event that such authority or power is not, in fact, held by the signatory or is withdrawn.
b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth inthe body of this Agreement.
251 -16 Page 14 of 15
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year firstabove - written.
ATTEST:
Maria D. Huizar
Clerk of the Council
APPROVED AS TO FORM:
Sonia R. Carvalho
City Attorney
inLisa E. Storck
Assistant City Attorney
CITY OF SANTA ANA, a municipalcorporation of the State of California
CITY"
amDavid Cavazos
City Manager
CONTRACTOR'
Network Kinection, LLC
By: Michael Marinoff
Executive Director /Chief Operating OfficerTax ID #:
251 -17 Page 15 of 15
Bridles- to- Eneineerine On The Job TrainineScope of Work
Develop On- The -Job Training and internship agreements with local private, engineering and otherscience, technology, engineering and mathematics ( STEM) companies on behalf of the Santa Ana
WORK Center to structure work based learning training opportunities for Bridges -to- Engineeringprogram participants,
1. Develop OJT and internship placements for 100 program participants. The Santa Ana WORKCenter will determine which participants will receive OJT, and which participants will receiveinternships based on program needs and requirements.
2. Recruit local private businesses to develop Engineering and other STEM related OJT andinternship agreements on behalf of the Santa Ana WORK Center.
3. Collect and review all OJT and internship related documentation and submit to Santa AnaWORK Center for review, approval, and processing, including:
a. OJT Contract Documents (Attachment I)
Three original signed copies of agreement are to be submitted. Once agreement is
approved by the City of Santa Ana, a copy of the agreement and OJT Invoice Forms willbe mailed to the employer.
b. OJT Employer Reimbursement Invoice (Attachment II) and supporting documentationincluding timecards, payroll registers, and cancelled checks. Payment requests by theOJT employer are to be submitted to the Santa Ana W /O /R/K Center on a billing cycleagreed to by both the employer and the OJT Program Coordinator (monthly is preferred); using the City of Santa Ana OJT Invoice form. OJT invoices must representreimbursement requests for hours worked in specified time periods which shouldcoincide with the regular payroll schedule of the OJT employer. However an OJT
employer may not request reimbursements more often than on a monthly basis. Note: Adefined work week may not exceed more than 40 working hours. OJT reimbursementsrequests must not reflect hours for company paid holidays, comp time, over time or sickleave or any time above a 40 hour work week.
c. Internship Documents ( Attachment IIl)
4, Submit monthly progress reports.
This project will be conducted in a manner that is consistent with the provisions of the Workforce
Investment Act and other provisions found in the H -1B Technical Skills Training grant.
a Poe
PROJECT TIMELINE
Enrollment Goal:
The enrollment goal is 100 placements ofprogram participants.
The employer recruitment goal is 20 to 25 companies for the 100 placements of program participants.
261Iglla
ATTACHMENT
1. Pre Award Survey
2, OJT Agreement Template
3. Exhibit A: Training Plan
4. Exhibit B: Assurances
5. Exhibit C: Insurance commercial /workers comp for 1, 000,000 with Additional InsuredEndorsement naming City of Santa Ana as Additional Insured. Insurance must be approvedby City Attorney prior to commencement of OJT.
6. Exhibit D: Drug Free Workplace Form completed and signed
7. Exhibit E: Debarment Certification signed
S. ADA Survey
9. Grievance Procedures
10. W9 and W9 Request Forms
251 -20
On the Job Training Pre Award SurveyBUSINESS NAME:
ADDRESS:
STATE TAX I.D. #_
FEDERAL TAX I.D. #
YES NO1. The business does provide worker' s compensation coverage.
Policy Number: 2. The business does provide General Liability Insurance in the amount of
One Million Dollars ($ 1, 000,000). Policy must identify the City of Santa Ana asthe certificate holder.
3. The system used for business accounting does document cash received, state andfederal tax withholdings, FICA deductions.
4. The business has not been cited for any health, safety, wage and hour, or childlabor violations during the past 12 months.
5. The business maintains a grievance and /or complaint handling procedures foremployees.
6. The prospective OJT client is not a former employee of the business.
7. Wages for the planned OJT position are wages comparable to similar positions.
8. A written job description for this position is on file.
9. Union concurrence has been obtained. NA
10. Business license is current,
11. The business does not have a history of failing to provide OJT participants with continued long term employment.
12. The business has not had any employees laid off in the past 6 months.
13. The business is financially stable and has the means to train and pay for the prospective OJT employee.
The employer stipulates and agrees by signing below that the establishment in which on- the -jobtraining will be given:
1) Has not been moved from any previous location less than 120 days prior to the effective date of theOJT contract.
2) Is not a branch, affiliate or subsidiary of a business entity in another location which has, at any timesubsequent to the date of the OJT contract, relocated or expanded so as to cause an increase in
unemployment or the closing down of operations in which the entity conducts business operations,
TOTAL WORKFORCE #
Employer Date OJT Coordinator /Case Manager Date
Carlos de Is Rive Date
Economic Development Specialist
CONTRACT RECOMMENDED: YES NO
Date
251 -21 Rev. 8/ 2012
Agreement No,
ON -THE -JOB TRAINING AGREEMENTUNDER THE WORKFORCE INVESTMENT ACT
THIS AGREEMENT is made and entered into this DAB' day of MONTH, YEARbetween the City of Santa Ana, a charter city and mmiicipal corporation duly organized andexisting under the Constitution and laws of the State of California ( hereinafter " CITY ") andCOMPANY NAME (Hereinafter " EMPLOYER ").
WITNESSETH
Recitals:
A. CITY has been designated a Local Workforce Investment Area ( " LWIA ")
pursuant to Section 116 of the Workforce Investment Act ( "WIA "), P. L. 105 -220, 29 USCSection 2801, to receive federal founds to promote effective delivery of job training services tolocal area residents.
B. The State of California has created the California Workforce Investment Boardpursuant to Section 111 of the Workforce Investment Act, P. L. 105 -220, 29 USC 2821 to
administer the WIA programs operated by the State of California.
C. As a LWIA, CITY is entitled to receive federal funds to establish programs to
prepare eligible unskilled youth, adults and dislocated workers for entry into the labor market, and to provide job training to those individuals who 'face serious barriers in obtaining productiveemployment ( "said Program ").
D. EMPLOYER is able and willing to train eligible unskilled applicants for entryinto the labor market and is willing to operate said program pursuant to the WIA and applicablefederal, state and local laws.
WHEREFORE, for and in consideration of the respective and muwal covenants andpromises hereinafter contained and made, and subject to all the terms and conditions hereof, the
parties hereto do hereby agree as follows:
Tenn. The effective term of this Agreement is for the period beginning START DATIE, and ending END DATE. The teen of this Agreement 'maybe extended upon agreementofall parties and execution of an amendment of the term.
2. Scone of Work. The EMPLOYER shall employ and train one employee ( hereinafterTrainee ") in the occupation and in accordance with the OJT Training Outline set forth in
Exhibit A, attached hereto and incorporated herein by this reference.
251 -22
Said Trainee shall be referred by the City of Santa Ana W /O /R/K Center. Training mustsignificantly raise the Trainee from his /her prior position in both level of skill and salaryby the end of the training period.
3. Fun in . CITY shall reimburse the EMPLOYER an amount not to exceed $ DQLLARAMOUNT in accordance with the Cost Computation included in Exhibit A.
EMPLOYER shall bill the CITY monthly on an invoice provided by CITY for actual andreasonable cost for providing the services described in this Agreement. Reimbursementof EMPLOYER under this Agreement shall be limited to the costs incurred during thebasic work week, excluding overtime and any paid holidays or sick leave.
4. Subcontracting Prohibited. The EMPLOYER shall not subcontract or assign the OJT
Training. Any attempt by the EMPLOYER to delegate or assign OJT training dutiesunder this Agreement shall void, and permit CITY to immediately terminate, thisAgreement.
5. Employer Obligations. During the training, the EMPLOYER shall ensure that theTrainee:
a. is on the EMPLOYER's payroll, not paid as a contracted employee /independentcontractor; and,
b. receives the same benefits as EMPLOYER's other employees performing similarwork; and,
C. is paid the salary as indicated in Exhibit A with appropriate payroll taxes withheldand reported; and,
d. is provided Worker's Compensation Insurance coverage, pursuant to state law; and,
e. is provided by EMPLOYER with safety instructions and equipment necessary forreasonable protection against injury and damage. CONTRACTOR shall maintain
appropriate standards for health and safety in work and training situations. Where specialclothing or equipment is provided to the EMPLOYER's regular employees, EMPLOYERshall provide the same type of clothing or equipment to the Trainee performing similarwork.
6. Employment of Trainee. The EMPLOYER shall employ the Trainee as a regularmember of EMPLOYER' s work force. If EMPLOYER wants to continue to employ theTrainee upon the successful completion of the training period under this Agreement, saidemployment shall be subject to the same conditions of employment applied to
EMPLOYER's other regular employees, including termination for unsatisfactoryperformance.
2
251 -23
7. Patent. Copyrights and Rights in Data. The EMPLOYER will disclose to the CITY anyinvention, written product, computer program developed or data assembled as a result of
performance of work under this Agreement within seventy four (74) days of invention, development or assembly. The CITY, State of California, and U.S. Department of Laborwill have the right to patent any invention and copyright any written product or computerprogram or data generated by EMPLOYER. Upon written request, EMPLOYER willtransfer all pertinent information, specifications and right, title and interest to the
designated agency.
8. INVENTIONS, PATENTS AND COPYRIGHTS.
A. Reporting Procedure. If any project produces patentable items, patentrights, processes, or inventions in the course of work under a U. S. Department of Labor (DOL)
grant or agreement, the CONTRACTOR shall report the fact promptly and fully to the CITY. The CITY shall report the fact to the Grant Officer, at the DOL. Unless there is a prioragreement between the CITY and the DOL and its representative on these matters, the DOL shalldetermine whether to seek protection on the invention or discovery, The DOL and its
representative shall determine how the rights in the invention or discovery, including rightsunder any patent issued thereon, will be allocated and administered in order to protect the publicinterest consistent with the " Governmental Patent Policy" ( President's Memorandum for Headsof Executive Departments and Agencies, August 23, 1971, and Statement of Government PatentPolicy).
B. Copyright Policy.
1. Unless otherwise provided in the terms of the grant or agreement, whencopyright -able material is developed in the course ofor under a DOL Grant or agreement, the
author and the CITY which developed the work is free to copyright material or to permit others
to do so. The EMPLOYER and the Workforce Investment Board (WIB) shall have a royalty - free, nonexclusive and irrevocable license to reproduce, publish, use and to authorize others touse all copyrighted material.
2. The DOL reserves a royalty -free, nonexclusive, and irrevocable license toreproduce, publish or otherwise use, and to authorize others to use, for Federal Government
piuposes: ( a) The copyright in any work developed under any grant, sub -grant, or contract undera grant or subgrant; ( b) Any right of copyright to which a grantee, subgrantee or a EMPLOYERpurchases ownership with grant support; and ( c) EMPLOYER shall comply with therequirements of 29 CFR Part 97.34.
C. Rights to Data. The DOL and the CITY shall have unlimited rights to
any data first procured or delivered under this Agreement.
9. Hold Harmless. The EMPLOYER shall indemnify, defend and hold harmless CITY, andits officers, agents and employees, from and against any and all damages to property orinjuries to or death of any person or persons, including property and employees or agentsof CITY, and shall indemnify, defend and hold harmless CITY, and its officers, agentsand employees, from any and all claims, demands, suits, actions or proceedings of anykind or nature, including, but not limited to, workers' compensation claims, resulting
251 -24
from or arising out of the negligent acts, errors or omissions of EMPLOYER, itsemployees, agents or subcontractors.
10. Insurance. The EMPLOYER shall obtain at its sole cost and file with the City of SantaAna — Santa Ana W /O /R/K Center, upon execution of this Agreement, and maintain for
the period covered by this Agreement, a policy or policies of commercial general liabilityinsurance or a certificate of such insurance, satisfactory to the City Attorney of CITY, naming CITY, and its officers, agents and employees, as insured or additional insuredsee attached Additional Insured Endorsement, Exhibit C), which provides coverage not
less than that provided in the form of a comprehensive general liability insurance policyagainst liability for any and all claims and suits for damages or injuries to persons orproperty resulting from or arising out of operations of EMPLOYER, and its officers, agents, or employees. Said policy or policies of insurance shall provide coverage forboth bodily injury and property damage in no less than One Million Dollars ($1, 000,000). Said policy of comprehensive public liability insurance shall be endorsed to provide toCITY and to the State of California, Employment Development Department, at leastthirty ( 30) days written notice prior to cancellation; name CITY, its officers, agents, employees, and volunteers, and the State of California, its officers, employees, and
volunteers as additional insured; and state that such coverage is primary to any othercoverage or self - insurance of the State of California and CITY. Governmental entitiesmay substitute a certificate of self- insurance.
11. Record Keeain . CITY, the State of California and the United States government and /or
their representatives shall have access for purposes of monitoring, auditing andexamining of EMPLOYER' S activities, performance, books, documents, papers, andrecords of EMPLOYER' S subcontractors, bookkeepers and accountants, and employees
and participants related to this Agreement. Such agencies or representatives shall also
schedule on -site monitoring in their discretion. Monitoring activities may also include, but are not limited to, questioning employees and participants and entering any premisesor onto any site in which any of the services or activities fiinded hereunder are conductedor in which any of the records of EMPLOYER are kept. Nothing herein shall beconstrued to require access to any privileged or confidential information as set forth infederal or state law.
In the event EMPLOYER does not make the above- referenced documents available
within the City of Santa Ana, California, EMPLOYER agrees to pay all necessary andreasonable expenses incurred by CITY in conducting any audit at the location where saidrecords and books of account are maintained.
All accounting records and evidence pertaining to all costs of EMPLOYER and alldocuments related to this Agreement shall be kept available at the location where
EMPLOYER conducted the program, as well as in the County of Orange, for the durationof this Agreement and thereafter for three ( 3) years after completion of an audit. Records
which relate to ( a) complaints, claims, administrative proceedings or litigation arising outof the performance of this Agreement, or ( b) costs and expenses of this Agreement towhich CITY, the State of California or the United States Government take exception,
4
251 -25
shall be retained beyond the three ( 3) years until resolution of disposition of such appeals,
litigation, claims, or exceptions,
12. Government Funding. This Agreement is valid and enforceable only if sufficient fundsare made available to the State by the United States Government for the same Fiscal Yearas for this Program. In addition, this Agreement is subject to any additional restrictions, limitations, or conditions enacted by Congress or any statute enacted by Congress whichmay affect the provision, terms or funding of this Agreement in any manner.
13. Payment Cap, City' s OJT payments to EMPLOYER shall not exceed a maximum offifty percent ( 50 %) of the wages paid by EMPLOYER during the training periodspecified in Exhibit A.
14. Amendment of Agreement. No alteration or variation of the terms of this Agreement
shall be valid and /or binding unless made in writing and signed by both parties. Thereare no oral understandings or agreements between the parties.
15. Breach/Sanctions. If, through any cause, EMPLOYER violates any of the terms andconditions of this Agreement, or if EMPLOYER reports inaccurately or if any AuditReport makes disallowances, EMPLOYER shall promptly remedy its acts or omissionsand /or repay CITY all amounts due CITY as a result of EMPLOYER's violation. For anysuch failures or violations, CITY shall also have the right at its sole discretion to either:
1) discontinue program support until such time as EMPLOYER fulfills its obligations or
remedies all violations of this agreement or prior agreements; and/or ( 2) collect
outstanding amounts as determined by CITY due CITY by offsetting or debiting fromcurrent claims or invoices, if after thirty (30) days' written notice EMPLOYER has failedto repay same or a repayment schedule has not been made; and /or ( 3) terminate thisAgreement by giving written notice to EMPLOYER of such termination in accordancethe notice provision in Paragraph XVIII herein below.
16. Termination. Either party may tenninate this Agreement upon thirty ( 30) days priorwritten notice to the other party. However, the CITY may immediately terminate thisAgreement at such time as funds are not made available to CITY through the UnitedStates Department of Labor or the State of California Employment Development
Department for the purpose of carrying out this Agreement.
17, Independent Contractor. The EMPLOYER, and any agents and employees of theEMPLOYER, in the performance of this Agreement, shall act in an independent capacityas independent contractors and not as officers, employees, or agents of the CITY. This
Agreement is not intended nor shall it be construed to create an employer - employee
relationship between EMPLOYER and CITY, nor a joint venture relationship. TheEMPLOYER shall not subcontract in the name of the CITY.
18. Equal Employment Opportunities. The EMPLOYER warrants that it will comply withTitle VI of the Civil Rights Act of 1964, . and the requirements relating to equalemployment opportunities set forth in Executive Order No. 11246, as amended by E. O.
251 -26
11375 and supplemented by the requirements of 41 CFR Part 60. EMPLOYER will alsocomply with all applicable federal and state laws and regulations, and particularly thoseassurances and certifications set forth in Exhibit B attached hereto and by this referenceincorporated herein.
19. Prohibitions. The EMPLOYER shall not use any of the training fiords provided underthis Agreement for political or sectarian activities.
20. Grievance Procedure. The EMPLOYER shall continue to operate, or shall establish andmaintain a grievance or complaint handling procedure relevant to the terms andconditions of employment and the EMPLOYER' s activities and programs, which shallmeet at a minimum the requirements set forth in Section 101 (31) of the Act and 663. 700-
710 and regulations promulgated by the State or Federal Govenunent. Employers that donot have a grievance or complaint handling procedure shall use the procedures prescribedby the CITY.
21. Guidelines. The CITY shall make the WIA applicable federal regulations and policyguidelines available to EMPLOYER at CITY — W /O /R/ K Center, 1000 E. Santa. AnaBlvd., Suite 200, Santa Ana, California 92701, The CITY shall also inform the
EMPLOYER of changes in the WIA regulations or policy guidelines if such changesaffect the operation of this Agreement.
22. Drug Free WoLkTlace. The EMPLOYER agrees to provide a drug -free work place and toexecute a certification as set forth in Exhibit D attached hereto and incorporated herein bythis reference.
23. Notices. All notices, reports and correspondence between the parties hereto respectingthis Agreement shall be in writing and deposited in the United States mail, postageprepaid, addressed as follows:
CITY:
City of Santa Ana — Santa Ana WORK Center1000 E. Santa Ana Blvd., Suite 200
Santa Ana, CA 92701
Attention: WORK Center Director
BUSINESS NAME. ADDRESSCITY, STATE ZIPATT: NAME
251 -27
24. Debarment. To protect the public interest and ensure the integrity of Federal programs, CITY may only conduct business with responsible persons and may not make any awardor permit any award to any party which is debarred or suspended or is otherwise excludedfrom or ineligible for participation in Federal assistance programs under Executive Order
12549, " Debarment and Suspension ", See also 29 CRP Parts 97.35 and 98. 510.
EMPLOYER must review and sign Exhibit E " Debarment ", which is attached hereto and
incorporated herein by this reference.
24. Merger. This Agreement, together with the attachments hereto, expresses the total
understanding of the parties. There are no oral understandings of the parties or terms andconditions other than as stated herein.
25. Validity. The invalidity in whole or in part of any provision of this Agreement shall notvoid or affect the validity of any other provision of this Agreement.
26, Miscellaneous Provisions.
a. Each undersigncd represents and warrants that its signature hereinbelow has the power,
authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify CITY fully, including reasonable costs and attorney' s fees, for anyinjuries or damages to CITY in the event that such authority or power is not, in fact, held bythe signatory or is withdrawn.
b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully setforth in the body of this Agreement.
7
251 -28
IN WITNESS WHEREOF, the parties hereto Have executed this Agreement the date andyear first above written.
ATTEST:
Maria D. Huizar
Clerk of the Council
APPROVED AS TO FORM:
Sonia R. Cawalho
City Attorney
By: Lisa StorckAssistant City Attorney
RECOMMENDED FOR APPROVAL:
Nancy Fong, AICPInterim Executive Director
Community Development Agency
CITY OF SANTA ANA
David Cavazos
City manager
EMPLOYER:
NAME c 17 BUSINESS.SIGNATORYTI'T' LE . Tax ID#: TAX ID
8
251 -29
I.
II.
c3
GENERAL
1. Name of OJT Employer: _
2. Address of OJT Work -site:
3. Phone Number:
C!
5.
6.
7.
8.
TRAINING PLAN
Training Supervisor:
Name of OJT Trainee:
Application Number ofTrainee:
Grant/Program:
Proportion of trainees /employees: ( at time Agreement entered into)
a. Total number of employer's regular employees
C. Cumulative number of trainees currently in OJT
OCCUPATION AND ON- THE -JOB TRAINING OUTLINE:
1. Occupation:
2. Length of Time in Business:
3. ONET Code: SVP Level:
4. Hourly Starting Wage:
Start Date: End D
Hours
S. State and Federal Tax I.D.: State: Federal
6. Basic Work Week Hours:
251 -30
Exhibit A
I
7. Outline of On -the -Job Training Plan and Method of Assessment:
ELEMENTS OF TRAINING HOURS OF TRAINING
Measurement Method: Q & A, task observation and inspection. Goal is to aehleve rate ofproftclencywithin ffistMonth and a halfa tradnin .
Measurement Method: Q & A, task observation and inspection. Goal Is to achleve rate ofproflelencywithin subse acts three and a halftunnilm
Measurement Method: Q & A task observation and inspection. Goal is to achieve rate ofprofteiencyroitldn subsequent three and a halfnnonths.
3. k
Measurement Method: Q & A task observation and inspection. Goal Is to aeldeve rate ofproficiencywithin subse net three and a halfmonths,
RATING LEVELS:
Measurement method: how will it be determined if OJT ,participant acquired the skill? Q &A, observation, product review/inspection, etc.
PROFICIENT MODERATE MARGINAL
II. COST COMPUTATION
Hourly Reimbursement: $ 0 ( 50% of $00) Training Hours: 000Cost Per Traince ( Hourly Reimbursement X Training Horns)
III. Person(s) authorized to sign payment invoices for EMPLOYER;
Print Name Signature Title
Print Name Signature Title
251 -31
Date
Date
2
ASSURANCES
A. The EMPLOYER assures that:
It will comply with the requirements of the Workforce Investment Act ( WIA), the CaliforniaUnemployment Insurance Code, as amended, and the regulations and policies promulgatedthereunder.
2. No OJT participant displaces a regular employee nor shall an OJT participant fill a position of aperson who has been laid off from the same or similar position.
No current employees are receiving unemployment insurance benefits as a result of layoffs orwork reductions.
4. No person in the United States shall on the grounds of race, color, sex, religion, national origin,
age, disability, sexual orientation, or marital status be excluded from participation in, be deniedthe benefits of, or be otherwise subjected to discrimination under any program or activity forwhich the applicant receives federal financial assistance and will immediately take any measurenecessary to effectuate this Agreement.
5. It will comply with provisions of the Hatch Act, if applicable, which limits the political activitiesof employees.
6. Individuals receiving training on the job shall be compensated by the EMPLOYER at such rate, including periodic increases, as may be deemed reasonable under regulations prescribed by theSecretary of Labor, but in no event at a rate less than that specified in Section 6 ( a) ( 1) of the pairLabor Standards Act of 1938 or, if higher, under the applicable State or local minimum wagelaw.
Services and activities provided tinder this Agreement will be administered by or under thesupervision ofthe EMPLOYER.
No relative by blood, adoption or marriages of the EMPLOYER may be trained under thisAgreement.
Appropriate standards for health and safety in work and training situations will be maintained.
10. Conditions of employment or training are appropriate and reasonable with regard to the type ofwork, the geographical region, and the proficiency of the trainee.
11. Training will not be for any occupation which requires less than six weeks of training accordingto the Specific Vocational Preparation Table (SVP Code).
1. 2. Training will, to the maximum extont practicable, be consistent with every individual' s fullestcapabilities and lead to employment possibilities,
13. The program will, to the maximum extent feasible, contribute to the occupational development
or upward mobility of individual participants.
14. Training will be in accordance with the training plan, which plan incorporates documentationthat must be completed by EMPLOYER before end of contract.
EXHIBIT B
251 -32
15. * Dot and * * SVP code books will be used to determine length of OJT period. The training timemay not be longer than the SVP Code allows; however, contractors are encouraged to negotiateshorter training periods whenever applicable.
16. OJT trainees shall not number more than 40% of the EMPLOYERS work force.
17. All EMPLOYER training payments ( reimbursements) must be exclusive of any and allEMPLOYER fringe benefits, paid holidays, paid sick days and overtime compensation.
18. The participating EMPLOYER must keep an accurate and up -to -date time sheet for the OJTtrainee.
19. Payroll records, time and attendance records and job duties retained on file by the participatingEMPLOYER for each OJT trainee are subject to review.
Employer Signature
EXHMIT B
251 -33
Date
MAYOR
Miguel A. Pulido
MAYOR PRO TEMCarlos Bustamante
COUNCILMEMBERS
Claudia Alvarez
P. David Benavides
Michelei
Vincent F. Sirmiento
Snl Tlnalero
Insurance
CITY OF SANTA ANA
FINANCE & MANAGEMENT SERVICES AGENCY
PURCHASING DIVISION20 CIVIC CENTER PLAZA M -I6
P. O. BOX 1988 • SANTA ANA, CALIFORNIA 92702
PHONE: ( 714) 647.5420 • FAX: ( 714) 647. 6944
CITY MANAGERDavid N. Ream
CITY ATTORNEY
Joseph W. Fletcher
CLERK OF THE COUNCIL
Patricia E. Healy
As a condition of, and throughout the term of the contract, the vendor shall have and maintain the insurancedescribed below:
Certificate of Insurance (Acord' s 25 -S form no.) to include:
General Liability-- $ 1, 000,000 each occurrence
Wor'ker' s Compensation — Within the limits required by theState of California
Automotive Insurance -- $ 1, 000,000 combined single limit
A notation in the Cancellation clause ( in the bottom right hand corner) of the Certificate must be made that theCity will be mailed 30 days written notice of policy cancellation and the references " endeavor to "and " ailure tomail such notice shall impose no obligation or liability of nay kind anon the company, its agents orrepresentatives" shall be either removed or X' d through.
The attached " Additional Insured Endorsement" provided by City must be completed and signed by the insurancebroker, or the insurance companies provided form number CG20 10. The forms Trust include the followingstatement: " The City of Santa Ana. it' s officers. employees, agents and representative are named as additional
insured ". The form must reference the Certificate of Insurance Policy number on the Additional Insurance.
Additionally, vendors working on City vehicles housed on the vendor' s property are required to carry GarageLiability.
251 -34
ADDITIONAL INSURED ENDORSEMENT
Insurance Company
This endorsement modifies such insurance as is afforded by the provisions of Policyrelating to the following:
The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701 it officers, employees, agents and representative are named as additional insureds ( "additional
insureds ") with regard to liability and defense of suits arising from the operations and usesperformed by or on behalf of the named insured.
With respect to claims arising out of the operations and uses performed by or on behalf ofthe named insured, such insurance as is afforded by this policy is primary and is notadditional to or contributing with any other insurance carried by or for the benefit of theadditional insureds.
This insurance applies separately to each insured against whom claim is made or suit isbrought except with respect to the company's limits of liability. The inclusion of any personor organization as an insured shall not affect any right which such person or organizationwould have as a claimant if not so included.
4. With respect the additional insureds, this insurance shall not be cancelled, or materiallyreduced in coverage or limits except after thirty ( 30) days written notice has been given tothe City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701.
Completion of the following, including countersignature, is required to make this endorsement effective.)
Effective
Policy #
Issued to
Name Insured
Countersigned by
this endorsement form as part of
251 -35
Certification Regarding Drug -Free Workplace Reaulrements
The certification set out below is a material representation upon which reliance is placed
by the U,S. Department of Housing and Urban Development in awarding the grant. If itis later determined that the contractor knowingly rendered a false certification, orotherwise violates the requirements of the Drug -Free Workplace Act, the U. S. Department of Housing and Urban Development, in addition to any other remediesavailable to the Federal Government, may take action authorized under the Drug -FreeWorkplace Act.
CERTIFICATION
A. The contractor certifies that it will provide a drug -free workplace by:
a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance isprohibited in the contractor' s workplace and specifying the actions that willbe taken against employees for violation of such prohibition;
b) Establishing a drug -free awareness program to inform employees about—
1) The dangers of drug abuse in the workplace; 2) The contractor' s policy of maintaining a drug -free workplace; 3) Any available drug counseling, rehabilitation, and employee
assistance program; and
4) The penalties that may be imposed upon employees for drug abuseviolations occurring in the workplace;
c) Making it a requirement that each employee who will be engaged in theperformance of the grant be given a copy of the statement required byparagraph ( a);
d) Notifying the employee in the statement required by paragraph -( a) that, as a condition of employment under the contract, the employee will -
Pg. 2
1) Abide by the terms of the statement; and
2) Notify the employer of any criminal drug statute conviction for aviolation occurring in the workplace no later than five days aftersuch conviction.
EXHIBIT D
251 -36
e) Notifying the U. S. Department of Housing and Urban Development withinten days after receiving notice under subparagraph ( d)( 2) from anemployee or otherwise receiving actual notice of such conviction;
f) Taking one of the following actions, within 30 days of receiving noticeunder subparagraph ( d)( 2), with respect to any employee who is soconvicted
1) Taking appropriate personnel action against such an employee, upto and including termination; or
2) Requiring such employee to participate satisfactorily in a drugabuse assistance or rehabilitation program approved for such
purposes by a Federal, State, or local health, law enforcement, orother appropriate agency;
g) Making a good faith effort to continue to maintain a drug -free workplacethrough implementation of paragraphs (a), ( b), ( c), ( d), ( e) and ( f).
B. The contractor shall insert in the space provided on the attached " Place of
Performance" form the site( s) for the performance of work to be carried out with
the grant funds ( including street address, city, county, state, and zip code) thecontractor further certifies that, if it is subsequently determined that additionalsites will be used for the performance of work under the contract, it shall notifythe U, S, Department of Housing and Urban Development immediately upon thedecision to use such additional sites by submitting a revised " Place ofPerformance" form.
Dated:
EXHIBIT D
251 -37
Employer Signature
DIVISION OF EMPLOYMENT SERVICES
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG -FREEWORKPLACE REQUIREMENTS
Name:
Name of Contractor:
Contractor Number:
Date:
The Contractor shall insert in the space provided below the site( s) expected to be used
for the performance of work under the contract covered by the certification:
Place of Performance ( include street address, city, county, state, zip code for each site):
EXHIBIT D
251 -38
Certification RegardingDebarment, Suspension, Ineligibility and Voluntary Exclusion
Lower Tier Covered Transactions
This certification is required by the regulations implementing Executive Order 12549, Debarment andSuspension, 29 CFR Part 98, Section 98.510, Participants` responsibilities. The regulations were published
as Part VII of the May 26, 1988 Federal Register (pages 19160 - 19211).
BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS FOR CERTIFICATION - Attached)
1) The prospective recipient of federal assistance funds certifies, by submission of this proposal, thatneither it nor its principals are presently debarred, suspended, proposed for debarment, declaredineligible, or voluntarily excluded from participation in this transaction by any federal department oragency.
2) Where the prospective recipient of federal assistance funds is unable to certify to any of thestatements in this certification, such prospective participant shall attach an explanation to thisproposal.
Name and Title ofAuthorized Representative
Signature Date
EXHIBIT E
251 -39
INSTRUCTIONS FOR CERTIFICATION
By signing and submitting this proposal, the prospective recipient of federal assistance funds isproviding the certification as set out below.
2. The certification in this clause is a material representation of fact upon which reliance was placedwhen this transaction was entered into. If it is later determined that the prospective recipient of
federal assistance funds knowingly rendered an erroneous certification, in addition to other remediesavailable to the Federal Government, the Department of Labor ( DOL) may pursue availableremedies, including suspension and/ or debarment.
3. The prospective recipient of federal assistance funds shall provide immediate written notice to the
person to which this proposal is submitted if at any time the prospective recipient of federalassistance funds learns that its certification was erroneous when submitted or has become erroneous
voluntarily excluded," as used in this clause, have the meanings set out in the Definitions andCoverage sections of rules implementing Executive Order 12549. You may contact the person towhich this proposal is submitted for assistance in obtaining a copy ofthose regulations.
The prospective recipient of federal assistance fiords agrees by submitting this proposal that, shouldthe proposed covered transaction be entered into, it shall not knowingly enter into any lower tiercovered transaction with a person who is debarred, suspended, declared ineligible, or voluntarilyexcluded from participation in this covered transaction, unless authorized by the DOL.
6. The prospective recipient of federal assistance funds further agrees by submitting this proposal thatit will include the clause titled " Certification Regarding Debarment, Suspension, Ineligibility andvoluntary exclusion - Lower Tier Covered Transactions," without modification, in all lower tiercovered transactions and in all solicitations for lower tier covered transactions.
A participant in a covered transaction may rely upon a certification of a prospective participant in alower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excludedfrom the covered transaction, unless it knows that the certification is erroneous. A participant maydecide the method and frequency by which it determines the eligibility of its principals. Eachparticipant may, but is not required to check the List of Parties Excluded from Procurement or Non - Procuremeut Prouarms,
8. Nothing contained in the foregoing shall be construed to require establishment of a system ofrecords in order to render in good faith the certification required by this clause. The knowledge andinformation of a participant is not required to exceed that which is normally possessed by a prudentperson in the ordinary course of business dealings.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who issuspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, inaddition to other remedies available to the Federal Government, the DOL may pursue availableremedies, including suspension and /or debarment.
EXHIBIT E
251 -40
SANTA ANA
PK AMERICANS WITH DISABILITY ACT (ADA)
CENTER AND
EQUAL OPPORTUNITY (EO) LAW
1. Is there a minimum of 2 designated disabled parking slots? Per Dept. ofRehab Sect. 504 YES[] NO[:]
II. Are parking slot occupants able to reach the building' s entrance for the disabledwithout having to go behind any other cars, or any other barriers ( curb, sidewalks, etc.)?
Per Dept. ofRehab. Sect. 504 YES NO
III. Is there a fiont door labeled with the international wheelchair access sign?
Per Dept, ofRehab. Sect. 504 YES NO[]
IV. Is the labeled entrance' s threshold not higher than 1/ 2 inch to allow for
wheelchair access? Per Dept. ofRehab. Sect, 504 YES NO
V. Is the door- handle to the labeled wheelchair entrance door, a lever handle (not around doorknob)?
Per Dept. ofRehab, Sect. 504 YES NO
VI. If any services are available on second floor, does the building have an elevator? Per Dept. ofRehab. Section 504 YES[] NO NA
VII. Does the classroom, working area, and break -room have enough room to maneuver awheelchair and /or crutches?
Per Dept, ofRehab. Sect. 504 YES NO
VIII. Does the school catalog / employee manual, contain the organization' sGrievance Policy? Per CTR Title 20, 29, 41 YES[:] NO
IX. Is Grievance Procedure and contact person made available in writing to theparticipant on first day of attendance? Per CFR Title 20,29,41 YES NO
X. If serving any Limited English individuals is the grievance procedure and proceduresavailable in their language?
Per CFR Title 20,29,41 YES NO NA
XI, is assessment used in a non - discriminatory way? (used to determine suitability fortraining andlor employment based on industry recognized required skills)? Per CFR Title 20,29, 41 YES Non
XII. Is there at least one internationally labeled accessible restroom for the disabled? Per Dept. ofRehab. Sect.. 504 YES[] NO
251 -41
XIIl. Does toilet stall for the disabled have bars on each side of wall?
Per Dept. ofRehab. Sect. 504 YES[-] NO
XIV. Is there a telephone reasonably accessible to handicap individuals? Per Dept. ofRehab. Sect. 504 YES NO[:]
XV. Is there a water fountain reasonably accessible to disabled individuals? Per Dept. ofRehab. Sect. 504 YES[] NO
XVI. Are auxiliary (supplementary) aides available when requested by the individual? Per CFR Title 20,29,41 YES NO
XVH Do all contracts and agreements signed by the individual contain Employer Equalopportunity employer language? CFR Title 20,29,41 YES[-] NO[]
I certify that I have validated all responses: W /O /R/K Center Staff Date
Service Provider Information:
First Name Last Name
Service Provider Signature Date
Business Address
Business Phone Number
251 -42
COMPLIANCE STATUS
Summary Sheet
Reviewer: Site Visit Date:
Contract/Vendor Information:
Director /Supervisor Name:
Business Name:
Address:
Phone #:
Program Element Compliance
Status
Person
Responsible
Mods, Mod, Cost Time Frame Location
Based on site visit and survey responses the site does not have any ADAnor EO issues to correct.
Currently ADA accessibility not fully available. WIA funds will not bereleased until the facility corrects issues to meet applicable Dept. of Rehab. Section 504 requirements?
Currently EO issue exist. WIA funds will not be released until theorganization corrects EO issues to meet applicable CPR 20, 29, 41
requirements.
I have been informed of the ADA & EO site visit review outcome( s).
Director /Supervisor
251 -43
Date
Certification Regardingthe
Americans with Disabilities Act
This certification is required by the regulation 101 -336 ( 42 U.S. C. 512101) enforced through theDepartment of Rehabilitation and mandated by the Governor of California. ADA has been in effectsince 1990, with the mission to provided equal protection to individuals with disabilities in the
public and private sector services, transportation, communications and employment,
I hereby certify that the following statement is correct and honestly states that our program facility isin compliance with the Americans Act with Disabilities (ADA). I understand that
Title I — V of the Act also applies to Workforce Investment Act (WIA) participants entering trainingunder the Workforce Investment Board / Youth Council funding.
Service Provider Signature
Print First Name
Organization Name
251 -44
Date
Print Last Name
Organization Address
Staff Grievance Policy and Procedures
i iltiellillCw]1
1. 1 COMPANY NAME, is committed to providing a fair, safe and productive workenvironment where grievances are dealt with sensitively and expeditiously. Anessential part of developing that environment is ensuring that staff is encouragedto come forward with their grievances in the knowledge that the responsible
supervisors will take appropriate action to address those grievances. Grievancesthat are not addressed have the potential to grow into major problems that can
cause tension, low morale and reduced performance and productivity.
1, 2 Grievance resolution is an integral part of a supervisor's duties. Each
supervisor has a responsibility to identify, prevent and address problems in theworkplace.
1. 3 Any member of staff may lodge a grievance regarding work - related problems. However, if other procedures exist that more appropriately address thatgrievance ( i. e. sexual harassment or unlawful discrimination), that mechanismshould be used.
2. 0 PROCEDURES
Preliminary Action
2. 1 Before initiating the grievance procedures, complainants are encouraged totry to resolve any grievance directly with the person /s concerned. If this is notpossible or appropriate, the complainant should proceed to Step 1 of thegrievance procedures.
2.2 A staff member should raise their grievance with the person /s concerned as
early as possible.
Step 1 - Talk to immediate supervisor
2. 3 Where the complainant has been unable to resolve the grievance, he /she
should take the matter up with their immediate supervisor. Where the grievanceinvolves the supervisor, the staff member should refer the matter to thesupervisor's supervisor.
2.4 The supervisor should address the grievance with a view to resolving itexpeditiously, normally within two weeks of receiving the complaint.
2. 5 Following resolution of the grievance, the supervisor should monitor thesituation for a period of time.
251 -45
2. 6 In any action taken, the supervisor should ensure procedural fairness for allparties involved, including informing the respondent of the allegations madeagainst him /her, and providing him /her with an opportunity to respond.
Step 2 - Referral to senior manager
2. 7 If the complainant believes the grievance has not been resolved to theirsatisfaction during Step 1, they can refer the matter to the senior manager in theDivision or Department. The senior manager may require the complainant to putthe grievance in writing. The senior manager should attempt to resolve the matterwithin three weeks of receiving the grievance and should follow similarprocedures outlined in Step 1,
3. 0 OUTCOMES
Outcomes could include:
The complainant gaining a better understanding of the situation and nolonger being aggrieved. The complainant receiving a verbal or written apology. The respondent receiving a verbal or written reprimand; One or both parties agreeing to participate in some form of counseling.
251 -46
MAYOR
Miguel A. Pulido
MAYOR PRO TEM
Claudia Alvarez z` COUNCILMEMBERS
Carlos Bustamante
P. David Benavides+_
Michele Martinez
Vincent F. Sarmlento
Sal TinaJera
CITY OF SANTA ANAFINANCE & MANAGEMENT SERVICES AGENCY
PURCHASING DIVISION20 CIVIC CENTER PLAZA M -16
P. O. BOX 1988 SANTA ANA, CALIFORNIA 92702
PHONE: (7141647 -6941 FAX:( 714) 647 -6944
CITY MANAGER
David N. Ream
CITY ATTORNEY
Joseph W, Fletcher
CLERK OF THE COUNCIL
Maria D. Huizar
The Tax Equity & Fiscal Responsibility Act of 1982 and Backup withholding Regulations of 1983require LIS to have a Social Security or Federal Tax Identification Number (TIN) on file for allvendors subject to form 1099 reportable payments. Please print, sign and return this form, alongwith your completed and signed W9 (attached) in order to allow us to process purchase ordersand payments.
Business Name
DBA (if applicable)
Purchase -From Address
Phone
Fax
Email
Web Address
Payment Terms
Sign Here F Title
251 -47
Remit -To Address
Form w -9 Request for Taxpayer Give Form to the
Rev. August 2013) Identification Number and Certificationrequester. Do not
Department of the Treasury send to the IRS. Internal Revenue Service
Name (as shown on your Income tax return)
N Business name /disregarded entity name, If different from above
mrnm Check appropriate box for federal tax classification: Exemptions (see Instructions): O
Individual/ sole proprietor C Corporation 9 Corporation Partnerahlp True estate
o Exempt payee code (If any)
SvLimped liability company. Enterthetax classification( C- C corporation, S= Scerporatlon, P= partnership) Exemption from FATCA reporting
coda (If any)
yr0 Cther( seelnstruotlonsj*
de
Address (number, street, antl apt. or sutra no.) Requester' s name and address (optional)
City, state, and ZIP nodev
List account number(s) here (optional
JZB Taxpayer identification Number TINEnter your TIN in the appropriate box. The TIN provided must match the name given on the " Name" line I Social security numberto avoid backup withholding. For Individuals, this is your social security number (SSN). However, for aresident alien, sole proprietor, or disregarded entity, see the Part I Instructions on page 3. For other - entities, it Is your employer identification number (EN). If you do not have a number, see How to get aTIN on page 3.
Note. If the account Is In more than one name, see the chart on page 4 for guidelines on whose Employer identification number
number to enter, T
1. The number shown on this form is my correct taxpayer Identification number (or I am waiting for a number to be issued to me), and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or ( b) I have not been notified by the Internal RevenueService ( IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I amno longer subject to backup withholding, and
3. 1 am a U. S. citizen or other U. S. person ( defined below), and
4. The FATCA code(s) entered on this form ( if any) indicating that I am exempt from FATCA reporting Is correct.
Certification instructions. You must cross out Item 2 above If you have bean notified by the IRS that you are currently subject to backup withholdingbecause you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgageInterest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), andgenerally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See theinstructions on page 3.
sign
ISignature of
Here U. S. person I• Date 1
Genera) InstructionsSection references are to the Internal Revenue Code unless otherwise noted.
Future developments. The IRS has created a page on IRS. gov for Informationabout Form W -9, at www1s.govlwa. Information about any future developmentsaffecting Form W -0 (such as legislation enacted after we release It) will be postedon that page.
Purpose of Form
A person who Is required to file an information return with the IRS must obtain yourcorrect taxpayer Identification number (TIN) to report, for example, Income paid to
You, payments made to you In settlement of payment card and thll'd party networktransactions, real estate itmonotions, mortgage Interest you paid, acquisition or
abandonment or secured property, cancellation of debt, or contributions you madeto an IRA.
Use Form W -9 only If you are a U. S. person ( including a resident alien), toprovide your correct TIN tothe person requesting It ( the requester) and, whenapplicable, to
1. Certify that the TIN you are giving Is correct (or you are walking for a numberto be Issued),
2. Certify thatyou are not subject to backup withholding, or
3. Claim exemption from backup withholding If you area U, S, exempt payee. Ifapplicable, you are also certifying that as a U. S. Parson, your allocable share ofany partnership income from a U. S. trade or business Is not subleot to the
withholding tax on foreign partners' share of effectively connected Income, and
4. Certify that FATCA cadets) entered on this farm (If any) Indicating that you areexempt from the FATCA reporting. Is careerNote. If you are a U. S. person and a requester gives you a form other than Form
W -9 to request your' rIN, you must use the requester' s form if It Is substantiallysimilar to this Form W -9.
Definition of a U8. person. for federal tax purposes, you are considered a U, S, person If you are:
An Individual who is a U, S. citizen or U. S. resident allen,
A partnership, corporation, company, or association created or organized In theUnitod States or underthe laws of the United States,
An aerate (other than a foreign estate), or
A domestic trust (on defined In Regulations section 301. 7701 - 7).
Special rules for partnorships, Partnerships that conduct a trade or business Inthe United States are generally required to pay a withholding tax under section1446 on any foreign partners' share of allectively connected taxable Income fromsuch business. Further, In certain cases where a Form W -9 has not been received, the rules under section 1446 require a partnerahip to presume that a partner Is aforeign person, and pay the section 1446 withhoiding tax. Therefore, If you are aU. S. person that Is a partner in o partnership conducting a trade or business in theUnited States, provide Form W -9 to the partnership to establish your U. S. statusand avoid section 1448 withholding on your share of partnership Income,
Cat, No, IMIX Form W -9 (Rev. 84013)
251 -48
Farm W -9 (Rev. 8 -2013) Page 2
In the cases below, the following person must give Form We to the partnershipfor purposes of establishing Its U. S, status and avoiding withholding on Itsallocable share of net Income from the partnership conducting a trade or businessIn the United Stales;
In the case of a disregarded entity with a U. S. owner, the U. S. owner of thedisregarded entity and not the entity,
In the case of a grantor trust with a U. S. grantor or other US. owner, generally, the US, grantor or other U. S, owner of the grantor trust and not the trust, and
r In the case of a U. S. trust (other than a grantor trust), the U. S. trust (other than agrantor trust) and not the baneficierlea of the trust.
Foreign person. If you are a foreign person at the U. S. branch of a foreign bankthat has elected to be treated as a U. S, person, do not use Form W -9. Instead, use
the appropriate Form W -8 or Form 8233 (see Publlcatlon 515, Withholding of Taxon Nonresident Aliens and Foreign Entldes).
Nonresident alien who becomes a resident alien. Generally, only a nonresidentalien Individual may use the terms of a tax treaty to reduce or eliminate US. tax oncertain types of Income. However, most tax treaties contain a provision known as
a " saving clause," Exceptions speclfied In the saving clause may permit anexemption from tax to continue for certain types of Income even after the payeehas otherwise become a U. S. resident alien for tax purposes.
If you are a U. S. resident alien who is relying on an exception contained In thesaving clause of a tax treaty to claim an exemption from U. S. tax on certain typesof Income, you must attach a statement to Form W -0 that specifies the followingfive Items:
1. The treaty country. Generally, this must be the same treaty under which youclaimed exemption from tax as a nonresident alien.
2. The treaty article addressing the Income,
3. The article number for location) in the tax treaty that contains the savingclause and Its exceptions.
4. The type and amount of Income that qualifies for the exemption from tax.
5. Sufficient facts to justlN the exemption from tax under the terms of the treatyarticle.
Examplo. Article 20 of the U. S; China Income tax treaty allows an exam tlon
ardent will become a resident alien forI States exceeds 6 calendar years.
to the U. S. -China treaty (dated April 30, continue to apply even after theof inn United Slates. A Chinese studentigraph 2 of the }last protocol) and Isetlon from tax on his or her scholarship
information described above to support that exemption.
If you area nonresident alien or a foreign entity, give the requester theappropriate completed Form W -8 or Form 6233,
What Is backup withholding? Persons making certain payments to you mustunder certain condhlons withhold and pay to the IRS a percentage of suchpayments. This Is called " backup withholding." Payments that may be subject tobackup withholding Include Interest, tax - exempt interest, dividends, broker andbarter exchange transactions, rents, royalties, nonemployee pay, payments madeIn settlement of payment card and third part network transactions, and certainpayments from fishing boat operators. Real estate transactions are not subject tobackup withholding.
You will not he subject to backup withholding on payments you receive it yougive the requester your correct TIN, make the proper certifications, and report allyour taxable Interest and dividends on your tax return.
Payments you receive will be subject to backupwithholding if:
1. You do not furnish your TIN to the requester,
2. You on not sanity your TIN when required (seethe Part II Instructions on page3 for details),
a, The IRS calls the requester that you furnished an Idoormat TIN,
4. The IRS tells you that you are subject to backup withholding because you didnot report all your Internet and dividends on your tax return (for reportable Interest
and dividends only), or
5. You do not certlfy to the requester that you are not subject to backupwithholding under 4 above (for reportable Interest and dividend accounts openedafter 1983 only).
Certain payees and payments are exempt from backup withholding. See Exemptpayee code on page 3 and the separate Instructions for the Requester of FarmW- g for more II matlon,
Also see Special rules forparfnershlps on page 1.
What Is FATCA roporting? The Foreign Account Tax Compliance Act ( FATCA) requires a participating foreign financial Institution to report all United Statesnascent holders that are specified United States persons. Certain payees are
exempt from FATCA reporting. See Exemption from FATCA reporting code onpage 0 and the Instructions for the Requester of Farm W -9 for more Infa'motion.
Updating Your InformationYou must provide updated Information to any person to whom you claimed to bean exempt payee If you are no longer an exempt payee and anticipate receivingreportable payments In the future from this person. For example, you may need toprovide updated Information If you are a C corporation that elects to be an Scorporation, or if you no longer are tax exempt. In addition, you must furnish a newForm W9 If the name or TIN changes for the account, for example, lithe grantorof a grantor trust also
Penalties
Failure to furnish TIN. If you fall to furnish your correct TIN to a requester, you are
subject to a penalty of $50 for each such failure unless your failure Is due toreasonable cause and not to willful neglect.
Civil penalty for false Information with respect to withholding, If you make afalse statement with no reasonable basis that results In no backup withholding, you are subject to a $500 penalty.
Criminal penalty for falsifying Information. Willfully falsifying certifications oraffirmations may subject you to criminal penalties deluding fines and /orImprisonment.
Misuse of TINS. if the reqnester discloses or uses The In violation of federal law, the requester may le su a act to civil and criminal penalties.
Specific instructions
Name
If you ere on Individual, you must generally enter the name shown on your Incometax return. However, if you have changed your last name, for Instance, due to
marriage without Informing the Social Security Administration of the name change, enter your first name, the last name shown on your social security card, and yournew last name.
If the account Is In joint names, list first, and then circle, the name of the personor entity whose number you entered In Part I of the form.
Sole proprietor. Enter your Indlvldual name as shown on your Income tax returnon the " Name" line, You may enter your business, trade, or " doing business asCBA)" name on the " Business nano /disrogarded entity name" line.
Partnership, C Corporation, or S Corporation. Enter the entlty' s name on theName" line and any bualnoss, trade, or "doing business as (DBA) name" on theBusiness name /disregarded entity name" line.
Disregarded entity. For U. S. federal tax purposes, an entity that is disregarded asan entity separate from Its owner Is treated as a " disregarded entity." SeeRegulation section 301. 7701- 2( c)(2)( III) Enter the owner' s name on the " NealIlne, The name of the entity entered on the "Name" line should never be adisregarded entity. The name on the " Name" line must do the name shown on theIncome tax return on which the Income should be reported. For example, if aforeign LLC that is treated as a dlaregarded entity for U. S, federal tax purposeshas a single owner that Is a US. person, the U. S. owner' s name Is required to heprovided on the " Name" line. If the direct owner of the entity Is also a dlaregardedentity, enter the first owner that Is not disregarded for federal tax purposes. Enterthe disregarded entity' s name on the " Business name/ dlsregamed entity name" line. If the owner of the disregarded entity is a foreign person, the owner mustcomplete an appropriate Form W -8 Instead of a Form W -9, This Is the case even Ifthe foreign person has a U. S. TIN.
Note. Check the appropriate box for the U. S. federal tax classification of theperson whose name Is entered on tie "Name" line (Indlvldual /oole proprietor, Partnership, C Corporation, S Corporation, Trust/ estate). Limited Liability Company (LLC). If the person Identified on the " Name" line is anLLC, check the " Umlted liability company" box only and enter the appropriatecode for the U. S. federal tax classification In the space provided. If you are an LLCthat Is treated as a partnership for U. S. federal tax purposes, enter " P" forpartnership. If you are an LLC that has filed a Form 9882 or Form 2663 to betaxed as a corporation, enter " C" for C corporation or "S" for S corporation, asappropriate. If you are an LLC that Is disregarded as an entity separate from Itsowner under Regulation section 301. 7701 -3 (except for employment and excisetax), do not check the LLC box unless the owner of the LLC ( required to beIdentified on the " Name" line) Is another LLC that is not disregarded for U. S. federal tax purposes, If the LLC Is disregarded as an entity separate from Itsowner, enter the appropriate tax classification of the owner Identified on the
Name" line.
Other entities. Enter your business name as shown on required U, S. federal taxdocuments on the " Name" line. This name should match the name shown on thecharter or other legal document creating tiro entity. You may enter any business, trade, or TEA name on the % shriss name /dlaregarded entity name' line.
Exemptions
If you are exempt from backup withholding and /or FATCA reporting, enter in theExemptlons box, any ccde(s) that may apply to you. See Exempt payee code andExemptlon from FATCA reporting code as page 3,
251 -49
Form W- 9 (Rev, 8 -201
Exempt payee coda. Generally, Individuals (Including sale proprietors) are notexempt from backup withholding. Corporations are exempt from backupwithholding for certain payments, such as Interest and dividends. Corporations arenot exempt from backup withholding for payments made In settlement of paymentcard or third parry network transactions.
Note. If you are exempt from backup withholding, you should still complete thisform to avoid possible erroneous backup withholding.
The fallowing codes Identify payees that are exempt from backup withholding:
1-- An organization exempt from tax under section 801( a), any IRA, orcustodial account under section 403(b)(7) If the account satlsflea the requirementsof section 401( f)( 2)
2 — The United States or any of Its agencies or Instrumentalities
3 — A state, the District of Columbia, a possession of the United States, or any oftheir political adbdlvislcns or Instrumentalltlse
4 —A foreign government or any of Its political subdivisions, agencies, orInstrumentalities
5 — A corporation
6 —A dealer in securities or commodities required to register In the UnitedStates, the District of Columbia, or a possession of the United States
7 —A futures commission merchant registered with the Commodity FuturesTrading commission
8 —A real estate Investment trust
9 — An entity registered at all times during thatax year underthe InvestmentCompany Act of 1940
10 —A common trust fund operated by a bank under sactlon 584(a) 11 — A financial Institution
12 — A middleman known In the Investment community as a nominee orcustodian
1S — A trust Exempt from tax under section 664 or described In section 4947
The following chart shows types of payments that may be exempt from backupwithholding. The chart applies to the exempt payees listed above, 1 through 1S.
IF the payment is for... THEN the payment is exempt for...
Interest and dividend payments All exempt payees except
for 7
Broker transaction Exempt payees 1 through 4 and 6through 11 and all C corporations, Scorporations must not enter an exempt
payee code because they are exemptonly for sales of noncovered securitiesacquired prior to 2012.
Barter exchange transactions and Exempt payees 1 through 4patronage dividends
Payments over $60o required to be Generally, exempt payeesreported and direct sales over j36,0001 1 through 62
Payments made In settlement of Exempt payees 1 through 4
payment card or third party networktransactions
See Form 1099 -MISC, Miscellaneous Income, and its Instructions,
However, the following payments made to a corporation and reportable on Form1099 -MISC are not exempt from backup withholding: medical and health carspayments, attorneys' fees, gross proceeds paid to an attorney, and payments forservioos paid by a federal executive agency,
Exemption from FATCA reporting code. The following codes Identify payeesthat are exempt from reporting under FATCA. These codes apply to personssubmitting this form for accounts maintained outside of the United States byconch foreign financial Institutions. Therefore, if you are only submitting this formfor an account you hold In the United States, you may leave this field blank. Consult with the person requesting this form it you are uncertain If the financialInstitution Is subject to these requirements.
A —An organization exempt from tax under section 501( a) or any individualretirement plan as defined In section 7701( a)(37)
B —The United States or any of its agencies or Instrumentalities
C —A state, the Dish let of Columbia, a posseasion of the United States, or anyof their political subdivisions or instmmentallties
D —A corporation the stack of which Is regularly traded on one or moreestablished securities markets, as described In Reg. section 1. 1472- 1 ( a)(1)( 1)
E — A corporation that is a member of the same expanded offilated group as acorporation described in Reg. section 1A472- 1( c((1)( I)
F — A dealer In securities, commodities, or derivative financial instruments
Including notional principal contracts, futures, forwards, and options) that Isreglstamd as such under the laws of the United States or any state
G — A real estate Investment trust
H — A regulated Investment company as defined In section 851 or an entityregistered at all times during the tax year under the Investment Company Act of1940
I — A common trust fund as defined In section 584(x)
J —A bank as defined In section 581
K —A broker
L— Atrust exemptfrom tax under section 684 or described In sectlon 4947(a)( 1)
M —A tax exempt trust under a section 403(b) plan or sactlon 457( 8) plan
Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a resident alien and you do not
have end are not eligible to get an SSN, your TIN Is your IRS Individual taxpayerIdandfiastlon number (ITIN). Enter It In the social security number box. If you do nothave an ITIN, see How to got a TIN below.
If you are a sole proprietor and you have an EIN, you may enter either your SSNor EIN, However, the IRS prefers that you use your SSN.
If you are a single- member LLC that is disregarded as an entity separate from Itsowner (see Limited Liability Company (LLC) on page 2), enter the owner' s SSN ( orEIN, If the owner has one), Do not enter the disregarded entity' s EIN. If the LLC Isclassified as a corporation or partnership, enter the entity' s EIN.
Note. See the chart on page 4 for further clarification of name and TINcombinations.
How to get a TIN. If you do not have a TIN, apply for one Immedlately. To applyfor an BEN, get Form 53 -5, Application for a Social Security Card, from your localSocial Security Ad mJ Narration office or get this form online at www.ase.gov, Youmay also get this form by calling 1 - 800- 772 -1213. Use Form W -7, Application forIRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS -4, Application for Employer Identification Number, to apply for an EIN. You can applyfor an BIN online by accessing the IRS website at www.1m, gowbusinesses andcllcking on Employer Identification Number (EIN) under Starting a Business. Youcan get Forms W -7 and SS -4 from the IRS by visiting IRS. gOV or by calling 1. 800 - TAX -FORM (1 - 800- 829- 3676).
If you are asked to complete Form W -9 but do not have a TIN, apply for a TINand write " Applied For' in the space for the TIN, sign and date the farm, and give Itto the requester, For Interest and dividend payments, and certain payments made
with respect to readlly tradable Instruments, generally you will have 60 days to geta TIN and give It to the requester berate you are subject to backup withholding onpayments. The 60 -day rule does not apply to other types of payments. You will besubject to backup withholding on all such payments until you provide your TIN tothe requester.
Note, Entering " Applied Far" means that you have already applied for a TIN or thatyou Intend to apply for one soon.
Caution: Adisregarded U.S. entity that has a foreign owner must use theappropriate Form W -8.
Part II, Certification
To establish toths withholding agent that you are a U. S. person, or resident alien, sign Form W4 You maybe requested to sign by the withholding agent even IfItems 1, 4, or 5 below Indicate atherwlse.
For ajoint account, only the person whose TIN Is shown In Part I should signwhen required). In the case of a disregarded entity, the person Identified on trioName" line must sign. Exempt payees, sea Exempt payee code earlier.
Signature requirements. Complete the certlflcatlan as Indicated In Items 1through 5 below.
1. Interest, dividend, and barter exchange accounts opened before 1964and broker accounts considered active during 1983. YOU must give yourcorrect TIN, but you do not have to sign the certification.
2. Interest, dividend, broker, and barter exchange accounts opened after
1983 and broker accounts considered Inactive during 1983. You must sign thecertlfloatlon or backup withholding will apply. If you are subject to backupwithholding and you are merely providing your correct TIN to the requester, youmust cross out Item 2 In the certification before signing the form.
3. Real estate transactions. YOU must sign the certification. You may crass outItem 2 of the certification.
4. Other payments. You must give your correct TIN, but you do not have to signthe certification unless you have been notified that you have previously given anIncorrect TIN. " Other payments" Include payments made In the coursa of therequester' s trade or business for rents, royalties, goods (other than bills for
merchandise), medical and health care services ( Including payments tocorporations), payments to a nonemployse for services, payments made In
settlement of payment card and third party network transactions, payments tocertain fishing boat crew member's and fishermen, and gross proceeds paid toattorneys (including payments to corporations).
5. Mortgage interest paid by you, acquisition or abandonment of securedproperty, cancellation of debt, qualified tuition program payments (undersection 529), IRA, Coverdell SEA, Archer MSA or HSA contributions or
distributions, and pension distributions. You must give your correct TIN, but youdo not have to sign the certification.
251 -50
Form W -9 ( Rev.
What Name and Number To Give the RequesterFor this type of account: Give name and SSN of:
1. Individual The Indlvldual
2. Two or more Individuals aolnt The actual owner of the account or, account) If combined funds, the first
Individual on the account
3. Custodian account of a minor The minor' Uniform Gift to Mlncra Act)
4. a. The usual revocable savings The grantor - trustee'
trust (grantor Is also trustee)
b. Se- called trust account that Is The actual owner' not a legal orvalld trust understate law
6. Sole proprietorship or disregarded The owner' entity owned by an Individual
6. Grantor trust filing under Colonel The grantor"
7. Disregarded entity not owned by an The ownerindividual
B. Avalld trust, estate, or pension trust Legal entity' 9. Corporation or LLC electing The corporation
corporate status on Farm 8832 orForm 2553
10. Association, club, religious, The organizationcharitable, educational, or other
tax - exempt organization
11. Partnership or multi- member LLC The partnership12. A broker or registered nominee The broker or nominee
13. Account with the Department of The public entityAgriculture In the name of a public
entity (such as a skate or localgovernment, school district, or
prison) that receives agricultural
program payments
14. Gramortiustfiling under the Form The trust1041 Filing Method or the OptionalForm 1099 Filing Method 2 ( seeRegulation section 1. 071- 4( b)( 2)(Ii
List first end olrcla the name of the parson whose number you furnish. If only one pat rson on ajoint account has an SSN, that person' s number must be furnished.
Clone the minor's name and furnish the minor' s SSN.
s YOU most show your Indlvldual name and you may also enter youi mistress or " DON' name onthe " Buelhere name /disregarded entity" name Ilno, YOU may use anhor' your SSN or El IN Of youhave oho), but hot IRS encourages you to use your SSN.
4 List fact and alydc the nema of the trust, estate, or pension trust, P. not furnish the TIN of thepersonal representative or trustee unless the legal entity Itself Is not rosenoted In the accounttitle.) Also see Special rules forpadnershlies on page t.
Note. Grantor also most provide a Form W -9 to bsense of bust.
Note. If no name Is circled when more than one name is listed, the number will beconsidered to be that of the first name listed.
Secure Your Tax Records from Identity TheftIdentity theft occurs when someone uses your personal Information such as yourname, social security number (SSN), or other Identlfying Information, without yourpermission, to commit fraud or other orimes An Identity thief may use your SSN togot a job or may file a tax return using your SSN to receive a refund.
To reduce your risk:
Protect your SSN,
Ensure your employer Is protecting your SSN, and
Ds careful when choosing a tax preparear. If your tax records ore affected by identity theft and you receive a notice from
the IRS, respond right away to the name and phone number printed on the IRSnotice or letter.
If your tax recoils are not currently affected by Identity theft but you think youare at risk due to a lost or stolen purse or wallet, questionable credit card activityor credit report, contact the IRS Identity Theft Hotline at 1 . 800. 906 .4490 or submitForm 14039,
For more Information, see Publication 4535, Identlty, Theft Prevention and VictimAssistance.
Victims of Identity theft who are experiencing economic harm or a systemproblem, or are seeking help in resolving tax problems that have not been resolvedthrough normal channels, may be el Is be for Taxpayer Advocate $ itwIce ( TAB) assistance. You can reach TAB by calling the TAB toll -free case Intake line at1 - 877- 777. 4778 or TTY/ TDD 1. 800. 829 -4059.
Protect yourself from suspicious amalls or phlshing schemes. Phishing Is thecreation and use of email and webaltes designed to mimic legitimate business
emalls and websites. The most common act is sending an email to a user falselyclaiming to be an established legitimate enterprise In an attempt to scam the userInto surrendering private Information that will be used for Identity theft.
The IRS does not Initiate contacts with taxpayers via emalls, Also, the IRS doesnot request personal detailed information through email or ask taxpayers for thePIN numbers, passwords, or similar secret access Information for their credit card, bank, or other financial accounts.
If you receive an unsolicited email claiming to be from the IRS, forward thismessage to phlshing @lm.gov, You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration at1- 800- 306 -4484. You can forward suspicious smalls to the Federal TradeCommission at: spident , gov or contact them at www.Rc.gov /(dthaff of 1- 877 - IDTHEFT (1- 877 - 438. 4338).
Visit IRS.gov to learn more about identity theft and how to reduce your risk
Privacy Act NoticeSection 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons it ojuding federal agencies) who ere required to file Information returns withthe IRS to report Interest, dividends, or certain Cartel' Income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellationof debt or contdbutlons you made to an IRA, Archer MSA, or HSA. The person collecting this farm uses the Information on the form to file Information returns with the IRS, reporting the above Information. Routine uses of this Informatlon include giving It to the Department of Justice for civil and criminal litigation and to titles, states, the Distl' ietOf COhlmbla and LL& commonwealths and possessions for use In adminlstflOng lhelr laws, The Information also may be disclosed to other countries under treaty, tofederal and state agencies to enforce civil and criminal laws, or to federal law enforcement and Intelligence agencies to combat terrorism. You must provide your TINwhether or not you are required to file a tax return. Undel' section 3406, payers must generally withhold a percentage of taxable Interest, dlvlderd, and certain otherpayments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent Information.
251 -51
ATTACHMENT II
1. OJT Employer Reimbursement Invoice
251 -52
FUNDING SOURCE
Dislocated Worker
QI Adult
Q Other
TI1.1,-", 1,- SANTA ANA
INVOICE#
x„ W RKCENTER
SANTA ANA WORK CENTER INVOICE
CITY OF SANTA ANAOJT INVOICE
DURATION OF
AGREEMENT# AGREEMENT: From: To:
INVOICING PERIOD: From: To:
NAME OF TRAINEE:
NAME OF EMPLOYER:
ADDRESS:
PHONE M
MAXIMUM
TRAINING HOURS:
HRS. INVOICED
TO DATEHRS. INVOICEDTHIS PERIOD
TOTAL HRS. INVOICED
EMPLOYER SIGNATURE
CASE M
CITY: NIN;
OJT MAXIMUM
REIMBURSEMENT AMOUNT:
REMAINING BALANCE
OJT HOURLYREIIMBUREMENT I
R
THTHIS
ERIODNTOJT COORDINATOR SIGNATURE
DATE DATE
H: /Acctg form White — Purchasing/ Canary — WIA Fiscul` iylt— t'oplyy 0peiator / Goldenrod — F'raployerRevised 1112 / 10 iJ 63
ATTACHMENT III
1. Internship Documents
a. Work Experience Agreement
b. Work Experience Sign in Sheet
c. Work Experience Timecard
251 -54
a..•:"." -SANTA ANA
WORKCENTER
WORKSITE AGREEMENT
Work Experience Program
The following Agency Worksite Agreement sets forth the responsibilities of the Santa Ana WORK Center asthe Work Experience Program Grantee and hereinafter referred to
as the " agency worksite ",
The purpose of the Work Experience program is to provide eligible participants with work experience thatwill prepare them for future employment and also meet their financial needs.
Total number of participants requested by your agency worksite( s): I-
A, The Agency Worksite ensures and agrees to fulfill the following:
1, Currently employed workers will not be displaced by any participant (including partialdisplacement, such as a reduction in hours of non over -time work, wages or employmentbenefits).
2. Participants may not be employed in or assigned to a job if any other individual is on layoff fromthe same or any substantially equivalent job,
3. Provide an orientation to each regular agency staff member who will supervise Work Experienceparticipant to include: a) the duties the participant will perform; b) the number of participants
assigned to each supervisor; c) the number of hours a participant may work each week; and, d) any applicable limits set forth in the Digest of California Labor Laws.
4. Provide an orientation to each assigned participant to include at a minimum: a) agencyexpectations of employees; b) agency policies mud procedures ( dress requirements, absenteeism, tardiness, lunch and break time, etc.); c) duties to be performed by the participant; d) times, daysand location to report to work, e) agency accident reporting policy; f) safety procedures andrequirements; and, g) introduction to the supervisor.
5. Provide participants with sufficient, meaningful duties, while they are at the worksite,
6. Participants will only perform duties outlined in the job description developed by WorkExperience staff mid the approved agency worksite.
7. Provide continual supervision of every assigned participant during the workday.
A. Part -time participants will not work more than twenty (20) hours per week, unless prior approvalby Work Experience staff has been given. Full -time participants will not work more than themaximum of forty (40) hours per week.
9. Objectively evaluate the performance of each participant.
W. Adhere to all Labor Laws and Child Labor Laws,
Rev. 0 &/12
251 -55
11, Comply with Title VI of the Civil Rights Act of 1963, and in accordance with Title VI of the Act, no person in the United States shall, on the grounds of race, color, sex, or national origin be
excluded to discrimination under a program activity for which the applicant receives federalfinancial assistance,
12, Maintain a hazard -free and sanitary working environment for participants, and make certain allsafety rules are followed,
13. Maintain participant time and attendance records on a daily basis and ensure the participant andsupervisor sign time cards.
14. Maintain a copy of the worksite agreement and Work Experience handbook on hand at worksite, and medical release ( if required). Post Worker' s Compensation Information Bulletin in an area
visible to participants and supervisors,
15. Complete participant time cards on a daily basis. Time card should be reviewed on the last day ofthe pay period and ready for pick up on designated day.
16, Participants shall be allowed release time for counseling, skill /remedial education, labor marketorientation, and /or other activities when requested by the grantee.
17. Work Experience staff will be notified of participant employment problems at the earliest possible
time by the worksite supervisor,
18. Report all accidents and injuries no later than 24 hours after the accident occurs.
19. Agency worksite supervisors will allow designated Work Experience staff, State, and Federalofficials, to perform on -site monitoring and visitation while participants are present,
20, Participants will not be released from work without pay, unless first cleared with WorkExperience staff.
21, Follow rules and regulations governing the Work Experience program.
B. The City of Santa Ana Work Experience Program ensures and agrees to fulfill the following:
I. Provide an orientation to agency worksite supervisors concerning Work Experience guidelines, California Labor Laws, California Child Labor Laws and departmental procedures.
2. Provide handbooks to participant and supervisors that provides an orientation to the Work
Experience program and their responsibilities as a partickpant/supervisor,
3. Provide participant time cards to worksites,
4, Process Work Experience participant payroll and pay participant wages.
S. Monitor program and worksite activities, and provide assistance to participants and supervisors
when needed.
6. Provide total medical costs associated with injuries that may occur on the job through the Workers' Compensation Program.
Rev. 08/ 12
251 -56
C. The City of Santa Ana Work Experience Program may terminate this Agreement upon five (5) days written notice should either party fail to perform any of the agreements written herein.
Santa Ana WORK Center Staff Signature Date Printed Name
Worksite Supervisor Signature Date Printed Name
Alternate Supervisor Signature Date Printed Name
Worksite Name
Address
Worksite Telephone Number
Carlos de la Riva
City of Santa AnaEconomic Development Specialist IIT
251 -57
Rev. 08/ 12
WE+ X EMPLOYMENT SERVICES DAILY SIGN IN SHEET
Participant
Last Name First Name Middle Initial
Worksite Name:
PLEASE SIGN IN AND OUT DAILYI ( SUPERVISOR MUST INITIAL)
Reminder:
Do not use pencil or whiteout
Hours must be in half or whole increments onlyIf you work 6 hours or more, yon must at a minimuou take an unpaid ya hour hunch
I certify that to the best of my knowledge, the information on this time sheet is true and correct,
Participant Signature: Date:
Supervisor Signature: Date:
251 -58
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COMPLAINT HANDLING
UNDER THE
WORKFORCE INVESTMENT ACT
SANTA ANA
WIA
Santa Ana Local Workforce Investment Area
Revised May 7, 2009
EXHIBIT B
251 -60
Table of Contents
I. Information Regarding Complaints 3
A. Nondiscrimination and Equal Opportunity Complaints 3
1, Policy Statem
2. Civil 0
3. Nondiscrimination laws under WIA 4
4. How to File Your Compla
B. Criminal Complaints 6
II. General Procedures for Handling Non - Criminal Violations of the Act 6
III, Procedures for Handling Complaints at the LWIA Level 8
IV. Procedures for Handling Complaints at the State 12
V. Procedures for Handling Discrimination Complaints by Participants 15
VI. Procedures for Handling Handicap Complaints by Participants 17
GLOSSARY OF WIA TERMS
2
251 -61
Information Regarding Complaints
A. Nondiscrimination and Equal Opportunity Complaints
1. Policy Statement
In carrying out the purpose of the Workforce Investment Act (WIA), the City of SantaAna Local Workforce Investment Area ( LWIA) will establish programs to prepare
youth and unskilled adults for entry into the labor force and to afford job training tothose individuals facing serious barriers to employment. Every effort will be made toprovide services necessary for eligible individuals to obtain productive employment.
In implementing WIA, all contractors in the Santa Ana LWIA will foster equalopportunity and non - discrimination, as provided in State and Federal equalopportunity and non - discrimination laws including, but not limited to:
Title VI of the Civil Rights Act of 1964
Title VII of the Civil Rights Act of 1964
The Age Discrimination Act of 1975, as amended
Section 503 of the Rehabilitation Act of 1973
Section 504 of the Rehabilitation Act of 1973
Title IX of the Education Amendments of 1972
Section 188 of the Workforce Investment Act of 1998
In keeping with our commitment, no individual shall be excluded from participation in, denied benefits of, subjected to discrimination under, or denied employment, in theadministration or of in connection with any WIA funded program because of race, color, religion, sex, national origin, age, handicap, or political affiliation or belief.
Participation in programs and activities financially assisted in whole or in part underWIA shall be open to citizens and nationals of the United States, lawfully admittedpermanent resident aliens, lawfully admitted refugee, parolees, and other individualsauthorized by the Attorney General to work in the United States.
No individual will be intimidated, threatened, coerced, or discriminated against
because of filing a complaint, furnishing information, or assisting or participating inany manner in an investigation, compliance review, hearing or any other activityrelated to the administration of WIA.
251 -62
Administration responsibility for this Equal Opportunity /Affirmative Action ( EO /AA) Program is delegated to the Equal Employment Opportunity ( EEO) Officer for theSanta Ana local Workforce Investment Area. Equal opportunity and non- discrimination, however, will only be achieved through leadership and implementationof a viable Affirmative Action Equal opportunity Program.
2. Civil Rights
No one applying for or enrolled in the Workforce Investment Act (WIA) programs maybe discriminated against because of race, color, creed, handicap, national origin, sex, age, political affiliation, or beliefs.
This means that — for any of the characteristics listed above:
You may not be denied the opportunity to enroll in WIA.
No benefits or services maybe denied you for discriminatory reasons.
You may not be segregated or treated any differently from other applicants or
participants, while you are being registered, interviewed, counseled or tested; or
while you are working or attending classes as part of the program.
You must be provided an equal chance to use all facilities available in the
program.
Fair employment practices must be provided to all staff with regard to recruiting,
hiring, transferring, promotions, training, compensation, benefits, layoff, and
termination.
You have the right to make a complaint if you feel you have been denied any of theabove opportunities. You cannot in anyway be penalized for filing a complaint. YourWIA sponsor has established a mechanism for handling complaints and grievances. Your complaint must be filed within 180 days, All complaints will be handledconfidentially.
3. Nondiscrimination Laws under WIA
Title VI of the Civil Rights Act of 1964
Prohibits discrimination on the basis of race, color, national origin, or religion.
The Age Discrimination Act of 1975
Prohibits arbitrary discrimination against persons age 40 -70.
The Rehabilitation Act of 1973
251 -63
Prohibits discrimination based on handicap. Title IX of the Education Amendments of 1972
Prohibits discrimination in any education or training program or activity receivingfederal financial assistance.
OTHER CIVIL RIGHTS LAWS:
Title VII of the Civil Rights Acts of 1964
Prohibits discrimination in employment based on race, color, religion, sex, ornational origin in all terms and conditions of employment and establishes the
Equal Employment Opportunity Commission as the administrative agency.
White House Executive Order no. 11246 as Amended by Executive Order No11375
Creates the office of Federal Contract Compliance and prohibits discriminationbased on race, color, sex, religion, or national origin.
Department of Labor Secretary's Order no. 4 -73
Prohibits discrimination based on sex.
Equal Pay Act of 1963
Prohibits pay differential solely because of sex.
Emergency Employment Act of 1971
Prohibits discrimination based on race, creed, national origin, political affiliation, orbeliefs.
4. How to File Your Complaint
a. Put your complaint in writing.
b. Have it sworn to before a notary public, if possible.
c. Provides details that tell what happened, where it happened and when it happened.
d. Give the name and addresses of all persons who were present or who had anythingto do with the matter.
Complaints on the basis of race, color, or national origin, age, sex, religion,
political affiliation or belief, retaliation and citizenship, must be filed within 180days of the alleged occurrence directly with:
251 -64
Director
Civil Rights Center
U, S, Department of Labor, Room N -4123200 Constitution Ave,, NWWashington, D. C. 20210
Complaints on the basis of handicap must be filed within 180 days of the allegedoccurrence. These complaints must be filed directly with the WIA administrativeentity. The WIA administrative entity shall issue a written decision within 30 daysof the filing of the complaint. If the complaint is still unresolved, an appeal may bemade to the Chief of State Workforce Investment Division Office,
The Department of Labor, the Civil Service Commission, the Equal Employment
opportunity Commission, and many other offices and agencies are committed toassuring equal employment opportunities for all persons, They will protect you.
A case may be taken to court if the other processes do not yield satisfactory results.
You may hire your own lawyer, or if you cannot afford one, the court may appoint onefor you.
It is unlawful for an employer, union, or employment agency to punish you or anywitness for attempting to present the facts in a case.
YOUR CIVIL RIGHTS UNDER THEWORKFORCE INVESTMENT ACT
Santa Ana Local Workforce Investment Area1000 E. Santa Ana Blvd., Ste 200
Santa Ana, CA 92701
714) 565 -2600
B. Criminal Complaints
In accordance with the WIA (P. L. 105 -200) and the implementing code of Federal section667. 600.... Federal handling of criminal complaints and report fraud, abuse and othercriminal activity. " All information and complaints involving fraud, abuse or other criminalactivity shall be reported directly and immediately to the City of Santa Ana and theSecretary of Labor."
IL General Procedures for Handling Nan- Criminal Violations of theAct
The following procedure is promulgated to meet the requirements of Title 20, of the Code ofFederal Regulations, Section 667.600 through 667. 640 of the WIA regulations, and Section181( c) of the Act (Public Law 105.200: 29 U. S, Code Sec. 2931 et seq.) at the State and LWIA
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level for the receipt, investigation, hearing, and resolution of complaints by WIA participants, sub recipients, applicants for participation, or financial assistance, labor unions, communitybased organizations, or any other persons.
These procedures provide for resolution of non - criminal complaints arising from the operation ofthe Santa Ana LWIA.
A complaint is defined here as a written expression by a party alleging a violation of the Act, regulations promulgated under the Act, recipient grants, sub agreements, or other specific
agreements under the Act, including terms and conditions of employment of suchparticipants in employment training programs. All complaints, amendments and withdrawalsshall be in writing. These procedures are intended to resolve matters which concern policies, procedures or action( s) arising in connection with WIA programs operated by each LWIA grantrecipient and sub recipient under the Act.
These procedures shall not be construed as affecting any other available legal remedy outsideof the WIA complaint process ( i. e., disputes regarding terms and conditions of employment ofany employee who is not a participant), either separately or simultaneously, that a person maywish to pursue in the resolution of a non -WIA complaint. Also, these procedures do not restrict
the LWIA grant recipient staff in carrying out informal discussion
Procedures do not restrict the LWIA grant recipient staff in carrying out informal discussion andresolution of any problems outside of and without resort to the formal complaint procedure.
A. The following principles and rules apply to all complaints at all steps of the complaintprocedures:
All complaints must be made in writing within 180 days of the alleged occurrence, except complaints alleging fraud or criminal activity.
2. All persons filing a complaint shall be free from restraint, coercion, reprisal, ordiscrimination. Good faith efforts shall be made to informally resolve the complaintprior to the scheduled hearing. Complainants have the right to withdraw theircomplaints ( in writing) at any time prior to the hearing. A complainant may amendhis /her complaint to correct technical deficiencies but not to add issues.
3. Complainants shall have the right to be represented at their own expense byperson( s) of their choosing at all levels of the complaint process.
4. Upon enrollment into employment or training, participants shall be provided with awritten description of these procedures, including notification of their right to filecomplaints and instructions for filing.
An employer of participants, including private -for- profit employers of participants, mayuse this or other complaint resolution procedures so long as the participant isinformed of the complaint resolution procedure they are to follow and the time framesgoverning review of complaints are met.
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A "participant ", within the meaning of these procedures, is an individual who receivesemployment - training services under a program funded by Santa Ana LWIA, TheComplaint Resolution Procedures contained herein ( or the alternative procedures
which an employer may use) shall be available to participants to resolve disputesregarding items and conditions of employment of such participants in employmenttraining programs. However, such procedures shall not be used to resolve disputesregarding terms and conditions of employment of any employee who is not aparticipant, as defined herein.
5 If a complaint does not receive a decision at the LWIA grant recipient level within 60
days of filing the complaint or receives an unsatisfactory decision, the complainantthen has a right to request a review of the complaint by the Governor.
6. Complainants must initially file and exhaust LWIA grant recipient /hearing proceduresprior to appealing to the State except where the State determines that the LWIA grantrecipient' s procedures are not in compliance with the State' s procedures.
III. Procedures for Handling Complaints at the LWIA Level
A. Receipt Complaints
Pursuant to the WIA regulations found at 20 CFR, Section 667.600, the LWIA administrativeentities have the responsibility to conduct hearings and resolve complaints made byindividuals about the administration of programs in the LWIA. " LWIA level" encompasses
LWIA administrative entity and employers to which the administrative entity has delegatedthe complaint resolution process. The following comprise the guidelines for resolving issuesarising in connection with WIA programs operated by the Santa Ana LWIA includingresolutions of complaints arising from actions, such as audit disallowances or the impositionof sanctions taken by the Governor with respect to audit findings, investigations ormonitoring reports.
1. Form and Filing of Compliant
Official filing date of the compliant is the date the written complaint is received. The filingof the complaint with the Santa Ana LWIA Equal Employment Opportunity Officer shallbe considered as a request for hearing and a decision must be issued within 60 days. The complaint must be in writing and must be signed and dated. The complaint shouldalso contain the following information:
a. Full name, telephone number, if any, and mailing address of the complainant;
b. Full name, telephone number, and mailing address of the agency involved ( respondent);
c. Clear and concise statement of facts including dates constituting alleged violation;
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d. What provisions under the Act, regulations, grant or other agreements under the Act, arebelieved to have been violated;
e. Remedy sought by the complainant; and
f. If the complainant is a private or public entity or corporation, and not a natural person, the filing of the complaint must be duly authorized by the governing body of such entityor corporation.
The absence of any of the requested information shall not be a basis for dismissing thecomplaint.
A copy of the complaint must be sent to the respondent and both parties notified of theopportunity for an informal resolution. At each step of the complaint process, the complainantmust be notified in writing of the next procedural step.
2. Informal Conference
Informal conferences will be utilized by the Santa Ana LW IA to resolve complaints; however, such informal conferences shall not extend the time within which a decisionmust be issued after receipt of a complaint. Attempts at informal resolution will
commence with two ( 2) weeks of the date of filing of the complaint.
a. The EEO Officer will review the case and ascertain facts prior to the conference so thatappropriate resolution can take place at the time of this meeting whenever possible.
b. Although the complainant should be encouraged to attend this conference, his /her failureto do so should not preclude his /her right to request a hearing on the matter.
c. If mutually satisfactory resolution results and the Santa Ana LWIA concurs, the EEOOfficer will write a brief report for the file stating the issues and resolution. The mattershall then be considered closed.
d. If resolution does not result, the complainant shall be provided the necessary informationand assistance to request a hearing if he /she so desires.
3. Request for Hearing
a. As in the case of the complaint, the request for a hearing should be put in writing andbe filed in person or by mail. A governing board resolution of authorization to appealshould also be submitted when appropriate. The request should be filled with:
Anita Queen
Sr. Personnel Analyst — EEO Officer
20 Civic Center Drive, M -24
Santa Ana, CA 92701714) 647 -5157
9
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b. A hearing will be scheduled by the EEO Officer within thirty (30) days of the date offiling of the complaint.
4. Notice of Hearing
Upon receipt of the request for hearing, the complainant and the respondent will benotified in writing of the hearing ten ( 10) calendar days prior to the date of the hearing. The ten -day notice may be shortened with the written consent of the parties, A decisionwill be issued by the Santa Ana LWIA within sixty (60) days of the date of filing of thecomplaint.
The hearing notice shall be in writing and contain the following information:
a. The date of notice, name of the complainant, and the name of the party against whomthe complaint is filed.
b. The date, time and place of hearing before an impartial hearing officer.
c. A statement(s) of the alleged violation(s)
d. Advise as to where information or assistance may be obtained, and the name, address, and telephone number of the Santa Ana LWIA Equal Employment Opportunities (EEO) Officer who can answer inquiries.
B. Conduct of Hearing
The hearing shall be conducted in an informal manner with strict rules of evidence notapplicable. Unnecessary technicalities should be avoided. It should provide the flexibility toenable adjustment to the circumstances presented.
1. The hearing officer shall have complete independence to obtain facts and makedecisions. The hearing officer shall be in a position to render impartial decisions andthus should not be subordinate to the Santa Ana LWIA or its sub recipients. The hearingofficer will be selected from a list of names on file with the EEO Officer.
2. Full regard must be given to the requirements of due process to insure a fair andimpartial hearing.
3. The hearing office designated by the EEO Officer to function in a quasi - judicial capacityshould begin the hearing by summarizing the record and the issue and should explainthe manner in which the hearing will be conducted, making sure that everyone involvedunderstands the proceedings. Such explanations should be adapted to the needs of thespecific situation. The hearing officer might take testimony under oath or affirmation togive some assurance of veracity to the hearing.
io
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4. The burden of proof should be reasonable and flexible, dependent upon the
circumstances of the case involved. The hearing officer determines the order of proof, Generally, the party making the complaint has the obligation of establishing his or hercase and should be examined first.
5. The party involved should have the right to be represented ( at their own expense) ifhe /she so desires. Other he /she is limited to his /her own abilities and those to thehearing officer in obtaining testimony in the case.
6. It is important that the hearing officer obtain the fullest information for the record. If theparties involved, or their representatives, do not know how to ask the right or pertinent
questions in pursuing their right to due process, it shall be necessary for the hearingofficer to step in to have all the materials and relevant facts elicited.
The practice in informal hearings is generally not to apply strict rules of evidence inobtaining facts. However, the quantity of evidence required to support a decision on anissue should be sufficiently credible that the state ( or other appropriate agency), uponreviewing the decision, would conclude that the decision is supported by substantialevidence.
8. The hearing officer should attempt to negotiate a resolution of the issue at any time priorto the conclusion of the hearing.
9. Within ten ( 10) days of the conclusion of the hearing, the hearing officer will issue arecommended decision to the LWIA for final determination. The recommended decision
shall be in writing and may be accepted, rejected or modified by the Santa AnaWorkforce Investment Board.
C. Issuance of Decision
Within sixty (60) calendar days of filing of the complaint, the Santa Ana LWIA shall issue awritten decision to all parties by first class mail. The final decision shall contain the followinginformation:
1. The name of the parties involved.
2. A statement of the alleged violation and issues related to the alleged violation.
3. A statement of the facts.
4. The decision and the reasons for the decision.
5. A statement of corrective action, if any, to be taken.
6. Notice of the right to request, within ten ( 10) calendar days of receipt of the decision, a
review of the decision by the State Review Panel.
D. Record of Hearing
11
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An administrative file containing support documents on the complaint resolution processhearing conducted will be retained by the Santa Ana LWIA. The purpose of a record is toserve as substantiation of the process followed by the Santa Ana LWIA on the resolution ofthe issues and the results. This information would then be available for subsequent reviewin the event the matter is raised with the State, Such records must be retained for a three - year period after the grant has been officially closed out,
The Santa Ana LWIA's written decision will be included in the record. Evidence received atthe hearing, notes by the hearing officer, stenographer's notes and tape recordings mayalso be used.
E. Establishment of Complaint Procedures
In accordance with Section 667.600, each employing agency including private -for- profitemployers of participants under the Act is required to establish a complaint procedure for
resolving matters relating to the terms and conditions of employment, Employers mayoperate their own grievance system or may utilize the Santa Ana LWIA' s establishedprocedures under Section 667.600. At a minimum these procedures must include:
Written notice, upon enrollment into employment training services, of the scope andavailability of such procedures. Employer' s grievance procedures shall be set forth in awritten document and must meet the regulation mandate that a complaint will beresolved with sixty (60) days from the date the complaint was filed. A copy of employer' sgrievance procedure shall be provided to each participant upon enrollment inemployment training.
2. Written notice, at the time the grievance is filed, of the procedures under which thegrievance will be processed,
3. Written notification of the disposition of the grievance and a written decision shall beissued within thirty (30) days of the filing of the grievance unless a present and longestablished grievance specifically provides other limits; and
4. Written notification of the participant' s right to request a review of the employer' sdecision by the Santa Ana LWIA and the State Review Panel in accordance with Section667.600.
IV. Procedures for Handling Complaints at the State Level
Section 181 ( c) of the Act and the WIA regulations at 20 CFR, Section 667.600 ( d) requires theGovernor to establish a State Review process of complaints filed at the LWIA grant recipientlevel and of complaints initially filed at the State level.
Appeals of decisions issued at the LWIA level including audit disallowances and sanctions shallbe reviewed by the State Review Panel. The State Review Panel shall review the recordestablished at the LWIA level and shall issue a decision based on the information containedtherein.
12
251 -71
Complaints which may be initially filed at the State level will be heard by an independenthearing officer designated by the State Workforce Investment Division ( WID). The hearingofficer shall conduct a hearing and issue a recommended decision to the State Panel. Therecommended decision shall be in writing and may be accepted, rejected or modified by theState Review Panel.
A. Form and Filing of Complaint.
1. Request for State Review of LWIA Level Decisions
On receipt of a complainant' s request for review because of an unsatisfactory decision, the State shall provide for an independent state review.
2. Filing of Requests for State Review
The State Review Panel shall review all LWIA level decisions when a request for reviewis filed within 10 days of receipt of the adverse decision. Such requests must be filed inwriting with the Chief of the WID Office. The request for review should contain thefollowing information;
a. Full name, address, and telephone number of the party requesting the review
b. Full name, address, and telephone number of the other party
c. A copy of the decision
d, Brief statement of reasons for review or the section of the LWIA decision to be
reviewed including regulatory and statutory citations
e. A statement of the relief sought.
3. Complainant Responsibility
It is the responsibility of the complainant to include in the request for review a writtenstatement setting forth the facts presented at the LWIA hearing which support therequested relief.
The Chief, WID, shall mail a copy of the request for review to the other party and to theLWIA. It shall be the responsibility of the LWIA to submit the complete record includingtyped record of the hearing to the Chief, WID, within ten ( 10) days.
B. Conduct of Hearings.
1. Request for Hearing at the State Level
If no decision has been issued at the LWIA level or the State has determined an audit
disallowance or imposed sanctions, the complainant may request a hearing. The
13
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hearing officer will then issue a recommended decision to the State' s Review Panel forfinal determination.
2. Filing for Request for Review
The request for a State hearing shall be filed within ten ( 10) days after LWIA shouldhave issued a decision or ten ( 10) days after the issuance of the audit disallowance or
sanction. The request shall be filed directly with the Chief of the WID in writing andshould include the following:
a. Full name, address, and telephone number of the LWIA
b. Name, address, and telephone number of the LWIA
C. Copies of complaints made at LWIA level from which no decisions were
issued or sanctions and imposed.
A statement of basis for the request for hearing.
3. Evidentiary Hearing
Upon receipt of the request for a State level hearing, a hearing before a designatedhearing officer will be scheduled.
The hearing will be recorded mechanically or by court reporter.
Both parties concerned will have the opportunity to present oral and written testimonyunder oath, to call and question witnesses in support of his /her position, to present oraland /or written arguments, to examine records and documents relevant to the issue( s), and to be represented.
The hearing officer shall issue a written decision, which shall be forwarded to the StateReview Panel for final determination.
The State Review Panel may accept, reject or modify this recommendation. Thedecision of the State Review Panel is final except for audit disallowances, which must be
approved by the Secretary of Labor
C. State Review Panel
The State Review Panel will consist of a panel of three representatives from theEmployment Development Department: one from the Legal Offices, one from the WID,
and one from the Director' s office. The panel will issue a written decision, which will be
sent to the appropriate parties within thirty (30) days of receipt of the request for Statereview.
Decisions issued by this panel, under the authority of the Governor, are final.
14
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D. Issuance of State Review Decision.
The State review will be limited to violations of the WIA, implementing WIA regulations orthe grant agreement. This review shall be limited to the record established at the LWIAhearing.
V. Procedures for Handling Discrimination Complaints byParticipants.
A. Complaints on the basis of race, color, or national origin, age, sex, religion, political
affiliation or belief, retaliation, and citizenship, where appropriate, must be filed within 180days of the alleged occurrence.
1. It is the responsibility of the Santa Ana LWIA' s Equal Employment Opportunity (EEO) Officer to determine jurisdiction and to make the complainant aware of and provide
assistance in filing a complaint in accordance with the Santa Ana LWIA's procedureunder Section II ( A).
15
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PROCEDURES FOR HANDLING NON- CRIMINAL COMPLAINTS
No later than
180 days ofalleged
discrimination
Within 10 days of
receipt of
unsatisfactorydecision or 10
days from date
LWIA decision
should have been
Issued.
Handling of complaints filed at LWIA level arising in connection with WIAprograms operated by LWIAs
Informal Resolution Process
Unsatisfactory Decision or LWIA Decision not issued within 60 days
w000
Request for State Review i w
Governor's Decision Issued by State Review Panel
If no decision issued by State Review Panel
Appeal to DOL
15
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0OaI u
m004H
2. In cases where areas of authority overlap, it is the responsibility of the EEO Officer toadvise the complainant of the existence of State, Federal and other proper action
agencies, which may also have a bearing.
3. Complainants alleging discrimination under this part will be made aware of their right tofile directly with the Office of Civil Rights ( OCR), U. S, Department of Labor andapplicable procedures.
4. Complainants must file their complaint directly with:
Anita Queen
Sr. Personnel Analyst — EEO Officer
20 Civic Center Drive, M -24Santa Ana, CA 92701
714) 647 -5157
VI. Procedures for Handling Handicap Complaints by Participants
Complaints alleging discrimination on the basis of handicap will be filed and processed underthe Department of Labor regulations implementing Section 504 of the Rehabilitation Act of 1973at 29 Code of Federal Regulations Section 32.
1. Complaints must exhaust the Santa Ana LWIA' s informal resolution procedures
before filing their complaint with OCR.
2. Complainants will be made aware of the 180 days requirement in which to file his /hercomplaint.
A. Procedures at the LWIA Level
1. The complainant shall file his/ her complaint directly with the Santa Ana LWIA. Uponreceipt of the complaint, the EEO Officer shall investigate and gather information
concerning the complaint.
2. An informal conference will be held with the parties concerned in an effort to resolve the
issue( s). The complainant has the right to be present and may be represented duringthe conference.
3. The Santa Ana LWIA shall issue in writing its decision to the complainant no later thanthirty (30) days after the filing of the complaint.
B. Procedures at the State Level
1. The complainant may appeal to the State if he /she is not satisfied with the decision of theSanta Ana LWIA.
17
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2. The Complainant must file his /her appeal as a request for review directly with the ChiefW ID within ten ( 10) calendar days after the receipt of the Santa Ana LWiA' s decision.
3. The Chief -W ID, shall issue a decision no later than thirty (30) calendar days after receiptof the request for review.
4. After the complainant has received a decision or no decision has been received from theDirector of Employment Development Department (on behalf of the Governor), thecomplainant has the right to appeal his /her complaint within thirty (30) calendar days tothe Office of Civil Rights (OCR) with the Department of Labor.
zs
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PROCEDURES FOR HANDLING HANDICAP COMPLAINTS
No later than
180 days ofalleged
discrimination
Filed within 30
days of
LWIA/ State
Decision or 90
days from date of
initial filing ofcomplaints
Filing of complaint on the basis Of Handicap with LWIA
Informal Resolution
If no resolution reached
Request for Hearing
Notice of Hearing
Hearing Conducted
LWIA Decision
Unsatisfactory Decision or No Decision
State Review
Governor' s Decision
Appeal to Assistant Secretary Department of Labor
W
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Day I
Day 145 Day
60 Days
GLOSSARY OF WIA TERM
AGE DISCRIMINATION ACT — A law passed by Congress in 1975 which prohibits discrimination onthe basis of age by any program or activity receiving Federal Funds.
APPLICANT — An individual who applies to a subrecipient or contract for services provided underWIA and who has not yet transitioned to the status of participant.
ASSESSMENT — Services designed to determine each participant' s employability, aptitudes, abilitiesand interests and to develop a plan to achieve the participant' s employment and related goals; also toidentify the available employment and traning activities appropriate for the participant. Testing andcounseling may also be used during assessment process.
CHARGING PARTY ( CP), COMPLAINANT. GRIEVANT, OR AGGRIEVED PERSON — The person
who charges that he /she has been discriminated against under Department of Justicenondiscrimination and civil rights regulations and /or guidelines.
DISCRIMINATION — In general, a failure to treat all equally, whether intentional or unintentional; theeffect of an action, policy or practice which selects an individual or class of persons to receiveunequal treatment,
ELIGIBLE NON - CITIZEN -- Lawfully admitted permanent resident, aliens, lawfully admitted refugees, and parolees and other individuals authorized by the Attorney General to work in the United States.
EMPLOYER — An employer subject to the provisions of the Civil Rights Act of 1964, as amended,
including state and local governments and any Federal agency subjects to the provisions of Section717 of the Civil Rights Act, as amended; and any Federal contractor or subcontractor covered byexecutive Order 11246, as amended.
GRIEVANCE — An allegation that something imposes an illegal obligation or burden or denies someequitable or legal right, or causes injustice .
HANDICAPPED INDIVIDUAL — Any individual who has a physical or mental disability that constitutesor results in a substantial handicap to employment.
INTAKE — Includes screening to determine eligibility; to select from eligible applicants thoseindividuals who are most in need and can benefit from program services; to complete procedural
requirements necessary to enroll an individual into the program and to refer those not enrolled toother programs.
JOINT COMPLAINT — A complaint of employment discrimination covered by Title VII or the EqualPay Act and by Title VI or Title IX. Individual ' joint complaints" are normally investigated by EEOC
20
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unless OCR has a compelling reason to investigate. " Joint complaints" alleging discrimination inemployment and other practices and pattern or practice " joint complaints" are normally investigatedby OCR.
JURISDICTION — Authority to investigate and resolve complaints against an institution subject to alaw or statute which has been assigned to OCR for enforcement, i. e., Title VI, Title IX, etc.
PARTICIPANT — Any applicant who has: ( 1) Been determined eligible for participation upon intake; and ( 2) Who is receiving subsidized employment, training or services ( except post - terminationservices) funded under the Act, following intake, except for an individual who receives only outreachand /or intake and assessment services.
21
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CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS
and COOPERATIVE AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief, that;
1) No Federal appropriated funds have been paid or will be paid, by or on behalf ofthe undersigned, to any person for influencing or attempting to influence anofficer or employee of any agency, a Member of Congress in connection with theawarding of any Federal contract, the making of any Federal grant, the making ofany Federal loan, the entering into of any cooperative agreement, and theextension, continuation, renewal, amendment, or modification of any Federalcontract, grant, loan, or cooperative agreement.
2) If any funds other than Federal appropriated funds have been paid or will be paidto any person for influencing or attempting to influence an officer or employee ofany agency, a Member of Congress, an officer or employee of Congress, or anemployee of a member of Congress in connection with this Federal contract,
grant, loan, or cooperative agreement, the undersigned shall complete and
submit Standard Form -LLL, " Disclosure Form to Report Lobbying." inaccordance with its instructions.
3) The undersigned shall require that the language of this certification be included in
the award documents for all subawards at all tiers ( including agreements) andthat all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placedwhen this transaction was made or entered into. Submission of this certification is a
prerequisite for making or entering into this transaction imposed by 31 U. S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty ofnot less than $ 10, 000 and not more than $ 100, 000 for each such failure occurring on orbefore October 23, 1993, and of not less than $ 11, 000 and not more than $ 110, 000 foreach such failure.
The certification set out below is a material representation upon which reliance is placedby the U. S. Department of Housing and Urban Development in awarding the grant. If itis later determined that the contractor knowingly rendered a false certification, orotherwise violates the requirements of the Drug -Free Workplace Act, the U. S. Department of Housing and Urban Development, in addition to any other remediesavailable to the Federal Government, may take action authorized under the Drug -FreeWorkplace Act.
CERTIFICATION
A. The contractor certifies that it will provide a drug -free workplace by:
a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance isprohibited in the contractor' s workplace and specifying the actions that willbe taken against employees for violation of such prohibition;
b) Establishing a drug -free awareness program to inform employees about—
1) The dangers of drug abuse in the workplace; 2) The contractor' s policy of maintaining a drug -free workplace; 3) Any available drug counseling, rehabilitation, and employee
assistance program; and
4) The penalties that may be imposed upon employees for drug abuseviolations occurring in the workplace;
c) Making it a requirement that each employee who will be engaged in theperformance of the grant be given a copy of the statement required byparagraph ( a);
d) Notifying the employee in the statement required by paragraph -( a) that, as a condition of employment under the contract, the employee will -
Pg. 2
1) Abide by the terms of the statement; and2) Notify the employer of any criminal drug statute conviction for a
violation occurring in the workplace no later than five days aftersuch conviction.
EXHIBIT D
251 -82
e) Notifying the U. S. Department of Housing and Urban Development withinten days after receiving notice under subparagraph ( d)( 2) from anemployee or otherwise receiving actual notice of such conviction;
f) Taking one of the following actions, within 30 days of receiving noticeunder subparagraph (d)( 2), with respect to any employee who is soconvicted -
1) Taking appropriate personnel action against such an employee, upto and including termination; or
2) Requiring such employee to participate satisfactorily In a drugabuse assistance or rehabilitation program approved for such
purposes by a Federal, State, or local health, law enforcement, orother appropriate agency;
g) Making a good faith effort to continue to maintain a drug -free workplacethrough implementation of paragraphs (a), ( b), ( c), ( d), ( e) and ( f),
B. The contractor shall insert in the space provided on the attached " Place of
Performance" form the site( s) for the performance of work to be carried out with
the grant funds ( including street address, city, county, state, and zip code) thecontractor further certifies that, if it is subsequently determined that additionalsites will be used for the performance of work under the contract, it shall notifythe U. S. Department of Housing and Urban Development immediately upon thedecision to use such additional sites by submitting a revised 'Place ofPerformance" form.
Organization
Authorized Signature Date
EXHIBIT D
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DIVISION OF EMPLOYMENT SERVICES
PLACE OF PERFORMANCE
FOR CERTIFICATION REGARDING DRUG -FREEWORKPLACE REQUIREMENTS
Name:
Name of Contractor:
Contractor Number:
Date:
The Contractor shall insert in the space provided below the site( s) expected to be usedfor the performance of work under the contract covered by the certification;
Place of Performance ( include street address, city, county, state, zip code for each site):
EXHIBIT D
251 -84
BUDGET FORM
AM" 11985
Administrative
Cost (Not to
Exceed 10 %)
Program
Cost
Match /In
Kind
Total
Cost
Personnel Salaries. , ,
Executive Director 3, 640. 00 69,160,00 72, 800. 00
Executive Director — 1 Full Time Employee - $ 72, 800. 00
Coordinator — 1 Part Time Employee -$ 31, 200.00
Accountant —1 Park Time Employee -$ 7, 800. 00
Operating Expensed: As MikeMarinoff com and Network Kinection, LLC is already doing the same service and hasthe necessary materials and resources needed to carry out the program, we narrowed down theexpenses to just Parking and Office Expenses.
Parking fee is required in some universities and office locations, and the computation is based onan average of $5 /day since the fee varies per location. Parking is 100% chargeable to theprogram.
Office Expenses are equally chargeable to both programmatic and administrative activities. Thesupplies used will be paper, printer toners, envelopes, folders, note pads, labels, binders, clips,
stamps, and other small but necessary items to carry out both functions.
No budget is applied to Vehicle Lease despite of the hefty mileage the project is expected tohave as all vehicle costs, including broad form general liability and automobile liability coveragewith a $ 1, 000, 000 minimum coverage, will be shouldered by MikeMarinoff.com and NetworkKinection, LLC.
ASSURANCES
Contractor agrees that in addition to those agreements and obligations specified in the
contract boilerplate, attached exhibits and scope of work, it will also adhere to and obeythe following provisions, assurances, and certifications.
1. Prohibited Uses, Contractor assures and certifies that it will not use any fundsappropriated under this agreement for religious activity or anti - religious activity, or to promote or oppose any political candidate, parties, and /or beliefs.
2. Modification. Contractor assures and certifies that any requested modification tothis agreement must be submitted in writing, explaining requested changes andrationale. Contractor further assures that no modification will be implementedwithout prior written approval from the Santa Ana WORK Center.
3. Cooperation. Contractor agrees to cooperate with any monitoring inspectionaudit or investigations of activities related to this Agreement as may bescheduled and conducted by the Santa Ana WORK Center.
4. Acknowledgement. Contractor agrees to acknowledge (give credit to) the Santa
Ana WORK Center in all oral presentations, written document publicity, andadvertisements regarding any activities that ensue from this Agreement.
Intellectual Property Rights. The federal Government reserves a paid -up, nonexclusive and irrevocable license to reproduce, publish or otherwise use, andto authorize others to use for federal purposes: !) the copyright in all products
developed under the grant, including a subgrant or contract under the grant orsubgrant; and !!) any rights of copyright to which the grantee, subgrantee or acontractor purchases ownership under an award ( including but not limited tocurricula, training models, technical assistance products and any relataedmaterials). Such uses include, but are not limited to, the right to modify anddistribute such products worldwide by any means, electronically or otherwise. Federal funds may not be used to pay any royalty or licensing fee associatedwith such copyrighted material, although they may be used to pay costs forobtaining a copy which are limited to the developer /seller costs of copying andshipping, If revenues are generated through selling products developed withgrant funds, including intellectual property, these revenues are program income. Program income is added to the grant and must be expended for allowable grantactivity.
6. Product Creation. If applicable, the following needs to be on all productsdeveloped in whole or in part with grant funds:
This workforce solution was funded by a grant awarded by the U. S. Department of Labor's Employment and Training Administration. The solution
EXHIBIT F
251 -87
was created by the grantee and does not necessarily reflect the officialposition of the U. S. Department of Labor. The Department of Labor makes
no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites andincluding, but not limited to, accuracy of the information or its completeness, timeliness, usefulness,, adequacy, continued availability, or ownership. Thissolution is copyrighted by the institution that created it. Internal use, by anorganization and /or personal use by an individual for non - commercialpurpose, is permissible. All other uses require the prior authorization of thecopyright owner."
