HomeMy WebLinkAboutAGMT - Orange County (Meal Gap Services)DocuSign Envelope ID: C10AE329-CC83-43ED-BC42-CB106A39671C
AGREEMENT NO. MA -012-22010638
BY AND BETWEEN
COUNTY OF ORANGE
AND
CITY OF SEAL BEACH
FOR MEAL GAP SERVICES
This Agreement for Meal Gap Services No. MA -012-22010638 ("Agreement") is made and
entered into by and between the County of Orange, a political subdivision of the State of
.California, hereinafter referred to as "County", and the City of Seal Beach, a municipal
corporation, hereafter referred to as "Subrecipient," with the County and Subrecipient
referred to individually as "Party," or collectively as "Parties."
WHEREAS, on February 26, 2020, the County Health Officer declared a local
health emergency based on an imminent and proximate threat to public health from the
introduction of a novel coronavirus (named "COVID-19") in Orange County (the "COVID-
19 Emergency"); and
WHEREAS, on March 2, 2020, the Board of Supervisors adopted Resolution No.
2020-11 ratifying the local health emergency declared by the County's Health Officer; and
WHEREAS, on March 4, 2020, the Governor of the State of California declared a
State of Emergency to exist in California as a result of the threat of COVID-19; and
WHEREAS, the COVID-19 pandemic and the necessary physical distancing
measures implemented have impacted many people, especially those with food
insecurities; and
WHEREAS, the Orange County Board of Supervisors has allocated $10 million in
American Rescue Plan Act of 2021 (ARPA), H.R. 1319 dollars equally between the five
supervisorial districts for meal gap support initiatives in response to COVID-19 on April
27, 2021; and
WHEREAS, pursuant to the authority delegated by the Orange County Board of
Supervisors, a share will be distributed to each city located in District 2 based on overall
district population; and
WHEREAS, in order to provide meals to those facing food insecurities in the
Second District due to the COVID-19 public health emergency, the Parties have agreed
that the County shall transfer the grant amount described herein to Subrecipient.
NOW, THEREFORE, the Parties mutually agree as follows:
1. TERM OF AGREEMENT. The term of this Agreement begins on the date
when fully executed by the Parties, and terminates on December 31, 2021, or
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when all of the Parties' obligations under this Agreement are fully satisfied,
whichever occurs earlier.
2. USE OF GRANT AMOUNT.
a. Subrecipient shall use the grant amount provided under this
Agreement to provide for food insecurities: (1) are necessary
expenditures incurred due to the public health emergency with respect
to COVID-19; and (2) were incurred during the period that begins on
the date the Agreement is fully executed and ends on December 31,
2021.
b. The term "Eligible Expenses," as used in this Agreement, shall mean
expenses incurred and paid for by Subrecipient for the provision of
providing food/meal gap programs to clients with insecurities due to
the Covid-19 pandemic located in the Second District in connection
with the COVID-19 public health emergency. Eligible expenses may
include improvements to or building of community gardens in
neighborhoods or schools to cover supplies, plantings of vegetables and
fruits, and waivers of community garden plot stipends. Eligible
expenses may also include planting of fruit trees like orange, lemon,
lime or apples in low income Covid impacted neighborhoods and
parks.
C. The following is a nonexclusive list of expenditures that shall not
constitute Eligible Expenses payable from the grant amount:
(1) Damages covered by insurance.
(2) Expenses that have been or will be reimbursed under any local,
state or federal program, such as the reimbursement by the
federal government pursuant to the CARES Act of contributions
by States to State unemployment funds.
(3) Reimbursement to donors for donated items or services.
(4) Workforce bonuses other than hazard pay or overtime.
(5) Severance pay.
(6) Legal settlements.
I Subrecipient must utilize the grant amount in accordance with all
local, state, and federal laws, including but not limited to the American
Rescue Plan Act of 2021 (ABPA), codified at 42 U.S.C. § 802, et seq.,
and all applicable regulations and guidelines implementing ARPA,
including the regulations issued by the Department of Treasury at 35
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CFR Part 35 regarding costs that are payable from Coronavirus State
and Local Fiscal Recovery Funds.
3. PAYMENT OF GRANT AMOUNT
a. The County will issue a one-time payment to the Subrecipient in the
amount of $70,000 within 10 business days of the full execution of this
Agreement. All of Subrecipient's expenditures of the grant amount
must be for costs as described in Paragraph 2 of this Agreement. The
grant amount represents the amount allocated to Subrecipient.
b. It is understood that the County makes no commitment to fund this
Agreement beyond the terms set forth herein.
C. Subrecipient will provide the County invoices and receipts as proof of
eligible expenses within 14 working days of expending the full $70,000.
C. If Subrecipient has not spent any portion of the grant amount it has
received under this Agreement to cover Eligible Expenses by December
31, 2021, Subrecipient shall return to the County by January 31, 2022
the amount remaining unspent as of December 31, 2021.
4. STATUTES AND REGULATIONS APPLICABLE TO GRANT.
Subrecipient must comply with all applicable requirements of local, state,
and federal laws, executive orders, regulations, program and administrative
requirements, policies and any other requirements governing this Agreement.
Subrecipient must comply with applicable local, state and federal laws and
regulations pertaining to labor, wages, hours, and other conditions of
employment. Subrecipient must comply with new, amended, or revised laws,
regulations, and/or procedures that apply to the performance of this
Agreement. These requirements include, but are not limited to:
a. Office of Management and Budget (OMB) Circulars. Subrecipient
must comply with OMB Circulars, as applicable: OMB Circular A-21
(Cost Principles for Educational Institutions); OMB Circular A-87
(Cost Principles for State, Local, and Indian Tribal Governments);
OMB Circular A-102 (Grants and Cooperative Agreements with State
and Local Governments); Common Rule, Subpart C for public agencies
or OMB Circular A-110 (Uniform Administrative Requirements for
Grants and Other Agreements with Institutions of Higher Education,
Hospitals and Other Non -Profit Organizations); OMB Circular A-122
(Cost Principles for Non -Profit Organizations); OMB Circular A-133
(Audits of States, Local Governments, and Non -Profit Organizations.
b. Political Activity Prohibited. None of the funds, materials, property, or
services provided directly or indirectly under this Agreement may be
used for any partisan political activity, or to further the election or
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defeat of any candidate for public office. Funds provided under this
Agreement may not be used for any purpose designed to support or
defeat any pending legislation or administrative regulation.
C. Tax Reporting. Subrecipient is responsible for any tax reporting
requirements that arise from this Agreement, including the filing of
any required tax forms with the IRS and the issuance of any required
tax forms to recipients of economic support from the Subrecipient.
5. REPORTS.
a. Progress Report. On December 1, 2021, Subrecipient shall provide a
report to the County that shall: (1) identify the Eligible Expenses paid
from the grant amount; (2) demonstrate how Subrecipient used the
grant amount consistent with the use requirements of Paragraph 2;
and (4) identify the balance of the grant amount that Subrecipient has
not spent.
b. Final Report. Upon the earlier of Subrecipient's expenditure of the
balance of the grant amount or January 15, 2022, Subrecipient shall
provide a report to the County that shall: (1) identify the Eligible
Expenses paid from the grant amount; (2) demonstrate how
Subrecipient used the grant amount consistent with the use
requirements of Paragraph 2; and (3) identify the balance of the grant
amount that Subrecipient has not spent, if any.
C. The Subrecipient shall provide a certification signed by its chief
executive officer with each report required under this Paragraph 5 that
the statements contained in the report are true and that the
expenditures described in the report comply with the uses permitted
under Paragraph 2.
d. Subrecipient shall maintain supporting documentation for the reports
required by this Paragraph 5 consistent with the requirements of
Paragraph 6.
6. RECORDS MAINTENANCE.
Records, in their original form, must be maintained in accordance with
requirements prescribed by the County with respect to all matters specified
in this Agreement. Original forms are to be maintained on file for all
documents specified in this Agreement. Such records must be retained for a
period four (4) years after termination of this Agreement and after final
disposition of all pending matters. "Pending matters" include, but are not
limited to, an audit, litigation or other actions involving records. Records, in
their original form pertaining to matters covered by this Agreement, must at
all times be retained within the County of Orange unless authorization to
remove them is granted in writing by the County.
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7. RECORDS INSPECTION.
At any time during normal business hours and as often as either the County
or the Auditor General of the State of California may deem necessary,
Subrecipient must make available for examination all of its records with
respect to all matters covered by this Agreement. The County and the
Auditor General of the State of California each have the authority to audit,
examine and make excerpts or transcripts from records, including all
Subrecipient's invoices, materials, payrolls, records of personnel, conditions of
employment and other data relating to all matters covered by this
Agreement. Subrecipient agrees to provide any reports requested by the
County regarding performance of this Agreement. With respect to inspection
of Subrecipient's records, the County may require that Subrecipient provide
supporting documentation to substantiate Subrecipient's expenses with
respect to the Subrecipient's use or expenditure of the grant amount.
8. INDEPENDENT CONTRACTOR.
The Subrecipient shall be considered an independent contractor and neither
the Subrecipient, its employees, nor anyone working under the Subrecipient
shall be considered an agent or an employee of County. Neither the
Subrecipient, its employees nor anyone working under the Subrecipient shall
qualify for workers' compensation or other fringe benefits of any kind through
County.
9. PERMITS, LICENSES, APPROVALS, AND LEGAL OBLIGATIONS.
Subrecipient shall be responsible for obtaining any and all permits, licenses,
and approvals required for performing any work under this Agreement.
Subrecipient shall be responsible for observing and complying with any
applicable Federal, State, or local laws, or rules or regulations affecting any
such work. Subrecipient shall provide copies of permits and approvals to the
County upon request.
10. INSURANCE.
Employee Dishonesty: coverage is required in the minimum amount of
$100,000 per occurrence. The County of Orange shall be the loss payee. A
Loss Payee endorsement evidencing that the County of Orange is a Loss
Payee shall accompany the Certificate of Insurance.
11. INDEMNITY.
The Subrecipient shall indemnify, defend with counsel approved in writing by
County, and hold County, its elected and appointed officials, officers,
employees and agents and those special districts and agencies which County's
Board of Supervisors acts as the governing Board harmless from any claims,
demands or liability of any kind or nature, including but not limited to
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personal injury or property damage, arising from or related to the
Subrecipient's receipt, distribution or expenditure of the grant amount under
this Agreement. The provisions of this paragraph shall survive the
termination of this Agreement.
12. NOTICES.
Any and all notices, requests, demands and other communications
contemplated, called for, permitted, or required to be given hereunder shall
be in writing. Any written communications shall be deemed to have been
duly given upon actual in-person delivery, if delivery is by direct hand, or
upon delivery on the actual day of receipt or no greater than four (4) calendar
days after being mailed by US certified or registered mail, return receipt
requested, postage prepaid, whichever occurs first. The date of mailing shall
count as the first day. All communications shall be addressed to the
appropriate Party at the address stated herein or such other address as the
Parties hereto may designate by written notice from time to time in the
manner aforesaid.
Subrecipient:
Jill Ingram
City Manager
City of Seal Beach
211 8th Street
Seal Beach, CA 90740
COUNTY:
Renee Ramirez
County of Orange
OC Community Services
1300 S. Grand, Bldg. B
Santa Ana, CA 92705
13. DEFAULTS.
Should either Party fail for any reason to comply with the contractual
obligations of this Agreement within the time specified by this Agreement,
the non -breaching Party reserves the right to terminate the Agreement,
reserving all rights under State and Federal law.
14. ATTORNEY FEES.
In any action or proceeding to enforce or interpret any provision of this
Agreement, each Party shall bear its own attorney's fees, costs, and expenses.
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15. ENTIRE CONTRACT.
This Agreement contains the entire agreement between the Parties with
respect to the matters herein, and there are no restrictions, promises,
warranties or undertakings other than those set forth herein or referred to
herein. No exceptions, alternatives, substitutes, or revisions are valid or
binding on the Parties unless authorized by the Parties in writing.
16. AMENDMENTS.
No alteration or variation of the terms of this Agreement shall be valid unless
made in writing and signed by the Parties; no oral understanding or
agreement not incorporated herein shall be binding on either of the Parties;
and no exceptions, alternatives, substitutes, or revisions are valid or binding
on County unless authorized by County in writing.
17. EQUAL EMPLOYMENT OPPORTUNITY.
The Subrecipient shall comply with U.S. Executive Order 11246 entitled,
"Equal Employment Opportunity" as amended by Executive Order 11375 and
as supplemented in Department of Labor regulations (41 CFR, Part 60) and
applicable State of California regulations as may now exist or be amended in
the future. The Subrecipient shall not discriminate against any employee or
applicant for employment on the basis of race, color, national origin, ancestry,
religion, sex, marital status, political affiliation or physical or mental
condition.
Regarding persons with disabilities persons, the Subrecipient will not
discriminate against any employee or applicant for employment because of
physical or mental disability in regard to any position for which the employee
or applicant for employment is qualified. The Subrecipient agrees to provide
equal opportunity to disabled persons in employment or in advancement in
employment or otherwise treat qualified disabled individuals without
discrimination based upon their physical or mental disabilities in all
employment practices such as the following: employment, upgrading,
promotions, transfers, recruitments, advertising, layoffs, terminations, rate of
pay or other forms of compensation, and selection for training, including
apprenticeship. The Subrecipient agrees to comply with the provisions of
Sections 503 and 504 of the Rehabilitation Act of 1973, as amended,
pertaining to prohibition of discrimination against qualified disabled persons
in all programs and/or activities as detailed in regulations signed by the
Secretary of the Department of Health and Human Services effective June 3,
1977, and found in the Federal Register, Volume 42, No. 68 dated May 4,
1977, as may now exist or be amended in the future.
Regarding persons with disabilities, Subrecipient agrees to comply with
applicable provisions of Title 1 of the Americans with Disabilities Act enacted
in 1990 as may now exist or be amended in the future.
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18. DEBARMENT.
Subrecipient shall execute and abide by the Debarment & Suspension
Certification, attached hereto as Exhibit 1 and incorporated herein by this
reference, and by so doing declares that it is not debarred or suspended or
otherwise excluded from or ineligible for participation in Federal/State
assistance programs in accordance with 29 C.F.R. Part 98.
19. LOBBYING CERTIFICATION.
a. Subrecipient shall execute and abide by the terms of the "Certification
Regarding Lobbying," which is attached hereto as Exhibit 2 and
incorporated herein by this reference. Subrecipient shall complete and
immediately forward to the County's Project Manager the "Disclosure
Form to Report Lobbying," a copy of which is attached hereto as
Exhibit 3 and incorporated herein by this reference, if Subrecipient, or
any person, firm or corporation acting on Subrecipient's behalf,
engaged or engages in lobbying any federal office, employee, elected
official or agency with respect to this Agreement or funds to be
received by Subrecipient pursuant to this Agreement.
b. Subrecipient agrees that the funds provided herein shall not be used to
promote, directly or indirectly, any political party, political candidate
or political activity, except as permitted by law.
C. Subrecipient shall be in compliance with the Byrd Anti -Lobbying
Amendment (31 U.S.C. 1352 and 29 CFR Part 93).
20. AUDIT.
a. If Subrecipient expends more than $750,000 in federal funds during
the term of this Agreement, Subrecipient shall arrange for an audit to
be performed, within one hundred fifty (150) days of the end of
Subrecipient's fiscal year and in accordance with 2 CFR Part 200,
Subpart F, "Audit Requirements of States, Local Governments, and
Non -Profit Organizations," which is incorporated herein by reference.
Furthermore, County retains the authority to require Subrecipient to
submit a similarly prepared audit at Subrecipient's expense even in
instances when Subrecipient's expenditure is less than $750,000.
b. Subrecipient shall take the following actions in connection with such
audit:
i. Ensure that appropriate corrective action is taken to correct
instances of noncompliance with federal laws and regulations.
Corrective action shall be taken within six months after County
receives Subrecipient's audit report;
ii. Adjust its own records as necessitated by the audit;
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iii. Permit independent auditors to have access to its records and
financial statements as is necessary for County or Subrecipient
to comply with 2 CFR Part 200, Subpart F;
iv. Submit two copies of its audit reports to County no later than 30
days after completion of the reports;
V. Procure audit services in accordance with 2 CFR Part, 215.40
(OMB Circular A-110) procurement standards and provide
maximum opportunity for small and minority audit firms;
vi. Include in contract(s) with auditor(s) provisions that the
auditor(s) will comply with all applicable audit requirements;
vii. Include in its contract with independent auditors a clause
permitting representatives of County or the State to have access
to the work papers of the independent auditors;
viii. Provide to County, the Bureau of State Audits, and their
designated representatives, the right to review and to copy all
audit reports and any supporting documentation pertaining to
the performance of this Agreement, and the option to perform
audits and/or additional work as needed;
ix. Cooperate with and participate in any further audits which may
be required by County or the State;
X. Ensure that its audit addresses all issues contained in any
federal OMB Compliance Supplement that applies to its
program;
xi. Ensure that the audit is performed in accordance with Generally
Accepted Government Auditing Standards -2 CFR 200.514 and
45 CFR 75.514, is performed by an independent auditor, and is
organization -wide;
C. Ensure that the audit is all-inclusive, i.e., it includes an opinion (or
disclaimer of opinion) of the financial statements; a report on internal
control related to the financial statements and major programs; an
opinion (or disclaimer of opinion) on compliance with laws, regulations,
and the provisions of contracts; and the schedule of findings and
questioned costs in accordance with 2 CFR 200.515 and 45 CFR
75.515; If total funds awarded under this Agreement equal or exceed
$10,000, Subrecipient shall be subject to examination and audit,
including interviews of its staff, by the County and State of California
for a period of three (3) years after final payment under this
Agreement.
21. NON-DISCRIMINATION AND COMPLIANCE PROVISIONS.
a. State laws.
i. Subrecipient shall, unless exempted, ensure compliance with the
requirements of Cal. Gov. Code §11135 et seq., and 2 CCR §
11140 et seq., which prohibit recipients of state financial
assistance from discriminating against persons based on race,
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OC Community Resources District Two Agreement No. MA -012-22010638
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national origin, ethnic group identification, religion, age, sex,
sexual orientation, color, or disability. [22 CCR § 98323]
ii. Subrecipient's signature affixed hereon shall constitute a
certification, under penalty of perjury under the laws of the
State of California, that Subrecipient has, unless exempted,
complied with the nondiscrimination program requirements of
Government Code Section 12900 (a -f) and Title 2, California
Code of Regulations, Section 8103.
iii. Subrecipient shall include the nondiscrimination and
compliance provisions of this Paragraph in all sub -contracts to
perform work under this Agreement.
b. Title VI of Civil Rights Act. SUBRECIPIENT hereby agrees that it will
comply with Title VI of the Civil Rights Act of 1964 [42 USC 2000d; 45
CFR 80](P.L. 88-352) and all requirements imposed by or pursuant to
the Regulation of the Department of Health and Human Services (45
CFR Part 80) issued pursuant to that title, to the end that, in
accordance with Title VI of the Act and the Regulation, no person in
the United States shall, on the ground of race, color, or national origin,
be excluded from participation in, be denied the benefits of, or be
otherwise subjected to discrimination under any program or activity
for which funds are made available under this Agreement.
Subrecipient hereby gives assurance that it will immediately take any
measures necessary to effectuate this Agreement.
C. Title VII of Civil Rights Act. SUBRECIPIENT shall comply with Title
VII of the Civil Rights Act of 1964 (42 U.S.C. 2000), as amended by the
Equal Opportunity Act of March 24, 1972 (Public Law No. 92-261), and
with all applicable rules, regulations and orders promulgated pursuant
thereto, as now in existence or as hereafter amended.
d. Disability discrimination. Subrecipient shall comply with Sections 503
and 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794),
the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.),
and all requirements imposed by the applicable regulations and
guidelines issued pursuant to those statutes, including 45 CFR, Part
84.
e. Failure to comply. If Subrecipient fails to comply with the
requirements of any Sub -Paragraphs of this Paragraph 21
Administrator may withhold payment to Subrecipient and/or
terminate this Agreement.
22. FEDERAL ENVIRONMENTAL LAWS.
If the amount of compensation Subrecipient shall receive under this
Agreement exceeds $100,000, Subrecipient and its subcontractors shall
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comply with all applicable orders or requirements issued under the following
laws:
a. Clean Air Act as amended (42 U.S.C. 7401)
b. Federal Water Pollution Control Act as amended (33 U.S.C. 1251 et
seq.)
C. Environmental Protection Agency Regulations (40 CFR 29, Executive
Order 11738).
d. State Contract Act [Cal. Pub. Con. Code §10295 et seq.]
e. Unruh Civil Rights Act [Cal. Pub. Con. Code § 2010]
23. CONTRACTOR/SUBRECIPIENT DETERMINATION:
In accordance with the requirements of 2 CFR 200.330 (Subrecipient and
Contractor determination) and for the purpose of this Agreement, City of
Irvine is determined to be a Subrecipient.
24. FEDERAL AWARD IDENTIFICATION:
FAIN INFORMATION
A.
Subrecipient Name:
City of Seal Beach
B
Subrecipient's Unique
060752607
Identifier -U-N-S :
Federal Award
C.
Identification Number
SLFRP1607
(FAIN):
D.
Federal Award Date:
March 11, 2021
E
Subaward Period of
Upon execution — December 31, 2021
Performance:
Total Amount of Federal
F.
Funds Obligated by the
$70,000
Action:
G
Total Amount of Federal Funds
$70 000
Obligated to the Subrecipient:
'
H
Total Amount of the Federal
$616,840,943
Award:
1
Federal Award Project
American Rescue Plan Act of 2021
Description:
J.
Federal Awarding Agency:
U.S. Department of the Treasury
K.
Name of PTE:
County of Orange
L
Contact Information for the
Dylan Wright, Executive Director
Awarding Official:
Phone Number:
(714) 480-2788
E-mail Address:
Dvlan.Wright@occr.ocgov.com
M.
CFDA Number:
21.027
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THE REMAINDER OF THIS PAGE WAS INTENTIONALLY LEFT BLANK
County of Orange Page 12 of 13 City of Sea[ Beach
OC Community Resources District Two Agreement No. MA -012-22010638
CFDA Name:
State and Local Fiscal Recovery Funds program
N.
Whether Award is R&D:
No
o'
Indirect Cost Rate for the
N/A
Federal Award:
THE REMAINDER OF THIS PAGE WAS INTENTIONALLY LEFT BLANK
County of Orange Page 12 of 13 City of Sea[ Beach
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IN WITNESS WHEREOF, the Parties hereto have executed this Agreement on the
day and year dated below.
CITY OF SE
d,4 -$-ACH
By: a Date: 11/12/2021
Jill Ingram, City Manager
DocuSigned
by:
�
By: t,+' �Date: 11/11/2021
Craig Steele, City Attorney
COUNTY OF ORANGE
A Political Subdivision of the State of California
DocuSigned by:
By: 1eg mi"
Dylan Wright, Director
OC Community Resources
APPROVED AS TO FORM
COUNTY COUNSEL
Dated: 11/14/2021
By: FDocuSigned by:
P bMS6 Dated:
Patrick Bruso
Deputy County Counsel
County of Orange Page 13 of 13
OC Community Resources District Two
11/10/2021
City of Seal Beach
Agreement No. MA -012-22010638
DocuSign Envelope ID: C10AE329-CC83-43ED-BC42-CB106A39671C
Exhibit 1
CERTIFICATION REGARDING
DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION
LOWER TIER COVERED TRANSACTIONS
This certification is required by the regulations implementing Executive Order 12549, Debarment
and suspension, 29 CFR Part 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)
(1) The contractor or grant recipient of Federal assistance funds certifies, by submission of this
exhibit document, that neither it nor its principals are presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from participation in
this transaction by any Federal department or agency.
(2) Where the contractor or grant recipient of Federal assistance funds is unable to certify to
any of the statements in this certification, the contractor or grant recipient shall attach an
explanation to this exhibit document.
Jill R Ingram
Name
City Manager
Title r—UocuSignedby:
31U. F lln vam 11/12/2021
Date
County of Orange Page 1 of 2 City of Seal Beach
OC Community Resources District Two Agreement No. MA -092-22010638
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Exhibit 1
DEBARMENT AND SUSPENSION CERTIFICATION - Instructions for Certification
1. By signing and submitting this exhibit document, the contractor or grant recipient of Federal
assistance funds is providing the certification as set out below.
2. The certification in the clause is a material representation of fact upon which reliance was
placed when this transaction was entered into. If it is later determined that the contractor or
grant recipient of Federal assistance funds knowingly rendered an erroneous certification in
addition to other remedies available to the Federal Government, the Department of Labor (DOL)
may pursue available remedies, including suspension and/or debarment.
3. The contractor recipient of Federal assistance funds shall provide immediate written notice to
the County of OrangeMorkforce Investment Board to which this certification document is
submitted if at any time the contractor or grant recipient of Federal assistance funds learns that
its certification was erroneous when submitted or has become erroneous by reason of changed
circumstances.
4. The contractor or grant recipient of Federal assistance funds agrees by submitting this
certification document that, should the covered transaction be entered into, it shall not knowingly
enter into any lower tier covered transaction with a person who is debarred, suspended,
declared ineligible, or voluntarily excluded from participation in this covered transaction, unless
authorized by the DOL.
5. The contractor or grant recipient of Federal assistance funds further agrees by submitting this
certification document that it will include the clause titled "Certification Regarding Debarment,
Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," without
modification, in all lower tier covered transactions and in all solicitations for lower tier covered
transactions.
6. The contractor or grant recipient in a covered transaction may rely upon a certification of a
contractor or grant recipient in a lower tier covered transaction that it is not debarred,
suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that
the certification is erroneous. The contractor or grant recipient may decide the method and
frequency by which it determines the eligibility of its principals.
7. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge
and information of the contractor or grant recipient is not required to exceed that which is
normally possessed by a prudent person in the ordinary course of business dealings.
8. Except for transactions authorized under paragraph 5 of these instructions, if the contractor or
grant recipient in a covered transaction knowingly enters into a lower tier covered transaction
with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation
in this transaction, in addition to other remedies available to the Federal Government, the DOL
may pursue available remedies, including suspension and/or debarment.
County of Orange Page 2 of 2 City of Seal Beach
OC Community Resources District Two Agreement No. MA -012-22010638
DocuSign Envelope ID: C10AE329-CC83-43ED-BC42-CB106A39671C
Exhibit 2
Page 1 of 1
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 of the undersigned, to
any person for influencing or attempting to influence an officer or employee of an agency, a member
of Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any Federal contract, the making of any Federal grant, the making of
any Federal loan, the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress,
an officer or employee of Congress, or an employee 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," in accordance 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 subcontracts, subgrants and contracts under grants, loans, and
cooperative agreements) and that all* subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for making or
entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file
the required certification shall be subject to a civil penalty of not less than $10, 000 and not more than
$100,000 for each such failure.
City of Seal Beach
Grantee/Contractor Organization
Jill R Ingram
Name
City Manager
Title cuSigned by:
5iiF(K'
*Note: In these instances, "All," in the Final Rule is expected to be clarified to show that it applies to
covered contract/grant transactions over $100,000 (per OMB).
County of Orange Page 1 of 1 City of Seal Beach
OC Community Resources District Two Agreement No. MA -012-22010638
DocuSign Envelope ID: C10AE329-CC83-43ED-13C42-CB106A39671 C
Exhibit 3
INSTRUCTIONS FOR COMPLETION OF
SF -LLL DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient at the initiation or receipt of a
covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each
payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress. or an employee of a Member of Congress in connection with a covered Federal action.
Use the SF LLL -A Continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the
initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional
information.
1. Identify the type of covered Federal action for which lobbying is and has been secured to influence the outcome of a covered action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If this is a follow up report caused by a material change to the information previously reported,
enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this
covered Federal action.
4. Enter the full name, address, city, state and zip code of the reporting entity. Include congressional district. if known. Check the appropriate
classification of the reporting entity that designates if it is, or expects to be a prime or subaward recipient.
Identify the tier of the subawardee, e. g. the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts.
subgrants and contract awards under grants.
5. If the organization filing the report, in item 4 checks "Subawardee", then enter the full name, address, city, state, and zip code of the prime Federal
recipient. Include congressional district, if known.
6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if
known. For example, Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic
Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e. g. Request for Proposal (RFP)
number; Invitation for Bid (IFB) number; grant announcement number the contract, grant. or loan award number; the application proposal control
number assigned by the Federal agency). Include prefixes, e.g., 'RFP DE 90 09."
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the
award/loan commitment for the primary entity identified in item 4 or 5.
10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to
influence the covered Federal action.
(b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First
Name, and Middle Initial (MI).
11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10).
Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report
enter he cumulative amount of payment made or planned to be made.
12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in kind contribution, specify the nature and value of
the in kind payment.
13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature.
14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to perform, and the date(s) of any
services rendered. Include all preparatory and related activity, not just time spent in actual contact with Federal officials. Identify the Federal
official(s) or employee(s) contacted and the officer(s), employee(s), or Member(s) of Congress that were contacted.
15. Check whether or not a SF LLL A Continuation Sheet(s) is attached.
16. The certifying official shall sign and date the form, print his/her name, title, and telephone number.
Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instructions.
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send
comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the
Office of Management and Budget. Paperwork Reduction Project (0348 0046) Washington D.C., 20503.
DocuSign Envelope ID: C10AE329-CC83-43ED-BC42-CB106A39671 C
Exhibit 3
DISCLOSURE OF LOBBYING ACTIVITIES
ComDlete this form to disclose activities pursuant to 31 U.S.0 1352
1. Type of Federal Actions:
2. Status of Federal Actions:
3. Report Type:
a. contract
a. bid/offer/application
a. initial filing
b. grant
b. initial award
b. material change
C. cooperative agreement
C. post -award
d. loan
For material change only:
e. loan guarantee
Year: Quarter:
f. loan insurance
Date of last report:
4. Name and Address of Reporting Entity
5. If Reporting Entity in No. 4 is a Subawardee:
Prime Subawardee
Enter Name and Address of Prime:
Tier if known
Congressional District, if known:
Con ressional District, if known:
6. Federal Department /Agency:
7. Federal Program Name/Description
8. Federal Action Number, if known:
9. Award Amount, if known:
10a. Name and Address of Lobbying Entity
10b. Individual Performing Services
(if individual, last name, first name, MI):
(including address if different from No. 1Oa)
(last name, first name, MI):
attach Continuation Sheets SF -LLL -A, if necessary)
11. Amount of Payment (check all that apply):
13. Type of Payment (check all that apply)
$ Actual
a. retainer
Planned
b. one-time free
C. commission
12. Form of Payment (check all that apply):
a. cash
d. contingent fee
b. in-kind: specify:
e. deferred
nature:
f. other specify:
value:
14. Enter Description of Services performed or to be Performed and date(s) of Service, including officer(s), employee(s), or Member(s)
contacted, for Payment indicated on item 11:
15. Continuation sheets SF -LLL -A attached: ❑ Yes cUaigned by:
16. Information requested through this form authorized by Title
yL r f ask
31 U.S.C. Section 1352. This disclosure of lobbying activities is a
Signature:
material representation of fact upon which reliance was placed by the
tier above when this transaction was made or entered into. This
disclosure is required pursuant to 31 U.S.C. 1352. This information
will be reported to the Congress semiannually and will be available for
]ill R Ingram
Print Name:
public inspection. An person who fails to file the required disclosure
city manager
shall be subject to a civil penalty of not less than $10,000 and not
Title:
more than $100,000 for each such failure.
Telephone No: 562-431-2527
Date: 11/12/2021
DocuSign Envelope ID: C10AE329-CC83-43ED-BC42-CB106A39671C
Exhibit 3
Reporting Entity:
DISCLOSURE OF LOBBYING ACTIVITIES
CONTINUATION SHEET
Approved by OMS - 0348-0046
Page of
BILLING CODES 3410-01 -C; 6450-01-C; 6890-01 ;6025-01-C; 7510-01-C, 35 1 0 -FE -C; 8120-01 -C; 4710-24-C, 6116-01 -C,
DocuSign Envelope ID: C10AE329-CC83-43ED-BC42-CB106A39671C
Exhibit 4
O R A N G E C O U N T Y
Occommunity Resources
Our Community. Our Commitment.
Subject: OC Community Resources Effective: July 1, 2010
Contract Reimbursement Policy Revised: January 17, 2020
PURPOSE:
This policy contains updated fiscal documentation requirements for contract reimbursement for
OC Community Services and OC Housing & Community Development. The procedures provide
instructions for submitting reimbursement demand letter or invoice.
REFERENCES:
Executed County Board of Supervisors approved contract
Budget included in contract or presented as an attachment
48 CFR Part 31 Contract Cost Principles and Procedures
24 CFR Parts 85, 570.502, 570.201, 576.21, 576.51 and 576.61: For OC Housing &
Community Development Contracts only.
2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements
for Federal Awards (Uniform Guidance)
BACKGROUND:
The executed Board of Supervisors approved contract is the authorization for all aspects of
payment, including the maximum amount to be paid, the payee, and the scope of services and
work. Payments are made in strict accordance with the contract terms. Allowable costs are
identified in referenced Uniform Guidance and Code of Federal Regulations (CFR).
ATTACHMENTS:
Reimbursement Policy Status Form (RPS -1)
POLICY:
Contractor is responsible for the submission of accurate claims. This reimbursement policy is
intended to ensure that the Contractor is reimbursed based on the code or codes that correctly
describe the services provided. This information is intended to serve only as a general reference
resource regarding OC Community Services' and OC Housing & Community Development's
reimbursement policy for the services described and is not intended to address every aspect of a
reimbursement situation. Accordingly, OC Community Services and OC Housing & Community
Development may use reasonable discretion in interpreting and applying this policy to services
provided in a particular case. Other factors affecting reimbursement may supplement, modify or,
in some cases, supersede this policy. These factors may include, but are not limited to: legislative
mandates and County directives. OC Community Services and OC Housing & Community
Development may modify this reimbursement policy at any time by publishing a new version of
the policy. However, the information presented in this policy is accurate and current as of the
date of publication.
Cost incurred by Contractor must be substantiated and incurred during the contract period.
Total of all reimbursements cannot exceed the amount of the contract. Cost must be allowable
under applicable Code of Federal Regulations (CFR) or Uniform Guidance. All supporting
documentation for reimbursement must be submitted with demand letter or invoice. If contract
Page 1 of 2
DocuSign Envelope ID: C10AE329-CC83-43ED-BC42-CB106A39671C
requires matching contribution, documentation substantiating contribution match must be
submitted with demand letter or invoice.
At any time, based on County's business needs and/or Contractor's performance, the County may
designate Contractor to submit abbreviated or comprehensive documentation, as identified in the
respective sections. Upon designation, Contractor will be notified, in writing via Reimbursement
Policy Status Form, of which requirements are in full force. When Contractor is required to submit
comprehensive documentation, in addition to the items identified in the Abbreviated
Documentation Requirements Section, Contractor must also provide the documentation identified
in the Comprehensive Documentation Requirements Section.
PROCEDURES:
Abbreviated Documentation Requirements
Compile and submit:
1. Supporting documentation includes, but is not limited to:
a. General ledger/expense transaction report
b. Payroll register or labor distribution report
c. Payroll allocation plan
d. Personnel Documentation
e. Benefit plan and calculation of benefit
f. Employer-employee contract for non -customary benefits (if applicable)
g. Pre -approval documentation for equipment purchases equal to or greater than
$5,000
2. The following is required with the first month's invoice only:
a. Cost allocation plan for rent, utilities, etc.
b. Indirect rate approved by cognizant agency (if applicable)
3. Summary of leveraged resources (if applicable)
4. Demand letters must contain the following certification (if required by Contract):
"By signing this report, I certify to the best of my knowledge and belief that the
report is true, complete, and accurate, and the expenditures, disbursements and
cash receipts are for the purposes and objectives set forth in the terms and
conditions of the Federal award. I am aware that any false, fictitious, or fraudulent
information, or the omission of any material fact, may subject me to criminal, civil
or administrative penalties for fraud, false statements, false claims or otherwise.
(U.S. Code Title 18, Section 1009 and Title 39 Sections 3729-3730 and 3809-3812)"
5. Grantee Performance Report (if required by Contract)
6. Supporting documentation shall be on single -sided sheets
7. Please redact employees' Social Security Number from payroll reports
8. Demand letter or invoice, along with supporting documentation shall be submitted to:
OC Community Resources Accounting
601 N. Ross St., 6t" Floor
Santa Ana, CA 92701
Comprehensive Documentation Requirements
In addition to abbreviated documentation, compile and submit:
9. Purchase orders, invoices, and receipts
10. Cashed checks
11. Check register
12. Consultant/sub-contractor invoices (with description of services)
13. Travel expense documentation: mileage reimbursement, hotel bill, meal reimbursement
ACTION:
Distribute this policy to all appropriate staff
INQUIRIES: Inquiries may be directed to OCCR Accounts Payable at:
OCCRAccountsPayable@occr.ocgov.com
Page 2 of 2
DocuSign Envelope ID: C10AE329-CC83-43ED-BC42-CB106A39671C
O R A N G E C O U N T Y
((0) C Community Resources
Our Community. Our Commitment.
Reimbursement Policy Status Form
Per CIC Community Resources Contract Reimbursement Policy, in regards to the Contract #
listed herein, Contractor is designated with the Documentation Status of Abbreviated unless
Comprehensive is checked below. If the contractor's designation should change to
Abbreviated, a new status form shall be approved. All related documentation requirements
are in full force, until further notice.
Contractor: City of Seal Beach
Effective Date: Upon final execution by County
Contract #: MA -012-22010638
Documentation Status: ® Abbreviated ❑ Comprehensive
Program Authorization by: Auditor Controller Authorization by:
Eliseo Gillamac
Renee Ramirez
Print Name DocuSigned by: i not Name cuSigned by:
Signed by: f-v�t�t- 1�"`" Signed by:risth l&Wo.L
Date: 11/14/2021 Date: 11/12/2021
Two signatures are required to implement the form.
Distribution:
Contractor
Auditor Controller
Contract File
Program File
Reimbursement Policy Status (RPS -1)