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HomeMy Public PortalAboutC-22-104 - SBCC AMENDMENT NO. 1 2023 AUG 8AMENDMENT NO. I TO 2022 SUBCONTRACT FOR PREVENTION AND AFTERCARE RAM -ACTIVITIES AND SERVICES This Amendment No...1 to 2022 :Subcontract for Prevention and Aftercare Program Activities and Services ("Amendment..No.:l") by and between SOUTH BAY CENTER FOR COUNSELING, a California . `corporati.on - .("Contractor"), and the CITY OF CARSON, a municipal corporation ("Subco.ntractor"), is effective .as of the 1 st day of July, 2023 (Contractor and Subcontractor referred to: collectively herein as the "parties," and individually depending on context as a "party"). RECITALS A. The . County of Los Angeles ("County") and Contractor entered into Contract Number 21-03-08 for prevention and. aftercare . services (CFDA No. 93.556) (the "Prime Contract"), whereby the County provided certain funding to Contractor for the provision of certain prevention and aftercare services to County residents.. B. The Prime Contract was entered into March 1, 2021, for an initial 16 -month term through June 30, 2022, with four County options to extend the term of the Prime Agreement for up to three additional one-year periods and one 6-monthperiod,. from July 1, 2022 through December 31, 2025. County, exercised. its first option to extend the term of the Prime Contract from July 1, 2022 through June 30, 2023, and has recently exercised its second option to extend the term of the Prime Contract from July 1, 2023 through June 30, 2024. C. In order to fulfill its obligations.under the Prime Contract, Contractor entered into a subcontract with Subcontractor effective March 1, 2021, which carried an initial 16 -month term through June 30, 2022, and included three one-year options of Contractor to extend the term of said subcontract (the "2021 Subcontract"). However, the 2021 Subcontract should have also included a fourth, 6 -month option to extend such that the term of the 2021 Subcontract, inclusive of all its option periods, would be co -extensive with -the term of the Prime Contract, inclusive of all its option periods. D. In order to address this discrepancy, upon expiration of the initial 16 -month term of the 2021 Subcontract, the parties entered into a new "Subcontract for Prevention and Aftercare Program Services and Activities" effective July 1, 2022 (the "2022 Subcontract"), whereby Contractor engaged Subcontractor to perform certain prevention and aftercare services as described in Section 3.3 of the 2022 Subcontract (the "Services") in exchange for compensation in the amount of $57,000 (the "Contract Sum") for the initial one-year term of the 2022 Subcontract, from July 1, 2022 through June 30, 2023. The 2022 Subcontract, at Section 2.0, provides Contractor with options to extend the term of the 2022 Subcontract beyond June 30, 2023 for up to two one (1) year periods and one (1) additional six (6) -month period (which options, collectively, would extend the term through December 31, 2025), or as otherwise authorized by the Prime Contract. 01007.0001/896541.1 1 E. Contractor and Subcontractor now desire to amend the 2022 Subcontract via this Amendment No. 1 to (i) exercise .Contractor's first option to extend the term of the 2022 Subcontract by one year, from July 1, 2023 through June 30, 2024, to correspond with the above - referenced extension of the term of the. Prime Contract for said period, and (ii) increase the Contract Sum by $57,000 for the one-year extension period, thereby increasing the total Contract Sum of the 2022 Subcontract from $57,000 to $114,000, and make other minor related modifications. TERMS 1. Contract Changes. The 2022 Subcontract is amended as provided herein (deletions shown in str-ik, thr-eug , additions shown in bold, italics, and underlined). A. Section 2.0, "TERM OF SUBCONTRACT,". is amended as follows: "The term of this Subcontract shall commence on July 1, 2022 and shall expire on June 30, 2024 jure 30, 20 ("Term"), unless terminated earlier pursuant to any of the conditions for termination in the Prime Contract. CONTRACTOR has the option to extend the term of this Subcontract thereafter for up to one 1 twe-(2) additional one (1) year periods and one (1) additional six (6)7month period, or as otherwise authorized by the Prime Contract." B Section 3.1 is amended. as follows: "CONTRACTOR shall compensate SUBCONTRACTOR a total maximum contract sum not to exceed ONE HUNDRED FOURTEEN THOUSAND DOLLARS ($114,000.00) FIFTY SEVEN T-14OUSAND DOLLARS ($57,0" ("Contract Sum") for the Term of this Subcontract to provide the service designated in Section 3.3 of this Subcontract with compensation as follows for each of the following riscal year periods of the Term of this Subcontract: For July 1, 2022 through June 30, 2023: $57,000 For July 1, 2023 through June 30, 2024: $57,000" C. Section 3.2 is amended as follows: "SUBCONTRACTOR shall invoice CONTRACTOR monthly in arrears for services provided. CONTRACTOR shall compensate SUBCONTRACTOR by check within sixty (60) days of receipt and approval of monthly invoice. At least seventy-five percent (75%) of the annual compensation amount for each fiscal year period of the Term of this Subcontract as specified in Section 3.1 Gent fact Suffi shall be expended by March 30; 2923. of the applicable Tscal year. Should seventy-five percent (75%) of the Contract Sum not be expended by March 30 2023 of the applicable fiscal year, SUBCONTRACTOR shall submit in writing a Program Plan, which includes an activity timeline and projected expenditures, to CONTRACTOR to be approved by the Program 01007.0001/896541.1 2 Director. If the Program Plan is not approved, remaining contract funds will be subject to reallocation." 2. Continuing Effect of Subcontract. Except as amended by this Amendment No. 1, all provisions of the 2022 Subcontract shall remain unchanged and in full force and effect. From and after the date of this Amendment No. 1, whenever the term "Subcontract" appears in the 2022 Subcontract in reference to the 2022 Subcontract, it shall mean the 2022 Subcontract, as amended by this Amendment No. l to the 2.022 Subcontract. 3. Affirmation of Subcontract; Warranty Re Absence of Defaults. Contractor and Subcontractor each ratify and reaffirm each and every one of the respective rights and obligations arising under the 2022 Subcontract. Each party represents and warrants to the other that there have been no written or oral modifications, to the 2022 Subcontract other than as provided herein. Each party represents and warrants to the other that the 2022 Subcontract is currently an effective, valid, and binding obligation. Subcontractor represents and warrants to Contractor that, as of the date of this Amendment No. 1, Contractor is not in default of any material term of the 2022 Subcontract and that there have been no events that, with the passing of time or the giving of notice, or both, would constitute a material default under the 2022 Subcontract. Contractor represents and warrants. to Subcontractor that, as of the date of this Amendment No. 1, Subcontractor is not in default of any material term of the 2022 Subcontract and that there have been no events that, with the passing of time or the giving of notice, or both, would constitute a material default under the 2022 Subcontract. 4. Adequate Consideration. The parties hereto irrevocably stipulate and agree that they have each received adequate and independent consideration for the performance of the obligations they have undertaken pursuant to this Amendment No. 1. 5. Authority. The persons executing this Amendment No. 1 on behalf of the parties hereto warrant that (i) such party is duly organized and existing, (ii) they are duly authorized to execute and deliver this Amendment No. 1 on behalf of said party, (iii) by so executing this Amendment No. 1, such party is formally bound to the provisions of this Amendment No. 1, and (iv) the entering into this Amendment No. 1 does not violate any provision of any other agreement to which said party is bound. (SIGNATURES ON FOLLOWING PAGE] 01007.0001/896541.1 IN WITNESS WHEREOF, the parties hereby have executed this Amendment No. 1 on the date(s) set forth below, with express intent that this Amendment No. 1 shall be effective as of July 1, 2023. ATTEST: LF Dr. Khaleah K. Bradshaw, City Clerk APPROVED AS TO FORM: ALESHIRE & WYNDER, LLP Sunny K. Soltani, City Attorney [brj] SUBCONTRACTOR: CITY F CARSON, a municipal corporation �"' '4� Davis -Holmes, Mayor Date: , 2023 CONTRACTOR: SOUTH BAY CENTER FOR COUNSELING ;•r By: Named n 11 -Q n00N Title: 4�, re By: . Name: Title: Address: 540 N. Marine ve. Wilmington, CA 90744 Date: _ Lp, fA , 2023 Two corporate officer signatures required when Consultant is a corporation, with one signature required from each of the following groups: 1) Chairman of the Board, President or any Vice President; and 2) Secretary, any Assistant Secretary, Chief Financial Officer or any Assistant Treasurer. CONSULTANT'S SIGNATURES SHALL BE DULY NOTARIZED, AND APPROPRIATE ATTESTATIONS SHALL BE INCLUDED AS MAY BE REQUIRED BY THE BYLAWS, ARTICLES OF INCORPORATION, OR OTHER RULES OR REGULATIONS APPLICABLE TO CONSULTANT'S BUSINESS ENTITY. 01007.0001/896541.1 4 IN WITNESS WHEREOF, the parties hereby have executed this Amendment No. 1 on the date(s) set forth below, with express. intent that this Amendment No. 1 shall be effective as of July 1, 2023. ATTEST: Dr. Khaleah K. Bradshaw, City Clerk APPROVED AS TO FORM: ALESHIRE & WYNDER, LLP Sunny K. Soltani, City Attorney fibril SUBCONTRACTOR: CITY OF CARSON, a municipal corporation Lula Davis -Holmes, Mayor Date: , 2023 CONTRACTOR: SOUTH BAY CENTER FOR COUNSELING By:' / Name< a l t Q o,, moors Title: r Name:�nOl, � Title: fin, l���je Address: 540 N. Marine Ave. Wilmington, CA 90744 Date: L, SL , 2023 Two corporate officer signatures required when Consultant is a corporation, with one signature required from each of the following groups: 1) Chairman of the Board, President or any Vice President; and 2) Secretary, any Assistant Secretary, Chief Financial Officer or any Assistant Treasurer. CONSULTANT'S SIGNATURES SHALL BE DULY NOTARIZED, AND APPROPRIATE ATTESTATIONS SHALL BE INCLUDED AS MAY BE REQUIRED BY THE BYLAWS, ARTICLES OF INCORPORATION, OR OTHER RULES OR REGULATIONS APPLICABLE TO CONSULTANT'S BUSINESS ENTITY. 01007.0001/896541.1 4 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy or validity of that STATE OF CALIFORNIA COUNTY OF LOS ANGELES �,}�, R,64c On koe' ; �Colleen 2 e3 2023 before me, _ O1 , personally appeared ' C , Iroved to me on the basis of satisfactory evidence to be the person( - whose names(s i are subscribed to the within instrument and ac;4 wledged to me that heA&they executed .the same in his a their authorized capacity(.ies), and that by his(he heir signature(s) on the instrument the perso*), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. 90my ROSANNA RIVERA Notary Public - California Signatuu�.Q,r y— Los Angeles County Commission b 2357151 Comm. Expires May 11, 2025 OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER ❑ INDIVIDUAL ❑ CORPORATE OFFICER. TITLE(S) ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER SIGNER IS REPRESENTING: (NAME OF PERSON(S) OR ENTITY(IES)) 01007.0001/896541.1 DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT OTHER THAN NAMED ABOVE CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy or validity of that STATE OF CALIFORNIA COUNTY OF LOS ANGELES cxrlae.l Publ:e. s a nn �m�ba0 On 3 , 2023 before me, sawnaero, , personally ap eared G ,proved to me on the basis of satisfactory evidence to a the person(s) whose names(s 1 are subscribed to the within instrument and acknowledged to me that he she hey executed the sante in his er heir authorized capacity(ies), and that by hi er heir signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. 90my ROSANNA RIVERA Notary Public - CaliforniaLos Angeles County Signature. �y ��.r Commission N 235715J2025 Comm, Expires May 11, OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER ❑ INDIVIDUAL ❑ CORPORATE OFFICER TITLE(S) ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL. ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER SIGNER IS REPRESENTING: (NAME OF PERSON(S) OR ENTITY(IES)) 01007.0001/896541.1 6 DESCRIPTION OF ATTACHED DOCUMENT TITLE OR TYPE OF DOCUMENT NUMBER OF PAGES DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE CERTIFICATE NO. ISSUE DATE GL1-1730 AIT—CERTIFICATE OF COVERAGE 1 06/29/2023 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR Public Risk Innovation, ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUTE A Solutions, and Management CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. C/O ALLIANT INSURANCE SERVICES, INC. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED and/or requesting a WAIVER OF 18100 VON KARMAN AVENUE, 10TH FLOOR IRVINE, CA 92612 SUBROGATION, the Memorandums of Coverage must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PHONE (949) 756-0271 / FAX (619) 699-0901 COVERAGE A- Public Risk Innovation, Solutions, and Management LICENSE #OC36861 AFFORDED Member: COVERAGE CITY OF CARSON AFFORDED B ATTN: ROOBIK GALOOSIAN COVERAGE 701 CARSON STREET AFFORDED C CARSON, CA 90745 COVERAGE AFFORDED D Coverages THIS IS TO CERTIFY THAT THE MEMORANDUMS OF COVERAGE LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER NAMED ABOVE FOR THE PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE COVERAGE AFFORDED BY THE MEMORANDUMS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUMS. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COMEMORANDUM TYPE OF COVERAGE COVERAGE EFFECTIVE COVERAGE EXPIRATION LIABILITY LIMITS LTR NUMBER DATE DATE A �X Excess General Liability PRISM PE 23 EL -115 07/01/2023 07/01/2024 $2,000,000 nX Auto Liability $1,000,000 Limits inclusive of the Member's Self -Insured Retention of $250,000 Description of Operations/Locations/Vehicles/Special Items: AS RESPECTS AGREEMENT BETWEEN CITY OF CARSON AND SOUTH BAY CENTER FOR COUNSELING AND COUNTY OF LOS ANGELES FOR THE ADMINISTRATION OF THE SAFE CHILDREN AND STRONG FAMILIES PREVENTION AND AFTERCARE PROGRAM SERVICES. COUNTY OF LOS ANGELES, ITS SPECIAL DISTRICTS, ELECTED OFFICIALS, OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE INCLUDED AS ADDITIONAL COVERED PARTIES, BUT ONLY INSOFAR AS THE OPERATIONS UNDER THIS CONTRACT ARE CONCERNED. COVERAGE FOR SEXUAL MISCONDUCT IS INCLUDED IN THE EXCESS GENERAL LIABILITY LIMITS SUBJECT TO TERMS, CONDITIONS AND EXCLUSIONS OF THE MEMORANDUM OF COVERAGE PURSUANT TO ENDORSEMENT NUMBER 3. Cancellation Certificate Holder SHOULD ANY OF THE ABOVE DESCRIBED MEMORANDUMS OF COVERAGES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WIL BE DELIVERED IN ACCORDANCE WITH THE MEMORANDUMS OF COVERAGE PROVISIONS. SOUTH BAY CENTER FOR COUNSELING ATTN: PROGRAM DIRECTOR AUTHORIZED REPRESENTATIVE 540 N MARINE AVE WILMINGTON, CA 90744 Public Risk Innovation, Solutions, and Management PAGE 1 OF 2 ENDORSEMENT NO. 3 PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT (PRISM) GENERAL LIABILITY 1 ADDITIONAL COVERED PARTY AMENDATORY ENDORSEMENT It is agreed that the "Covered Party, Covered Persons or Entities" section of the Memorandum is amended to include the person or organization named below, but only with respect to liability arising out of premises owned by or rented to the Member, or operations performed by or on behalf of the Member or such person or organization so designated. Coverage provided under this endorsement is limited to the minimum limits required by contract. Additional Covered Party: County of Los Angeles, its Special Districts, Elected Officials, Agents, Employees and Volunteers As Respects: Agreement between City of Carson and South Bay Center for Counseling and County of Los Angeles for the Administration of the Safe Children and Strong Families Prevention and Aftercare Program Services. This endorsement is part of the Memorandum and takes effect on the effective date of the Memorandum unless another effective date is shown below. All other terms and conditions remain unchanged. Effective Date: Memorandum No.: PRISM -PE 23 EL -115 Issued to: City of Carson Issue Date: June 29, 2023 )!Ijiw6j4� Authorized Representative Public Risk Innovation, Solutions, and Management (PRISM) ACOR&CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 6/29/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Alliant Insurance Services, Inc. 18100 Von Karman Avenue, 10th Floor Irvine, CA 92612 CONTACT Armando Vie ra NAME: y PHONE 949 660 5930 FAX 619 699-0901 A/C, No, Ext): ( ) ac No): ( ) ADDRESS: avieyra@alliant.com INSURERS AFFORDING COVERAGE NAIC # PH: (949)756-0271 INSURER A: Beazley Syndicate 2623 & 623 License # OC36861 INSURED MWIDO Public Risk Innovation, Solutions, and Management (PRISM) INSURER B: INSURER C: and its member agencies as endorsed: INSURER D: City of Carson INSURER E: ATTN: Roobik Galoosian EACHOCCURRENCE f 701 Carson Street Carson, CA 90745 1 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POUCY NUMBER MMA)D MWIDO LIMITS COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE f CLAIMSidADE OCCUR DAMAGE TO RENTED PREMISES (Se oavrrence) i MED EXP (Any one perecn) 8 PERSONAL B ADV INJURY f UMITAPPUESPER: GENERALAGGREGATE f PRO - LOC POLICY RAGGREGATE JECT PRODUCTS COMPIOPAGG f i OTHER: AUTOMOBILE UABILITY IT COMBINED SINGLE UN (Ea aaltlen0 f BODILY INJURY (Per perew) f ANYAUTO BODILY INJURY (Per a Ident) f OWNEDAUTOSONLY SCHEDULEDAUTOS HIREDAUTOSONLY NONOWNED AUTOS PROPERTY DAMAGE (Per aC Idwt) f f UMBRELLA LIMB HOCCUR EACH OCCURRENCE f AGGREGATE. f EX E .LIAB CLAIMM$-MADE DED RETENTIONS f WORKERS COMPENSATION OTH- AND EMPLOYERS' LIABILITY YM ER STATUTE ER ANY PROPRIETORIPARTNERID(ECLMVE E.L EACH ACCIDENT f OFRCEWMEMBER EXCLUDED? WA E.L DISEASE - EA EMPLOYEE f (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT f DESCRIPTION OF OPERATIONS WI— OTHER: CYBER LIABILITY .-MEMBER LIMIT: $ 2,000,000 A CLAIMS MADE AND REPORTED POLICY N/A N/A FN2333951 7/1/2023 7/1/2024 +POLICY ANNUAL AGGREGATE *RETROACTIVE DATE: MARCH 31, 2010 $ 25,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) Re: As respects agreement between City of Carson (Subcontractor) and South Bay Center for Counseling and County of Los Angeles or the administration of the safe children and strong families prevention and aftercare program services. Subject to policy limits, terms, conditions and exclusions. Breach Response costs are sub- limited. *Retroactive and Continuity date: A. March 31, 2010 or the effective of coverage for a specific member added subsequent to a renewal. **The total policy annual aggregate limits are shared by all members of the policy. """The member limit applies to all members of City of Carson combined and not per member. CERTIFICATE HOLDER CANCELLATION FOR THE PURPOSE OF EVIDENCE ONLY: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Los Angeles County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department of Children and Family Services ACCORDANCE WITH THE POLICY PROVISIONS. DCFS Contracts Administration AUTHORIZED REPRESENTATIVE 425 Shatto PI, Rm 400 Los Angeles, CA 90020 (J¢ 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) TheACORD name and logo are registered marks of ACORD AC40RDO a 164,�CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 6/29/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Alliant Insurance Services, Inc. 18100 Von Karman Avenue, 10th Floor CONTACT NAME: Armando Vieyra PHONE 949 660 5930 FAX 619 A/c No, Ext : ( ) A/c No): ( ) 699-0901 Irvine, CA 92612 ADDRESS: avieyra@alliant.com INSURERS AFFORDING COVERAGE NAIC # PH: (949)756-0271 INSURER A: Beazley Syndicate 2623 & 623 License # OC36861 INSURED EACHOCCURRENCE II Public Risk Innovation, Solutions, and Management (PRISM) INSURER B: INSURER C: and its member agencies as endorsed: INSURER D: City of Carson INSURER E: ATTN: Roobik Galoosian 701 Carson Street Carson, CA 90745 INSURER F: ctH rlhlcATE THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBRPOLICY WVD POLICY NUMBER EFF MMND POLICVEXP MM)DD LIMITS COMMERCIAL GENERALLIABILITV EACHOCCURRENCE II CLAIMS -MADE ❑ OCCUR DAMAGE TO RENTED PREMISES (Ea s MED EXP (Any ane per—) $ PERSONALS ADV INJURY $ MITAPPUESPER: GENERALAGGREGATE II POUCV PRO-LOC RAGGREGAT JECT PRODUCTSCOMPIOP AGG $ OTHER: 8 AUTOMOBILE LIABILRY COMBINED SINGLE LIMIT BODILY INJURY (Per pereon) S ANYAUTO BODILY INJURY (Per acddenp $ OWNEDAUTOSONLY SCHEDULEDAUTOS HIREDAUTOSONLY NON-0WNEDAUTOS PROPERTY DAMAGE (Per axMenp $ II UMBRELLA UAB OCCUR EACH OCCURRENCE II AGGREGATE s EXMEune c1All -WQE DEC I I ETENTIONS $ WORXERS COMPENSATION TH- AND EMPLOYER51JABILRY YM ER STATUTE EER ANY PROPRIETOfl?ARTNERIEXECUTIVE E.L EACH ACCIDENT $ OFRCERMEM BER EXCLUDED? ❑ WA E.L. DISEASE - EA EMPLOYEE (Mandatory In NH) I/yes, descdbe Isder E.L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS beIM OTHER: CYBER LIABILITY ""MEMBER LIMIT: $ 2,000,000 A CLAIMS MADE AND REPORTED POLICY *RETROACTIVE N/A N/A FN2333951 7/1/2023 7/1/2024 *pOLICYANNUALAGGREGATE DATE: MARCH 31, 2010 $ 25,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Re: As respects agreement between City of Carson and South Bay Center for Counseling and County of Los Angeles for the administration of the safe children and strong families prevention and aftercare program services. Subject to policy limits, terms, conditions and exclusions. Breach Response costs are sub- limited. "Retroactive and Continuity date: A. March 31, 2010 or the effective of coverage for a specific member added subsequent to a renewal. "*The total policy annual aggregate limits are shared by all members of the policy. ***The member limit applies to all members of City of Carson combined and not per member. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE FOR THE PURPOSE OF EVIDENCE ONLY: THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN South Bay Center for Counseling ACCORDANCE WITH THE POLICY PROVISIONS. '5540 N. Marine Ave. AUTHORIZED REPRESENTATIVE Wilmington, CA 90744 ^ ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CERTIFICATE NO. ISSUE DATE WC -585 CERTIFICATE OF COVERAGE 06/29/2023 PUBLIC RISK INNOVATION, THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY SOLUTIONS, AND MANAGEMENT OR NEGATIVELY AMEND, EXTENDR ALTER THE COVERAGEDED CERTIFICATE OF COVERAGE DOES NOT CONSTTTUUEACONTRACOTBBETWEEN BELOW. HE HIS ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE C/O ALLIANT INSURANCE SERVICES, INC. CERTIFICATE HOLDER 18100 VON KARMAN AVENUE, 10TH FLOOR IMPORTANT: If the certificate holder is requesting a WAIVER OF SUBROGATION, the IRVINE, CA 92612 Memorandums of Coverage must be endorsed. A statement on this certificate does not confer PHONE (949) 756-0271 / FAX (619) 699-0901 rights to the certificate holder in lieu of such endorsement(s). COVERAGE LICENSE #OC36861 AFFORDED BY: A - See attached schedule of insurers Member: COVERAGE CITY OF CARSON AFFORDED BY: i3 ATTN: ROOBIK GALOOSIAN COVERAGE 701 CARSON STREET CARSON, CA 90745 AFFORDED BY: C COVERAGE AFFORDED BY: D Coverages THIS IS TO CERTIFY THAT THE MEMORANDUMS OF COVERAGE AND POLICIES LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER NAMED ABOVE FOR THE PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE COVERAGE AFFORDED BY THE MEMORANDUMS AND POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUMS AND POLICIES. CO TYPE OF COVERAGE MEMORANDUM/ COVERAGE EFFECTIVE COVERAGE EXPIRATION LIABILITY LIMITS LTR POLICY NUMBER DATE DATE A EXCESS WORKERS' See attached 07/01/2023 07/01/2024 WORKERS' COMPENSATION: COMPENSATION & Schedule of Insurers Difference between EMPLOYER'S LIABILITY for policy numbers Statutory and Member's $750,000 Retention EMPLOYERS' LIABILITY: Difference between $5,000,000 and Member's $750,000 Retention LIMITS APPLY PER OCCURRENCE FOR ALL PROGRAM MEMBERS COMBINED. Description of Operations/Locations/Vehicles/Special Items: AS RESPECTS EVIDENCE OF COVERAGE ONLY. Cancellation Certificate Holder SHOULD ANY OF THE ABOVE DESCRIBED MEMORANDUMS OF COVERAGE/POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE MEMORANDUMS OF COVERAGE/POLICIES PROVISIONS. FOR THE PURPOSE OF EVIDENCE ONLY AUTHORIZED REPRESENTATIVE C/O CITY OF CARSON 701 CARSON STREET CARSON, CA 90745 Public Risk Innovation, Solutions, and Management PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT EXCESS WORKERS' COMPENSATION PROGRAM 2023/2024 SCHEDULE OF INSURERS CITY OF CARSON PROVIDER MEMORANDUM/ POLICY NUMBER LIMIT Public Risk Innovation, Solutions, PRISM PE 23 EWC-165 Workers' Compensation: and Management $50,000,000 each accident/each employee for disease (Difference between $50,000,000 and the individual member's retention) Employers' Liability: $5,000,000 each accident/each employee for disease (Difference between $5,000,000 and the individual member's retention) Liberty Insurance Corporation EW7-64N-444785-013 Statutory each accident/each employee for disease excess of $50,000,000 CERTIFICATE NO. ISSUE DATE GL1-1715 Ai CERTIFICATE OF COVERAGE 1 06/29/2023 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR Public Risk Innovation, ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUTE A Solutions, and Management CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. C/O ALLIANT INSURANCE SERVICES, INC. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED and/or requesting a WAIVER OF 18100 VON KARMAN AVENUE, 10TH FLOOR IRVINE, CA 92612 SUBROGATION, the Memorandums of Coverage must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PHONE (949) 756-0271 / FAX (619) 699-0901 COVERAGE A- Public Risk Innovation, Solutions, and Management LICENSE #OC36861 AFFORDED Member: COVERAGE CITY OF CARSON AFFORDED B ATTN: ROOBIK GALOOSIAN COVERAGE 701 CARSON STREET AFFORDED C CARSON, CA 90745 COVERAGE AFFORDED D Coverages THIS IS TO CERTIFY THAT THE MEMORANDUMS OF COVERAGE LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER NAMED ABOVE FOR THE PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE COVERAGE AFFORDED BY THE MEMORANDUMS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUMS. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COTYPE OF COVERAGE MEMORANDUM COVERAGE EFFECTIVE COVERAGE EXPIRATION LIABILITY LIMITS LTR NUMBER DATE DATE A X Excess General Liability PRISM PE 23 EL -115 07/01/2023 07/01/2024 $2,000,000 nX Auto Liability $1,000,000 Limits inclusive of the Member's Self -Insured Retention of $250,000 Description of Operations/Locations/Vehicles/Special Items: AS RESPECTS AGREEMENT BETWEEN CITY OF CARSON (SUBCONTRACTOR) AND SOUTH BAY CENTER FOR COUNSELING AND LOS ANGELES COUNTY FOR THE ADMINSTRATION OF THE SAFE CHILDREN AND STRONG FAMILIES PREVENTION AND AFTERCARE PROGRAM SERVICES. LOS ANGELES COUNTY, ITS SPECIAL DISTRICTS, ELECTED OFFICIALS, OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS, ARE INCLUDED AS ADDITIONAL COVERED PARTIES, BUT ONLY INSOFAR AS THE OPERATIONS UNDER THIS CONTRACT ARE CONCERNED. COVERAGE FOR SEXUAL MISCONDUCT IS INCLUDED IN THE EXCESS GENERAL LIABILITY LIMITS. SUBJECT TO TERMS, CONDITIONS AND EXCLUSION OF THE MEMORANDUM OF COVERAGE. PURSUANT TO ENDORSEMENT NUMBER 4. Cancellation Certificate Holder SHOULD ANY OF THE ABOVE DESCRIBED MEMORANDUMS OF COVERAGES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WIL BE DELIVERED IN ACCORDANCE WITH THE MEMORANDUMS OF COVERAGE PROVISIONS. LOS ANGELES COUNTY DEPARTMENT OF CHILDREN AND FAMILY SERVICES AUTHORIZED REPRESENTATIVE DCFS CONTRACTS ADMINISTRATION 425 SHATTO PL, RM 400 LOS ANGELES, CA 90020 - Public Risk Innovation, Solutions, and Management PAGE 1 OF 2 ENDORSEMENT NO.4 PUBLIC RISK INNOVATION, SOLUTIONS, AND MANAGEMENT (PRISM) GENERAL LIABILITY 1 ADDITIONAL COVERED PARTY AMENDATORY ENDORSEMENT It is agreed that the "Covered Party, Covered Persons or Entities" section of the Memorandum is amended to include the person or organization named below, but only with respect to liability arising out of premises owned by or rented to the Member, or operations performed by or on behalf of the Member or such person or organization so designated. Coverage provided under this endorsement is limited to the minimum limits required by contract. Additional Covered Party: Los Angeles County, its Special Districts, Elected Officials, Agents, Employees and Volunteers As Respects: Agreement between City of Carson (Subcontractor) and South Bay Center for Counseling and Los Angeles County for the Administration of the Safe Children and Strong Families Prevention and Aftercare Program Services. This endorsement is part of the Memorandum and takes effect on the effective date of the Memorandum unless another effective date is shown below. All other terms and conditions remain unchanged. Effective Date: Memorandum No.: PRISM -PE 23 EL -115 Issued to: City of Carson Issue Date: June 29, 2022 / 6-&� Authorized Representative Public Risk Innovation, Solutions, and Management (PRISM)