HomeMy WebLinkAboutBoys & Girls Club ARPA Grant Agreement_Nov 2023Exhibit B
Grant Agreement Report
Organization Agreement No. ____________________________________
Contact Person Contact Title ____________________________________
Phone Number and Email ____________________________________
Report Type ☐ annual Reporting Period ☐ quarterly
Grantee Information
Grant Amount: ____________________________
Funding expended during the reporting period: _____________________________
Funding expended to date: _______________________
Remaining award amount: _______________________
Award Details
Receipts and thorough documentation of grant fund expenditures have been
maintained and can be produced upon request: ☐ yes ☐ no
Grant Outcomes
Narrative – description of how the funds were used and what was accomplished through the
use of grant funds. Please include any relevant quantitative outcomes, as needed.
Grantee Representative Signature
I hereby declare that the goods or materials covered by this report are complete and accurate, and are
eligible under the agreement.
Printed Name: _______________________________
Title: _______________________________
Signature: _______________________________
Date: _______________________________
EXHIBIT C
INSURANCE REQUIREMENTS
Grantee shall procure and maintain for the duration of this Agreement, including any
extensions thereto, insurance against claims for injuries to persons or damages to
property which may arise from or in connection with the performance of services
hereunder by the Grantee, their agents, representatives, or employees or subcontractors.
It shall be a requirement under this Agreement that any available insurance proceeds
broader than or in excess of the specified minimum Insurance coverage requirements
and/or limits shall be available to the Additional Insured. Furthermore, the requirements
for coverage and limits shall be (1) the minimum coverage and limits specified in this
Agreement; or (2) the broader coverage and maximum limits of coverage of any Insurance
policy or proceeds available to the named Insured; whichever is greater. No
representation is made that the minimum Insurance requirements of this agreement are
sufficient to cover the obligations of the Grantee under this agreement.
MINIMUM SCOPE AND LIMIT OF INSURANCE
Coverage shall be at least as broad as:
1. Commercial General Liability (CGL): Insurance Services Office Form CG 00 01
covering CGL on an “occurrence” basis, including products and completed
operations, property damage, bodily injury and personal & advertising injury with
limits no less than $1,000,000 per occurrence. If a general aggregate limit applies,
either the general aggregate limit shall apply separately to this project/location or
the general aggregate limit shall be twice the required occurrence limit (i.e.,
$2,000,000).
2. Automobile Liability: Insurance Services Office Form Number CA 0001 covering
Code 1 (any auto), or if Grantee has no owned autos, Code 8 (hired) and 9 (nonowned),
with limits no less than $1,000,000 per accident for bodily injury and
property damage.
3. Workers’ Compensation insurance as required by the State of California, with
Statutory Limits, and Employers’ Liability insurance with a limit of no less than
$1,000,000 per accident for bodily injury or disease. (WC insurance is not
required if the grantee provides written verification it has no employees).
4. Professional Liability (Errors and Omissions) Insurance appropriates to the
Grantee’s profession, with limits no less than $1,000,000 per occurrence or claim,
$2,000,000 policy aggregate.
Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following
provisions:
1. The City, its officers, officials, employees, and volunteers are to be covered
as additional insureds on the CGL policy with respect to liability arising out of
work or operations performed by or on behalf of the Grantee including materials,
parts, or equipment furnished in connection with such work or operations. General
liability coverage can be provided in the form of an endorsement to the Grantee’s
insurance (at least as broad as ISO Form CG 20 10 11 85 or both CG 20 10 10 01
and CG 20 37 10 01 forms if later revisions used).
2. For any claims related to this contract, the Grantee’s insurance coverage shall
be primary insurance as respects the City, its officers, officials, employees, and
volunteers. Any insurance or self-insurance maintained by the City, its officers,
officials, employees, or volunteers shall be in excess of the Grantee’s insurance
and shall not contribute with it.
3. Each insurance policy required by this clause shall provide that coverage shall not
be canceled, except with thirty (30) days prior written notice to the City.
Waiver of Subrogation
Grantee hereby grants to City a waiver of any right to subrogation which any
insurer of said Grantee may acquire against the City by virtue of the payment of any
loss under such insurance. Grantee agrees to obtain any endorsement that may be
necessary to affect this waiver of subrogation, but this provision applies regardless of
whether or not the City has received a waiver of subrogation endorsement from the
insurer.
Deductibles and Self-Insured Retentions
Any deductibles or self-insured retentions must be declared to and approved by the
City. The City may require the Grantee to provide proof of ability to pay losses and
related investigations, claim administration and defense expenses within the retention.
Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of no less than
A:VII, unless otherwise acceptable to the City.
Claims Made Policies
If any coverage required is written on a claims-made basis:
1. The retroactive date must be shown, and this date must be before the execution
date of the contract or the beginning of contract work.
2. Insurance must be maintained and evidence of insurance must be provided for at
least five (5) years after completion of contract work.
3. If coverage is canceled or non-renewed, and not replaced with another claimsmade
policy form with a retroactive date prior to the contract effective date, the
Grantee must purchase extended reporting period coverage for a minimum of five
(5) years after completion of contract work.
Verification of Coverage
Grantee shall furnish the City with original certificates and amendatory endorsements
or copies of the applicable insurance language, effecting coverage required by this
contract. All certificates and endorsements are to be received and approved by the
City before work commences. However, failure to obtain the required documents prior
to the work beginning shall not waive the Grantee’s obligation to provide them. The
City reserves the right to require complete, certified copies of all required insurance
policies, including endorsements, required by these specifications, at any time.
Subcontractors
Grantee shall require and verify that all subcontractors maintain insurance meeting all
the requirements stated herein, and Grantee shall ensure that City is an additional
insured on insurance required from subcontractors. For CGL coverage subcontractors
shall provide coverage with a format least as broad as CG 20 10 10 01 and CG 20 37
10 01.
Special Risks or Circumstances
City reserves right to modify these requirements, including limits, based on the nature
of the risk, prior experience, insurer, coverage, or other special circumstances.