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R-2015-2932 - 10/22/2015 RESOLUTION NO. R-2015-2932 WHEREAS, the City of Round Rock has previously entered into a Vendor Agreement ("Agreement") with the Capital Area Council of Governments/Area Agency on Aging ("CAPCOG") on January 24, 2013; and WHEREAS, CAPCOG has submitted Amendment No. 5 and the related Certification to the Contract for Older American Act Programs to renew the Agreement and to provide nutrition trip funding through September 30, 2016; and WHEREAS, the City Council desires to enter into said Amendment No. 5 with CAPCOG, Now Therefore BE IT RESOLVED BY THE COUNCIL OF THE CITY OF ROUND ROCK, TEXAS, That the Mayor is hereby authorized and directed to execute on behalf of the City Amendment No. 5 and the related Certification to the Contract for Older American Act Programs with the Capital Area Council of Governments, a copy of same being attached hereto as Exhibit "A" and incorporated herein for all purposes. The City Council hereby finds and declares that written notice of the date, hour, place and subject of the meeting at which this Resolution was adopted was posted and that such meeting was open to the public as required by law at all times during which this Resolution and the subject matter hereof were discussed, considered and formally acted upon, all as required by the Open Meetings Act, Chapter 551, Texas Govermnent Code, as amended. RESOLVED this 22nd day of October, 2015. ALAN MCGRAW, Mayor City of Round Rock, Texas ATTEST: &k4- SARA L. WHITE, City Clerk 0112.1504;00343916 EXHIBIT "A„ Amendment No.5 to the Contract for Older American Act Programs (Capital Area Council of Government Subcontractors) The Capital Area Council of Governments(CAPCOG)and City of Round Rock (Contractor)agree to amend to the contract between them for Older American Act Programs(the"Base Contract")in accordance with the terms and conditions set forth in this amendment(CAPCOG and Contractor,collectively,the "parties,"each a"party"). The parties hereby agree as follows: Purpose.This amendment will modify provisions of the Base Contract relating to the protection of confidential information. 1. Data Use Agreement.The Health and Human Services(HHS)Data Use Agreement(DUA),Attachment A,is hereby incorporated by reference and made therefore,a part of the Base Contract.The DUA,will, as of the effective date of this amendment,govern the handling of"Confidential Information,"as that term is defined in the DUA,under the Base Contract. 2. Liability.By signature and acceptance of this amendment and the Data Use Agreement,CONTRACTOR agrees to fully cooperate with the direction of the HHS and the Office of the Attorney General of Texas in any claim arising from a disclosure of information subject to this DUA.To the extent permitted by the Texas Constitution,laws and rules,CONTRACTOR will hold harmless CAPCOG and its workforce against all actual and direct losses,suffered by CAPCOG and its workforce arising from or in connection with any breach of this DUA or from any acts or omissions related to this DUA by CONTRACTOR or its employees,directors,officers,subcontractors,or agents or other members of its workforce,including,without limitation the costs of reasonable attorneys'fees,required notices and mitigation of a breach and any fines or penalties imposed on CAPCOG by any regulatory authority. CONTRACTOR will be solely responsible for any damages resulting from its disclosure of information made in violation of this DUA. 3. Insurance. CONTRACTOR either maintains commercial insurance or self-insures with policy limits in an amount sufficient to cover CONTRACTOR's liability arising under this DUA and under which policy CAPCOG is a beneficiary.CONTRACTOR shall identify CAPCOG as an additional insured under any and all insurance policies used to satisfy this provision and provide proof to CAPCOG. CAPCOG reserves the right to consider alternative means for CONTRACTOR to satisfy CONTRACTOR's financial responsibility under this DUA. Nothing herein shall relieve CONTRACTOR of its financial obligations set forth in this DUA if CONTRACTOR fails to maintain insurance. CONTRACTOR will provide CAPCOG with written proof that required insurance coverage is in effect,at the request of CAPCOG. 4. Effective Date.This amendment is effective when signed by both parties. S. Terms Remain in Effect.The parties agree the terms of the Base Contract shall remain in effect and continue to govern except to the extent modified in this amendment. 6. Amendment Execution.By signing this amendment,the parties expressly understand and agree this amendment is hereby made a part of the Base Contract as though it were set out word for word in the Base Contract.This amendment may be executed in counterparts,each of which will be deemed an original,and both of which taken together will constitute one and the same document.Electronically transmitted signatures will be deemed originals for all purposes relating to the Base Contract. 7. Entire Amendment.By signing below,the parties acknowledge they have read the amendment and agree to its terms,and the persons whose signatures appear below have the requisite authority to execute this amendment on behalf of the named party. Capital Area Council of Governments BY: BY: NAME: Betty Volghts NAME: TITLE: Executive Director TITLE: DATE: DATE: DOR ,. CERTIFICATION REGARDING DEBARMENT,SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR COVERED CONTRACTS AND GRANTS Federal Executive Order 12549 requires the Texas Department of Aging and Disability Services(DADS)to screen each covered potential contractor/grantee to determine whether each has a right to obtain a contract/grant in accordance with federal regulations on debarment,suspension,ineligibility,and voluntary exclusion. Each covered contractor/grantee must also screen each of its covered subcontractors/providers. In this certification "contractor/grantee" refers to both contractor/grantee and subcontractor/subgrantee; "contract/grant" refers to both contract/grant and subcontract/subgrant. By signing and submitting this certification the potential contractor/grantee accepts the following terms: i. The certification herein below is a material representation offact upon which reliance was placed when this contract/grant was entered into. [fit is later determined that the potential contractor/grantee knowingly rendered an erroneous certification,in addition to other remedies available to the federal government,the Department of Health and Human Services,United States Department of Agriculture or other federal department or agency,or the Texas Department of Aging and Disability Services may pursue available remedies,including suspension and/or debarment. 2. The potential contractor/grantee shall provide immediate written notice to the person to which this certification is submitted if at any time the potential contractor/grantee learns that the certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 3. The words"covered contract,""debarred,""suspended,""ineligible,""participant,""person,""principal,""proposal,"and"voluntarily excluded,"as used in this certification have meanings based upon materials in the Definitions and Coverage sections of federal rules implementing Executive Order 12549. Usage is as defined in the attachment. 4. The potential contractor/grantee agrees by submitting this certification that,should the proposed covered contract/grant be entered into,it shall not knowingly enter into any subcontract with a person who is debarred,suspended,declared ineligible,or voluntarily excluded from participation in this covered transaction,unless authorized by the Department of Health and Human Services,United States Department of Agriculture or other federal department or agency,and/or the Texas Department of Aging and Disability Services,as applicable. Do you have or do you anticipate having subcontractors/subgrantees under this proposed contract? W1 r YES [:]NO 5. The potential contractor/grantee further agrees by submitting this certification that it will include this certification titled "Certification Regarding Debarment,Suspension,Ineligibility,and Voluntary Exclusion for Covered Contracts and Grants"without modification,in all covered subcontracts and in solicitations for all covered subcontracts. 6. A contractor/grantee may rely upon a certification of a potential subcontractor/subgrantee that it is not debarred,suspended,ineligible,or voluntarily excluded from the covered contract/grant,unless it knows that the certification is erroneous. A contractor/grantee must,at a minimum,obtain certifications from its covered subcontractors/subgrantees upon each subcontract's/subgrant's initiation and upon each renewal. 7. Nothing contained in all 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 certification document. The knowledge and information of a contractor/grantee is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 8. Except for contracts/grants authorized under paragraph 4 of these tenns,ifa contractor/grantee in a covered contract/grant knowingly enters into a covered subcontract/subgrant with a person who is suspended,debarred,ineligible,or voluntarily excluded from participation in the transaction,inaddition to other remedies available to the federal government,Department of Health and Human Services,United State Department of Agriculture,or other federal department or agency,as applicable,and/or the Texas Department of Aging and Disability Services may pursue available remedies,including suspension and/or debarment. CERTIFICATION REGARDING DEBARMENT,SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR COVERED CONTRACTS AND GRANTS Indicate which statement applies to the covered potential contractor/grantee: I—y71 The potential contractor/grantee certifies,by submission of this certification,that neither it nor its principals is presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily excluded from participation in this contract/grant by any federal department or agency or by the State of Texas. The potential contractor/grantee is unable to certify to one or more of the terms in this certification. In this instance,the potential contractor/grantee must attach an explanation for each of the above terms to which he is unable to make certification. Attach the explanation(s)to this certification. NAME OF POTENTIAL CONTRACTOR/GRANTF..E City Of Round Rock VENDOR ID NO./FEDERAL EMPLOYER'S ID NO, 74-6017485 Signature of Authorized Representative Printed/Typed Name of Authorized Representative October 01,2014 Date Title of Authorized Representative THIS CERTIFICATION IS FOR FY 2015,PERIOD BEGINNING October I,2015 and ENDING September 30,2016. CERTIFICATION REGARDING DEBARMENT,SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR COVERED CONTRACTS AND GRANTS Federal Executive Order 12549 requires the Texas Department of Aging and Disability Services(DADS)to screen each covered potential contractor/grantee to determine whether each has a right to obtain a contract/grant in accordance with federal regulations on debarment,suspension,ineligibility,and voluntary exclusion. Each covered contractor/grantee must also screen each of its covered subcontractors/providers. in this certification "contractor/grantee" refers to both contractor/grantee and subcontractor/subgrantee; "contract/grant" refers to both contract/grant and subcontract/subgrant. By signing and submitting this certification the potential contractor/grantee accepts the following terms: 1. The certification herein below is a material representation of fact upon which reliance was placed when this contract/grant was entered into. If it is later determined that the potential contractor/grantee knowingly rendered an erroneous certification,in addition to other remedies available to the federal government,the Department of Health and Human Services,United States Department of Agriculture or other federal department or agency,or the Texas Department ofAging and Disability Services may pursue available remedies,including suspension and/or debarment. 2. The potential contractor/grantee shall provide immediate written notice to the person to which this certification is submitted if at any time the potential contractor/grantee learns that the certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 3. The words"covered contract,""debarred,""suspended,""ineligible,""participant,""person,""principal,""proposal,"and"voluntarily excluded,"as used in this certification have meanings based upon materials in the Definitions and Coverage sections of federal rules implementing Executive Order 12549. Usage is as defined in the attachment. 4. The potential contractor/grantee agrees by submitting this certification that,should the proposed covered contract/grant be entered into,it shall not knowingly enter into any subcontract with a person who is debarred,suspended,declared ineligible,or voluntarily excluded from participation in this covered transaction,unless authorized by the Department of Health and Human Services,United States Department of Agriculture or other federal department or agency,and/or the Texas Department of Aging and Disability Services,as applicable. Do you have or do you anticipate having subcontractors/subgrantees under this proposed contract?_YES � NO 5. The potential contractor/grantee further agrees by submitting this certification that it will include this certification titled"Certification Regarding Debarment,Suspension,Ineligibility,and Voluntary Exclusion for Covered Contracts and Grants"without modification,in all covered subcontracts and in solicitations for all covered subcontracts. 6. A contractor/grantee may rely upon a certification of a potential subcontractor/subgrantee that it is not debarred,suspended,ineligible,or voluntarily excluded from the covered contract/gmnt,unless it knows that the certification is erroneous.A contractor/grantee must,at a minimum,obtain certifications from its covered subcontractors/subgrantees upon each subcontract's/subgrant's initiation and upon each renewal. 7. Nothing contained in all 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 certification document. The knowledge and information of a contractor/grantee is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 8. Except for contracts/grants authorized under paragraph 4 of these terms,if a contractor/grantee in a covered contract/grant knowingly enters into a covered subcontract/subgrant with a person who is suspended,debarred,ineligible,or voluntarily excluded from participation in the transaction,in addition to other remedies available to the federal govemment,Department of Health and Human Services,United State Deparnnent of Agriculture,or other federal department or agency,as applicable,and/or the Texas Department of Aging and Disability Services may pursue available remedies,including suspension and/or debarment. CERTIFICATION REGARDING DEBARMENT,SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR COVE D CONTRACTS AND GRANTS Indica which statement applies to the covered potential contractor/grantee: The potential contractor/grantee certifies,by submission of this certification,that neither it nor its principals is presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily excluded from participation in this contract/grant by any federal department or agency or by the State of Texas. The potential contractor/grantee is unable to certify to one or more of the terms in this certification. In this instance,the potential contractor/grantee must attach an explanation for each of the above terms to which he is unable to make certification. Attach the explanation(s)to this certification. NAME OF POTENTIAL CONTRACIOR/GRANTEEy/ S�4VT7 1' s i iJ G VENDOR ID NO./FEDERAL EMPLOYER'S ID NO. Jn4 -P I e of Authonzed Repre ntative Printed/Typed Name of Authorized Representative October 01 2014 Date Title of Authorized Representative THIS CERTIFICATION IS FOR FY 2015,PERIOD BEGINNING October 1,201.5 and ENDING September 30,2016. STARSHU-01 NCVDMS CERTIFICATE OF LIABILITYINSURANCE DATE(tAu1DDNYlY) 1/30!2015 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(ies)must be endorsed. if SUBROGATION IS WAIVED,subject to the terns 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 NAME CT Donna Schultz American Highways ins.Agency PHONE Ext: 800 935-2442 Afc No: 330)659-8912 3250 Interstate to Driv a nREss:donna.schultz hlghwaysinsurance.com 44286 INSURERS AFFORDING COVERAGE NA4C S INSURER A:National Interstate Insurance Company 32620 INSURED INSURER 8: Star Shuttle,Inc.dba Star Shuttle&Charter INSURER c: P.O.Box 17967 INSURER 0: San Antonio,TX 78217 INSURER E: 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 CONDITIDNS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED 13Y PAID CLAIMS. iL R TYPE OF INSURANCE POLICYNUMBER MMfDD EFF MVIDD EXP LIMITS A X COMMERCIAL GENERALLIABIUTY EACH OCCURRENCE 5 5,000,00 ED CLAIMS-MADE ®OCCUR X X XPP2400020.11 02101/2015 02/01/2016 PREMISES Ea occurrence $ 250,00 MED EXP(Any oneperson) $ 5,00 PERSONAL&ADV INJURY $ 5,000,00 GEN7L AGGREGATE IJN41T APPLIES PER: GENERAL AGGREGATE $ 5,000,00 X PRO I LOC PRODUCTS-COMPOPAGO $ 5,000,00 POLICY SECT $ OTHER: AUTOMOBILE LIABILITY (Eaac i eD 1 LELIAI $ 1,000,00 A X ANY AUTO X X XPP2400020-11 02/0112015 02/0112016 BODILY INJURY(Pat Person) $ ALL OWNEDJAUTOS SCHEDULED BODILY INJURY(Per accident) $ AUTOS NWNED OPERTYO E �( Peracddant HIREDAUTOSAUTOSUMBRELLALIMX OCCUREACH OCCURRENCE 5 4,000,00A }( EXCESS LiABGLAI,ts-MADE XEX2400020.12 02/0112015 02/01/2016 AGGREGATE $ OED RETENTIONS AL Only 5 PER OTH- WORKERS COMPENSATION STATUTE ER AND EMPLOYERS'LIABILITY ANY PROPRIErOWPARTNEIMECUTWE YIN E.L,EACHACCIDENT $ OFFICERIMEMBEREXCLUDEDI NIA (Mandatory In NH) 5.1-DISEASE-EA ELfPLOYE $ If yes,dasaibe under E,L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS betaa DESCRIPTION OF OPERATIONS J LOCATIONS I VEHICLES(ACORD 101,Add}tfonal Romarks Schedule,may be attachadif more apace Is requlmd) $4M X SIM Coverage only applies to Charter Buses(>29 PAX),Charter Mlnls(>15 PAX),Charter Vans(<16 PAX),School Buses Physical Damage Deductibles: Charter Bus vehicles:$20,OOD specified poriislcollislon All other vehicles:$5,00D specified perilsl$10,000 collision Private passengerlservice vehicles$2,500 comprehensive/collision CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Round Rock,its officers and employees ACCORDANCE WITH THE POLICY PROVISIONS. 221 East Main Round Rock,TX 78664-5299 AUTHORIZED REPRESENTATIVE B ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks ofACORD THIS ENDORSEMENT CHANGES THE POLICY-PLEASE READ IT CAREFULLY ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABHJTY COVERAGE FORM SCHEDULE Name of Persons or Organization(s) City of Round Rock, its officers and employees A. Section If—Who Is An Insured is amended to include as an insured any person or organization shown in the above Schedule who you are required to add as an additional insured on this policy under a written contract or written agreement. The written contract or agreement must have been signed and executed by you and the additional insured prior to any"bodily injury","property damage"or "personal and advertising injury"and in effect during the policy period. B. The insurance provided to the additional insured person or organization applies only to"bodily injury","property damage"or"personal and advertising injury" covered under Section I—Coverage A--Bodily Injury and Property Damage Liability and Section I—Coverage B—Personal and Advertising Injury Liability,but only with respect to liability for"bodily injury","property damage"or"personal and advertising injury"caused in whole or in part,by 1. Your acts or omissions;or 2. The acts or omissions of those acting on your behalf;and resulting directly from: a. Your ongoing operations performed for the additional insured, which is the subject of the written contract or agreement;or b, "Your work"completed as included in the"products-completed operations hazard",performed for the additional insured, which is the subject of the written contract or agreement. C. For the coverage provided by this endorsement: 1. The following paragraph is added to Paragraph 4,a.of the other Insurance Condition of Section IV—Commercial General Liability Conditions: NI CG 20 54 01 11 This insurance is primary insurance as respects our coverage to the additional insured person or organization where the written contract or agreement requires that this insurance be primary and non contributory. In that event,we will not seek contribution from any other insurance policy available to the additional insured where the additional insured person or organization is a Named Insured. I NI CG 20 54 01 11 POLICY NUMBER: XPP2400020-4 9 COMMERCIAL GENERAL LIABILITY CG 24 44 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE.PART SCHEDULE Name Of Person Or Organization: City of Round Rock, its officers and employees Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The following is added to Paragraph S. Transfer Of Rights Of Recovery Against Others To Us of Section IV--Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included In the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. POLICY NUMBER: XPP2400020-11 COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO U (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Star Shuttle, Inc. dba Star Shuttle &Charter Endorsement Effective Date: 2/1/2015 SCHEDULE Name(s)Of Person(s)Or Organization(s): City of Round Rock, its officers and employees Information required to com fete this Schedule,if not shown above,will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Oth- ers To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the"ac- cident"or the 'loss" under a contract with that person or organization. CA 04 44 0310 ©Insurance Services Office, Inc., 2009 Page 1 of 1 ❑ THIS ENDORSEMENT CHANGES THE POLICY-PLEASE READ IT CAREFULLY ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY COVERAGE-BUSINESS AUTO This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE Name of Person(sl or Or anizatioll O City of Round Rock,its officers and employees-. A. The following is added to Paragraph c.under A.I.Who Is An Insured,of Section Ii—Liability Coverage: Any person or organization shown in the above Schedule who is required to be named as an additional insured under a written contractor agreement between you and that person or organization is an"insured"for Liability Coverage,but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an"insured"under the Who Is An Insured provision contained in Section II. In addition, the written contract or agreement must be signed and executed by you and the person or organization before the"bodily injury"or"property damage"occurs and in effect during the policy period. B. The following is added to Paragraph 5. Other Insurance,under B.General Conditions of Section IV—Business Auto Conditions: If the person or organization in the above Schedule under a written contract or agreement with you requires this insurance to be primary and non contributory, regardless of the provisions under paragraph a. and paragraph d.ofpart 5.Other Insurance, this insurance will be primary and non contributory to any other insurance where the scheduled person or organization is a Named Insured. The written contract or agreement must be signed and executed by you and the person or organization before the "bodily injury"or"property damage"occurs and in effect during the policy period. NI CA 20 52 0111