1.D MOU WITH CITIES & HOPE CENTER OF ORANGE COUNTY FOR NATIONAL OPIOID STATEMENT FUNDS

Agenda Item No: 1.d

PLACENTIA CITY COUNCIL AGENDA REPORT
Meeting Date: April 15, 2025
Submitted by: Teri Knutson
From: Police Department
Subject:

Memorandum of Understanding (MOU) with Cities and HOPE Center of Orange County for National Opioid Statement Funds
Financial Impact:

Fiscal Impact:

Expense: $ 15,000 (910000-6290)
Revenue: $151,924 (910000-4299)
Summary:

The National Opioid Settlement Funds are allocated to states for opioid crisis prevention, treatment and harm reduction. The State of California, in turn, has provided funds to cities and counties that have elected to participate in the settlements. Participants must comply with specific spending guidelines established by the National Settlement Agreements including that 50% of the funds be spent on what are considered High Impact Abatement Activities. The cities of Placentia, Brea, Buena Park and Fullerton are working with the HOPE Center of Orange on the use of these funds. This Agenda Report requests that the Placentia City Council approve the required Joint Agreement and appropriation of these funds.

Recommendation:

Recommended Action: It is recommended that the City Council take the following actions to:

1. Authorize the Interim City Administrator to execute an Agreement between the HOPE Center and the Cities of Placentia, Brea, Buena Park and Fullerton, for a three-year term using the respective cities’ National Opioid Settlement Funds, including an expenditure of $15,000 for Placentia’s portion to fund one Street Outreach Case Manager position; and

2. Approve Resolution R-2025-12 amending the FY24/25 budget by adding an appropriation and revenue in the amount of $151,924 for National Opioid Settlement funds received and expected to be received; and

3. Authorize the Interim City Administrator and/or his designee to execute all necessary documents, in a form approved by the City Attorney.

Strategic Plan Statement:

This item is consistent with the City Council approved Strategic Plan Goal 2, to Ensure that Public Safety Continues to be a High Priority.
1 Discussion:

The National Opioid Settlement (NOS) Funds are allocated to states for opioid crisis prevention, treatment and harm reduction. The State of California Department of Health Care Services is overseeing the distribution and monitoring of these funds, which are being given to cities and counties, known as “Participating Subdivisions.” Use of the funds requires compliance with the specific spending guidelines of the National Settlement Agreements, as well as that 50% of the funds be used according to the Department of Health Services’ designation of High Impact Abatement Activities.

The City of Placentia received $19,263 in Fiscal Year 2023/2024 and is expected to receive $132,661 in a future reporting period for Fiscal Year 2024/2025. The purpose of this Agenda Report is to request that the City Council enter into a Memorandum of Agreement (MOU) with the HOPE Center and the Cities of Brea, Buena Park and Fullerton, for the use of a portion of the funds to contract for one full-time Street Outreach Case Manager position. The term of the MOU is July 1, 2025, to June 30, 2028. The Case Manager position will focus on Medication- Assisted Treatment services, Opioid Use Disorder and Substance Use Disorder services to better address the needs of vulnerable populations in Placentia.

Additional cities may join the initiative through an amendment, subject to the consensus of all participating cities. If new cities opt-in, the funding formula will be recalculated, potentially reducing Placentia’s financial contribution. The formula will be updated annually at the start of each fiscal year based on data collected and provided by the HOPE Center. While the MOU currently provides that City of Placentia’s financial part is $15,000, the MOU provides that services can be expanded.

Fiscal Impact Summary:

Fiscal Impact:

It is recommended that the Placentia City Council approve a total appropriation of $15,000 to the MOU with the HOPE Center. Future funds received will be recommended for expenditure in the City’s annual budget processes. The receipt and use of National Opioid Settlement Funds are no cost to the City of Placentia.

Attachments
HCOC MOA_FINAL_03-12-2025_EXECUTED HCOC.pdf
Resolution R-2025-12.docx
City of Placentia W/C Insurance
City of Brea W/C Insurance
City of Buena Park W/C Insurance
City of Fullerton W/C Insurance
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MEMORANDUM OF AGREEMENT

OPIOID USE DISORDER AND MEDICATION ASSISTED TREATMENT PROGRAM

MEMORANDUM OF AGREEMENT BETWEEN THE CITIES OF BREA, BUENA PARK,

FULLERTON, PLACENTIA AND THE HOPE CENTER OF ORANGE COUNTY (HCOC)

This Memorandum of Agreement (“MOA”) is by and between the California Cities of Brea, Buena Park, Fullerton, and Placentia (collectively, the “Cities” and individually a “City”) and the HOPE Center of Orange County (“HCOC”), a non-profit corporation of California, (collectively, the “Parties” and individually, a “Party”) to be effective as of July 1, 2025 and signed by all Parties.

RECITALS:

A. The HCOC is a ground-breaking multi-city, multi-disciplinary partnership that seeks to establish community-wide coordination and standardization in homeless outreach and engagement by centralizing resources, coordinating responses, and integrating data. HCOC’s mission is to help individuals experiencing homelessness in the North Orange County Service Planning Area (SPA) gain more reliable relief and consistent support. The HOPE Center’s mantra is “Right People, Right Resources, Right Now.” They work diligently to align the efforts and strategies of North Orange County cities, community-based organizations, behavioral health street practitioners, and community health workers to improve the capacity of the homeless services system to effectively plan, manage, and allocate resources so that responses are appropriate and expedient.

B. The Cities desire to expand access to and the availability of Medication Assisted Treatment (MAT) and related services by contracting with HCOC to provide one (1) full time Clinical Manager to develop service coordination and access for vulnerable populations (including those in emergency or temporary shelter and unsheltered populations) that are disproportionately impacted by Substance Use Disorder (SUD) and Opioid Use Disorder (OUD), herein referred to as the “Program;”

C. HCOC desires to provide such services to the Cities, and the Cities have agreed to allocate a portion of the funding each received from the National Opioid Settlement to pay for the cost of such services, subject to the terms and conditions specified in this MOA;

D. The Cities and the HCOC desire to set forth the terms of their ongoing collaboration with respect to this effort in this MOA;

E. These services referred to as the “Program” will be an integrated component of the HCOC street outreach, engagement and services, which operates in the cities of the North Orange County Public Safety Collaborative.

NOW, THEREFORE, the Parties agree to the following:

I. TERM:

The term of this MOA shall commence on July 1, 2025 and upon execution of the MOA by all Parties and shall continue through June 30, 2028 (“Term”). The Term of this MOA may be extended by mutual agreement of all Parties by way of a written amendment to this MOA.

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II. RESPONSIBILITIES OF EACH OF THE PARTIES:

A. HCOC agrees to:

1. Undertake the hiring and all other duties related to employment of a Clinical Manager to implement the Program.
a. The Clinical Manager, as an addiction specialist, will focus on coordinating wraparound support services, including but not limited to:
i. Medical referrals for treatment.
ii. Job-related information and employment assistance.
iii. Food and housing support.
iv. Follow-up care to ensure treatment continuity.
v. Linkages to additional social and health services aimed at supporting long-term recovery.

2. Manage, make eligible payments if required, and administer any necessary agreements with MAT service provider(s) if required to ensure the Program is being implemented as contemplated under this MOA.

3. Respond to and address Cities’ concerns regarding Clinical Manager performance within a reasonable time.

4. Coordinate conference calls and/or meetings with Cities as necessary.

5. Gather data related to MAT, SUD, and OUD calls for service and utilize/interpret the data to enhance program effectiveness.

6. Provide Cities with monthly reports illustrating program effectiveness to include quantitative data analysis, performance metrics, and any other information necessary to fulfill National Opioid Settlement annual reporting requirements.

7. HCOC shall promptly review all documents submitted by Cities. HCOC shall advise Cities of decisions pertaining to such documents within a reasonable time after submission.

8. HCOC hereby designates its executive director, or designee, to act as its representative for the performance of this MOA (“HCOC’s Representative”). HCOC’s Representative shall have the power to act on behalf of HCOC for all purposes under this MOA.

9. Provide any updated point-of-contact described in Section V. to serve as the HCOC’s Project Manager with name, title, and contact information.

B. Cities agree to:

1. Participate in conference calls and/or meetings with HCOC, as necessary.

2. Provide any updated point-of-contact described in Section V. to serve as each City’s Project Manager with name, title, and contact information.

3. Manage program budget and process payments to HCOC for program expenses per Exhibit A attached hereto and incorporated herein by reference.

4. As needed, hold internal City meetings to continue to push the program forward and build internal buy-in across staff.

5. Provide feedback to the HCOC on the implementation of the Substance Use Disorder, Opioid Use Disorder and Medication Assisted Treatment Program.

6. Respond to requests, provide data and information as requested, review materials, and provide input to the HCOC to support the implementation of the Program.

7. Complete annual California Department of Health Care Services (DHCS) reporting requirements per the National Opioid Settlement Agreement.

8. Should a City not provide the required resources, as determined by HCOC, to support the Program, the HCOC reserves the right to withdraw the Program’s services from 4 3
said City. Said City must provide 120 days advanced written notice to the remaining Cities in order for the remaining Cities to evaluate whether to terminate the Program or provide additional funding above their contracted allocation percentage, as further detailed in Section III (Compensation) of this MOA, to cover the difference.

III.COMPENSATION:

A.For the performance of all Services rendered by HCOC through the Clinical Manager under this MOA, Cities shall pay HCOC in accordance with the following Cost Allocation Plan based on the MAT services provided to respective Cities by treatment provider from February 2024 to August 2024 (“Compensation”):
i.Brea (19 or 16%): not to exceed $40,000
ii.Buena Park (33 or 28%): not to exceed $70,000
iii.Fullerton (59 or 50%): not to exceed $125,000
iv.Placentia (7 or 6%): not to exceed $15,000
This amount of Compensation to HCOC for the services provided under this MOA is not to exceed two-hundred and fifty thousand dollars ($250,000) annually, as further detailed in the HCOC program budget enclosed in Exhibit A of this MOA. Budget modifications are permitted and will be allowed on a case by case basis upon approval by the Cities.

After completion of the first year of the MOA, as measured by the start date of July 1, 2025, this allocation formula shall be reviewed by the Parties and percentages adjusted according to new MAT-treatment client residence data to be provided by HCOC. The percentage shall always equal 100% to fund the activities identified in the budget within Exhibit A attached to this MOA and will only adjust internally between the participating Cities.

The percentage allocation may also change via an amendment to the MOA if additional cities wish to enter this MOA.

B.Any consideration for an increase in Compensation shall occur no more than once per fiscal year, irrespective of the number of additional National Opioid Settlement funds secured within a single fiscal year by Cities. If the Cities agree that sufficient funding exists to support an increase in Compensation, the Parties shall execute a written amendment to this MOA to reflect such increase. In no event shall any increase in Compensation exceed the actual percentage increase in the Consumer Price Index – All Urban Consumers covering Orange County, as determined by the United States Department of Labor, Bureau of Labor Statistics for the preceding Twelve (12) months.

C.For the first six (6) months of the Term, HCOC shall invoice Cities individually for the Compensation within 30 days of the of the effective date of this MOA, July 1, 2025.

Thereafter, HCOC shall invoice each City on the last day of each month for that month’s compensation during the Term of this MOA. The first six (6) months of the Term will be paid in advance by the Cities, thereafter, payments shall be made on a monthly reimbursement basis. Cities shall pay the invoice within 30 days of its receipt 5 4
thereof.

IV. AMENDMENTS:

A. PROJECT SCOPE

1. For any change which materially affects the project scope of work or budget, or in any way modifies any term or condition included under this MOA, a written amendment to the MOA shall be prepared and executed by the Cities and the HCOC for such change to be effective.

2. Changes affecting the project scope of work must be in compliance with Exhibit E of the National Opioid Settlement Agreement.

B. NEW PARTIES

1. Qualifying Agencies: Only those cities whose jurisdictional boundaries include portions of, or overlap with, the Program Area qualify to be a party to this MOA (“Qualifying Agency”).

2. Financial Contribution of New Parties: After July 1, 2025, a Qualifying Agency that is not a participating City may petition the Parties to be added to this MOA, and will be made a Party hereto if, 1) the petition of the Qualifying Agency is approved by all Parties; 2) the Qualifying Agency pays a pro-rated share of the costs incurred by the Cities paid to the HCOC for the current fiscal year.

Upon being made a party to this MOA, and as condition precedent thereto, the Qualifying Agency shall be allocated and pay their contribution amount consistent with the Cost Allocation Plan set forth in Section III of this MOA, and all other allocations of the Cities shall be adjusted accordingly. The Parties acknowledge and agree that payments to be made by a Qualifying Agency under this Section fairly represent the Program benefits and burdens to the Parties.

V. PROJECT MANAGEMENT:

A. For purposes of this MOA, the HCOC designates the following individual as its Project Manager:

Sarah Bernal, Operations Manager | [email protected]

B. For purposes of this MOA, the City of Brea designates the following individual as its Project Manager:

Tiara Solorzano, Management Analyst | [email protected]

C. For purposes of this MOA, the City of Buena Park designates the following individual as its Project Manager:

Rosemary Nielsen, Homeless Outreach Supervisor | [email protected] 6 5

D. For purposes of this MOA, the City of Fullerton designates the following individual as its Project Manager:

Pedram Gharah, Police Captain | [email protected]

E. For purposes of this MOA, the City of Placentia designates the following individual as its Project Manager:

Chris Anderson, Admin. Lieutenant | [email protected]

F. All notices required herein shall be sent by email, except for a notice of termination, default, or failure to cure, which shall be sent by certified mail, postage pre-paid, return receipt requested. Any Party may change its Project Manager or contact upon written notice to the other party and shall promptly update the other party in writing of any such changes.

VI. TERMINATION:

A. This MOA may be terminated by the Cities at any time without cause if all participating Cities agree to termination. Termination will occur 120 days after written notice is issued to HCOC’s Project Manager. The HCOC shall stop work and not incur any additional expenses upon receipt of or issuance of such notice, except that which is reasonable and necessary to effectuate the termination. The HCOC shall be entitled to reimbursement for eligible expenses that are reasonably and necessarily incurred up to the date that such termination is effective.

B. Should a City elect to withdraw from the MOA without cause, said City must provide 120 days advanced written notice to remaining Cities and HCOC. Additionally, withdrawing City shall be responsible for agreed upon fees due for remainder of HCOC’s current fiscal year, payable to HCOC prior to effective date of termination.

Withdrawal and termination of City’s participation in the MOA will be effective at the start of the next year of the MOA (fiscal year).

C. Should a City not provide the required funding resources to support the Program, the HCOC reserves the right, in its sole discretion, to withdraw the Program’s services from the City. Said City must provide 120 days advanced written notice for remaining Cities to evaluate whether to terminate the Program or provide additional funding above their contracted allocation percentage to cover the difference.

D. HCOC may terminate this HOA at any time without cause with 120 days’ notice. As of the effective termination date of this termination notice, HCOC will cease all expenditures associated with this Program as defined by this MOA.

VII. INDEMNITY:

A. HCOC agrees to defend, indemnify, and hold free and harmless each City individually, its member agencies, and its respective elected and appointed boards, officials, officers, 7 6
agents, employees, and volunteers, at HCOC’s sole expense, from and against any and all claims, actions, suits, or other legal proceedings brought against that City, its member agencies, and its respective elected and appointed boards, officials, officers, agents, employees, and volunteers arising out of or relating to the acts or omissions of the HCOC in connection with this MOA.

B. Each City individually agrees to defend, indemnify, and hold free and harmless the HCOC and its employees, at that City’s sole expense, from and against any and all claims, actions, suits, or other legal proceedings brought against the HCOC and its employees arising out of or relating to the acts or omissions of that City in connection with this MOA.

VIII. INSURANCE:

A. Cities and HCOC shall each maintain and keep in full force and effect during the Term of this MOA, insurance or a program of self-insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder by Cities, HCOC, their agents, representatives, employees, or subcontractors. Cities and HCOC shall provide current evidence of the required insurance in a form acceptable to the Parties and shall provide replacement evidence for any required insurance which expires prior to the completion, expiration, or termination of this MOA.

B. MINIMUM SCOPE AND LIMITS OF INSURANCE

1. Commercial General Liability Insurance. HCOCHCOC shall maintain commercial general liability insurance coverage in a form at least as broad as ISO Form #CG 00 01, with a limit of not less than $2,000,000 each occurrence.

If such insurance contains a general aggregate limit, it shall apply separately to the MOA or shall be twice the required occurrence limit.

2. Business Automobile Liability Insurance. HCOCHCOC shall maintain business automobile liability insurance coverage in a form at least as broad as ISO Form # CA 00 01, with a limit of not less than $1,000,000 each accident.

Such insurance shall include coverage for owned, hired and non-owned automobiles.

3. Workers’ Compensation and Employers’ Liability Insurance. HCOC shall maintain workers’ compensation insurance as required by the State of California and employers’ liability insurance with limits of not less than $1,000,000 each accident.

4. Professional Liability Insurance. HCOC shall maintain professional liability insurance appropriate to HCOC’s profession with a limit of not less than $2,000,000. Architects’ and engineers’ coverage shall be endorsed to include contractual liability. If policy is written as a “claims made” policy, the retro date of the policy shall be prior to the start of the contract work

5. Sexual Abuse or Molestation (SAM) Liability Insurance: If the work will 8 7
include contact with minors, and the CGL policy referenced above is not endorsed to include affirmative coverage for sexual abuse or molestation, HCOC shall obtain and maintain a policy covering Sexual Abuse and Molestation with a limit no less than $1,000,000 per occurrence or claim.

C. DEDUCTIBLES AND SELF-INSURED RETENTIONS. Any deductible of self- insured retention must be declared to and approved by all Parties.

D. OTHER INSURANCE PROVISIONS. The required insurance policies shall contain or be endorsed to contain the following provisions:

1. Commercial General Liability. Cities, their elected or appointed officials, officers, employees and volunteers are to be covered as additional insureds with respect to liability arising out of work or operations performed by or on behalf of HCOC, including materials, parts or equipment furnished in connection with such work or operations. Such coverage as an additional insured shall not be limited to the period of time during which HCOC is conducting ongoing operations for Cities but rather, shall continue after the completion of such operations. The coverage shall contain no special limitations on the scope of its protection afforded to Cities, their officers, employees and volunteers.

2. Commercial General Liability. This insurance shall be primary insurance as respects to Cities, their officers, employees and volunteers and shall apply separately to each insured against whom a suit is brought or a claim is made.

Any insurance or self-insurance maintained by Cities, their officers, employees and volunteers shall be excess of this insurance and shall not contribute with it.

3. Professional Liability. If the professional liability policy is written on a “claims made” form, the retroactive date must be shown and must be before the date of the contract or beginning of contract work. The insurance must be maintained and evidence of insurance must be provided for at least (5) years after completion of the contract work. If the coverage is canceled or non-renewed and not replaced with another claims-made policy form with a retroactive date prior to the contract effective date, HCOC must purchase “extended reporting coverage” for a minimum of five (5) years after completion of work.

4. Workers’ Compensation and Employers’ Liability Insurance. Insurer shall waive their right of subrogation against Cities, their officers, employees and volunteers for work done on behalf of Cities.

5. All Coverages. Each insurance policy required by this clause shall be endorsed to state that coverage shall not be canceled, except after thirty (30) days’ prior written notice by certified mail, return receipt requested, has been given to Cities.

6. Special Risks or Circumstances. Cities reserve the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage or other special circumstances.

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E. ACCEPTABILITY OF INSURERS. All required insurance shall be placed with insurers acceptable to Cities with current BEST’S ratings of no less than A, Class VII.

Workers’ compensation insurance may be placed with the California State Compensation Insurance Fund. All insurers shall be licensed by or hold admitted status in the State of California. At the sole discretion of Cities, insurance provided by non- admitted or surplus carriers with a minimum BEST’S rating of no less than A- Class X may be accepted if HCOC evidences the requisite need to the sole satisfaction of Cities.

F. VERIFICATION OF COVERAGE. HCOC shall furnish Cities with certificates of insurance which bear original signatures of authorized agents and which reflect insurers names and addresses, policy numbers, coverage, limits, deductibles and self-insured retentions. Additionally, HCOC shall furnish copies of all policy endorsements required herein. All certificates and endorsements must be received and approved by Cities before work commences. Cities reserve the right to require at any time complete, certified copies of any or all required insurance policies and endorsements.

IX. OTHER TERMS AND CONDITIONS:

A. No Partnership. This MOA is not intended to be, and shall not be construed as, an agreement to form a partnership, agency relationship, or a joint venture between the Parties. Except as otherwise specifically provided in the MOA, neither Party shall be authorized to act as an agent of or otherwise to represent the other Party.

B. Entire MOA. This MOA constitutes the entire understanding between the Parties with respect to the subject matter herein and supersedes any and all other prior writings and oral negotiations. This MOA may be modified only in writing and signed by the Parties in interest at the time of such modification.

C. Governing Law. This MOA shall be governed by and construed under California law and any applicable federal law without giving effect to that body of laws pertaining to conflict of laws. In the event of any legal action to enforce or interpret this MOA, the Parties hereto agree that the sole and exclusive venue shall be a court of competent jurisdiction located in Orange County, California.

D. Excusable Delays. Neither Party shall be considered in default in the performance of its obligations hereunder to the extent that the performance of any such obligation is prevented or delayed by unforeseen causes including acts of God, floods, earthquakes, fires, acts of a public enemy, pandemic, epidemic, and government acts beyond the control and without fault or negligence of the affected Party. Each Party hereto shall give notice promptly to the other of the nature and extent of any such circumstances claimed to delay, hinder, or prevent performance of any obligations under this MOA.

E. Waiver. Waiver by any Party to this MOA of any term, condition, or covenant of this MOA shall not constitute a waiver of any other term, condition, or covenant. No waiver of any provision of this MOA shall be effective unless in writing and signed by a duly authorized representative of the Party against whom enforcement of a waiver is sought.

F. Standard of Skill. HCOC shall perform all services in the manner and according to the standards currently observed by a competent practitioner of the services in California, 10 9
and shall at all times, meet or exceed any applicable professional standards of care, workmanship, or conduct. All products of whatsoever nature that HCOC delivers to Cities pursuant to this MOA shall be prepared in a professional manner and conform to the standards of quality normally observed by a person currently providing similar services. The acceptance of the services by Cities shall not operate as a release of HCOC from such standards of care, workmanship, or conduct.

G. Independent Contractor. HCOC is and shall at all times remain as to Cities a wholly independent contractor. Neither Cities nor any of its agents shall have control over the conduct of HCOC or any of HCOC's employees or agents, except as herein set forth.

HCOC shall not at any time or in any manner represent that it or any of its agents or employees are in any manner agents or employees of Cities. HCOC shall have no power to incur any debt, obligation, or liability on behalf of Cities or otherwise act on behalf of Cities as an agent. HCOC shall not have the status of an employee of Cities under this MOA, or be entitled to participate in any insurance, medical care, vacation, sick leave or other benefits provided for Cities' officers or employees. In the event that HCOC, or any of its employees, agents, or subcontractors providing services under this MOA, claims or is determined by a court of competent jurisdiction or the California Public Employees Retirement System (“PERS”) to be eligible for enrollment in PERS as an employee of Cities, HCOC shall indemnify, defend, and hold Cities harmless for the payment of any employee and/or employer contributions for PERS benefits on behalf of HCOC or its employees, agents, or subcontractors, as well as for the payment of any penalties and interest on such contributions, which would otherwise be the responsibility of Cities. HCOC represents that it has, or will secure at its own expense, all personnel required to perform the services under this MOA. All of the services to be performed by HCOC or under its direct supervision, and all personnel engaged in the work shall be qualified to perform it. HCOC reserves the right to determine the assignment of its own employees to the performance of the services under this MOA, but Cities reserve the right, for good cause, to require HCOC to exclude any employee from performing services on Cities' premises.

H. Records. HCOC shall maintain complete and accurate records with respect to sales, costs, expenses, receipts and other such information relating to the services, as required by Cities or the Cities’ Project Managers. HCOC shall maintain adequate records on services provided in sufficient detail to permit an evaluation of the services. All such records shall be maintained in accordance with generally accepted accounting principles and shall be clearly identified and readily accessible. At all times during regular business hours, HCOC shall provide access to such books and records to the Cities, and shall give the Cities, or his or her designees, the right to examine and audit such books and records and to make transcripts as necessary, and shall allow inspection of all work, data, documents, proceedings and activities related to this MOA.

I. Permits and Licenses. HCOC, at its sole expense, shall obtain and maintain during the Term of this MOA all appropriate permits, licenses, and certificates that may be required in connection with performing the services.

J. Headings. The section headings contained in this MOA are for convenience and identification only and shall not be deemed to limit or define the contents to which they relate.
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K. Assignment. Neither Party may assign its interest in this MOA, or any part thereof, without the prior written consent of the other Party. Any assignment without consent shall be void and unenforceable.

L. Severability. If any provision of this MOA is held by a court of competent jurisdiction to be invalid, void, or unenforceable, the remaining provisions shall nevertheless continue in full force without being impaired or invalidated in any way.

M. Authority to Execute. The person executing this MOA on behalf of a Party warrant that they are duly authorized to execute this MOA on behalf of said Party, and that by doing so said Party is formally bound to the provisions of this MOA.

N. Counterparts. This MOA may be executed in multiple counterparts, each of which shall be deemed an original, but all of which taken together shall constitute one and the same instrument.

O. Electronic Signatures. This MOA may be executed with electronic signatures in accordance with Government Code Section 16.5. Such electronic signatures will be treated in all respects as having the same effect as an original signature.

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In witness whereof, the Parties enter into this MOA on the date of last execution by the Parties.

FOR THE CITY OF BREA
By: ___________________________
Kristin Griffith
City Manager
Date: __________________________
APPROVED AS TO FORM:
_______________________________
Terrance Boga
City Attorney

FOR THE HOPE CENTER OF ORANGE
COUNTY
By: ____________________________
George Searcy
Executive Director
Date: __________________________ March 12, 2025
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In witness whereof, the Parties enter into this MOA on the date of last execution by the Parties.

FOR THE CITY OF BUENA PARK
By: ___________________________
Aaron France
City Manager
Date: __________________________
APPROVED AS TO FORM:
_______________________________
City Attorney

FOR THE HOPE CENTER OF ORANGE
COUNTY
By: ____________________________
George Searcy
Executive Director
Date: __________________________ March 12, 2025
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In witness whereof, the Parties enter into this MOA on the date of last execution by the Parties.

FOR THE CITY OF FULLERTON
By: ___________________________
Eric J. Levitt
City Manager
Date: __________________________
APPROVED AS TO FORM:
_______________________________
Richard D. Jones
City Attorney

FOR THE HOPE CENTER OF ORANGE
COUNTY
By: ____________________________
George Searcy
Executive Director
Date: __________________________ March 12, 2025
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In witness whereof, the Parties enter into this MOA on the date of last execution by the Parties.

FOR THE CITY OF PLACENTIA
By: ___________________________
Thomas Hatch
Interim City Administrator
Date: __________________________
APPROVED AS TO FORM:
_______________________________
Christian Bettenhausen
City Attorney

FOR THE HOPE CENTER OF ORANGE
COUNTY
By: ____________________________
George Searcy
Executive Director
Date: __________________________ March 12, 2025
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EXHIBIT A

HOPE CENTER- OPIOID USE DISORDER AND MEDICATION ASSISTED TREATMENT

PROGRAM BUDGET
Year 1
FY2025-26
Year 2
FY2026-27
Year 3
FY2027-28
1 Clinical Manager
Salary 125,000 128,750 132,613
Benefits 27,500 28,325 29,175
Subtotal 152,500 157,075 161,787
2 Supplies & Program Materials 25,000 25,750 26,523
3 Program Evaluation Consultant 25,000 25,750 26,523
4 Program Training and Education 25,000 25,750 26,523
Subtotal 75,000 77,250 79,568
Grand Total $227,500 $234,325 $241,355
Budget Item Description:

1.Clinical Manager
This position will require an experienced LCSW or LMFT with knowledge of best practices in addressing the needs of persons with opioid use disorders in non-clinical community settings.
•The Program will provide program protocols and standard operations procedures for a mobile street outreach program to utilize with the identified population and will engage personally in providing services personally through the mobile program. •This position will also lead the implementation of a system for tracking outreach efforts, client engagement, and program outcomes.
•Regular evaluation processes will provide for adapting engagement and treatment strategies to meet changing community needs effectively.

2.Supplies and Program Materials
•The program will maintain a stock of naloxone and other harm reduction supplies and ensure that all staff within the HOPE Center operation are trained in the effective and appropriate use. Staff will also be trained in and provided with information about treatment options and response protocols.

3. Program Evaluation Consultant
•External evaluation services will be provided to determine whether the program is conforming to evidence-based practices and program standards and what targeted outcomes are being achieved as a part of the HOPE Center operations model.

4. Program Training and Education
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• Continuous training on trauma-informed care, overdose prevention, and the use of naloxone (an opioid overdose reversal drug) is crucial. All HOPE Center staff will receive training on cultural competence and the specific needs of the populations they serve.

18 Resolution R-2025-12 ATTACHMENT 1

Page 1 of 3 ends

RESOLUTION NO. R-2025-12

A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF

PLACENTIA, CALIFORNIA AUTHORIZING A BUDGET
AMENDMENT IN FISCAL YEAR 2024-25 IN COMPLIANCE

WITH CITY CHARTER OF THE CITY OF PLACENTIA
SECTION 1206 PERTAINING TO APPROPRIATIONS FOR

ACTUAL EXPENDITURES
A. Recitals.
(i). The adopted budget for the 2024-25 Fiscal Year sets out estimated appropriations for City expenses throughout the year.
(ii). From time to time the adopted budget must be adjusted when precise expenditures are finally determined or when estimated expenditures exceed projected costs allocated.
(iii).City Charter of the City of Placentia § 1206 authorizes the City Council to amend or supplement the budget by motion adopted by the affirmative votes of at least three members so as to authorize the transfer of unused balances appropriated for one purpose to another purpose, or to appropriate available revenues not included in the budget. All other legal prerequisites to the adoption of this Resolution have occurred. (iv).The City Council desires to amend said Opioid Settlement funds in accordance with the provisions of the Fiscal Year 2024-25Budget, effective July 1, 2024. (v). The City Council desires to appropriate a portion of the National Opioid Settlement Funds to join the Cities of Brea, Buena Park and Fullerton pursuant to the Memorandum of Understanding with these cities, in contracting a full-time Street Outreach Case Manager with the HOPE Center.

B. Resolution.

NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF PLACENTIA DOES HEREBY FIND, DETERMINE AND RESOLVE AS FOLLOWS:

1. In all respects as set forth in the Recitals, Part A., of this Resolution. 19 Resolution R-2025-12 ATTACHMENT 1

Page 2 of 3 ends

2. The adopted budget for Fiscal Year 2024-25, Resolution No. R-2024-12, is hereby amended to reflect the following changes to the appropriations in the Account(s) specified:

Fund Description Department GL Account Amount Type
Opioid
Settlement
Fund
Revenues
received
Public Safety –
Police
Police Administration
910000-
4299
$174,387.26 Revenue
Opioid
Settlement
Fund
Expenditures for
Street Outreach
Case Manager
Public Safety –
Police
Police Administration
910000-
6290
$15,000.00 Expense

4. The Mayor shall sign this resolution, and the City Clerk shall attest and certify to the passage and adoption thereof.

PASSED, ADOPTED AND APPROVED THIS 15th DAY OF APRIL2025. _____________________________
Kevn Kirwin, Mayor
ATTEST:
____________________________
Robert S. McKinnell, City Clerk

STATE OF CALIFORNIA

COUNTY OF ORANGE
20 Resolution R-2025-12 ATTACHMENT 1

Page 3 of 3 ends

I, Robert S. McKinnell, City Clerk of the City of Placentia, do hereby certify that the foregoing resolution was adopted at a regular meeting of the City Council of the City of Placentia held on the 15th day of April 2025by the following vote:

AYES:Councilmembers:

NOES:Councilmembers:

ABSENT:Councilmembers:

ABSTAIN:Councilmembers:
__________________________________
Robert S. McKinnell, City Clerk
APPROVED AS TO FORM:
______________________________
Christian Bettenhausen, City Attorney
21 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE
INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #
NAME:CONTACT
(A/C, No):FAX
E-MAILADDRESS:

PRODUCER
(A/C, No, Ext):PHONE

INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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).

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.

OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD

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. $
$
$
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY
Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT

EROTH-STATUTEPER

LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR

CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED $PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY PRO-JECT LOC

CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED

AUTOS ONLY
[email protected]
(888) 627-4735
A
Client# 20022834-CA
06/01/2025
2,000,000
2,000,000
Mary Storti
c/o Paychex Insurance Agency, Inc.
225 Kenneth Drive,
Rochester, NY 14623
06/01/2024
2,000,000
04/02/2025
Location Coverage Period:
20176845
Coverage is provided for only those co-employees of, but not subcontractors to: Hope Center of Orange County, 2050 Youth Way Bldg 1, BLDG 1, Fullerton CA 92835
Endorsement: Waiver of Subrogation
City of Placentia, its elected or appointed officials,
officers, employees and volunteers.
401 East Chapman Avenue
Placentia CA 92870
Zurich-American Insurance Company
06/01/2025
N
16535
Paychex PEO Holdings, LLC Labor Contractor, for
co-employees of: Hope Center of Orange County
911 Panorama Trail South
Rochester NY 14625
06/01/2024
WC 38-04-379-01
20176845 | PaychexPEOHoldingsLLC IND (CA) WC380437901 | AG | 04/02/2025 5:27:26 PM EDT | Page 1 of 2 22 WORKERS’ COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84)

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT – CALIFORNIA

We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the schedule (This agreement applies only to the extent that you per- form work under a written contract that requires you to obtain this agreement from us.)

You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.

The additional premium for this endorsement shall be of the California workers’ compensation premium otherwise due on such remuneration.

SCHEDULE

Person or Organization Job Description

IN FAVOR OF:

This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.)

Endorsement Effective: Policy No: Endorsement No:

Insured:

Insurance Company: Countersigned by

WC 04 03 06

Copyright 1983 National Council on Compensation Insurance 04/02/2025
Zurich-American Insurance Company
WC 38-04-379-01
$0
City of Placentia, its elected or appointed officials,
officers, employees and volunteers.
401 East Chapman Avenue
Placentia CA 92870
Paychex PEO Holdings, LLC Labor Contractor, for co-employees of: Hope Center of Orange County 20176845 | PaychexPEOHoldingsLLC IND (CA) WC380437901 | AG | 04/02/2025 5:27:26 PM EDT | Page 2 of 2 23 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE
INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #
NAME:CONTACT
(A/C, No):FAX
E-MAILADDRESS:

PRODUCER
(A/C, No, Ext):PHONE

INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY
Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT

EROTH-STATUTEPER

EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR

CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED $PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY PRO-JECT LOC

CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED

AUTOS ONLY
[email protected]
(888) 627-4735
A
Client# 20022834-CA
06/01/2025
2,000,000
2,000,000
Mary Storti
c/o Paychex Insurance Agency, Inc.
225 Kenneth Drive,
Rochester, NY 14623
06/01/2024
2,000,000
04/02/2025
Location Coverage Period:
20176843
Coverage is provided for only those co-employees of, but not subcontractors to: Hope Center of Orange County, 2050 Youth Way Bldg 1, BLDG 1, Fullerton CA 92835
Endorsement: Waiver of Subrogation
City of Brea, its elected or appointed officials,
officers, employees and volunteers.
1 Civic Center Circle
Brea CA 92821
Zurich-American Insurance Company
06/01/2025
N
16535
Paychex PEO Holdings, LLC Labor Contractor, for
co-employees of: Hope Center of Orange County
911 Panorama Trail South
Rochester NY 14625
06/01/2024
WC 38-04-379-01
20176843 | PaychexPEOHoldingsLLC IND (CA) WC380437901 | AG | 04/02/2025 5:19:06 PM EDT | Page 1 of 2 24 WORKERS’ COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84)

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT – CALIFORNIA

You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.

The additional premium for this endorsement shall be of the California workers’ compensation premium otherwise due on such remuneration.

SCHEDULE

Person or Organization Job Description

IN FAVOR OF:

Endorsement Effective: Policy No: Endorsement No:

Insured:

Insurance Company: Countersigned by

WC 04 03 06

Copyright 1983 National Council on Compensation Insurance 04/02/2025
Zurich-American Insurance Company
WC 38-04-379-01
$0
City of Brea, its elected or appointed officials,
officers, employees and volunteers.
1 Civic Center Circle
Brea CA 92821
Paychex PEO Holdings, LLC Labor Contractor, for co-employees of: Hope Center of Orange County 20176843 | PaychexPEOHoldingsLLC IND (CA) WC380437901 | AG | 04/02/2025 5:19:06 PM EDT | Page 2 of 2 25 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE
INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #
NAME:CONTACT
(A/C, No):FAX
E-MAILADDRESS:

PRODUCER
(A/C, No, Ext):PHONE

INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY
Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT

EROTH-STATUTEPER

EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR

CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED $PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY PRO-JECT LOC

CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)

CANCELLATION

CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED

AUTOS ONLY
[email protected]
(888) 627-4735
A
Client# 20022834-CA
06/01/2025
2,000,000
2,000,000
Mary Storti
c/o Paychex Insurance Agency, Inc.
225 Kenneth Drive,
Rochester, NY 14623
06/01/2024
2,000,000
04/02/2025
Location Coverage Period:
20176844
Coverage is provided for only those co-employees of, but not subcontractors to: Hope Center of Orange County, 2050 Youth Way Bldg 1, BLDG 1, Fullerton CA 92835
Endorsement: Waiver of Subrogation
City of Buena Park, its elected or appointed officials
officers, employees and volunteers.
6650 Beach Blvd
Buena Park CA 90621
Zurich-American Insurance Company
06/01/2025
N
16535
Paychex PEO Holdings, LLC Labor Contractor, for
co-employees of: Hope Center of Orange County
911 Panorama Trail South
Rochester NY 14625
06/01/2024
WC 38-04-379-01
20176844 | PaychexPEOHoldingsLLC IND (CA) WC380437901 | AG | 04/02/2025 5:22:37 PM EDT | Page 1 of 2 26 WORKERS’ COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84)

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT – CALIFORNIA

You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.

The additional premium for this endorsement shall be of the California workers’ compensation premium otherwise due on such remuneration.

SCHEDULE

Person or Organization Job Description

IN FAVOR OF:

Endorsement Effective: Policy No: Endorsement No:

Insured:

Insurance Company: Countersigned by

WC 04 03 06

Copyright 1983 National Council on Compensation Insurance 04/02/2025
Zurich-American Insurance Company
WC 38-04-379-01
$0
City of Buena Park, its elected or appointed officials
officers, employees and volunteers.
6650 Beach Blvd
Buena Park CA 90621
Paychex PEO Holdings, LLC Labor Contractor, for co-employees of: Hope Center of Orange County 20176844 | PaychexPEOHoldingsLLC IND (CA) WC380437901 | AG | 04/02/2025 5:22:37 PM EDT | Page 2 of 2 27 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE
INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #
NAME:CONTACT
(A/C, No):FAX
E-MAILADDRESS:

PRODUCER
(A/C, No, Ext):PHONE

INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

OTHER:
(Per accident)
(Ea accident)
$
$
N / A
SUBR
WVD
ADDL
INSD

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY
Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE
$
$
$
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT

EROTH-STATUTEPER

EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
$
OCCUR

CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED $PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY PRO-JECT LOC

CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)

CANCELLATION

CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED

See additional remarks
Endorsement: Waiver of Subrogation
City of Fullerton
303 West Commonwealth Avenue
Fullerton CA 92832
Zurich-American Insurance Company
06/01/2025
N
16535
Paychex PEO Holdings, LLC Labor Contractor, for
co-employees of: Hope Center of Orange County
911 Panorama Trail South
Rochester NY 14625
06/01/2024
WC 38-04-379-01
20144422 | PaychexPEOHoldingsLLC IND (CA) WC380437901 | JD | 07/18/2024 4:06:44 PM EDT | Page 1 of 3 28 ACORD 101 (2008/01)
The ACORD name and logo are registered marks of ACORD
© 2008 ACORD CORPORATION. All rights reserved.

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE:

ADDITIONAL REMARKS
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY CUSTOMER ID:

LOC #:

AGENCY

CARRIER NAIC CODE

POLICY NUMBER

NAMED INSURED
EFFECTIVE DATE:

HOLDER:

ADDRESS:
25 Certificate of Liability (03/16)
WC 38-04-379-01
16535
303 West Commonwealth Avenue, Fullerton, CA 92832
Paychex PEO Holdings, LLC Labor Contractor, for co-employees of: Hope Center of Orange County
911 Panorama Trail South
Rochester NY 14625
CG 20 12 12 19, CG 20 12 04 13 or SB300100B
City of Fullerton
1 06/01/2024
1 Mary Storti
c/o Paychex Insurance Agency, Inc.

Zurich-American Insurance Company
20144422 | PaychexPEOHoldingsLLC IND (CA) WC380437901 | JD | 07/18/2024 4:06:44 PM EDT | Page 2 of 3 29 WORKERS’ COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84)

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT – CALIFORNIA

You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.

The additional premium for this endorsement shall be of the California workers’ compensation premium otherwise due on such remuneration.

SCHEDULE

Person or Organization Job Description

IN FAVOR OF:

Endorsement Effective: Policy No: Endorsement No:

Insured:

Insurance Company: Countersigned by

WC 04 03 06

Copyright 1983 National Council on Compensation Insurance 07/18/2024
Zurich-American Insurance Company
WC 38-04-379-01
Re: City of Fullerton, its elected or appointed officials, officers, employees and volunteers.

CG 20 12 12 19, CG 20 12 04 13 or SB300100B
$0
City of Fullerton
303 West Commonwealth Avenue
Fullerton CA 92832
Paychex PEO Holdings, LLC Labor Contractor, for co-employees of: Hope Center of Orange County 20144422 | PaychexPEOHoldingsLLC IND (CA) WC380437901 | JD | 07/18/2024 4:06:44 PM EDT | Page 3 of 3 30

Placentia City CouncilApril 15, 2025

Placentia City Council
April 15, 2025