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Home My WebLink About5.1093 Original ContractPURPOSE c. j, lok C Pre AGENCY RESPONSIBILITIES The Agency shall: 803 W. Park Avenue, Port Townsend, WA 98368 Telephone (360) 385 -2571 Fax (360) 385 -5185 LOW- INCOME HOME HEATING ENERGY VENDOR AGREEMENT This agreement dated as of November 12. 2010, is entered into by and between glyCAP, (Agency) and City of Port Angeles, a supplier of home heating energy, (Vendor). Funding for Low Income Home Energy Assistance Program (LIHEAP) payments is governed by Federal Law 42 U.S.C. 8624: Low Income Home Energy Assistance Act of 1981, and subsequent amendments. This act requires that certain assurances be satisfied before energy assistance payments are made on behalf of eligible individuals to suppliers of home heating energy. This agreement defines the conditions that the Energy Vendor must agree to so that the Agency can make energy assistance payment to the Energy Vendor on behalf of eligible households. 1. Accept and review client applications and determine eligibility of households for LIHEAP payments. 2. Follow procedures that minimize the time elapsing between the receipt of LIHEAP funds and their disbursement to Vendor. 3. Make payments in a timely manner to the Vendor on behalf of eligible households between October 1 and August 31 of the program year for the term of this agreement. 4. Follow sound fiscal management policies, including, but not limited to segregation of LIHEAP funds from other operating funds of the Agency. 5. Notify customer and /or vendor of the customer's eligibility and total benefit amount. 6. Incorporate policies that assure the confidentiality of eligible households' energy usage, balance and payments. 7. Upon request from Vendor, provide a statement verifying income of an eligible household for the sole purpose of determining moratorium eligibility within the statutory guidelines of confidentiality. ENERGY VENDORS RESPONSIBILITIES The Energy Vendor shall: 1. Immediately apply the benefit payment to customer's current/past due bill, deposit/reconnect requirements, or delivery of fuel to eliminate the amount owed by the customer for a period determined by the amount of the benefit, or; 2. Apportion the LIHEAP over several billing periods to reduce the amount owned by the customer until the benefit is exhausted, or; 3. Establish a line of credit for the customer to be used at the discretion of the customer until the benefit is exhausted. 4. Notify the customer of the amount of benefit payments applied to the customer's billing. 5. Keep customer records confidential. 6. Maintain records for four years from the date of this agreement, or longer if the energy Vendor is notified that a fiscal audit for a specific program year is unresolved. 7. Not treat adversely or discriminate against any household that receives LIHEAP payments, either in the cost of the goods supplied or the services provided. 8. Upon request of the agency provide eligible customer's energy consumption history for the sole purpose of determining customer benefit. 9. Comply with the provisions of the State law regarding winter disconnects and pertinent provisions of the Washington Administrative Code related to the winter moratorium, if governed by that ruling. 10. Make records available for review by authorized staff of the agency and the Department of Commerce, and the U.S. Department of Health and Human Services. REQUIRED RECORDS FOR AUDIT PURPOSES The Vendor will keep records showing the following: 1. Name and address of household who received LIHEAP payments 2. Amount of assistance accrued to each household 3. Source of payment (Energy Assistance, Project Share, etc) 4. Amount of the household's credit balance when the benefit payment establishes a line of credit. This credit balance also needs to show on all customer billing documents CREDIT BALANCES In the event that a customer has a credit balance and no longer needs service from the energy Vendor, the vendor shall: 1. Forward a check in the amount of any remaining credit balance directly to the customer, or if directed by the customer, forward a two -party check for this balance to the customer in the customer's name and the name of the new home heating energy Vendor 2. If the customer dies leaving a credit balance resulting from a LIHEAP payment, the remaining credit becomes part of the customer's estate 3. The energy Vendor shall dispose of all unclaimed credit balances according to customary procedures or applicable Washington State law OTHER PROVISIONS Term of Agreement This agreement is effective from the date of execution for the current heating season which is defined as October through August and must be renewed on an annual basis. Termination 3 This agreement may be terminated by either party with a thirty (30) day written notice to the other party. Termination shall not extinguish authorized obligations incurred during the term of the agreement. If LIHEAP funding is withdrawn, reduced or eliminated by the Department of Commerce, the agency has the right to terminate this agreement immediately. Assignment of Agreement Neither party may assign the agreement or any of the rights, benefits and remedies conferred upon it by this agreement to a third party without the prior written consent of the other party, which consent shall not be unreasonably withheld. The Vendor and the Agency do hereby agree to the conditions set forth in this agreement. Agency Signature f-Ipcick1 Timothy L. Hockett Printed Name Executive Director Title Olympic Community Action Proarams Name of Company Date -4 Vendor HOME HEATING ENERGY VENDOR AGREEMENT Signature 7 Pi/5 Printed Na e I"(-v A ayta a Title 1 C,i Name of Company I a. /oloi /ob Date U THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSITUTE 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 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 CANFIELD ASSOCIATES 451 DIAMOND DRIVE EPHRATA, WASHINGTON 98823 PHONE (509) 754 -2027 INSURED AUTOMOBILE LIABILITY FAX (509) 754 -3406 American Alternative Insurance Corporation Olympic Community Action Programs 803 Park Ave. Port Townsend, WA 98368 -2274 TYPE OF INSURANCE 1 GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM INCLUDES STOP GAP N1 A2 RL 0000013 03 06/01/2011 (LIABILITY IS SUBJECT TO A $25,000 SIR PAYABLE FROM POOL FUNDS) 1 AUTOMOBILE LIABILITY ANY AUTO N1- A2 -RL- 0000013 -03 06/01/2011 (LIABILITY IS SUBJECT TO A 25,000 SIR PAYABLE FROM POOL FUNDS) 1 PROPERTY (PROPERTY IS SUBJECT TO A 25.000 SIR PAYABLE FROM POOL FUNDS) MISCELLANEOUS PROFESSIONAL LIABILITY. N1- A3 -RL- 0000060 -03 06/01/2011 r 06/01/2012 (LIABILITY IS SUBJECT TO A 25,000 SIR PAYABLE FROM POOL FUNDS) 1 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES 1 SPECIAL ITEMS Evidence of Insurance regarding Oral Health Program City of Port Angeles City Hall Port Angeles, WA 98362 2524533 Non Profit Insurance Program CERTIFICATE OF INSURANCE ISSUE DATE: 05/25/2011 POLICY NUMBER POLICY EFF DATE N1- A2 -RL- 0000013 -03 06/01/2011 1 06/01/2012 COMPANIES AFFORDING COVERAGE GENERAL LIABILITY American Alternative Insurance Corporation PROPERTY American Alternative Insurance Corporation MISCELLANEOUS PROFESSIONAL LIABILITY Princeton Excess and Surplus Lines Insurance Company COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED'TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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 POLICY EXP DESCRIPTION LIMITS DATE 06/01/2012 06/01/2012 PER OCCURRENCE PER MEMBER AGGREGATE PRODUCT COMP /OP PERSONAL ADV INJURY ANNUAL POOL AGGREGATE COMBINED SINGLE LIMIT ANNUAL POOL AGGREGATE ALL RISK PER OCC EXCL EQ FL EARTHQUAKE PER OCC FLOOD PER OCC ANNUAL POOL AGGREGATE PER CLAIM ANNUAL POOL AGGREGATE CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE d f_./01/,, OIymCAP8 5I(O 3 $5,000,000 $10,000,000 $5,000,000 $5,000,000 $50,000,000 $5,000,000 NONE $50,000,000 EXCLUDED EXCLUDED NONE $5,000,000 $40,000,000 Non Profit Insurance Program NJ P I P For Non Profits, By Non Profits To: Certificate Holder From: Non Profit Insurance Program (NPIP) Date: May 25, 2011 Re: Account Name: Olympic Community Action Programs Cancellation of Insurance Certificates /Additional Insured Endorsements Please disregard the 2011 -12 Certificate of Insurance (including Additional Insured /Loss Payee Endorsements) that you previously received for Olympic Community Action Programs and replace it with the attached copy. As of 6 -1 -11, Olympic Community Action Programs elected to exclude Earthquake and Flood coverage through NPIP. Therefore, the previous Certificate of Insurance you received for the 2011 -12 policy is null and void. Please direct any questions to the NPIP Underwriting Department at 800 407 -2027 451 Diamond Drive Ephrata, WA 98823 (509) 754 -2027 TOLL FREE (800) 407 -2027 FAX (509) 754 -3406 www npip org Program Administrator Canfield