Community Development Block Grant (CDBG) Subrecipient Agreement- Crescent Community Health Center - Mobile Dental Unit Copyrighted
April 6, 2026
City of Dubuque CONSENT ITEMS # 12.
City Council
ITEM TITLE: Community Development Block Grant (CDBG) Subrecipient
Agreement- Crescent Community Health Center - Mobile
Dental Unit
SUMMARY: City Manager recommending City Council approve the
attached CDBG Subrecipient Agreement with Crescent
Community Health Center and authorize the Mayor to
execute the agreement on behalf of the City.
RESOLUTION Authorizing Execution Of CDBG Subrecipient
Agreement With Crescent Community Health Center
SUGGUESTED Receive and File; Adopt Resolution(s)
DISPOSITION:
ATTACHMENTS:
1. MVM Memo CDBG Subrecipient Agreement— Crescent Community Health Center-
Mobile Dental Unit
2. Staff Memo
3. Resolution
4. CDBG Agreement - CCHC
Page 968 of 2358
Dubuque
THE CITY OF �
uhA�eMa cin
DuB E ; . � ,
I � � I.
Maste iece on the Mississi t 2oo�•zoiz•zois
�P Pp zoi�*zoi9
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: CDBG Subrecipient Agreement — Crescent Community Health Center-
Mobile Dental Unit
DATE: April 1, 2026
Housing & Community Development Director Madeline Haverland is recommending City
Council approve the attached CDBG Subrecipient Agreement with Crescent Community
Health Center and authorize the Mayor to execute the agreement on behalf of the City.
On Tuesday, March 24, Community Development Advisory Commission (CDAC)
approved $413,119 in CDBG funding to support the acquisition of a mobile dental unit
and the renovation and equipment for a dedicated imaging room. These additions will
enable Crescent to better serve residents who face barriers to accessing care.
The attached CDBG Subrecipient Agreement pertains specifically to the acquisition of
the Mobile Dental Unit. The total project budget for the Mobile Dental Unit is $398,098,
including $234,976 from other funding sources, with $163,119 in CDBG funds serving
as gap funding necessary to complete the project.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
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Mic ael C. Van Milligen
MCVM:sv
Attachment
cc: Crenna Brumwell, City Attorney
Cori Burbach, Assistant City Manager
Madeline Haverland, Housing & Community Development Director
Page 969 of 2358
Dubuque
THE CITY OF �
All•Merioa Ciry
DuB E a� r�� �
; � ��►
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Maste iece on the Mississi i zoo�.zo�z�2013
�`p pp 2017*2019
TO: Michael C. Van Milligen, City Manager
FROM: Madeline C. Haverland, Housing and Community Development Director
SUBJECT: CDBG Subrecipient Agreement — Crescent Community Health Center-
Mobile Dental Unit
DATE: March 30, 2026
Introduction
The attached memorandum transmits the subrecipient agreement for Community
Development Block Grant (CDBG) funds to assist Crescent Community Health Center
with the acquisition of a Mobile Dental Unit.
Background
On Tuesday, March 24, Community Development Advisory Commission (CDAC)
approved $413,119 in CDBG funding to support the acquisition of a mobile dental unit
and the renovation and equipment for a dedicated imaging room. These additions will
enable Crescent to better serve residents who face barriers to accessing care.
The attached CDBG Subrecipient Agreement pertains specifically to the acquisition of
the Mobile Dental Unit. The total project budget for the Mobile Dental Unit is $398,098,
including $234,976 from other funding sources, with $163,119 in CDBG funds serving
as gap funding necessary to complete the project.
Discussion
Crescent Community Health Center is seeking CDBG support to expand service
delivery and community outreach for oral health services. The mobile dental unit
responds to persistent barriers to oral healthcare access, particularly lack of
transportation and mobility limitations, which disproportionately affect seniors and
individuals with disabilities.
Crescent's initial service plan focuses on establishing agreements with nursing homes
and long-term care facilities to serve residents who have significant oral health needs
but limited ability to travel to a dental clinic. The Mobile Dental Unit will improve access
to care for these residents and expand Crescent's outreach capacity.
This activity meets the CDBG National Objective of Low- and Moderate-Income (LMI)
clientele under the presumed benefit for elderly persons and qualifies as Eligible
Page 970 of 2358
Activity 03P — Health Facilities..
Recommendation
I respectfully request the City Council approve the attached CDBG Subrecipient
Agreement with Crescent Community Health Center and authorize the Mayor to execute
the agreement on behalf of the City.
Prepared by: Mary Bridget Corken-Deutsch, Community Development Specialist
Page 971 of 2358
Prepared by Mary Bridget Corken-Deutsch Community Devel Specialist 350 W. 61h St Dubuque IA 52001 (563)
690-6094
Return to Adrienne N. Breitfelder, City Clerk, 50 W. 13'h St., Dubuque, IA 52001, (563) 589-4100
RESOLUTION NO. 103-26
RESOLUTION AUTHORIZING EXECUTION OF CDBG SUBRECIPIENT AGREEMENT
WITH CRESCENT COMMUNITY HEALTH CENTER
Whereas, Crescent Community Health Center prepared a request to expand
service delivery and community outreach for oral health utilizing Community
Development Block Grant funds; and
Whereas, the request for CDBG funds was approved by the Community
Development Advisory Commission on March 24th, 2026; and
Whereas, the City Council approved the CDBG Fiscal Year 2026/Program Year
2025 Amendment #1 budget that included funding available for CDBG Revolving
Application Fund; and
Whereas, all services provided will be to a minimum of 51 % low/moderate
income residents, meeting the CDBG National Objective of Low/Moderate-Income
clientele —presumed benefit for elderly persons —and qualifies under the Eligible Activity
03P — Health Facilities
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY
OF DUBUQUE, IOWA:
Section 1. That the subrecipient agreement with Crescent Community Health
Center be approved.
Section 2. That the Mayor of the City of Dubuque is hereby authorized to
execute said Agreement.
Passed, approved, and adopted this 6th day of April 2026.
,A L (
lfr v
Attest
a4t ' "Ire P a vJ T P'e's ' N/o r Pro 'TC f r7
Adrienne Breitfelder, (tity Clerk
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SUBRECIPIENT AGREEMENT BETWEEN �
THE C[TY OF DUBUQUE
AND i
CRESCENT COMMUNITY HEALTH CENTER
THlS SUBRECIPIENT AGREEMENT is entered into by and between the City of
Dubuque (herein called fhe "City") and Crescent Community Health Cenfier (herein
called the "Subrecipient"), effective upon the date last signed below.
WHEREAS, the City has applied for and received Community Development
Block Granfi (CDBG) fiunds from the Unified States Government through the Deparkment
of Housing and Urban Development under Title I of the Housing and Community
Development Act of 1974, Public Law 93-383 and has received appraval of activities ;
under Federal Award Identifier Number B-25wMC-'19-0004 which was awarded to fihe
City on September 16, 2025 for the purpose of ineeting the CDBG National Objective of i
Law/Moderate-lncome clientele—presumed benefit for elderly persons--and qualifies !
under the Eligible Activity 03P— Health Facilities; and �
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WHEREAS, the City wishes to engage Subrecipient to assist the Ci#y in utilizing �
such CDBG funds to assist Subrecipient wifih acquisifiion suppart of a public facility, I
WHEREAS, both the City and the Subrecipient desire to make a written �
agreement with respect to said funds and the implementation of fihe projecfi to which �
they pertain; and j
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WHEREAS, both the City and the Subrecipient certify that the activity wil! meet �
fihe CDBG National Objecfiive of benefit fio low- and moderate-income persons; I
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NOW, THEREFORE, in cansidera#ion of the mutual promises af the parties, it is �
agreed as fol(aws: ;
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A. STATEMENT OF WORK I
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1. Activities ;
The Subrecipient will be responsible for administering a CDBG Year 25 Public �
Facility Acquisition Project, detailed in Exhibit A, in a manner satisfactory to fihe ;
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City and consistent wifih any standards required as a condition of providing these i
funds. The scope of activities to be rendered by the Subrecipient as a condition I
af receiving funds for the Project/Activity pursuan# to this Contract is attached as �
Exhibit A hereto and made a part of this Contract. i
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2. NationalObjectives i
The Subrecipient will carry aut the activities funded under this Agreemenfi that
meet the CDBG program's National Objective of:
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fx7 Assisting low and moderafie-income persons, said income guidelines
found in Exhibit B
❑ Aid in the prevenfiion or elimination af slums ar blight
❑ Meet community development needs having a particular urgency, as
defined in 24 CFR 570.208.
❑ Other(Explain)
3. Praiect Budqet
The City agrees, subject to the terms and conditions of this Agreement, to
compensate the Subrecipient for fihe Stafiement of V11ork outlin�d in Exhibit A, in
accordance with the budgefi presented in Exhibit C not to exceed $163,119.00.
If indirect costs are charged, fihe Subrecipient will develop an indirect cast
allocation plan for determining the appropriate Subrecipient's share of
administrative casts and sha(I submit such plan to the City for approval, in a fiorm
specified by the Ci#y.
4. Reallocations
The Subrecipient may reallocate up to ten percent (10%) ofi' the total grant
amount received to an eligible activity cosfi. Such reallacation will be re#erred to
as a revision. The Subr�cipient must, prior ta the drawdown reflecting the
change, contac# fihe City ta discuss the reallocation. Any change that results in a
cumulative reallocation of ten percent ('{0%) or more of fihe tofial grant, any
� inclusion of a new activity, deletion af an approved activity, any change in the
implementation schedule, or any change in grant terms will require an
amendment and prior City approval per Section E {7} of this Agreement. Such
reallocation will be referred fio as an amendment. Requests for revisions or
arnendmenfis are due na later than March 31 of the program year. Budget
revisions or amendments requested during the final ninety (90) days of the
agreement period will be approved by fihe City only if it determines that the
revisions are necessary to complete projecfi activities.
5. Retainaqe
Five percent (5%) ofi fihe fiatal grant amount may be retained from payment until
such report of audit refsrenced in Section B (7) of this Agreemen#, has been
provided to, and accepted by fihe City. No audit fees will be reimbursed by fihe
City.
6. Term and Time of Performance
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Services of the Subrecipient shall start an April 6, 2026, and end on June 30,
2026. All fhe required activities and services, except for audit, will be completed
by or befare this date. The Cifiy may grant exfiensions at ifis sole discretion. Only
a valid written Amendment to the Agreement shall alter this campletion date.
The term of this Agreemenfi and the provisions herein shall be extended ta cover
_ any additional time period during which the Subrecipient remains in confirol of
CDBG funds or other assets, including program incame.
7. Per�armance Measures and Monitarinq
In compliance with the Department af Housing & Urban Development's Outcome
PerFormance measurement system (24 CFR 91.22a(e}) -
The City will manitor the performance ofi fihe Subrecipient against gaals and
required pertormance standards. Substandard perFormance as defiermined by
the City will canstitute non-compliance with this Agreement. If action to�correct
such subsfiandard perfarmance is not taken by the Subrecipien# within a
reasanable periad after being notified by the City, agreement suspension or
termination procedures wiil be initiated.
8. On Site Monitorin
The Subrecipient shall be subject t� site visits, desktap monitoring, or othsr
methods of monitoring as deemed necessary by personnel ofi the City, ar a
designee af the City or duly autharized officials of federaf government, for the
purpose of monifioring fihe Subrecipienfi's delivery of services and compliance
wiih terms of the agreement and federal s#andards that pertain ta federalfy
funded granfi activities. Review may include but are not limited to: agency and
program policies, procedures, standards, handbooks and opera#ional documents;
accounting books and records for financial management and documentatian of
program cosfis such as time sheets and mileage lags; verification records ofi the
persons to participate ar benefit fram grant funded activities; dacumentatian of
report data and o#her program progress; and records demonstrating pracurement
pracedures and property management. The reviewers will have access to and
the righf ta examine, audit, duplicate, excerpt and/or transcribe any of the
Subrecipient's records pertaining to all matters covered by this Agreement. The
Subrecipient shall be subjecfi fio subsequent site visits to review correction of any
deficiencies.
B, RECORDS AND REPORTS
1. Maintenance
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The Subrecipient shall maintain all records required by #he federal regulafiions
specified in 24 CFR Part 570.546 and by the City that are pertinent to the
activities tp be funded under this Agreement. Such records shall include but not
be limited fio:
a) Records providing a full description of each activity undertaken;
b) Records demonstrating that each activity undertaken meefis one of the
Natianal Objectives of the CDBG program;
c) Records required to determine the eligibility of activities, individuals, or
households;
d) Records required to document fihe acquisitian, improvement, use ar
disposition of real praperty acquired or improved with CDBG assistance;
e) Records documenfiing compliance with th� fair housing and equal
opportunity components of the CDBG program, such as
€) Financial records as required by 2 CFR 200 and 24 CFR Part 570.502;
g) Other records necessary to document campliance with Subpart K of 24
C�R 570;
h) A list of current board members, calendar of upcoming board meetings
and minutes of all board meetings; and
i} Metrics in accordance with 2 CFR 200.329
2. Retenfiion
The Subrecipient agrees to keep the records required by this Agreement. The
Subrecipient shall retain all records for a period of five (5) years. The retention
period begins on #he date of submission of the City's annua[ performance and
evaluation report to HUD in which activifiies assisted under fihis agreement are
reported for the final time. Records for non-expendable property acquired with
funds under this Agreement shall be retained for five �5) years after final
disposition of such property. Properties retained shall continue tn meet eligibility
criteria and shall conform with the "reversion of assets" restrictions specified in
5ection G of this Agr�ement. Records for any displaced person must be kept for
five (5} years after helshe has received final payment. Nofiwithstanding the
above, if there is litigation, claims, audits, negotiations or other actions that
involve any of the records cited and that have started before the expiration of fihe
five (5) year period, then such records must be retained until completion of the
actions and resolution of all issues, or the �xpiration of the �ive (5) year period,
whichever occurs later.
The list of current board members and minutes of all board meefiings will be kept
on file and maintainet! at the Subrecipient's main business office as public
records. The minutes and board member list shall be �vaifable for the public fio
view during the Subrecipient's normal working hours. Copies may be provided,
according to the SubrecipienYs policy.
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3. Clienfi Data. Subrecipient shall maintain Client Data demonstrating client
eligibifity far services provided. Such data shall include, but not be limified to:
client name, address, income level or ofiher basis for determining eligibility, and
description of service provided, racial and ethnic data and singEe head-of-
househald data, and any other records pertaining fio CDBG funds as required by ?
2 CFR Part 240. In addition, data will be retained far affardability and incnme
targeting for each hausehold. Such infarmation shall be made available to City
monitors or their designees for review upon request.
4. Disclosure. The Subrecipienfi understands fihat client information coilected under
this con#ract is private and the use or disclosure of such information, when nat
directly cannected with fihe administrafiion of the city's or Subrecipient's
responsibilifiies with respect ta services provided under this contract may be
prohibited by federal or state law unless writfien consenfi is obtained�from such
persan reeeiving service and in the case of a minor, that of a responsible
parenfiJguardian. �
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5. Re�ortinq Procedures
The Subrecipient wil[ submifi quarterfy reports to the Cifiy detailing its activities
related to #he use of City funds including a performance report and a financial '
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report outlining the use of City funds and shall be submitfied no later fihan the
fifteenth (15t") day af October, January, April, and July and a final perFormance
report by July 31St, in such farms as the City requires. In the event a due date far
a repart falls on a weekend or holiday, the report will be due the next business
day. The Subrecipient shall provide infqrmation upon request for preparation of
the Cansalidated Plan, the CAPER, and any other reports or plans required by
the City or HUD.
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6. Clase-out {
The Subrecipient's obligatian to the City shall not end until all close-out
requirements are completed. Activifiies during this close-out periad sha[I include �
but are not limited to: makir�g final payments, disposing of program assets '
(including the return of all unused materials, equipment, unspent cash advances, ;
program income balances, and accaunts receivable ta the City), and determining
the custadianship of records. Nofiwithstanding the foregoing, the terms of this '
Agreement shall remain in effect during any period that the Subrecipienfi has '
control over CDBG funds, including program income.
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7. Audits & Inspections �
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AI{ Subrecipient records with respect to any matters covered by this Agreemenfi
shall be rnade avaiiable to the City, ifis designees or the federal government, af
any time during normal business hours, as often as the City or #ederal
government deerns necessary to audit, examine, and duplicate or make excerpts
or transcripts of all relevant data. Any deficiencies nofied in audit repor#s musfi be
fully cleared by the Subrecipient within timeframe stipulated by the City. Failure
of the Subrecipient to comply with the above audit requirements will cons#itute a
violation o#this Agreement and may result in the withholding of future payments.
The Subrecipient hereby agrees to have an annual agency audit conducted by a
certifiied accountant according to Generally Accepted Government Auditing
Standards. �lgencies that had total expenses of less fihan $150,000 on the audit
for the mosfi recently audited fiscal year and had no deficiencies or findings on
that audit or subsequent monitoring visits may be eligible to submit an audit
every other year subjec# to writt�n approval from the City. This written approval, if
granted, will be included in Exhibit D. Additionally, if the agency mee#s the
thresholds established in 2 CFR Part 20U, the Uniform Adrrrinistrative
Requiremen#s, Cost Principles, and Audit Requirements for Federal Awards
Subpart F the audit will be performed as a Single Audifi. The subrecipient agrees
t� follow any other audit procedures as established by the City. The cornpleted
audit, audited financial statements, schedule af findings, all related reports, the
management letter fram the auditor to the Subrecipient, and the Subrecipient's
response(s} to the auditor (if required by the audit) must be provided to the City
within six (6) manths of the Subrecipient's fiscal year-end. No audit fees will be
reimbursed under this CDBG agreement by the City.
8. Pavment
a. Maximum Amount and Drawdowns
It is expressly agreed and understood that the total amount fio be paid by the City
under this Agreement shall not exceed the amounfi stipulated in Section 3 of this
Agreem�nt. Drawdowns for the payment of eligible expenses are reimbursemen#
only and shall be made against fihe line itern budgets specified in Exhibit C herein
and in accordance with any City policy concerning payments.
b. Financial Manaqement Svsfiem Certification
Payments may be confiingent upon certification of the Subrecipient's financial
management sysfism in accordance with the standards specified in 2 CFR Part
200, the Uniform Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards. The entire amount of allowable grant
expenses (including those to be paid with program income) shal! be supparted by
saurce documentation (e.g., invoices, time sheefis, receipts, etc.}. The City
reserves fihe right to request any additional documentation, as it deerns
necessary.
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c. Reimbursement Schedule �
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The Subrecipient may requisition a reimbursement af expenses for project costs. i
Such reimbursemenfi requests must include praof of payment of the requested ,
expense. Request fnr salary reimbursement must be within 30 days from end of �
pay periad. �fiher requests dafied wifihin 60 days from date of service/purchase j
wifl be accepted. Final request must be submitted by June 15, 2026. ;
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C. PROGRAM INCUME �
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The Subrecipient shall report all program incame (as defined at 24 CFR i
570.500(a)) generated by activities carried out with CDBG funds. The i
dacument�tion, reporting and use of program incnme by the Subrecipient shail ' �
cnmply wifih the requiremenfis set farth afi 24 CFR 570.504 and 2 CFR Part 204 ;
for activities permitted under this agreemenfi. Requests far funds shall be '
reduced by the arnount of any such pragram income balances on hand. Any i
� program income on hand when this Agreement expires, or received after this ;
Agreement's expiratian, shall, at fhe City's discretion, be returned to the City or I
used by the Subrecipient for eligible acfiivities as identified in an agreement fihafi
becomes effective upon expiration of this Agreement. Any interest earned from
funds held in a revolving fund account is not program income and shall be
remitted to the City which will, in turn, remit it to HUD.
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D. UNIFORM ADlVlINISTRATIVE REQUIREMENTS
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1. AccounfiincLStandards �
The Subrecipient agrees to comply wifih 2 CFR Part 200, Uni�Form Administrative
Requirements, Cost Principfes, and Audit Requirements for Federal Awards, and
agrees to adhere to the accounting principles and pracedures required fiherein,
use adequate internal contrals, and maintain necessary source documentation
for all costs incurred.
2. Cost Principles i
The Subrecipient shall administer its program in conforrnance with 2 CFR Part
200, the Unifarm Adminisfirafiive Requirements, Cost Principles, and Audit j
Requirements far Federal Awards, as applicable. These principles shall be �
applied for all cos#s incurred. ;
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3. Pracurement �
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The Subrecipient shall have its own procurement policies and procedures. Said
policies shall meet the requirements of 2 CFR Part 200 Subpart D Procurement
Standards. The Subrecipient shall follow Management Standards as madified by
24 CFR 570.502.
4. Copvright
If this Agreement results in any copyrightable material or invenfiions, the City
andlor fed�ral government reserves the right to royafty-free, non-exclusive and
irrevocable license to reproduce, publish or ofherwise use and to authorize
others to use the work or materials for government purpases.
�. 07HEFa. PROGRAM REQIJIREMENTS
1. General Compliance
The Subrecipient agrees to cnmply with fihe requirements of 24 CfR 570. The
Subrecipient also agrees to comply wi#h all other applicable federal, state and
iocal laws, regulations, and policies governing its operations and the funds
pravided under this Agresmenfi. Th� Subrecipient agrees to remain current on all
applicable taxes, assessments and other governmental charges and to maintain
all Subrecipient awned property(ies) in compliance with all applicable City Codes.
The Subrecipient further agrees to use funds availabfe under this Agreement to
supplement rather than suppiant funds otherwise available.
2. Independent Contracior
Nathing contained in fihis Agreement is intended to, or shall be construed in any
manner, as creating or establishing the relationship af employerl�mployee
befween the parties. The Subrecipient shall at all times remain an "independent
contracfior" with respect to the services to be perFormed under this Agreement.
Except �for the bene�ts and stipulated amounts indicated under this Agreement,
the City shall be exempfi from payment of alf Unemployment Compensation,
FICA, retirement, life and/ar medica[ insurance and Workers' Compensatian
Insurance as the Subrecipient is an independent contracfior.
Ths Subrecipient shall be responsible #or hiring all program personnel. All such
personnel shail be considered to be employees o�F the Subrecipient.
3. Hold Harmiess and Indemnification
The Subrecipient, its agents and any assignees shall agree to hold harmless and
indemnify the Cifiy and its agents, officials and employees against all suits,
c(aims, damages, and losses, including attorney fees that may be based on any
injury to person or property due to negligent acts, errors or omissions of fihe
Subrecipient.
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i 4. Worker's Compensation
The Subrecipient shall provide Worker's Compensation Insurance coverage for
, ifis employees per lowa State Code, Chapter 85.
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; 5. Insurance & Bondinq
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The Subrecipienfi shall comply wifih the bonding and insurance requirements of 2
CFR 200 and any applicable state and local requirements for insurance and
bonding. The Subrecipient must carry insurance in accordance with City of
Qubuqus Insurance Scheduie G attached as Exhibit E. The Subrecipient's
contractors and subcantractors musfi carry insurance in accardance with City af
Dubuque Insurance Schedule F attached at Exhibit F and list the City of
. Dubuque and Subrecipient as additional insureds.The Subrecipient is
responsible for providing fihe Certificate of Insurance wifih �all required
endorsements for all contractars and subcontractors to the City of Dubuque upon
request.
Far constructian or facility improvement contracts or subcontracts entered by the
Subrecipient for the purpose of executing the scope of warEc in Exhibit A, the City
may accept the bonding policy and requirements af the Subrecipient provided
that fihe Cifiy has made a defiermination #hat the City's interest is adequateiy
protected. If such a determination has not been made, the minimum
requiremenfis must be as outlined in the Cifiy of Dubuque's Administrative Policy
3.02 Public Improvement Cantracts and Goods and Services Purchasing Policy—
Procedure V. A-D. �
6. City,Recognitian
The Subrecipient shali insure recagnitian of the role of the City in providing
• services through thi� Agreement. All activities, facilities, and ifiems used
pursuant to this Agreement shall be prominently labeled as to funding source. In
the event that a program fiunded fihrough CDBG is described in literature,
newspaper articles, TV reports, social media, and other public medium, the
Subrecipient must give credit to the City and fihe CDBG program,
7. Amendments
The City or Subrecipient may amend this Agreement at any time provided that
such amendments make specific reference to this Agreement and are executed
in writing and signed by a duly authorized representative of both organizations.
The deadline fior amendments in any pragram year is June 15, unless extended
at the sole discretion of the City in extraordinary circumstances. Such
amendments shall not invalidate this Agreement, nor relieve or release the City
or Subrecipient from its �bligations under this Agreement.
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The City may amend this Agreernent to conform with federal, state or local
governmen�al guidelines, policies and available funding amounts, ar for ofiher
reasons. If such amendment results in a change in the funding, the scope of
services, or schedule of the activities to be undertaken as part of this Agreement,
such modifications will be incorparated only by written amendment signed by
bofih City and Subrecipient.
8. Relocation Prop�r�Acquisition and One-For-One Hausinq Replacemenfi
The Subrecipient a�rees to comply with (a) the Uniform Relocatian Assistance and
Real Property Acquisition Policies Act of 1970, as amended {URA), and
implemPnting regulations at 49 CFR Part 24 and 24 CFR 570.606(b}; {b) fihe
requirements af 24 CFR 570.606(c) governing the Residential Anfii-displacement and
f�elocation Assistance Plan under section 104(d) of the HCD Act; and (c) the
requirements in 24 CFR 570.606(d) gaverning optianal relocation policies. 7he
Subrecipient shall provide relocation assistance to displaced persons as defined by
24 CFR 570.606(b)(2) that are displaced as a direct result af acquisition,
rehabilitation, demolition or conversion for a CDBG-assisted project. The
Subrecipienfi also agrees to comply with applicable Recipient ordinanc�s, resolutions
and policies concerning the displacemenfi of persons from their residences.
9. Federal, State, and Local Law Applicabilitv
By virtue of the federaf funding provided for under this agreement, the parties hereto
sh�il be bound by and adhere ta afl applicable federal, state, and lacal laws, rufes,
policies, orders and directions, inc{uding by way of specification but not limited to the
following:
- Title Vl ofi fihe Civil Rights Act of 1964, as amended;
- The Fair Housing Act—Title VII I of the Civil Rights Act of 1968, as amended;
- Section 104(b) ofi Title I of the Housing and Community Development �1ct of
197�, as amended;
- Section 109 of Title I of fihe Housing and Community Development Act of
1974, as amended;
- Secfion 504 of fihe Rehabiiitation Acfi of 1973,
- The Americans with Disabilifiies Act of 1990, as amended;
- Section 3 of the Housing & Community Development Act of 1968 (12 U.S.C.
1701 u);
- The Age Discriminafiion Act af 1975, as amended;
- Executive �rder 11063, as am�nded by Execufive �rder 12259 (implemented
in 24 C�R Part 107};
- Executive Order 11246 (as amended by Executive Orders 11375 and 12086)
— Equal Oppartunity Under HUD contracts and HUD-assisted construction
Contracts;
- Age Discrimination in Employmenfi Act af 1967, as amended.
- Chapfier 216 of the lowa Civil Rights Act of 1965, as amended
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Page 982 of 2358
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- The Equal Pay Acfi af �963, as amended.
- The Civil Rights Act of 1991, as amended
- Davis-Bacan Act, as amended, where applicable under Section 110 of the
I Housing and Community Development Act of 1974, as amended;
� - Contract Work I-lours and Safety Standards Act;
- Copeland Anti-Kickback Act;
- lowa Civil Rights Act of 1965, as amended;
- Dubuque Civil Righfis Ordinance, City of Dubuque Code of Ordinances, Title
8, and.
- Others as applicable
and shafl include compliance with these pravisians in every subcontract ar
purchase order, specifically or by reference, so that such provisions will be
binding upon each of its own subcontractors.
10.Nondiscrimination :
No person shall be exciuded from or denied the benefits of Subrecipient's service
or programs or be denied employment on the basis of race, calor, religion, creed,
sex, sexual orientatinn, gender idenfiity, national origin, ancestry, age, mental or
physical disability, marital status or fami[ial status. The Subrecipient will take
affirmative action to ensure fihat all employment practices are free from such
discrimination and state #ha# it is an Equal Opportunity or Affirmative Actian
employer.
11. W/MBE
The Subrecipient will use its best efforts ta affard minarity — and women-owned
business enterprises (at ieasfi fiffiy-one (�1} percent awned and controlled by
minority group member or women) the maximum practicable opportunity ta
participa#e in the performance of this Agreemenfi.
12.Land Covenants
This contract is subject to the requiremenfis of Title VI of the Civil Rights Act ofi
1964 and 24 CFR 570.6�1 and 570.602. In regard to fhe sale, lease, or other
transfer of land acquired, cleared or improved with assistance provided under
this contract, the Subrecipient shall cause or require a covenant running with the
land to be inserted in the deed or iease for such transfer, prohibiting
�iscriminafiion as herein defined, in the sale, lease or rental, or in the use or
occupancy of such land, or in any improvements erected or to be erected
therean, providing #hat fihe Recipient and the United Sfiates are beneficiaries ofi
and entitled tn enforce such covenants. The Subrecipient, in undertaicing its
obligation to carry out the program assisted hereunder, agrees to taEce such
measures as are necessary to enforce such cavenant, and wiil nat itself so
discriminate.
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Page 983 of 2358
13.Assiqnabilifiy
The Subrecipient shail nat assign or transfer any interest in this Agreement
withoufi the prior written consent of the City thereta; provided, however, that
claims for money due ar to becorne due firom to the subrecipienfi from the City
under this Agreement may be assigned to a bank, trust campany, or other
financial instifution without such approvaL Notice nf any such assignment ar
firansfer shall be furnished promptly fio the City. No real property acquired,
improvEd or otherwise invested in with CDBG funds, including loan portfolios
attributable to the us� of C�BG funds, may be assigned, firansferred or sold
wiihout the prior written consent af the City thereto.
� 14.Canflict af Interest
The Subr�cipient �grees to abide by the provisions of 24 CFR 570.611 and ?
CFR Part 2Q0 with respect to conflicts of infieres#. Requests for exceptions, as
permitted by federal regulations, must be made in the mann�r prescribed by the
City.
15.Hatch Act
I The Subrecipient agrees fihat no funds provided, nor personnel employed under
� this Agreement, shall be in any way or fio any extent engaged in the conduct af
' political activifiies in violation of Chapter 15 of Title V of fihe U.S.C.
16.Lobbvina
The Subrecipient hereby certifies that:
a. Na f�deral funds appropriated under this agreement have been paid or will be
paid, by or on behalf of it, to any person For inffuencing or attempting fio influence
an officer or employee of any agency, a Member of Congress, an officer ar
ernployee of congress, or an employee of a Member of Congress in connection
with the awarding af a�y federal contracfi, the making of any federal grant, the
making of any federal Ioan, the entering into of any cooperative agreement, and
the extension, cor�tir�uatian, renewal, amendment, or modification of any federal
contract, granf, loan or cooperafiive agreement;
b. If any funds other than federal appropriated funds have been paid or will be
paid ta any person for influencing or attempting to influence an officer or
employee ofi any agency, a Member of Congress, an afficer or employee of
Congress, or an employee of a Member of Congress in connection with this
federal contract, grant, loan, or cooperative agreement, it wilf complete and
submit Standard Form-LLL, "Discfosure Form ta Report Lobbying," in accordance
with its instructions;
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. Page 984 of 2358
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c. It will require that the language of paragraph (d) of fihis cerfiification be j
included in the award documents for a[I subawards at all tiers (including �
subcontracts, subgrants, and contracts under grants, loans, and cooperative i
agreements) and thafi all Subrecipienfis shall certify and disclose accordingly; ;
I
d. This certification is a material representatian of facfi upan which reliance was !
placed when this transaction was made or entered into. Submission of this ;
certification is a prerequisite for mal<ing or entering into this transaction imposed �
�y section 1352, fiitle 31, U.S.C. Any person who fails to file the required ;
�er�ifiicatian shall be subject to a civil penalty of not less than $10,000 and not i
more than $100,000 for such failure. i
17. Restrictians i
The Subrecipient is prahibited from using CDBG funds or personnel employed in ;
the administration of the program for political purposes, or to engage in ather �
partisan political activities, sectarian, or religious activities ar nepotism activities. �
18. Environmentai Standards �
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The Subrecipient agrees to comply with the poficies of the National i
Environmental Policy Act of 1969. The purpose of this Acfi is to attain the widest ;
use of the environment wifihou# degradation, risk ta hea[th or safety or ofiher ;
undesirable and unintended consequences. The Subrecipient agrees to comply �
with 24 CFR I'art 58; 24 CFR 570.604; and Secfiion 104(g) HCD. �
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19.Air, Water and Solid Waste !
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The Subrecipient agrees ta comply with the follawing requirements insofar as '
they apply fio the performance of this Agreement: !
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- The Clean Air Acfi, 42 U.S.C. 7401, et seq., as amended. �
- Federal Water Pollution Control Act, as amended, 33 U.S.C. 1251, et seq., as i
amended, 1318 relafiing to inspecfiion, moni#oring, entry, reports, and ;
information, as well other requirements specified in said Section 114 and i
Section 308, and all regulations and guidelines issued thereunder. �
- Environmental Protectian Agency {EPA) regulations pursuant to 40 CFR Part �
50, as amended. j
- The Safe Drinking Water Act of 1974 {42 U.S.C. 201, 3a0 {f) et seq., and 21
U.S.C. 349) as amended;
- 42, U.S.C. 6901 et seq., as amended. _
20.Flood Disaster Protection
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Page 985 of 2358
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[n accordance with the requirements of the Flood Disasfier Protection Act of 1973,
the Subrecipient shal! assure that for activitiss located in an area identified by the
Federal Emergency Management Agency (FEMA) as having special flood hazards,
filood insurance under the National Flood Insurance Program is obtained and
maintained as a condition of financial assistance for acquisitian or consfiruction
purposes, including rehabilitation.
21.Lead-Based Paint
The Subrecipient agrees that any consfiruction or rehabilitation Qf residential
struc#ures with assistance provided under this Agreement shall be subject to HUD
Lead-Based Paint Regulations. Such regulations pertain to all CDBG-assisted
housing and require that all owners, prospective owners, and tenants of properties
constructed prior to 1978 be properly notified that such properties may include lead-
based paint. Such notification shall point aut the hazards of lead-based paint and
explain the symptnms, tr�atment and precautions that should be taken wh�n dealing
with lead-bas�d paint poisaning and the advisability and availabili#y of blood lead
lev�l screening for children under seven {7}. The notic� should aiso p�int out that if
lead-based paint is found an the property, abatemenfi measures may be undertaken.
The regulations further reguire thafi, depending on the amount of i`ederal funds
applied to a property, paint testing, risk assessment, treatrnent and/or abatement
may be conducted.
22.Historic Preservation
The Subrecipient agrees tn comply wifih the Histaric Preservation requirements set
forth in the National Historic Preservation Act of 1966, as amended and the
procedures set fnrth by the Advisory Council an Historic Preservation Procedures for
Protection of Historic Properties, insofar as they apply to the perFormance of this
agreement.
In general, this requires cancurrence from the State Historic Preservation Office for
alE rehabilitation and demolifiion of historic properties that are fifty {50) ysars oid or
older or that are included fln a fed�ral, stat�, or local histaric property list.
23.Buy America, Build America
The Subrecipient must comply wifih the requirements ofi the Build America, Buy
America (BABA)Acfi, 49 USC 8301 note, and a!I applicable rules and notices, as
may be amended, if applicable to the Subrecipient's infrastructure projecfi. Pursuant
ta HUD's Notice, "Public Infierest Phased Implementation Waiver for FY 2022 and
2023 of Build America, Buy America Provisions as Applied to Recipients of HUD
Federa{ Financial Assistance" (88 FR 17001), �ny funds obligated by HUD on or
after the applicable listed effective dates, are subject to BABA requirements, unless
excepted by a waiver.
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Page 986 of 2358
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F. REMEDIES FOR NON-COMPLIANCE AND TERMINATI4N
'!. Remedies for Noncompfiance
If the City afi any fiime defiermines the Subrecipient materiafly fails to comply with
any term o# fihis Agreement, or with any af the rules, regulatians, or pravisions
referred ta herein, the City may use any or all of the remedies allowed under 2
CFR Part 200.338 and 200.339 ta ensure compliance. The City may also impose
additianal specific award conditions as neecfed afi any time fio ensure compliance
in accordance with 2 CFR Part 200.2d7. Passible remedies include:
a. Warninq
Issuance of a written warning citing the vialatian that has occurred, and a
deadline when #he violatinn must be r�medied if it is still occurring,
b. Withholding Payment
Withholding of funds by the City untif the Subrecipient is found to be in
compliance by the City.
c. Gran#Adjustment
Adjustment in the payment method or reduction nf the grant to the Subrecipient
when there is noncompliance and the violation cited has not been remedied as
specified.
d. Reimbursement
Reimbursement by the Subrecipient with non-CDBG funds for CDBG funds �
which have not been spent in accordance with this Agreement.
e. Termination
Termination of funds in whole or in part by the City if the Subrecipient materially
fails to camply with any term or condition of this Agreemenfi or with any of the
rules, regulations or provisions referred ta herein, or for cause as allowed in 2
CFR Part 2a0.339. In the event of termination of this award, in accordance wifih 2
CFR Part 200.340(c), the information required under the Federal Funding
Accountability and Transparency Acfi (FFATA} must be provided to the Federal
Web site established to fulfili the requirements of FFATA, and update or
notificatian must be provided to any other relevant governmentwide systems or
entities ofi any indications of poar performance as required by 41 U.S.C. 417b
and 31 U.S.C. 3321 and implementing guidance at 2 CFR Part 77. Additianally,
the requirements for Suspension and Debarment at 2 CFR Part 180 may apply.
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Page 987 of 2358
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f. Non artici ation
Prohibition of fihe Subrecipient from future parfiicipafiion in the CDBG program if
the Subrecipient has not complied wifih the action administered by fihe City.
g. Termination for Convenience
' This Agreement may be terminated in whale or in part by eifiher party upon
providing the other party a written, ninety (90) day nafiice, in which case the City
and Subrecipient shall agree upon the fiermination conditions, inckuding the
� effective date, the disposifiion of agreement amounts, and in the case of parfiial
' termination the porfiion to be terminated. However, if, in the case of partial
I fiermination, the City determines that the remaining portinn of fihe award will not
i accomplish the purposes for which the award was made, and the award is
� terminated in its entirety, Subrecipient shall promptiy r�pay to the City the full
i grant amaunt or that porfiion of the amount which has been disbursed to
I Subrecipienfi prior to such termination.
h. Termination due ta Loss o#Funds
I
This Agreemenfi will terminate in full or in part, at the discretion of the City, in the
event fihe City sufFers a loss of funding or termination of the federal funds which
permits it to fund fihis grant. In the event the City suffers such a loss of funding,
fihe City will give the Subrecipienfi as much written natice as possible which will
set forth the effecfiive date of full or partial terminafiion, or if a change in funding is
required, setting forth the change in funding and the changes in approved
budget.
G. R�VERSION OF ASSETS
1. Program Assets Reversion
Upon the expiration of this Agreement, the Subrecipient shall transfier to the City
any CDBG funds on hand at the time of expirafiion and any accounts receivable
attributable to the use of CDBG funds. All program assets (unexpended program
income, property, equipmen#, etc.) shall revert to the City upon terminatior� of this
Agreement, unless addressed under another agreement as provided in Section
C.
2. Real Pro erfi Reversion
Any real properfiy under the Subrecipient's control that was acquired or improved
in whole or in part with CDBG funds (including CDBG funds provided to the
Subrecipient in the �Form af a loan) in excess of $25,OOQ shall comply with either
of the faliowing:
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Page 988 of 2358
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a. Nationa! �bjective Compliance
Used to meet one of the national objectives in 24 CFR 570.208 until five
years after expirafiion of this Agreement, or for such longer period of #ime as
! determined tn be appropriate by the City; or
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b. National Objective Noncompliance
Nofi used in accordance with Section G (2) (a) of this Agreement, in which
event the Subrecipienf shall pay ta the City an amount equal to the current
market value of fihe property less any portian of the value atfiributable fio
expenditures of non-CDBG funds far the acquisition of, or improvement to, �
the praperty. The payment is program income tc� the City. {Na payment is
required after the period of time specified in Section G (2) (a) of this
� Agreement.) �
,
Fio MISCELLANEOUS '
1. Subrecipienl Leqal Autharit�r
By using this Agreement, the Subrecipient warran#s and represents that it has the ,
requisite authority and capacity fio perform all terms and conditions on �
Subrecipienfi's part to be perFormed hereunder.
2. Waiver
a. No conditions or provisions of this Agreemenfi can be waived unless
approved by the City in writing.
b. The City's failure to insist upon the strict performance of any provision �
of this Agreement or to exercise any right based upan breach will not
canstitute a waiver of any rights under this Agreement.
3. Desiqnation of OfFicials
City designates the City Manager or the City Manager's designee as its
authorized representative with respect to the work to be performed under this
Agreement including, but not limited to, the ability to execute any changes in the
terms, candifiions, or amounts specified in this Agreement .
The Board Chair of fihe Subrecipient or designee is the official authorized to
execute any changes in the terms, conditians or amounts specified in this
Agreement.
4. S ecial Conditions for Release of Funds
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Page 989 of 2358
Funding of the amount stipulated in Section 3 and Exhibifi C af this Agreement
will not be released to the Subrecipienfi by the City until fihe Subrecipient
demonsfirafies compliance with the Section D {1).
5. Code of Conduct
The City expecfis fihat Subrecipien#s and any subcontractors of Subrecipients to
demonstrate courtesy, consideration and promptness in dealing with the public,
program participanfis, the City, and ather governmental agencies.
6. Aareement Coveraqe
This instrument along with any Exhibits and the grant application contain the
entire agreemenfi between the parties. Any sfiatements, inducements or
promises not contained will not be binding upon the parlies. This Agreement will
be binding upon the successors in ofFice of the respective parties.
7. Severabilitv
!f any provision of this Agreemenfi is held invalid, the remainder of the
Agreemenfi shall not be affected thereby and all other parts of this Agreement
shal! nevertheless be in full force and effect.
8. Notice to Proceec�
The City will issue a Notice to Proceed to the Subrecipient to incur costs relative
to the program implernentation.
9. Exhibits
All Exhibits are hereby incorporated into this Agreement.
14. Notices
Notices required by this Agreemenfi shall be in writing and delivered via mail,
commercial courier, or personal delivery or sent by facsimile or other electronic
means. Any notice delivered or sent as afioresaid shall be effective on fihe date
of delivery or sending. Ali notices and other written communications under this
Agreement shall be addressed to the individuals in the capacities indicafied
belaw, unless otherwise modified by subsequent written notice.
City Subrecipient
Mary Bridget Corken-Deutsch Chad Wolbers
Community Development Specialist Crescent Community
Housing & Community Dev. Depfi Health Cenfier
350 W. 6th Street, Suite 312 1694 Elm St. STE 300
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Page 990 of 2358
Dubuque, IA 52001
Dubuque, IA 52001
11. Compliance with Laws. Subrecipient shall be responsible for laws at the
federal, state, and local level.
12. Governing Law
This Agreement is a contract executed under and to be construed under the
laws of the State of Iowa. Any legal action arising out of or related to this
Agreement shall be brought in a court of competent jurisdiction in Dubuque
County, Iowa.
13. Section Headings and Subheadings
The section headings and subheadings contained in this Agreement are
included for convenience only and shall not limit or otherwise affect the terms of
this Agreement.
14. Contractor Warranties/Guarantees
Contractors shall guarantee and warranty the work done pursuant to a CDBG
project for a period of two (2) years. In addition, Contractor shall furnish
property owners with all manufacturers' and suppliers' written guarantees and
warranties covering materials and equipment furnished under the contract.
IN WITNESS WHEREOF, the Parties have executed this Agreement as of the
day of April 6, 2026.
CITY OF DUBUQUE, IOWA, Crescent Community Health Center
50 W 13th Street 1600 Elm Street, STE 300
Dubuque, Iowa 52001 Dubuque, IA 52001
UEI# TLJMHPVMMUD3 UEI# FFXJXUTPGMG8
V
ature Signature
Executive Director
Dr.\v,'d T Rc5ncK
Printed Name
Mayor Fro Te M
Printed Name
Executive Director
19
LIST OF EXHIBII"S
EXHIBIT A Sl'ATEMENT OF WORK
EXWIBIT � INCOME GUIDELIIVES
EXHIBIT C PROJE�TIACTIVIYY BUDGET
EXHIBIT E CITY OF DUBUQUE INSURANCE SCHE�ULE G
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� STATEMENT OF WORK j
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Crescent Community Health Center will be responsible for the acquisition of a Mabile �
� Dental Unit. i
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CDBG Eli rbilit This ro ect meets the CDBG National 4b'ective of Low/Moderafie- f
� J� Y� p J J
3 Income clientele—presumed benefit for elderl y persons—and qualifies under the
� Eligible Activity 03P—Health Facilities.
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Page 993 of 2358
EXHIBIT B
INCOME GUIDELINES
- Ber�efi�a c#ientele that is generaCly presumed tm be p��n�ipaAy LMi. This�aresumption
cave�s abused chiidren, ba�tered s�o��ses, ��c��erl� per�c��s, severely disabled adul#s (see
the�aax below), horrieless persons, illi�eraxe ad�tlis„ p��rscrr�s liaing with AI�S and migrant
farm w�rkers; or
Page 994 of 2358
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IEXHlBIT C
� PROJECT/ACTIVITY BUDGET
Total Project Budget
Total Project
Cost Category Costs CDBG Funds Other Funds
,
1 Administrative
i 2 Personnel: Salaries
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;
; 4 Travel
5 Space/Utilities
6 Equipment
Mobile Dental Unifi: Mobile denta!
unit payment $398,095 $163,119 $234,976
7 Contractors
OTHER
a. Telephane
b. Postage
c. Publication/dues "
d. Audix
e. Supplies/Printing
f.
�•
Subtotal a. to g. $0 $0 $0
Program Incorne/7hird Party Payments $� $0 $0
Total $398,095 $163,119 $234,976
Page 995 of 2358
EXHIBIT D
INSURANCE SCHEDULE G
�.Ity ot bu6tllqWe IA9urenGe Ii6qfIk9MBnl3(of V@ndofs(SuppllBts,3ervEce Provide[e)
CITY OF DUBUQUE INSUF�ANCE SCHEDULE G
1. Yendur shsll turnish a s[gned certificate of insurance to the City of Dubuque,lowa,far the caver�ge
required in E�chibit I prior t�a�ontr�ct commencement. Each certifi�ate shall be prepr�red t�n the rrAast
currant ACORD#orm approved 6y the Cowa lnsurance Division or an equivalent. Each certificate�hall
include a statemend under D�scriptian of Operations as to why the certificate was issued. Vendnr Secvice
A�reeme�rot dated: Apnl 6,202fi
2. All poUcies of insurance required hereunder shall be with an insurer�tuiharized fo do bws{ness�n luwe and
aU insur�rs sln�ll have a ratfng df�4 or hetter in the current A.M.Best's Rafing Guide.
3. Each certi(icate shail b�fumish+�ti tn: Cityt af Dubuque,Finance Depertme�t,5�Q W.13�'Str'eel.,Dubuque.
lowa,52bQi.
4. Ttie Vendor sh�l!ta�reqwired fo carry the minimum cnverage/limits,or�reat�r if rer�uired by law ar other
legal a�reernent,ir�Exhibit I. F�ilure to pro�aide the r�quired minimum cover�rge shall nbt be deer��d a
w�iver a9 such requiremen4s hy the City of Dub�que.
5. F�ilure to o6tffbm or malntain the req�airetE tnsurance shaQ be consideret�a msterial hreach af this
agreemenc.
6. Alt required enddr$erraents shal!be attach�tf to certiflcate.
7. Wheneaer a�pe�lfEc ISO fc�em is l�siect,the current edikian of the form must be r�sec�unless sn equ€uat�nt
farm is approvad by the Clnief F�nancial Q�cer� The Vendor must identify or tist in writl�g all dev6ations�rnd
exclusians frnen the IS�6orm.
8. If Vendor's timlts of ti�biLity are hig�er than the required minimum timlts then the V�ndoe's U€nif���nal�he
this agreemenYs r�qu6r�d lirnits.
9. Vendor shall requ�re all su�contractor's and sub-sui�contrsctor�to obtain and mainia�n during tEre
perform��nce t�f wurk insurs�nCe tor the coverag��described in this Insurance Schedul�and shallabt�[n
c�rtificat�s df insurs�ae from all such subcontractors and�ub-sub�ontractors. 4'end�r�rees that fi shaU
be Uable for'the failur�of�subcantractar and sub-subcontra�tnr t�abtafn�nd maintain such couera�e.
The City of Dubuque may request a copy of su�N certificates from the Vendor.
10.Vendnr shall be responsibt�far dedu�tibEes/s�lt-insured retention far payment afi al�poliCy pr�miums and
ether costs asso�iaked with Yhe insurance policies required below.
11.Atl cert`rficates of insuranc�must include�gent's name,phone number,and erraadt address.
12.The City of�ubuque reserves the tight to require comptete,certified copies of all requlred insuranca
policies,includingendorsements,required by this Schedule�t�ny time.
13.The Clty nf Dubuque resenres the right to madify these requirements,incWding limits,bas�d bn changes In
risk nr other special circumstances during the term of the agreement,subject ta written mutuat agreement
of the p�rties.
Page 996 of 2358
Cilq o}6ubuque Ineura�rce RequfremeoL�tor Vendors(Suppllers,Serv6ce PrwidervJ
ClTY OF DUBu¢UE INSURANCE SCHEDULE�
(continued)
EXHIBIT I
A. COMMER�IAL GEh�ERAL t1AB1�ITY
G�nera�A,ggregat�ILirnit $2,000,00�
Rroduc�s-Camp�leted�perstiarns/4g�regateLimit $1,000,�@0
Rersar�al and Ade�ertising Irej�ury Limit $1,000,000
E�ch Occurr�on�e $1,0�0,000
FEre Dacnage Lirnit(aray�ar�e o�curFence) $5U,000
htedic�l Pa�rrra�nts $S,OOD
1} Covera�s shall bs u�ari¢te�n an an accurrenCe,not claims mad�,form. Th��er,eral iiabilii�r
co+.rverage st�aQl be written in�ccord with ISO fc�rm CG 00 01 or t�usiness o4�ners�rarro 6P 00 d2.
Ail deu�iailons irar�tFee standard ISd commercial general Usbilfty farm CG Q0 01,or 6uainess
aMoners from BP f1�Q2,shail be clearty idenCified.
2) 1r�claode ISO�endorsehn�nt�form CC 25 04"Designate�l Locatidn(s)GeneEal A�;esgate Umit:"
3) Inclwde endorsemervt iradiaatin�that covera�e is prim�ry and nnn-cantributary.
d� lncludle P'reservation a(Gmw�rnrreental Immunities Endorsement(sarraple attaehed�.
5} Includs�dditiohal irosured endorsement for:
The Cit�r a6 Qubuque,Inctuding all its elect�d�nd appointed officiats,all kts employees arad
vo4urateers,atl'its boards,commissians and/ar authortties and their t�€�ard members,
emp4oyees and volunteers. Use ISO form CG 2010(Ongaing Operations�or tts equinaatent.
6} PcaUcy�st�al�inclvde VIPai�er o6 R'rght tv Recover from Others Ehdorserro�nt.
7} Po�icyr sha9f incla�de cancellaiion and material chan�e endorsement provi€Ji�g thErty(30)days
advance w�rltten raati�e of cancellatfon,non-renewal,reduction in inslirance cavera�e�ndloe
liroaits ar�ai t�n(1i1�dsys�vriYten natice of non-p�yment df premEum shali be sent to: CPty of
Dubv�ue,Finance Oepartmeni,50 West 13"'Street,Dubuque,lawa,52G01.
Page 997 of 2358
CITY OF DUBUQUE INSURANCE SCHEDULE G
(continued�
8. WORKERS'C�MPENSATI4N&EMPL�YERS LIABII.ITY
Statutory benefiks covering all empldy��s injured on the j�ob hy�ccident ar disee.s�es prescrihed by lowa
Gads Ch�pter g5 as�mended.
Coverage A Statutnry—State of lowa
Couerage B Ereaploy�rs Lisbitiry
Each Accident $100„0�0
E�ch Emptoye�-Disease �100,000
PoGcy Limit F Disease S>SQD,OQO
Pt�lb��shsti i€�clude W�iver of Right td Recbver from Qthers endorsemen4.
QS
Vf„by lo►�va Cutte SeGdon 851.A,the Vendor is not required to purchase tM'4rkers`�ompensatEon Insurance,
the lfend'or shal4 have a copy of the State's Nonelection of Wo►kers'Gorr���ns�a�tio�a a�Emplayers'Liahitity
�overa�e form on fite wlth the low�Workers'Compensat'saro la�sura�ce Commissicutier,�s requtred by low�
Gade Sectior�8'T.22. Cnmpleted form must be att�ched.
C. POLLUTION LIABILlTY
Cave��e Requered: Yes X No
F�ullu4ion liability cover�ge sN�ll 6e required if the lesse�,cnntracting party,or permittee hss�ny pattution
exp��ure for abatement of hazardous or cankaminated mat�er�sts include�g�but mot l6mited to petroleum
products,the r�rna+�l oF le��l,a�b�stos,or PCBs. Pallut{Un product�cyd compleC�d uperations coveraq�
shall�Iso be covered.
Each Caverage 52,(f00,000
Policy Aggregate �a,t300,00d
1} Policy to include job site and transportation coverage.
2} Iraclude additional insured fnr:
The Clry of Dubuque,includin�all its elected and appointed officials,all Ets errapEoyees and
volunte�ers,all its boards,commissions and/or authorities and their board mecnbers,employeas
and volunteers. Use�SO form CG 20 1 D(Ongoing OperntEons)or Ets equivalent snd CC 20 37
(Competed Operations).
Page 998 of 2358
Ciiy M Dwhuque Msnranca Ra�u6�amants Wt V[�dats{Su:pplier3,Service PreWdersy
INSURANCE-$CHE[�ULE G
(cantinuedj
3) Include PreseT+tativn o�Gavem��n4�1 Immunitiss Endorsement.
4) provide evidence of covera�e fa�r 5 years afier cor�pleNen of project.
5a Inclvde endorsement indicating that coverage as primary and non•contributary.
6J Policy shall include Wai+e�r at Rigrit tea Recavery Eram Others Endorsement.
D. PitOF�5S10NAt LIABlLITY
Coverage Required: ldes � t�bo
If the required policy pro�idss�laimc.msde coverage:
1 j The retroactive da4e areust be shown and must ae betore the date of the agreement.
2� Insurance must b��aintai n�cl,am�d eUidence a�insurance must be provided for at lesst five{Sy years
after completion af the wark or seruicres.
3J !f coverage is canGe�ied or nondene�r.�d and nca replaced with another claims•made Rolicy fomn uvith a
retroactiv�date pri�r ta the da�4e oi 4he agreement,the contractor must provide"extended reporting"'
coverage for a minimum o!five(5�y�ers after compdetion of the work services.
�. CYBER LIE1gIL11'Y/BREACF# �1,QOO,U06
�overage Required: 'les x fi!c
Coverage for First and Third-Party Bre�sch Lfability;including bt�t not limited to lost data and res4oration,
loss of income and cyher lareac3�af information.
F. UMBRELLA/EXCESS $1,000,4U0
X Yes No
The Generat Liability,Automobile Liability,and Employers Lishility Insurance requirements may be satisfied
with a combination of prirnary and Umbrella or Excess tia6ility fnsurance. If the Umbrelta or�xcess
Insurance policy does not foUow the form of tiie primary policies,it shall include the same endorsements
as required of the primary pol�cies inctuding Waiver of Subrogation and Primary and Non-contributory in
favor of the City.
Page 999 of 2358
CHy at�bnque Meuranee Ftequkaments tor 1lendors�SupplFere.Service Provlden)
lawa Code Chapter 670,Uability of Gov�emrrterttal Su6divisions,provides cities with certain irnmunities
which may be availabie to yau_ Ndaming the City of Dubuque as an additio�al insured on your insurance as
is requested by this insurance schedule may result ieu your wsiver of those immunities. li you would�9�tn
preserve those immunities,ptesse us�e 4his endarsem+e�or an equivalert form. The preservatian oi
immunities is for your 6enefit.
PRESERVATIOtV Q�F�OVEFiNMENTAL IM�IiJNITIES ENDORSEMEfNT
1. ^�on��river of C--bernment�llmm�nta��h�insurer expr�essly agrees a�d states that the purch�s�of
this palicy and the inctuding of the City of Dubuque as sn additional insured does noi waive any otthe
defenses of govemmenta�ir�munity av�ilabte ta tfis CiY7/ot b�buGue,lowa,under Code ofi lowa
Section 670.A ss it is noma exi s�s ar�d as id may bE amended from time to time.
2. Gtaims Covera��7Fue insurer�furtfier agrees that this poticy of insurance shall cover only those claims
not su6ject to the defen,se gavemmental imm�nity under�he Code of lowa Section 670_R�s it now
exists and as it m�+y h�arayendet!frvtrn teme ka tirne.Those cQaims not subject to Code of Iowa Ssction
670.4 shalt be caver�d hy 4he terms ar�d cvndations c�f this insuraace policy.
3. 4�ePrtion ot Gavemmera#_bmrn�hnity,City of Du�buque.laraa, shatl be respnnsible for asserting any
defense of governmental i�rxeuniry,and may c@o so at any ttme and shall do so upon the tlmeiy written
request of the insurer.
B, Non•Denial of Coverape.The insurer shaU Rat de�y cvaerage under this policy and the insurer shall not
deny any of the rights and benetits acc�t�ing tQ the Cit7�caf Dubuque under this policy for reasons of
goVemmental immunity un(ess and until a court vi campetent jurisdiction has ruled in fawr of the
defense(s)of govemmerrtal immur�tiy�tsserted try the Ci�y of dubuque,lowa.
5. No C?ther Ghange in Pc�9icv.The a6awe preser��ati�n of governmental immunities shall not otherwise
change or alter the coverage availabte under the poiicy.
�PECIIVIEl'�
(bEPARTM�N7 MANAGER: FktL IN A€L BLANKS AND CM�CK BOXES]
Page 1000 of 2358