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HomeMy WebLinkAboutResidential Repair Program ELIZABETH A. NEVILLE TOWN CLERK REGISTtL~ OF VITAL STATISTICS MARRL~.GE OFFICER . RECORDS ~IAGEME~2~T OFFICEI~ FREEDOM OF INFOPA&kTION OFFICER Town Ha~l, 53095 Ma~n Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoIdtown.nortt~fork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 694 OF 2004 WAS ADOPTED AT TI~. REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON SEPTEMBER 21, 2004: RESOLVED that thc Town Board of the Town of Southold hereby authorizes and directs Supervisor Joshua Y. Horton to execute an Agreement with the Suffolk County Office of the A~ing for community services for the Elderly Residential Repair Program IFMS No. SCS E~. 0000000 No_~ 001-6777-4980-95285 from April 2004 through March 2005, subject to the approval of the Town Attorney. Elizabeth A. Neville Southold Town Clerk ELIZABETH A. NEVILLE TOWN CLERK REGISTR.Pdt OF VITAL STATISTICS A~kRRIAGE OFFICER ~.RECORDS NLkNAGEMENT OFFICER . FREEDOM OF INFOI~IATION OFFICER Town Hall, 53095 Main Road P.O. Box 1.179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtov~.northfork.net OFFICE OF TI-IE TOWN CLERK TOWN OF SOUTHOLD September 24, 2004 Leonor Hunter, Fiscal Administrator County of Suffolk Office for the Aging Post Office Box 6100 Hauppauge, New York 11788-0099 Dear Ms. Hunter: Enclosed please find the three (3) copies of the agreement for the Elderly Residential. Repair Program for the Town of Southold including the SCEX Form 22 Public Disclosure Statement that have been signed by the Supervisor Horton. I have circled Except Governmental Entities and wrote NAY on the bottom of the form in accordance with telephone instructions in your office. Please remm a fully executed copy to my offiee for f'fling Thank you. Ve~ truly yours, Elizabeth A. Neville Southold Town Clerk Enclosures (3)~ cc: K. McLaughlin Town Attorney Town Comptroller : L~/N,o~ AG006M/0ff29-06RA IFMS No. SCS EXE 04000008796 · .~ -Rev: 6:/25/04 No. 001-6777-4980-95285-8796 Community Services for the Elderly - Residential Repair First Amendment Amendment of Agreement This is a First Amendment of an. Agreement, (Agreement), last dated October 15, 2003, ~between the.County of Suffolk (County), a municipal corporation of the State of New York, having its principal office at the County Center, Riverhead, New York' 11'901, acting through its :duly constituted Office for the Aging (Aging), having its principal office at the H. Lee Dennison Building - 3rd Floor, 100 Veterans Memorial Highway, Hauppaugej. New York (Mailing address: P.O. Box 6100, Hauppauge, NeW York 11788-0099.), and Town of Southold {Contractor), a New :York municipal corpera[ion, having its principal place of business at 53095 Main Road, P.O. Box 1179, Seuthold, Nbw York 1197t. The parties hereto desire to make modify the Agreement tb extend the ter~m of the CSE Residential Repair Pr(~gr~am from March 31,2004 through March 31,2005 (the period. · Apr 1,2004 through M~rch.31, 2005 being hereinafter called the "2004 Budget Period") as set forth herein; SuffEient funding exists in the 2004 Suffolk County Operating Budget. Term of Ag~-eement: Shall be April 1, 2003 through March 31, 2005, with one one-year extension at the County's option. Units of Service: 1,050 Units of Residential Repair Service Total Cost of Agreement: Shall not exceed $ 40,000 (of which $20,000 is for the 2004 Budget Period). Terms and Conditions: Shall be as set forth in Exhibit A-2004, C-2004 and the Exhibit entitled "Suffolk County Legislative Requirements Exhibit for Contracts" revised 5/28/04, attached. In Witness Whereof, the parties hereto have executed this First Amendment of Agreement as of the latest date written below. Town of S. outhold ~/'Joshu& Y.-~rt~n (' Supervisor Fed. Taxpayer ID #: 11-6001939 Date: Approved as to Legality: Robert J. Cimino Suffolk County Attorney County of Suffolk By: Paul Sabatino II Chief Deputy County Executive Date: Approved: By: Holly S. Rhodes-Teague Director, Office for the Aging Recommended: Date By: Samantha McEachin Assistant County Attorney Date By: Maureen Porta Date Senior Citizens Programs Administrator II AG 6 AG6 CSE Res Rpr SohJd ext 04 Eaw N~. 'AG00~M/0029,06RA IFMS No. SCS EX£ 0~,00000879'6 Rev. 6/25/04 No. 001-6777.,4980-95285-8796 Community Services for the Elderly ~ R~i~hti~l Repair First Amendment Exhibit A-2004 . Whereas, the County and Contractor have entered into an Agreement (Law No. AG006M/0029- 06R); Fast dated October 15, 2003, for a term from April 1, 2003 through March 31, 2004 for a CSE 'Residential Repair Program for the elderly at a Total Cost of $20,000; and '.Whereas, the parties hereto desire to modify the Agreement to extend the term from March 31, 2004 through March 31, 2005 (at an additional cost of= $20,000) and to increase the Total Cost of the Agreement to $40,000, as set forth below; Now; Therefore, in consideration of the covenants, promises and consent herein contained, the ' parties hereto agree as follows: 1, Term of Agreement: The Term 0fAgreement paragraph on page 1 of the Agreement is amended to read Apdl 1, 2003'thro'bgh March 31, 2005 as set forth on the page 1 of this First Amendment of Agreement. 2. Payment of Services: The Total Cost of Agreement $40,000 is comprised as follows: (al $20,000 for program year 2003/2004; (b) $20;000 for program year 2004/2005; 3. Reportin,q Requirements: Paragraph 5 of Exhibit B to the Agreement is amended to read as follows, as of April 1, 20'04: 3. Reporting Requirements A. The Contractor must at a minimum determine and maintain the following specific type of demographic information for each individual receiving services: · Name. · Sex. · Age. · Disabled/Frail. Disabled - Any person who has a physical or mental impairment which substantially limits one or more major life activities, has a record of= such impairment, or is regarded as having such an impairment. This includes alcoholism and drug addiction. Frail - A person with one or more functional deficits in the following areas: physical functions; mental functions; activities of dally living (ADL) (eating, bed/chair transfer, dressing, bathing, toileting and continence); instrumental activities of daily living (IADL) (meal preparation, housekeeping, shopping, medications, telephone, travel and money management). · Live Alone. · Rural AG 6 (3/02) Page 2 AG6 CSE Res Rpr Sohld ext 04 Law Nb. AG006M/0029-06RA IFMS No. SCS EXE 04000008796' Rev. 6125104 No. 001-6777-4980-95285-8796 Community Services for the Elderly - Residential Repair First Amendment any, 5. · Low Income - The need resulting from an income level at or below the pove~y threshold, as established by the Bureau of the Census as follows: Size of Family Unit Poverty Threshold 1 $9,3'1 O/year 2 $12,490/year · Minority - Those individuals belonging to one of the ~ollowing groups: Native American/Alaskan Native, Asian, Native Hawaiian/Pacific Islander, Black, and Hispanic. · Low Income Minodty - those minority persons whose income is at or below the poverty-threshold. B. The Contractor shall submit monthly reports covedng program activity and expenses, containing at least but not limited to the above, to be submitted to Aging by the tenth day of the month following the period being repoded, and any other reports as required by Aging. Such reports must be on a form specified by Aging and shall complywifh all procedures requ!red by Aging for the proper payment of vouchers and audits. C. The Contractor shall submit to Aging a calendar of activities thirty days before such activities/services/tests are scheduled to .take place each month. Budget: The Budget annexed hereto as Exhibit C - 2004, including advance payment schedule, if ~s made part of the Agreement. Suffolk County Living Wa,qe Law: The Contractor represents and warrants that it has read and is familiar with the requirements of Section 6 of Chapter 347 of the Suffolk County Code, the Living Wage Law, attached hereto as part of the "SLiffolk County Legislative Requirements Exhibit for Contracts" and · made a part hereof. 6. Child Sexual Abuse Reporting Policy: The Contractor agrees to comply with the Suffolk County Child Sexual Abuse Reporting Policy, Chapter 577, Article IV, of the Suffolk County Code, attached hereto as part of the "Suffolk County Legislative Requirements Exhibit for Contracts" and made a part hereof, as now in effect or amended hereafter or of any other Suffolk County Local Law that may become applicable during the term of this Agreement with regard to child sexual abuse reporting policy. 7. Gratuities: The Contractor represents and warrants that it has not offered or given any gratuity to any official, employee or agent of Suffolk County or New York State or of any political party, with the purpose or intent of securing an agreement or securing favorable treatment with respect to the awarding or amending of an agreement or the making of any determinations with respect to the performance of an agreement, and that he has read and is familiar with the provisions of Local Law No. 32-1980 of Suffolk County (Chapter 386 of the Suffolk County Code). 8. Except as herein amended, all other representations, terms and conditions of said Agreement, including any and all a, Fnendments or budget modifications executed prior to the date hereof, are hereby ratified and confirmed to be in full force and effect. --End of Text -- AG 6 (3/02) Page 3 AG6 CSE Res Rpr SohJd ex~ 04 Law No. AG006M/0029-06RA IFMS NO. SCS'EXE 04000008796 Rev. 6/25/04 No. 001-6777-4980.95285-8796 Community Services for the Elderly - Residential RepairFirst Amendment Exhibit C-2004 Budget Town of Southold CSE Residential Repair Program April 1, 2004- March 31',' 2005 PERSONNEL Mechanic I Mechanic I $18~161 11,557 6,604 FRINGE TRAVEL 1~300 700 .EQUIPMENT Tools/Supplies 539 539 TOTAL ~20,700 Less Anticipated income (700) NET REIMBURSEMENT $__20,000 ~last re~/. 5128[04 Suffolk County Legislative Requirements Exhibit for Contracts This exhibit is attached to and is made part of the contract executed with the County. Suffolk County Living Wage Requirements "Suffolk County :Living Wage Requirements Exhibit As Last Revised by the Suffolk County Department of Labor or) 5/12/04" (2 pages). Child Sexual Abuse Reporting Policy Chapter 577, Article IV, of the Suffolk County Code entitled "Child Sexual Abuse Reporting Policy" (3 pages)_ III Gratuities Chapter 386 of the Suffolk Cqunty Code, entitled "Political Parties, Gifts to Officials Of" (2 pages). IV Contractor's/Vendor's Public Disclosure Statement Form SCEX 22; rev. 3~30~04 (form consists of three pages; requires signature & notarization) Note: The Contractor's/Vendor's Public Disclosure Statement Form SCEX 22; rev. 3/30/04, references the following law, which is included with this Exhibit. Suffolk County Administrative Code Section A5-7 (consists of 3 pages). I Suffolk. County Living Wage; D~oCuments SU~lk C6un'ty Living Wage':Requi,rements Exhibit As Last Revised by the Suffolk County Department of Labor on 5/12/04 Suffolk County Living Wage Requirements Exhibit As Last Revised by the Suffolk County Department of Labor on 5/12/04 Pursuant to Section 6 of Chapter 347 of the Suffolk County Local Law No. t2-2001, "A Local Law to' Ir~plement Living Wage Policy for the County of'Suffolk" (the "Living Wage Law"). all RFPs, County contracts and financial assistance agreements subjectto the law shall contain the following two paragraphs or sub{tantially equivalent language: This Agreement is subject to the Living Wage Law of the County of Suffolk. The law requires that, unless specific exemptions apply all employers (as. defined) under service, contracts and recipients of County fi.nancial assistance, (asldefined) shall provide payment of a minimum wage to employees as set forth in the Living Wage Law. Such rate'shall be adjusted annually pursbant to the terms of the Suffolk County Living Wage Law of the County Of Suffolk. Under the provisions of the Living Wage Law, the County shall have the authority, under appropriate circumstances, to terminate this Agreement and to seek other remedies as set forth therein, for violations of this Law. Suffolk County Local Law No, 18-2002, "A Local Law to Implement Living Wage Policy for the County of Suffolk" provided for certain amendments to the Living Wage Law. Forms for Completion and/or Signature (as applicable) Suffolk County Department of Labor - Living Wage Unit Notice of Application for County Assistance (Contract) Form LW-1 (consists of t page) Suffolk County Department of Labor - Living Wage Unit Certification/Declaration - Subject to Audit Form LW-38 (consists of I page) (Replaces LW2, LW3 and LW33) Suffolk County Department of Labor- Living Wage Unit Request for General Living Wage Exemption Form LW-4 (consists of 1 page) Suffolk County Department of Labor- Living Wage Unit Request for Specific Living Wage Exemption Form LW-5 (consists of 2 pages) I of 2 pages SUFfolk CduntY Livin~ wage. Requirements Exhibit As East Revised by the Suffolk County Department of Labor on 5/12/04 Note: Pursuant to Section 7 of Local Law No.18- 2002, "A Local Law to Implement Living Wage Policy for County of. Suffolk", all covered employers subject to the provisions of the Living Wage Law shall submit a completed ahd sworn (under penalty of perjury) Certification/Declaration - Subject to Audit Form LW-38, signed by an authorized representative, as part of an executed contract with the County of Suffolk. The complete Certification/Declaration- Subject to Audit Form LW-38 shall be made a part of any ex~cuted, contract or project agreement and made available to the public upon request. To certify Living Wage compliance: Return Forms LW-1 and LW-38. or To certify non-applicability of Living Wage law: Return Form LW-38. or To request and document a general living wage exemption: Return Forms LW-1, LW-38 and LW-4_ or · To request and document a specific living wage exemption: Return Forms LW-1, LW-38 and LW-5. In the event that there is a change in circumstances, it is the Contractor's responsibility to submit to the County additional Living Wage forms which either replace or supplement prior submissions of Living Wage forms. Living Wage Law Information Fact Sheet, text of the Local Law, Frequently Asked Questions, Forms, and Rules and Regulations can be found on the Suffolk County web site at www.co.suffolk.ny.us Click: Department Directory Labor Living Wage Law Info Suffolk County Department of Labor Living Wage Unit Tel. (631) 853-3808 End of Text for Suffolk County Living Wage Requirements Exhibit As Last Revised by the Suffolk County Department of Labor on 5/12/04 2 of 2 pages II Child Sexual Abuse Reporting Policy CHAPTER 577, ~/~TiCLE IV, Child Sexual Abuse Reporting Policy 2002 by Res_ No. 543-2002] [Adopted 577-15_ Policy established. The County of Suffolk hereby establishes a forma] child sexual abuse reporting policy as follows: A. Each County Department that has a contract or agreement with any individual, partnership, corporation, joint venture, buni~ess organization, or other, entity which receives pa}~ents from the County cf Suffolk, either directly or as a conduit for pa}~ent from another level of government, shall notify such individual, partnership, corlDoration, joint venture, business organization, or other entity that Suffolk County requires full compliance with the reporting and disclosure provisions of Subsection C of this section] ~s a condition precedent to receipt of such pa}~ent and continuing receip~ cf such payment, in those instances in which an allegation has been made of sexual abuse of a minor by any empl6yee or member of such contract vendor, including any member of the clergy, involving any of the following sex effensee: (1)Rape in the third degree, § 130_25 (less than 17 }'ears old) of 5he New York Penal Law; (2)Rape in the second degree, ~ 130.30 (less than 14 years old) of the New York Penal Law; (3)Rape in the first degree, ~ 130_35 (less than 11 years old) of the l~ew York Penal Law; (4)Sodomy in the third degree, § 130.40 (less than 17 }'ears old) of the New York Penal Law; (5)Sodomy in'the second degree, ~ 130.45 (less than 14 years old) of the New York Penal Law; (6)Sodomy in the first degree, § 130.50 (less than 11 }'ears old) of ~he New York Penal Law; (7)Sexual abuse in the New York Penal Law; (8)Sexual abuse in the New York Penal Law; (9)Sexual abuse in the New York Penal Law; (10)Aggravated sexual abuse in the third degree, old) of the New York Penal Law; (Il)Aggravated sexual abuse in the second degree, old) of the New York Penal Law; (12)Aggravated sexual abuse in the first degree, old) of the New York Penal Law; (13)Course of sexual conduct against a child in the first degree, ~ 130_75 (lens than 11 years old) of the New York Penal Law; and (14)Course of sexual conduct against a child in the second degree, § 130 80 (less than 11 years old) of the New York Penal Law; (15)Se×ual misconduct, § 130.20 (sexual intercourse without consent) of the New York Penal Law; (16)Forcible touching, § 130.52 (sexual or intimate parts) of the New ~rk Penal Law; (17)Persistent sexual abuse, ~ 130.53 (two or more convictions within the past 10 years for less than 17 },ears old or 14 }'ears old) of ~he llew York Penal Law; (18)Aggravatnd sexual abune in the fourth degree, § 130.65a (less than 17 },ears old) of the New York Penal Law; (19)Female genital mutilation, Section 130.85 (less than 18 years old, nonmedical procedure) of the New York Penal Law; ' (20)Facilitating a sex offense with a controlled nubstance, § 130_90 (without connent to commit a felony) of the New York Penal Law. third degree, § 130.55 (less than 17 years old) of the second degree, § 130.60 (less than 14 },ears old] of the first degree, § 130.65 (less than 11 }'ears old) of the § 130_66 (less than 11 years ~ 130.67 (less than 11 }'ears § 130_70 (less than 11 years B. Definitions. For the purposes of this article,'the following terms shall have the meanings indicated: CLERGY -- A duly authorized Dishop, pastor, rector, priest, rabbi, minister, imam, nun, or a person having authority from, or in accordance with, the rules and regulations of the goYerning ecclesiastical bed~' of the denomination or order, if any, to which the church belongs, or otherwise from the church, synagogue, or mosque to preside over and direct the spiritual affairs of the church, synagogue, or mosque, as the case may be. r4INOR -- A~yone under the age of 18 years of age; All supervisory, administrative, or management employees of any individual, partnership, corporation, joint venture, business organization, or 0thar entity receiving pa}~ent from the County of Suffolk, either directly or as a conduit for payment from another level of government, under agreement or contract with the County of Suffolk, shall report or cause a report to be made to 911 or the pertinent village, town, or county Police Department when he/she, or it has reasonable cause to suspect that a minor coming before them is or has been the victim of sexual abuse, or when another person or clergy person comes before them and states from personal 'knowledge facts, conditions, or circumstances which, if co,oct, would render the minor a victim of sexual abuse under any of Ehe followin§ sex offenses, said reporting to occur within 24 hours after forming the reasonable cause er firs5 learning of the allegations: [Amended 8-28-2002 by Res. No. 819-2002] (1)Rape in the third degree, ~ 130.25 (less than 17 }'ears old) of the New York Penal Law; (2)Rape in the second degree, ~ 130.30 (less than 14 years old) of the New York Penal Law; (3)Rape in the first degree, ~ 130.35 (less than 11 years old) of the Rew York Penal Law; (4)Sodomy in the third degree, § 130.40 (less than 17 years old) of the New York Penal Law; (5)Sodomy in the second degree, ~ 130.45 (less than 14 years old) of the New York Penal Law; (6) Sodomy in the first degree, ~ 130.50 (less than 11 years eld) of the New York Penal Law; (7)Sexual abuse in the third degree, § 130.55 New York Penal Law; (8)Sexual abuse in the second degree, § 130.60 New York Penal Law; (9)Sexual abuse in the first degree, ~ 130.65 New York Penal Law; (10)Aggravated sexual abuse in the third degree, ~ 130.66 old) of the New York Penal Law; (Il)Aggravated sexual abuse in the second degree, ~ 130.67 old) of the New York Penal Law; (12)Aggravated sexual abuse in the first degree, § 130_70 old) of the New York Penal Law; (13)Course of sexual conduct against a child in the first degree, ~ 130.75 (less than 11 years old) of the New York Penal Law; and (14)Course of sexual conduct against a child in the second degree, ~ 130.80 (less than 11 }'ears old) of the New York Penal Law; (15)Sexual misconduct, ~ 130.20 (sexual intercourse without consent) of the New York Penal Law; (16)Forcible touching, ~ 130.52 (sexual or intimate parts) of the New York Penal Law; (17)Persistent sexual abuse, ~ 130.53 (two or more convictions within the past 10 years for less than 17 years old or 14 years old) of the New York Penal Law; (18)Aggravated sexual abuse in ~he fourth degree, § 130.65a (less than 17 }.ears old) of thm New York Penal Law; (19)Female genital mutilation, ~ 130.85 (less than 18 years old non-medical procedure) of the New York Penal Law; (20)Facilitating a sex offense with a controlled substance, § 130.90 (without consent to commit a felony) of the New York Penal Law; (less than 17 }'ears old) of the (less than 14 years old) of the (less than 11 years old) of the (less than 11 years (less than 11 }'ears (less than 1I years ~Whenever a clergy person is req~irsd to report under this arEicle, ~n his or her capacity as a member of the clergy, he or she shall immediately notify the person in charge of such church, ~h~he, ~ mosque, or his or her designated agent, who shall then also become responsible to report or cause reports to be made to 911 or the pertinent village, town, or county Police Department when he or she has reasonable cause to suspect that a minor coming before them is or has been the victim of sexual abuse, or when another clergy person comas before them and states from personal knowledge facts, conditions, or circumstances which, if correct, would render the minor a victim of sexual abuse, [Amended 8-28-2002 by Res. No. 819-2002] No information deri~ed from a confession or confidential communicat~0n to a clergyman shall be disclosed pursuant to the requirements of this article if the confession or confidence is made to the clergyman in his or her prefesslonal capacity as a spiritual advisor, unless the person so confessing or confiding waives this privilege. All oontract vendors covered by this article shall inform all of their employees in writin~ as to the disclosure requirements of this article and shall also inform them that each of them must report any allegations of child abuse covered in paragraph (A) of the 1st RESOLVED clause of this article to supep~,isor]q management, or.designated administrative personnel of the employer. 577-17. Failure to comply; penalties for offenses. Failure to comply with the terms and conditions of this article shall result in the following: First violation: the contract vendor shall be issued a warning and all supervisory, administrative, and management employees of such contract vendor shall be required to attend a child sexual abuse prevention/education workshop provided by a contract agency approved by the County of Suffolk vis duly enacted resolution, which workshop shall include specific skills for adults to help prevent childhood sexual abuse; skills that adults can react children to help protect themselves from childhood sexual abuse; skills for detecting the signs of cki!dhood sexual abuse; and how to report allegations of childhood sexual abuse. The cosz of this training shall be paid for by the contract vendor. In addition, the contract vendor shall submit a corrective plan of ~ctiea to the Suffolk County office of Labor Relations. Second violation within a three-year period subsequent to a first ¥iolation: the contract vendor shall be subject to a fine of 101 percent of the contracts that the pertinent violating individual supervisor, manager, or administrator oversees, not to exceed $50,000. In addition, the contract vendor shall be put on probation for three years. An annual review shall be conducted by the Suffolk County Department of Audit and Control_ Third violation within a three-year period subsequent to a first ¥~01ation: the termination of the agreements with such individual, partnership, corporation, joint venture, business organization, or other entity overseen by ~he pertinent violating individual supervisor, manager, or administrator and the withholding of all pa}~ents to said individual, partnership, corporation, joint venture, business organization, or other entity for such agreements re§ardless of whether such payments are for past or future goods or services. The contrac~ vendor shall not be eligible for funding from the County for three years from the date of such termination. 577-18. Authority to issue rules and regulations. The Suffolk County Department of Law is hereby authorized, empowered, and directed to issue and promulgate such rules and regulations as shall be deemed necessary and appropriate to implement the provisions of this article. I II ratuities §386-1 GIFTS TO ~ARi'¥ OFFICIALS {}386-1 CHAPTER 386 POLITICAL PARTIES, GIFTS TO OFFICIALS OF 386-1. 386-2. 386-3. 386-4. 386-5. Definitions. Prohibited acts. Clause required in all contracts. Penalties for offenses. Excepted contributions. [HISTORY: Adopted by the Suffolk County Legislature 12-9-80 as L.L. No. 32-1980. Amendments noted where applicable.] .- {}386-1. Definitions. As used in this chapter, the following terms shall have meanings indicated: AGREEMENT -Any written or oral contract or any implied Contract, including but not limited to a contract for the sale of goods or services, a construction contract or a lease or contract relating to real or personal property. The term "agreement" shall also include any transaotion whereby a person agrees to sell goods or services, or both, to the county pursuant to a successful bid. GRATUITY -Any money, benefit, entertainment, gift or any other consideration whatsoever. OFFICIAL OF A POLITICAL PARTY -A party officer as defined by §1-104, Subdivision 5, of the Election Law. PERSON -Any individual, partnership, firm, corporation or other legal entity, as well as their employees, agents or representatives. POLITICAL PARTY -A party as defined by § 1-104, Subdivision 3, of the Election Law_ § 386-2. Prohibited acts. It shall be a crime for any person to offer or give any gratuity to an official of any political party with the purpose of intent of securing or obtaining an agreement with the County of Suffolk or securing favorable treatment with respect to the awarding or amending of such agreement or the making of any determination with respect to the performance of an agreement. Page 1 of 2 B. It shall be a crime for an offidial bf 2 ~}bli~ibal Partyto'solicit, receive or accept a' gratuity in connection with securing or obtaining an agreement with the County of Suffolk or secudng favorable treatment with respect to the awarding or amending of such agreement or the making of a determination with respect to the performance of such agreement. § 386-3. Clause required in all contracts. In all agreements with 'the County of Suffolk made after the effective date of this chapter, there shall be written representation by the person entering the agreement with the county that he has not offered or given any gratuity to any official, employee or agent of Suffolk County or New York State or of any political party, with the purpose or intent of secudng an agreemen,t or securing favorable treatment with respect to the awarding or amending of an agreement or the making of any determinations with respect to the performance of an agreement, and that such person has read and is familiar with the provisions of this'chapter. § 386-4. Penalties for offenses. Criminal. A violation of §386-2 of this chapter shall be a Class A misdemeanor and shall be punishable by a sentence of not more than one (1)year in prison or a fine of not more than one thousand dollars ($1,000) or by both such fine and imprisonment, Civil remedies. A violation of § 386-2 or 386-3 of this chapter shall give the county the option, among other civil remedies, of either terminating the agreement or deducting the value of the gratuity from any amount due or to become due from the county thereunder. §386-5. Excepted contributions. This chapter shall not apply to contributions to political parties, committees or candidates as defined by § 14-100, Subdivision 9, of the Election Law. Such contributions shall be excluded from and shall not be in violation of this chapter. Page 2 of 2 IV ,,Co'ntractor's/Vendor's Public DisclOSure' Statement Documents· Suffolk County Form 22 Contractor's/vendor's Public Disclosure Statement Pursuant to Section A5-7 of the Suffolk County Administrative Code, this Public Disclosure Statement- must be completed by all contractors/vendors that have a contract with Suffolk County. In the event contractor/vendor is exempt from 9ompleting paragraphs numbered 1 through 11 belo,,~; s'o indicate at paragraph number 12 below setting forth the reason for such exemption. Notwithstanding such exempt status, you must execute ihis form below before a notary public. 5,b Contractor's/Vendor's Name Address City and state Contracting Deparunent's Name Address Zip Code Payee Identification or Social Security No. T3?e ofBusiness~Corporation~Partnership__Sole ProprietorshiLOther Is contractor/vendor entering into or has contractor/vendor entered into a contract with Suffolk Countyin excess of $1,000? Yes No. Has c6x~tractor/vendor entered into three or more contracts, including the one for which you are now completing this form, with Suffolk County, any three of which, when combined, exceed $1,0007 Yes No. Table of Organization. List names and addresses of all principals; that is, all indMduals selMng on the Board of Directors or comparable body, names and addresses of all partners, and names and addresses of alt corporate officers. Conspicuously identify any person in this table of organization who is also an officer or an employee of Suffolk County. (Attach additional sheet if necessary.) List all names and addresses of those individual shareholders holding more than five percent (5%) interest in the contractor/vendor. Conspicuously identify any shareholder who is also an officer or an employee of Suffolk County. (Attach additional sheet if necessatb9. 10. Does contractor/vendor derive 50¢/o or more of its total revenues from its contractual or vendor relationship ~vith Suffolk County? Yes No. If you answered yes to 8 above, you must submit with this disclosure statement, a complete financial statement listing all assets and liabilities as xvell as a profit and loss statement. These statements must be certified by a Certified Public Accountant. (Strike this out if not applicable.) The undersigned shall include this Contractor's/Vendor's Public Disclosure Statement with the contract. (Describe general nature of the contract.). Page 1 of 3 Public Disclosure Form 11. Remedies. The failure to file aver, fied public d~sclosure statement as required under local law shall constitute a material' breach of contract. Suffolk County may resort, use or employ any remedies contained in Article II of the Uniform Commercial Code of the State of New York. h~ addition to all legal remedies, Suffolk County shall be entitled, upon a determination that a breach has occurred, to damages equal to fifteen percent (15%) of the amount of the contract. 12. If you are one of the entities listed below at a) through c) or you qualify under d) below, you are exempt from completing paragraphs numbered '1 through 11 herein: a) Hospital ~7- b) Educational or governmental entities __ c) Not-for-profit corporations __ d) Contracts providing for foster care, family day-care providers or child protective services Please check to the left side of the appropriate exemption. 13. Verification. This section must be si=m~ed by an officer or principal of the contractoffvendor authorized to sign for the company for the purpose of executing contracts. The undersigned being sworn, affirms under the penalties of perjury, that he/she has read and understood the foregoing statements and that they are, to his/~l~r own knowledge, tree. Dated: *//~?/Z~, Signed: Pnnted Name of S,gner: .~r~{~ Title of Signer: Name of ContractoffVendor: UNIFORM CERTIFICATE OF ACKNOWLEDGMENT (Within New York State) STATE OF NEW YORK) COUNTY OF ) ss.: On the ~j day of ~/- in the >,ear 2004 before me, the undersigned, personally appeared ,.J'OStq~8 }1. I-torO'~ personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/hefftheir capacity(ies) and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. (signature and office of indMdual taking acknoxvledgement) LI~ D,:A & OO0~R Page 2 of 3 Public Disclosure Form UNIFORM CERTIFICATE ~-F ACKNOWLEDGEMENT (without Ne~v York State) STATE OF ' ) )SS.: COUNTY OF ) On the ' day of in the 3'ear 2004 before me, the undersized, personally appeared personally known to me or proved to me on the basis of satisfactory evidence to be the indiyiduaI(s) w. hose nmne(s) is (are) subscribed to the within instrument and aclmowledged to me that he/ghe/they executed the same in his/her/their capakity(ies) and that by hisA~er/their signature(s) on the in~trumenL the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument, and that such individual(s) made such appearance before the undersig-ned in (Insert the,city Or 6ther political subdivision and the state or country or other place the acknowledgement was taken) (signature and office of individual taking acknowledgement) Contractor's/Vendor's Public Disclosure Statement Form (Rev. 3/04) Page 3 of 3 Public Disclosure Form C:\Doeuments and Settings\mvalerie-kempinski\My Documents\LEGAL\Standard Contract elauses'~CEX 22 Discl 5-04.doe SUFFOLK COUNTY ADMINISTRATIVE CODE SECTION A5-7 § A5-7. Contractors and vendors required to submit full disclosure statement. [Derived from L.L. No. 14-1976, as amended 2-27-1979 by L.L. No. 6-1979] A. Definitions. As used in this section, the following terms shall have the. meanings indicated: CONTRACT - Any written agreement between Suffolk County and a contractor or vendor to do or perform any kind of labor, service, purchase, construction or public work, unless the con.tract is for a federally or state- aided, in whole or in par[, program required' to be bid pursuant to § t03 of the New York General Municipal Law. [Amended' 6-29-1993 by L.L. No. 28-1993~] NOTE: L.L. No. 28-1993 also pr_ovided as follows: Section 1, Legislative Intent. This Legislature hereby finds and determines that Suffolk County's comprehensive · Contractor/Vendor Public Disclosure Statement Law currently applies to a broad array of contracts that exceed one thousand dollars {$1,000.) in value, subject to exemptions for contractors doing business with the County Department of Social Services; hospitals; educational, medical, and governmental entities; and not-for-profit corporations. This Legislature further finds and determines that these exemptions prevent full disclosure of important information that may be useful to elected county officials in determiaing whether or not specific types of contracts are in the public interest, especially in light of recent trends towards privatization and use of outside consultants on an increased basis by municipalities. Therefore, the~ purpose of this law is to eliminate many of the exemptions from completing and filing verified public disclosure statements with the County Comptroller available to certain contractors providing social services or health services contracts. CONTRACTOR or VENDOR [Amended 12-'18-1990 by L.L. No. 41- 19902; 6-29-1993 by L.L. No. 28-19933] - Any proprietorship, partnership or closely held corporation which has a contract with Suffolk County in excess of one thousand dollars ($1,000.) or which has three (3) or more contracts with Suffolk County, any three (3) of which, when combined, exceed one thousand dollars ($1,000.), except: (1) Hospitals. (2) Educational or governmental entities. I Editor's Note: This local law was adopted by the legislature after disapproval l~y the Executive on 5-26-1993. 2 Editor's No[e: This local law was adopted by the Legislature after disapproval by the Executive on 12-13-1990. See the note at § A4-12. 3 Editor's Note: This local law was adopted by the Legislature after disapproval by the Executive on 5-26-1993. See note above. Page 1 of 3 (3) Not-for-'profit corporations. (4) Contracts providing for foster care, family day-care providers or child protective consulting services. FULL DISCLOSURE CLAUSE - A proviso to be included, as a material part of a contract imposing upon the contractor or vendor' a material, contractual and statutory duty to file a verified public disclosure statement. VERIFIED. PUBLIC DISCLOSURE STATEMENT - A declaration, the contents of w.hich are acknowledged before a notary public, containing information required under this section. A full disclosure clause is to be included in all future contracts between Suffolk County and a contractor or vendor. Such full disclosure clause shall constitute a material part of the contract. Notice of the full disclosure clause shall be included and made a pad of the specifications, if any, which are submitted to interested potential bidders. Each contractor or vendor shall file a verified public disclosure statement with the Comptroller of Suffolk County as soon as practicable prior to being awarded the contract_ An updated disclosure statement shall be filed by the contractor or vendor with the Comptroller by the 31st day of January in each year of the contract's duration. It shall be the duty of the Comptroller to accept and file such statements. No contract shall be awarded to any contractor or vendor, as defined in this section, unless prior to such award a verified public disclosure statement is filed with the Comptroller as provided in this section. Any verified public disclosure statement containing fraudulent information shall constitute, for all purposes,a failure to file such statement in the first instance. F. The verified public disclosure statement required by this section shall include: (1) A complete list of the names and addresses of those individual shareholders holding more than five-percent interest in the firm. (2) The table of organization for the company shall include the names and addresses of all individuals serving on the board of directors or comparable body, the names and addresses of all partners and the names and addresses of all corporate officers. The contractor or vendor shall conspicuously identify any such person in this table of organization who is an officer or an employee of Suffolk County. Page 2 of 3 (3) A complete financial statement listing all assets' and liabilities as well as a profit-and-less statement, certified by a certified public accountant. Such statement shall be the most current available and in no event shall have been prepared more than six (6) months prior to the date of the filing of the bid. No financial statement or profit-and-loss statement shall be required from any contractor or vendor having fifty percent (50%) or more of their gross revenues from sources other than the County of Suffolk. A separate folio for each company shall be maintained alphabetically for public inspection by the Comptroller. Remedies. The failure to file a verified public.discl0sure statement as required under this section shal! constitute a material breach of contract. Suffolk County may resort, use or employ any remedies contained 'in"' Article 2 of the Uniform Commercial Code of the State of New York. In addition to alt legal remedies, Suffolk County shall be entitled,, upon a determination that a breach has occurred, to damages equal to fifteen percent (15%) of the amount of the contract. Under no circumstances shall the county be precluded from invoking any remedy contained, in the preceding section by reason of its failure to invoke promptly its remedies. Page 3 of 3 CERTIFICATE OF LIABILITY INS PRODUCER T~JS CERI~F[CA'r~ IS ~UED ~ A ~R OF IN~N ROY HRE~ AGENt, ~C. ~LY ~D CONF~S N0 RIGH~ UPON ~E CER~ ~ ~X ~, 1~ ~IN RD. HOLOE~ ~ C~Fi~A~ ~ NOT AMID, ~ND OR ~CK ~ ~1952 ~ ~E COVE~GE ~FORDED ~ ~E POLI~ BEL~. PHONE: F~: 631-~850 INS~FO~ING ~GE T~ ~ SO.OLD ]NSU~ B: ~eH~n ~ I~u~ C~ny P.O. ~X 11~9 IN~R~ C: I~u~ ~omflon ~ ~nnov~ ~S ~N RO~ SOU~O~ ~ t197~959 COVERAGES CER'llFICATE HOLDER ~z~m'no~. ~su~;, r~su~m ~ COUNTY OF SUFFOLK OFFICE FOR THE AGING P.O. BOX 6100 HAUPPAUGE, NY 11788-0099 AUm'~flon: . FAX: 298-4462.KAREN McLAUGHLIN ACORD 25 (200t1~8) CANCELLATION 4158 Thomas A. Dickerson