Loading...
HomeMy WebLinkAboutCommunity Projects Appropriation M051096 RESOLUTION 2007-430 ADOPTED DOC ID: 2849 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2007-430 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON MAY 8, 2007: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Snpervisor Scott A. Russell to execute an Amendment to A!!reement #M-051096 in connection with the a!!reement pertainin!! to the installation of a fIashin!! beacon li!!ht on State Route 25 at the Greenport School. which Amendment extends the fundin!! for this A!!reement to Julv 31. 2008, subject to the approval of the Town Attorney. ,rt~"U:la~l"It.. Elizabeth A. Neville South old Town Clerk RESULT: ADOPTED [UNANIMOUS) MOVER: Louisa P. Evans, Justice SECONDER: Thomas H. Wickham, Councilman AYES: Evans, Wickham, Ross, Edwards, Russell, Krupski Jr. APPENDIX X Agency Code Contract Period ]9000 04/01/0S - 07/31/08 Contract Number Funding for Period MOS]096 $ 17.S00.00 This is an AGREEMENT between THE STATE OF NEW YORK, acting by and through the New York State Department of State, having its principal office in Albany, New York (hereinafter referred to as the ST ATE), and Town of Southold (hereinafter referred to as the CONTRACTOR), for modification of Contract Number MOS]096, as amended above. All other provisions of said AGREEMENT sball remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this AGREEMENT as of the dates appearing under their signatures. S c' t A. Ru sse 11 (print name) Title: Supervisor Title: ~-----._._-- Date: Date: State Agency CCl1ification: "In addition to the acceptance of this Conlracl, I also certify that original copies ofthi8 signature page will be attached to all other exact copies of this Contract." STATE AGENCY SIGNATURE By: CONTRACTOR S]G By: (print name) STATE OF NEW YORK ) COUNTY OF SUF1"OLK ) ss: On this &- day of '1r) 0.<1"' ' in the year 20 _~, before me personally appeared S cot t A. Ru s se._1~__ , to me known, who, being by me duly sworn, did depose and say that (s)he resides at Cu tc hogu e. ; that (s)he is the Supervisor _____-~f_ the Towr;-o!=~~outhOTCl- ____ the corporation described herein whieh executed the foregoing instlUment; and that (s)he signed (her)his name thereto by order of the board of directors of said corporation. ~//t rb- [) 09~~-kJ_ N l1rt"D~~ g~te of New York NOTA~l6~~~~~6~~ Suffolk Cou~ ~~~ Expires December 31, 20JJL ___, in the year 20____, before me personally appeared _______.___________, to me known and known to me to be the _______ of_____ , the unincorporated association described in and which executed the above agreement; and who acknowledge to me that (s)he executed the foregoing agreement for and in bchalf of said unincOI])orated association. STATE OF NEW YORK COUNTY OF ) ) ss: On this _ day of _.._ Thomas P. DiNapoli State Comptroller: NOTARY PUBLIC By: Date: y .' GEORGE E. PATAKI GOVERNOR W ~.D.t STATE OF NEW YORK DEPARTMENT OF STATE 41 STATE STREET ALBANY, NY 12231-0001 October 19, 2006 CHRISTOPHER L. JACOBS SeCRETARY OF STATE Mr. Scott Russell, Supervisor Town of Southho1d PO Box 1179,53095 Main Road Southhold, New York 11971 fD)~C~IWIE~ UI1 OCT 2 3 2006 lW SUPERVISOR'S OFFICE TOWN OF SOUTHOlD Dear Mr. Russell: Re: Community Projects Appropriatiou Agreement # M051096 Enclosed is a fully-executed copy of the subject Agreement for your records. Also enclosed are V ouchering Procedure Guidelines and a Payment Request Package consisting of Documentation Forms and a Standard Voucher to be used when requesting reimbursements. Please read the instructions carefully and submit payment requests in accordance with Appendix C of the approved Agreement. Please note your contract date has been extended to 7/31/07. Please call our office at 518-486-3905 if you have questions regarding the payment forms. Sincerely, ~t0 Lisa A. Kois Principal Clerk LK:kc Enclosures WWW.DQS.STATE.NY.US . E-MAIL: INFO@OOS.STATE.NY.US . . , NEW YORK STATE DEPARTMENT OF STATE CONTRACT ADMINISTRATION UNIT VOUCHERING PROCEDURES GUIDELINES FOR LEGISLA TIVE MEMBER INITIATIVES I. These guidelines explain what supporting documentation is required to be submitted for each payment request to be considered a proper invoice. 2. For the purpose of this Program the designated payment office is: New York State Department of State Contract Administration Unit - LMI 41 State Street, 10th Floor Albany, New York 12231-0001 3. A payment request consists of a properly completed and signed Standard Voucher, a Summary Sheet and Forms I through 4. A desk audit must be completed before payment can be made. Generally, payments will be made approximately twenty (20) working days from receipt of a complete claim provided all requirements are met and, your agency is meeting all other contractual obligations. Care should be taken to insure that all forms are legible and completely filled out. 4. Please note that when signing the Voucher, you are also certifying to the statements in the certification section of the Summary Sheet, which is an integral part of our payment review, allowing you to maintain source documentation at your local office versus our requiring copies of all documentation to be submitted to the Department of State for review. The certification also places the responsibility of assuring that appropriate expenditures are being made in relation to the project with your organization. 5. Please take care in completing all documents as any errors can and will result in the rejection of your payment request. If assistance is needed in completing the Documentation Forms, please call the number below. NOTE: Please photocopy the Voucher, Summary Sheet and Forms to use for subsequent payment requests. If you have any questions regarding these guidelines, please contact the Contract Administration Unit at 518-486-3905. I . SUMMARY SHEET Insert your contract number, as it appears on the Contract Face Page, of your contract in the space provided. Insert the inclusive (start and end) dates within which the expenditures claimed this report were incurred (goods and services received or completed) in the spaces provided. SECTION I: Column #1 - Please insert the current budget amounts reflected in the most recently approved budget. Column #2 - These figures must reflect the expenditures being documented on Forms 2-4 in this payment request only. Column #3 - These figures represent the cumulative expenditures documented to date including this payment request and previous payment requests in which expenditures were documented. If this is the first payment request, Columns #2 and #3 will be the same. Column #4 - The Available Balance to Document can be calculated by subtracting the Cumulati ve Expenditures to Date (Column #3) from the Current Budget Amounts (Column #1). If this results in a negative balance which exceeds the budget amount by 10 percent or $1,000.00, whichever is greater, or there is no budget amount for the category of expense, a budget amendment is required in accordance with Appendix C of your Contract. SECTION II: Interim Claims - If your organization chose to receive an advance payment, interim Claims will be reimbursed in an amount equal to 75 percent of the Expenditures Documented this Report (Column #2 in Section I). The 25 percent balance will be applied toward documenting the advance payment. Otherwise, reimbursement will be made in an amount equal to 100 percent of the total, acceptable expenditures claimed in Column #2. 2 , Final Claims - Any claim for any period during which all project activities shall have been completed shall be considered the Final Claim. The final claim amount is calculated by subtracting the total payments including the advance from the total cumulative expenditures in Column #3 of Section 1. If this results in a negative number (total payments exceed total expenditures), you must submit such excess to the Department with your Final Claim. FORMS 1-4 The purpose of these forms is to detail the expenditures claimed in Column #2 of the Summary Sheet. Although these forms are the same design and format as the forms used in Appendix B of the Agreement which detail the budget categories, please do not photocODY the budget pages to be used as documentation forms in the payment requests. Since supporting documentation (receipts, invoices, etc.) is not required, unless requested, it is very important that these forms be completed as accurate and detailed as possible. Failure to do so will result in the rejection of your payment request. FORM 1: PROJECT NARRATIVE This report should describe in detail all project accomplishments and any problems encountered during the period being reported. Whereas the project narrative in the Agreement details the project intent, the project narrative in payment requests must detail what project accomplishments have been met with the funds being claimed for reimbursement in the payment request. If your Contract is for purchase of commodities or equipment only, this form is not required. FORMS 2 - 4: EXPENDITURE DETAIL For each category claiming reimbursement, detail the types of expenses, the actual costs and the dates incurred. The items detailed must be the same as those included in the original budget, and must be shown in the same budget categories. The amount reflected in the Sub-total line of each category must be the same amount claimed in Column #2 of the Summary Sheet. 3 , DETAIL: Except for equipment, it is not necessary to list each item purchased; like items can be combined. However, the expenditures being documented should be descriptive and itemized to some extent. Listed below are some examples for documenting expenditures. A. Salaries. Wages and Fringe: Include all pay periods covered by this report and list the amount paid (including Fringe) to each employee for the work done relating to this Contract during the pay periods covered by this report. B. Travel: Break-out the traveling expenses incurred, including date, destination and purpose of travel, in relation to the project. How much of the total travel amount was for taxi fare? or mileage reimbursement? How many miles were traveled? C. Supplies and Materials: List the different types of supplies and materials purchased, the cost of each and the dates received. I.e. Office Supplies (paper, pens, stationary) - $845.00 - received 06/30/99 Medical Supplies (splints, bandages, blankets) - $420.00 - received 06/30/99 Gas and Oil $35.00 - received 06/30/99 15 Gallons of Gas @ $1.50/gallon = $22.50 - received 06/30/99 10 Quarts of Oil @ $1.25/quart = $12.50 - received 06/30/99 D. Equipment: List each piece of equipment purchased, the cost of each piece and the dates received. Please give some description of the equipment such as make, year, model number, etc. E. Contractual Services: The contractual services category includes items such as telephone, postage, rent, utilities, rental or repairs to equipment, lease of equipment, sub-contracted services and construction costs. List the different types of contractual services, the cost for each and the dates services provided. I.e. Insurance (fire, theft, auto) $1500.00 - 06/01/99-12/31/99 Telephone $136.00 - June 1999 Lease (photocopying machine) $200.00 - June 1999 Construction contract $2,000.00 - 06/01/99-07/31/99 If there are any questions on how to correctly document expenditures, please call the number listed on Page 1 of the instructions. 4 . STANDARD VOUCHER - complete Sections 3, 4, 6 and 7 only In Section 3, Payee ID, indicate your Federal ID number as submitted on the CONTRACT FACE PAGE. NOTE: If the contract is with a county, city, town or village government, DO NOT COMPLETE SECTION 3. In Section 4, Payee Name and Address, indicate the organization's name and address as it appears on the CONTRACT FACE PAGE. In Section 6, indicate your Contract Number, as it appears on the CONTRACT FACE PAGE of your contract, in the space provided. Indicate the total expenditures claimed (total of Column 2 on the Summary Sheet) in the space provided to the far right. DO NOT put anything else in this Section. The Payee Certification, Section 7, must be an original signature by the responsible official authorized to certify claims. If the Voucher is not signed the payment request will automatically be rejected. 5 DOCUMENT A TION FORMS LEGISLATIVE MEMBER I!\'ITIA TIVES CONTRACT # Expenditures Incurred During the Period / / through / / SUMMARY SHEET I BlJDGETIEXPE!\'DITVRE DATA Currenl Budget Amount (I) CumUlal]ve Expend]tures Documented 10 Dale (3) Expend]tures Documented this Repon (2) A SalJrJes, Wages and Fnnge B T]a'el C Suppl]es and Matenals 0 Equ]pment E Contractual Services F Other TOTAL A vatlable Balance to Document (J -3) II. CLAIM TYPE _ final Claim Interim Claim HI. CERTIFICATION B> slgnaturc on the allached voucher, I funher ccn]fy that I) the JmOUnlS cla]med accurateJv represent the expenses as recorded In our accounting ]ccords, 2) lAe are In compl]ance w]th all appltcable DrOVIS]OnS of the obove-referenced Conllact. 1) the 31tached ndfT"all\'e repon (tI regulled) accuDtcly represents proJcct Jccompl"hmems. 4) fuods rcce]ved Me he]ng used solely fCJr the puqJOSCS Dr the "Project" JS descnbcd]n ,"rpcnulx D of the (jho\c-refcrenc:ed Contracl fOR'1 I PROJECT NARRA 1'IVE DEl' AILl1"G PROJECT ACCO;\lPLlSHI\1[~TS A~D THE DATES GOODS WERE RECEIVED AND SERVICES WERE COMPLETED FORi\!.2 - Expenditure Detail ror this Pa)ment Request Be descripti\e and specific ~ _ S-\L\ RIES. W A GFS AND FRI1'\CE BE"iEFlTS REOFEST B. TRA VEL (include date, destination and purpose) Sl BTOT \L s fOR:\IJ J C. SUI'I'L1ESfMA TERIA lS (include dates recehed) SUBTOTAL $ D. EQUJPMEI\'T (include dates receiHd) q'BTOTA L $ FOR\! 4 E. CONTRACTUAL SER\iICES (include dales senices recei\ed) SUBTOTAL $ F. OTHER (include dales goods or senices recehed) Sl'JlTOT~ L $ . Voucher No. AC92 (Rev. 6194) STANDARD VOUCHER 1 Originating Agency Orig. Agency Code Interest Eligible (YINI 2 P-Contract DEPARTMENT OF STATE 19000 Payment Date (MM) (DO) (VY) I OSC Use Only Liability Date (MM) (DO) (VY) I I I I Additional Zip Code Route Payee Amount MIR Date (MM) (DO) (VY) 3 Payee ID I I 4 PIIyee Name (limit to 30 spaces) IRS Code IRS Amount Payee Name (limillO 30 spaces) Stat. Type Statistic Ilndlcator.o.p1. I Indicator-Statewide Address (Umitla 30 spaces) 5 Refllnv. No. (Urn! 10 20 spaces) Addres. (Limit to 30 spaces) Re1ltnv.Oale (MM) (00) (YY) I I City (Lirnl 10 20 spaces) (Urnl to 2 Spaces)...... State I Zip Code 6 Claiming reimbursement of expenditures incurred pursuant to Community Projects Contract # as detailed on the attached Documentation Forms. Total this claim (Total Summary Sheet Column #2) $ 7 Total Payee Certification: I certify that the above bill is just, true and correct; that no part thereof has been paid except as staled and that the balance is actually due and owing, and that taxes from which the Stale is exempt are excluded. ~ Discount % Payee's Signature in Ink Title Net Date Name of Company FOR AGENCY USE ONLY STATE COMPTROLLER'S PRE-AUDIT Merehand_Receillld I certily that this voucher is correct and just, and payment is approved, and the goocls or services Certified lor Payment rendered or fumished are tor use in the perlormance 01 the oflicial junctions and duties of this 0' agency. Net Amount 0.1. V.r~,ed P.geNo A..,::jiled Authorized Signature " SpecilllApprov.1 By (..Requited) Date Title Expenditure Liquidation Cost Cenler Code Accum Oep!. CostCenlerUnit Va' V, Object Oapl Statewide Amount Orig. Agency PO/Contract line FlP osc . . CONTRACT FACE PAGE STATE AGENCY New York State Department of State 41 State Street Albany, New York 12231 BOX 1 - CONTRACTOR (Name and Business Address) Town of Southhold 53095 Main Road P.O. Box 1179 Southo1d, NY 11971-0959 BOX 2 - FEDERAL TAX ID NUMBER 116001939 I ". MUNICIPAL~DI;# ' . 3:/..7 :"Ri:Z'!l.i1 .t1 i:L . ',,'," I e(ui;.' . BOX 3 - STATUS Sectarian entity? Not-for-profit organization? Yes_ No X- Yes No x IN),'SqO~CTl"Wl\1BER:",',\l\ff)SI99(j 1 1'6iijGI#ATINQA~ENCYCOriJ: . '. : : 190001 .... ,-.,... " l't:~~";~ii~{..;t,\';,'~?~~'?r~~.:: . , s~., J99.l1. FCdei'a1' () ~".. . I Fl;DERALF1JNDSCFJ>A.#: N}A. .,' I INITIAL CC)~CT PERIOD: .' . .'. .. FROM:04JOll100S' TO: 07/31/2007 ;'" .. __>. .' .. ....... .. ",d,' ". ._.,' ;,'~ .. ,_, ';c_::.."_' .." '0 .. ," '<,' .. ,.'.. .... cO ,,'~",..'_'.. _"." ". ", , 1.~..'..T:i~YE .AA'..n.... 1m:. . NfA.,,' """OM" .... .. TO . :, .....a,', :';,:': "':':~'~:;>':>'.. ".... :", ..~ FUNDING"FORINITlAL PERIOD: . .. ;::'..~'.G..:.,; -" ',. ,'" .. , .. .--', " ',' '... .." .. .-- .. , .. ,', ,'" $17,500.00 BOX 4 - CHARITIES REGISTRATION NUMBER _Nil: - _ _ - _ _I EXEMPTION (E.2) -3- A. ESTATES, POWERS AND TRUSTS LAWS REPORTING EXEMPTION (E-3) -12. .J.. BOX 5 - If you did not claim an exemption to both of the items in Box 4, you must check the applicable response in the following: N I A Contractor has _I has not ~ timely filed with the Attorney General's Charities Bureau all required periodic or annual written reports. APPENDICES A TT ACHED TO AND PART OF THIS AGREEMENT APPENDIX A: APPENDIX A I: APPENDIX B: APPENDIX C: APPENDIX D: APPENDIX E: APPENDIX X: Standard Clauses as Required by the Attorney General for all State Contracts Agency-specific Clauses Budget Payment and Reporting Schedule Program Workplan Charities Bureau Registration and Reporting Exemptions Modification Agreement Form (to accompany modified appendices for changes in term or consideration on an existing period or for renewal periods) 2005-2006 LMI SIG.NATURE PAGE IN WITNEs'S THEREOF, the parties hereto have executed or approved this AGREEMENT on the dates below their signatures. CONTRACTOR Town of Southold By: ..-J~a/~ Scott A. Russell Title: Date: . (Print Name) SupervJ.sor 8 J7,~ / STATE OF NEW YORK) COUNTY OFSUFFOLK ) ss.: CONTRACT #MOSI096 STATE AGENCY New York State Department of State B, ~~L~ J"'c\lrh e, Kehh DOS Director(I'tiIfN~inistr t!Of. Title: and Management Date: ~ State Agencv Certification "In addition to the acceptance of this Contract, I also certify that original copies of this signature page will be attached to all other exact copies of this Contract/' On this J 7 day of August , in the year 20 06 , before me personally appeared Scott A. Russell , to me known, who being by me duly sworn, did depose and say that helw is the Suoervi "or of the Town of Southold , the organization described in and which executed the above instrument; and that he/she has the authority to sign on behalf of said organization; and that he/she executed the foregoing agreement for and in behalf of said organization. b.}~..,~ (J~ Not Public LINDA J COOPER NOTARY PUBLIC. State of New York NO. 01 C04822563, Suffolk COYJ;ltJ Term Expires December 31, 2~ APPROVED: Title: OCT - 4 ZOOS )4..i('..... '-'I, ~ 8!NIM~~o'lf~ Date: ALAN G. HEVESI, STATE COMPTROLLER APPR . OF AUDIT & CONTROL Title: Date: &"u~ ;I~ FOR THE STATE COMPTROLlER I STATE OF NEW YORK AGREEMENT This AGREEMENT is hereby made by and between the State of New York agency (STATE) and the public or private agency (CONTRACTOR) identified on the face page hereof. WlTNESSETH: WHEREAS, the STATE has the authority to regulate and provide funding for the establishment and operation of program services and desires to contract with skilled parties possessing the necessary resources to provide such services; and WHEREAS, the CONTRACTOR is ready, willing and able to provide such program services and possesses or can make available all necessary qualified personnel, licenses, facilities and expertise to perform or have performed the services required pursuant to the terms of this AGREEMENT; NOW, THEREFORE, in consideration of the promises, responsibilities and covenants herein, the STATE and the CONTRACTOR agree as follows: I. Conditions of A~reement A. This AGREEMENT may consist of successive periods (PERIOD), as specified within the AGREEMENT or within a subsequent Modification . Agreement(s) (Appendix X). Each additional or superseding PERIOD shall be on the forms specified by the particular State agency, and shall be incorporated into this AGREEMENT. B. Funding for the first PERIOD shall not exceed the funding amount specified on the face page hereof. Funding for each subsequent PERIOD, if any, shall not exceed the amount specified in the appropriate appendix for that PERIOD. C. This AGREEMENT incorporates the face pages attached and all of the marked appendices identified on the face page hereof. 2 D. For each succeeding PERIOD of this AGREEMENT, the parties shall prepare new appendices, to the extent that any require modification, and a Modification Agreement (the attached Appendix X is the blank form to be used). Any terms ofthis AGREEMENT not modified shall remain in effect for each PERIOD of the AGREEMENT. To modify the AGREEMENT within an existing PERIOD, the parties shall revise or complete the appropriate appendix form(s). Any change in the amount of consideration to be paid, or change in the term, is subject to the approval of the Office of the State comptroller. Any other modifications shall be processed in accordance with agency guidelines as stated in Appendix AI. E. The CONTRACTOR shall perform all services to the satisfaction of the STATE. The CONTRACTOR shall provide services and meet the program objectives summarized in the Program W orkplan (Appendix D) in accordance with: provisions of the AGREEMENT; relevant laws, rules and regulations, administrative and fiscal guidelines; and where applicable, operating certificates for facilities or licenses for an activity or program. F. If the CONTRACTOR enters into subcontracts for the performance of work pursuant to this AGREEMENT, the CONTRACTOR shall take full responsibility for the acts and omissions of its subcontractors. Nothing in the subcontract shall impair the rights of the STATE under this AGREEMENT. No contractual relationship shall be deemed to exist between the subcontractor and the STATE. G. Appendix A (Standard Clauses as required by the Attorney General for all State contracts) takes precedence over all other parts of the AGREEMENT. II. Payment and Reporting A. The CONTRACTOR, to be eligible for payment, shall submit to the STATE's designated payment office (identified in Appendix C) any.appropriate documentation as required by the Payment and Reporting Schedule (Appendix C) and by agency fiscal guidelines, in a manner acceptable to the STATE. 3 B. The STATE shall make payments and any reconciliations in accordance with the Payment and Reporting Schedule (Appendix C). The STATE shall pay the CONTRACTOR, in consideration of contract services for a given PERIOD, a sum not to exceed the amount noted on the face page hereof or in the respective Appendix designating the payment amount for that given PERIOD. This sum shall not duplicate reimbursement from other sources for CONTRACTOR costs and services provided pursuant to this AGREEMENT. C. The CONTRACTOR shall meet the audit requirements specified by the STATE. III. Terminations A. This AGREEMENT may be terminated at any time upon mutual written consent of the STATE and the CONTRACTOR. B. The STATE may terminate the AGREEMENT immediately, upon written notice oftermination to the CONTRACTOR, if the CONTRACTOR fails to comply with the terms and conditions ofthis AGREEMENT and/or with any laws, rules, regulations, policies or procedures affecting this AGREEMENT. C. The STATE may also terminate this AGREEMENT for any reason in accordance with provisions set forth in Appendix AI. D. Written notice of termination, where required, shall be sent by personal messenger service or by certified mail, return receipt requested. The termination shall be effective in accordance with the terms of the notice. E. Upon receipt of notice of termination, the CONTRACTOR agrees to cancel, prior to the effective date of any prospective termination, as many outstanding obligations as possible, and agrees not to incur any new obligations after receipt of the notice without approval by the STATE. F. The STATE shall be responsible for payment on claims pursuant to services provided and costs incurred pursuant to terms of the AGREEMENT. In no event shall the STATE be liable for expenses and obligations arising from the program(s) in this AGREEMENT after the termination date. 4 IV. Indemnification A. The CONTRACTOR shall be solely responsible and answerable in damages for any and all accidents and/or injuries to persons (including death) or property arising out of or related to the services to be rendered by the CONTRACTOR or its subcontractors pursuant to this AGREEMENT. The CONTRACTOR shall indemnify and hold harmless the STATE and its officers and employees from claims, suits, actions, damages and costs of every nature arising out of the provision of services pursuant to this AGREEMENT. B. The CONTRACTOR is an independent contractor and may neither hold itself out nor claim to be an officer, employee or subdivision of the STATE nor make any claim, demand or application to or for any right based upon any different status. V. Property Any equipment, furniture, supplies or other property purchased pursuant to this AGREEMENT is deemed to be the property of the STATE except as may otherwise be governed by Federal or State laws, rules or regulations, or as stated in Appendix AI. VI. Safeguards for Services and Confidentiality A. Services performed pursuant to this AGREEMENT are secular in nature and shall be performed in a manner that does not discriminate on the basis of religious belief, or promote or discourage adherence to religion in general or particular religious beliefs. B. Funds provided pursuant to this AGREEMENT shall not be used for any partisan political activity, or for activities that may influence legislation or the election or defeat of any candidate for public office. C. Information relating to individuals who may receive services pursuant to this AGREEMENT shall be maintained and used only for the purposes intended under the Contract and in conformity with applicable provisions of laws and regulations, or specified in Appendix A I. A-I APPENDIX A Standard Clauses for All New York State Contracts The parties to the attached contract, license, lease, amendment or other agreement of any kind (hereinafter, "the contract" or "this contract") agree to be bound by the following clauses which are hereby made a part of the contract (the word "Contractor" herein refers to any party other than the State, whether a contractor, licenser, licensee, lessor, lessee or any other party): I. EXECUTORY CLAUSE. In accordance with Section 41 of the State Finance Law, the State shall have no liability under this contract to the Contractor or to anyone else beyond funds appropriated and available for this contract. 2. NON-ASSIGNMENT CLAUSE. In accordance with Section 138 of the State Finance Law, this contract may not be assigned by the Contractor or its right, title or interest therein assigned, transferred conveyed, sublet or otherwise disposed of without theprevIDus consent, in writing, of the State and any attemptsto assign the contract without the State's written consent are null and void The Contractor may, however, assign its right to receive payment without the State's prior written consent unless this contract concerns Certifi'cates of Participation pursuant to Article 5-A of the State Finance Law. 1 COMPTROLLER'S APPROVAL In accordance with Section 112 of the State Finance Law (or, if this contract is with the State University or City University of New York, Section 355 or Section 6218 of the Education Law), if this contract exceeds $15,000 (or the minimum thresholds agreed to by the Office of the State Comptroller for cenain S.U.N.Y. and C.U.NY. contracts), or if this is an amendment for any amount to a contract which, as so amended, exceeds said statutory amount, or if, by this contract, the State agrees to give something other than money when the 'value or reasonably estimated value of such consideration exceeds $1 0,000, it shall not be valid, effective or binding upon the State until it has been approved by the State Comptroller and filed in his office. Comptroller's approval of contracts let by the Office of General Services is required when such contracts exceed $30,000 (State Finance Law Section 163.6a). 4. WORKERS' COMPENSA nON BENEFITS. In accordance with Section 142 of the State Finance Law, this contract shall be void and of no force and effect unless the Contractor shall provide and maintain coverage during'the life of this contract for the benefit of such employees..as are required to be covered by the provisions of the Workers' Compensation Law. 5. NON-DISCRIMINATION REOUIREMENTS. To the extend required by Article 15 of the Executive Law (also known as the Human Rights Law)and all other State and Federal'statutory and constitutional non-discrimination provisions, the Contractor will not discriminate against any employee or applicant for employment because ofrace, creed, COlOT, sex, national origin, sexual orientation, age, disability or marital status. Furthennore, in accordance with Section 220-e of the LaboT Law, if this is a contract for the construction, alteration or repair of any public building or public work or for the manufacture, sale or distribution of materials, equipment or supplies, and to the extent that this contract shall be performed within the State of New York, Contractor agrees thai neither it nor its subcontractors shall, by reason of race, creed, color, disability, sex, or national origin: (a) discriminate in hiring against any New York State citizen who is qualified and available to perfonn the wOTk; OT (b) discriminate against or intimidate any employee hired for the performance of work under this contract. If this is a building service contract as defined in Section 230 of the Labor Law, then, in accordance with Section 239 May 2003 thereof, ContTactor agrees that neither it nor its subcontractors shall by reason of race, creed, color, national origin, age, sex, or disability:, (a) discriminate in hiring against any New York State citizen who is qualified and available to perfonn the work; or (b) discriminate against or intimidate any employee hired for the performance of work under this contract. Contractor is subject to fines of$50.oo per person per day for any violation of Section 220-e or Section 239 as well as possible tennination of this contract and forfeiture of all moneys due hereunder for a second or subsequent violation. 6. WAGE AND HOURS PROVISIONS. If this is a public work contract covered by Article 8 of the Labor Law ora'" building service contract covered by Article 9 thereof, neither Contractors employees nor the employees of its subcontractors may be required or permitted to work more than the number of hours or days stated in said statutes, except as otherwise provided in the Labor law and as set forth in prevailing wage and supplement schedules issued by the State Labor Department. Furthermore, Contractor and its subcontractors must pay at least the prevailing wage rate and pay or provide the prevailing supplements, including the premium rates for overtime pay, as detennined by the State Labor Department in accordance with the Labor Law. 7. NON-COLLUSIVE BIDDING REOUlREMENT.In accordance with Section 139-d of the State Finance Law, if this contract was awarded based upon the submission of bids, Contractor warrants, under penalty of perjury, that its bid was arrived at independently and without collusion aimed at Testricting competition. Contractor further warrants that, at the time Contractor submitted its bid, an authorized and responsibteperson executed and delivered to the State a non-collusive bidding certification on Contractor's behalf. 8. INTERNA nONAL BOYCOTT PROHIBITION. In accordance with Section 220.f of the Labor Law and Section 139-h of the State Finance Law, if this contract exceeds $5,000, the Contractor agrees, as ~ material condition of the contract, that neither the Contractor nor any substantially owned or affiliated person, firm, partnership or corporation has participated, is participating, or shall participate in an international boycott in violation of the federal Export Administration Act of 1979 (50 use App. Sections 2401 et seq.) or regulations thereunder. If such Contractor, or any of the aforesaid affiliates of Contractor , is convicted or is otherwise found to have violated said laws or regulations upon the final determination oftke United States Commer~e Department or any otherappropTiate agency of the United States subsequent to the contractors execution, such contract, amendment or modification thereto shall be rend~ed forfeit and void. The Contractor shall so notify the State Comptroller within five (5) business days of such conviction, determination or disposition of appeal (2NYCRR 105.4). 9. SET-OFF RIGHTS The State shall have all of its common law, equitable and statutory rights of set-off. These rights shall include, but not be limited to, the State's option to withhold for the purposes of set-off any moneys due to theContractorunder this contract up to any amounts due and owing to the State with regard to this contract, any other contract with any State department or agency, including any contract for a term commencing prior to the tenn of this contract, plus any amounts due and owing to the State for any other reason including, without limitation, tax delinquencies, fee delinquencies or moneta!)' penalties relative thereto. A-2 The State shall exercise its set-off rights in accordance with normal State practices including, in cases of set-off pursuant to an audit, the finalization of such audit by the State agency, its representatives, or the State Comptroller. 10. RECORDS. The Contractor shall establish and maintain complete and accurate books, records, documents, accounts and other evidence directly pertinent to performance under this contract (hereinaft~. collectively, "the Records"). The Records must be kept for the balance of the calendar year in which they were made and for six (6) additional years thereafter. The State Comptroller, the Attorney General and any other person or entity authorized to conduct an examination, as well as the agency or agencies involved in lhis contract, shall have access to the Records during nonnal business hours at an office of the Contractor within the State of New York or, if no such office is available, at a mutually agreeable and reasonable venue within the State, for the tenn specified above for the purposes of inspection, auditing and copying. The State shall take reasonable steps to protect from public disclosure any of the Records which are exempt from disclosure under Section 87 of the Public Officers Law (the "Statute") provided that: (I) the Contractor shall timely infonn an appropriate State official, in WTiting, that said records should not be disclosed; and (ii) said records shall be sufficiently identified; and (iii) designation of said records as exempt under the Statute is reasonable. Nothing containedhcrein shall diminish, or in any way adversely affect, the State's right to discovery in any pending or future litigation. 11. IDENTIFYING INFORMATION AND PRIVACY NOTIFICA- ~. (a) FEDERAL EMPLOYER IDENTIFICATION NUMBER andlor FEDERAL SOCIAL SECURITY NUMBER All invoices or New York State standard vouchers submitted for payment for the sale of goods or services or the lease of real or personal property to a New York State agency muSt include the payee's identification number, i.e., the seller's or lessor's identification number. The number is either the payee's Federal employer identification number or Federal social security number, or both such numbers when the payee has both such numbers. Failure to include this number or numbers may delay payment. Where the payee does not have such number or numbers, the payee, on its invoice or New York State standard voucher, must give the reason or reasons why the payee does not have such number or numbers. (b) PRlV ACY NOTIFICATION. (1) The authority to request the above personal infonnation from a selJerofgoods or sClVices or a lessor of real or personal propertY, and the authority to maintain such infonnation, is found in Section 5 of the State Tax Law, Disclosure ofthisinfonnation by the seller or lessor to the State is mandatory. The principal purpose for which the infonnation is collected is to enable the State to identify individuals, businesses and others who have been delinquent in filing tax- returns ormay have understated their tax liabilities and to generally identify persons affected by the taxes administered by the Commissioner of Taxation and Finance. The information will be used for tax administration purposes and for any other purpose authorized by law. (2) The personal infonnation is requested by the purchasing unit of the agency contracting to purchase the goods or services or lease the real or personal property covered by this contract or lease. The infonnation is maintained in New York State's Central Accounting System by the Director of Accounting Operations, Office of the State Comptroller, AESOB, Albany, New York 12236. 12. EOUAL EMPLOYMENT OPPORTUNITIES FOR MINORITIES AND WOMEN. In accordance with Section 312 of the Executive Law, if this contract is: (I) a written agreement or purchase order instrument, providing for a total expenditure in excess of $25,000.00, whereby a contracting agency is committed to expend or does expend funds in return for labor, services, supplies, equipment, materials or any combination ofthe foregoing, to be performed for, or rendered or furnished to the contracting May 2003 agency; or (ii) a written agreement in excess of $100,000,00 whereby a contracting agency is committed to expend or does expend funds for the acquisition, construction, demolition, replacement, major repair or renovation of real property and improvements thereon; or (iii) a written agreement in excess of $1 00,000.00 whereby the owner of a State assisted housing project is committed to expend or does expend funds for the acquisition, construction, demolition, replacement, major repair or ren. ovation of real property and improvements thereon for such project, then: (a) The Contractor will not discriminate against employees or applicants for employment because of race, creed, color, national origin, sex, age, disability or marital status, and will undertake or continue existing programs of affirmative action to ensure that minority group members and women are afforded equal employment opportunities without discrim-ination. Affinnative action shall mean recruitment, employment, job assignment, promotion, upgradings, demotion, transfer, layoff, or tennination and rates of payor other fonns of compensation; (b) at the request of the contracting agency, the Contractor shall request each employment agency, labor union, or authorized representative of workers with which it has a collective bargaining or other agreement or understanding,-to furnish a written statement that such employment agency, labor union or representative will not discriminate on the basis of race, creed; color, national origin, sex, age, disability or marital status and that such union or representative will affirmatively cooperate in the implementation of the contractor's obligations herein; and c) the Contractor shall state, in all solicitations or advertisements for employees, that, in the perfonnance of the State contract, all qualified applicants will be affQrded equal employment opportunities without dis- crimination because of race, creed, color, national origin, sex, age, disability or marital status. Contractor will include the provisions of "a, "bit, and "c" above, in every subcontract over $25,000.00 for the construction, demolition, replacement, major repair, renovation, planning or design of real property and improvements thereon (the "Work") except where the Work is for the beneficial use of the Contractor. Section 312 does not apply to: (I) work, goods or services unrelated to this contract; or(ii) employment outside New York State; or (iii) banking services, insurance policies or the sale of securities. The State shall consider compliance by a contractor or subcontractor with the requirements of any federal law concerning equal employment opportunity which effectuates the purpose of this section. The contracting agency shall detennine whether the imposition of the requirements of the provisions hereof duplicate or conflict with any such federal law and if such duplication or conflict exists, the contracting agency shall waive the applicability of Sect ion 312 to theextent of such duplication or conflict. Contractor will comply with all duly promulgated and lawful rules and regulations of the Governor's Office of Minority and Women's Business Development pertaining hereto. 13. CONFLICTING TERMS. In the event of a conflict between the terms of the contract (including any and all attachments thereto and amendments thereof) and the terms of this Appendix A, the terms of this Appendix A shall control. 14. GOVERNING LAW This contract shall be governed by the laws of the State of New York except where the Federal supremacy clause requires otherwise. A-3 15. LATE PAYMENT. Timeliness of payment and any interest to be paid to Contractor for late payment shall be governed by Article Il-A of the State Finance Law to the extent required by law. 16. NO ARBITRATION. Disputes involving this contract, including the breach or alleged breach thereof, may not be submitted to binding arbitration (except where statutorily authorized), but must, instead, be heard in a court of competent jurisdiction of the Stale of New York. 17. SERVICE OF PROCESS. In addition 10 the methods of service allowed by the Slate Civil Practice Law & Rules ("CPLR"), Contractor hereby consents to service of process upon it by registered or certified mail, return receipt requested. Service hereunder shall be complete upon Contractor's actual receipt of process or upon the State's receipt of the return thereof by the United States Postal Service as refused or undeliverable. Contractor must promptly notify the State, in writing, of each and every change of address to which service of process can be made. Service by the State to the last knOWll address shall be sufficfent. Contractor will have thirty (30) calendar days after service hereunder is complete in which to respond. 18. PROHIBITION ON PURCHASE OF TROPICAL HARD- WOODS. The Contractor cenifies and warrants that all wood products to be used under this contract award will be in accordance with, but not limited to, the specifications and provisions of State Finance Law ~ 165. (Use of Tropical Hardwoods) which prohibits purchase and use of tropical hardwoods, unless specifically exempted, by the State or any governmental agency or political subdivision or public benefit corporation. Qualification for an exemption under this law will be the responsibility of the contractor to establish to meet with the approval of the State. In addition, when any portion of this contract involving the use of woods, whether supply or installation, is to be performed by any subcontractor, the prime Contractor will indicate and certify in the submitted bid proposal that the subcontractor has been infonned and is in compliance with specifications and provisions regarding use of tropical hardwoods as detailed in 9165 State Finance Law~ Any such use must meet with the approval of the State, otherwise, the bid may not be considered responsive. Under bidder certifications, proof of qualification for exemption will be the responsibility of the Contractor to meet with the approval of the State. 19. MACBRIDE FAIR EMPLOYMENT PRINCIPLES. In accordance with the MacBride Fair Employment Principles (Chapter 807 of the Laws of 1992), the Contractor hereby stipulates that the Contractor either (a) has no business operations in Northern Ireland, or (b) shall take lawful steps in good faith to conduct any business operations in Northern Ireland in accordance with the MacBride Fair Employment Principles (as described in Section 165 of the New York State Finance Law), and shall permit independent monitoring of compliance with such principles. 20. OMNIBUS PROCUREMENT ACT OF 1992. It is the policy of New York Slate to maximize opportunities for the participation of New York State business enterprises, including minority and women.owned business enterprises as bidders, subcontractors and suppliers on its procurement contracts. Information, on the availability of New York State subcontractors and suppliers is available from: NYS Department of Economic Development Division for Small Business 30 South Pearl Street, 7th floor Albany, New York 12245 518-292-5220 May 2003 A directory of certified minority and women-owned business enterprises is available from: NYS Department of Economic Development Minority and Women's Business Development Division 30 Soulh Pearl Street, 2"" floor Albany, New York 12245 http://www.empire.state.ny.us The Omnibus Procurement Act of 1992 requires that by signing this bid proposal or contract, as applicable, Contractors certify that whenever the total bid amount is greater than $1 million: (a) The Contractor has made reasonable effons to encourage the participation of New York State Business Enterprises as suppliers and subcontractors, including certified minority and women-owned business enterprises. on this project, and has retained the documentation of these efforts to be provided upon request to the State; (b) The Conlractor has complied with the Federal Equal Opportunity Act of 1972 (P.L. 92-261), as amended; 0) The Contractor agrees to make reasonable efforts to provide notification to New York State residents of employment opponunities on this project through listing any such positions with the Job Service Division of the New York State Department of Labor, or providing such notification in such manner as is consistent with existing collective bargaining contracts or agreements. The Contractor agrees to document these efforts and to provide said documentation to the State upon request; and (d) The Contractor acknowledges notice that the State may seek to obtain offset credits from foreign countries as a result of this contract and agrees to cooperate with the State in these efforts. 21. RECIPROCITY AND SANCTIONS PROVISIONS. Bidders are hereby notified that if their principal place of business is located in a country, nation, province, state or political subdivision that penalizes New York State vendors, and if the goods or service.s they offer will be _substantially produced orperl'onned outside New York State, theOmnibus Procurement Act 1994 amendmC{lts and 2000 amendments (Chapter 684 and Chapter 3'83 respectively) require that they be denied contracts which they would otherwise obtain. NOTE: As of May 15,2002, the list of discriminatory jurisdictions subject to this provision includes the states of South Carolina, Alaska, West Virginia, Wyoming, Louisiana and Hawaii. Contact NYS Department of Economic Development for a cunent list of jurisdictions subject to tbis provision. 22. PURCHASES OF APPAREL. In accordance with Slate Finance Law 162 (4-a), the State shall not purchase any apparel from any vendor unable or unwilling to certify that: (1) such apparel was manufactured in compliance with all applicable labor and occupational safety laws, including, but not limited to, child labor laws, wage and hours laws_and workplace safety laws, and (ii) vendor will supply, with its bid (or, ifnot a bid situation, prior to or at the time of signing a contract with the State), ifknown,-the names and addresses of each subcontractor and a list of all manufacturing plants to be utilized by the bidder. AI-I APPENDIX At Agency-Specific Clauses I. General A. For the purposes of this Agreement, the tenns "State" and "Department" are inter-changeable, unless the context requires otherwise. B. The Contract Period as set forth on the Face Page is the inclusive period within which the provisions of this Agreement shall be perfonned. Costs incurred for project activities conducted prior to or after the Contract Period will not be reimbursed under this Agreement. C. TheContractor and Project (as described in the Legislative Initiative Fonn provided to the Contractor by the Department and incorporated herein by references and as detailed in the Program Workplan, Appendix D) have been identified to the Department for receipt of a local grant award not to exceed the Funding Amount as set forth on the Contract Face Page. D. The Department shall not be liable for expenses of any kind incurred in excess of the Funding Amount, and shall not be responsible for seeking additional appropriations or other sources of funds for the Project. E. The Contractor shall perfonn all services to the satisfaction of the Department. The Contractor shall provide all services and meet the program objectives set forth in Appendix D in accordance with: provisions of this Agreement; relevant laws, rules and regulations, administrative and fiscal guidelines; and where applicable, operating certificates for facilities or licenses for an activity or program. F. Pursuant to the provisions set forth in Section V., page 3 of this Agreement, the ownership of all property described. therein shall reside with the Contractor unless otherwise specified in writing by the Department at anytime during the tenn of this Agreement and up to thirty (30) days following the issuance of the final payment. AI-2 II. Funding A. Funding for this project has been appropriated in the Community Projects Fund as established by Section 99-d of the State Finance Law (Chapter 474 of the Laws of 1996). Pursuant to Paragraph 6(a) of Section 99-d, "The state shall not be liable for payments pursuant to any contract, grant or agreement made pursuant to an appropriation in any account of this fund if insufficient monies are available for transfer to such account ofthis fund, after required transfers pursuant to sUbdivision three of this section." B. Notwithstanding the Contract Period set forth on the Face Page, absent reappropriation in the subsequent State budget, funds for this project will cease to be available for payments on September 15,2007; in that event, to afford reasonable assurance that payment can be made by the Department, final payment requests must be received by the Department's payment office by not later than August 20, 2007. III. Terminations A. In addition to any other actions authorized by this Agreement, the Department may terminate the Agreement in the best interests of the State of New York by providing written notice to the Contractor as provided in this Agreement. B. The Contractor shall complete the project as set forth in this Agreement, and failure to render satisfactory progress or to complete the project to the satisfaction of the State may be deemed an abandonment of the project and may cause the suspension or termination of any obligation of the State. In the event the Contractor should be deemed to have abandoned the project fo any reason or cause other than a national emergency or an Act of God, all monies paid to the Contractor by the State and not expended in accordance with this Agreement shall be repaid to the State upon demand. If such monies are not repaid within one year after such demand, the State Comptroller of the State of New York may cause to be withheld from any State assistance to which the Contractor would otherwise be entitled an amount equal to the monies demanded. AI-3 C. In the event that the Department has provided written notice to the Contractor directing that the Contractor correct any failure to comply with this Agreement, the Department reserves the right to direct that the Contractor suspend all work during a period of time to be determined by the Department. If the Contractor does not correct such failures during the period provided for in the notice, this Agreement shall be deemed to be terminated after expiration of such time period. During any such suspension, the Contractor agrees not to incur any new obligations after receipt of the notice without approval by the Department. IV. Vendor (Contractor) Responsibility A. The Department is required to conduct a review of a prospective contractor to provide reasonable assurance that the contractor is responsible. To be considered responsible a contractor should have appropriate legal authority to do business in New York State, a satisfactory record of integrity, appropriate financial, organizational and operational capacity and controls and acceptable performance on previous governmental contracts, ifany. The State and any of it's agencies may use information gathered from whatever resources it deems appropriate to assist in making a. responsibility determination. B. If the prospective contractor is a non-governmental entity and this contract has a total value in excess of $15,000 in state-provided funds a Vendor Responsibility Questionnaire, with certification is included with the contract package. This Questionnaire is designed to provide information to assist the contracting agency in assessing a contractor's responsibility prior to entering into a contract and must be completed and returned with the contract. C. Contractor hereby acknowledges that, where required, the Vendor Responsibility Questionnaire and certification is made a part of this contract by reference hereto and that any misrepresentation of fact in the Questionnaire and attachments, or in any contractor responsibility information that may be requested by the Department, may result in termination ofthis contract. During the term of this Contract, any changes in the information provided in the Questionnaire shall be disclosed to the Department, in writing, in a timely manner. Failure to make such disclosure may result in a determination of non-responsibility and termination of the contract. AI-4 D. Should it be determined at any time that a contractor is not responsible, the Department will notify the contractor in writing setting forth the basis for the determination and affording the contractor reasonable time in which to refute the determination, justify why the basis fot the determination is not relevant to this contract or to take corrective action to eliminate the responsibility impediment. If the responsibility condition cannot be reconciled to the satisfaction of the Department and the State the contract, or contract offer will be terminated by written notification. v. Fully-Executed Agreement or Amendment Thereto A. If this Agreement, or amendments thereto, allocates funds totaling $15,000 or less, it shall be deemed to be fully executed when approved and signed by the Contractor and the Department. B. If this Agreement, or amendments thereto, allocates funds totaling more than $15,000, it shall be deemed to be fully executed when approved by the Office of the State Comptroller. Attachment I to Appendix A I Article 15-A ofthe New York State Executive Law The Department of State administers a Minority and Women-owned Business Enterprises (MWBE) Program as mandated by Article 15-A of the New York State Executive Law. This law supersedes any other provision in state law authorizing or requiring an equal employment opportunity program or a program for securing participation by minority and women-owned business enterprises. Under this law, all state agencies must, subject to certain exceptions, establish goals for minority and women-owned business participation in certain state contracts and grants. Where MWBE goals are required, even in circumstances where this goal is zero, a Quarterly Grantee Report is required to be submitted to the Affirmative Action Office ofthe Department on forms provided by the Department. Article I5-A requires that rules and regulations be established for contracts entered into by the Department. In accordance with Article I5-A, goals must be set for contracts entered into by the Department in excess of$25,000 for labor, services, supplies; equipment, and materials, or any combination of the foregoing, and for contracts entered into by the Department in excess of $100,000 f{)T acquisition, construction, demolition, replacement, major repair, renovation or improvement of real property. In applying these rules and regulations, the Department must consider the availability of certified minority and women-owned businesses in the region in which the state contract will be performed, the total dollar value of the Contract, the scope of work to be performed, and the project size and term. The contractor will, when required as a part of the bid or proposal, submit a Staffing Plan on the form provided by the Department. This Plan will detail the work force anticipated in the performance of the state contract broken down by ethnic background, gender, and Federal Occupational Categories. After a bid opening and prior to the award of a state contract, the contractor will su bmit an Equal Employment Opportunity (EEO) Policy Statement to the Department within the time frame established by the Department. The law requires that, as a precondition to entering into a valid and binding state contract, the contractor shall agree to the following stipulations and will include them in the EEO Policy Statement: . The contractor will not discriminate against any employee or applicant for employment because of race, creed, color, national origin, sex, age, disability or marital status. . . The contractor wiII undertake or continue existing programs of affirmative action to ensure that minority group members and women are afforded equal employment opportunities without discrimination because ofrace, creed, color, national origin, sex, age, disability or marital status. For these purposes, affirmative action applies in areas of recruitment, employment, job assignment, promotion, upgrading, demotion, transfer, layoff, or termination and rates of payor other forms of compensation. . The contractor will make active and conscientious efforts to employ and to utilize minority group members and women at all levels and in all segments of its work force on state contracts, and the contractor will document these efforts. . The contractor will state in all solicitations and advertisements for employees that, in the performance of the state contract, all qualified applicants will be afforded equal employment opportunities without discrimination because of race, creed, color, national origin, sex, age, disability or marital status. . The contractor will, at the request of the Department, request each employment agency, labor union, or authorized representative of workers at which it has a collective bargaining or other agreement or understanding, to furnish a written statement that such employment agency, labor union, or representative will not discriminate because of race, creed, color, national origin, sex, age, disability or marital status, and that such union or representative will affirmatively cooperate in the implementation of the contractor's obligations herein. . The contractor will include the provisions regarding the EEO Policy Statement and the Staffing Plan enumerated above in each and every subcontract of a state contract in such a manner that the subcontractor is bound by these requirements. . Failure to provide an EEO Policy Statement and a Staffing Plan without reasonable written justification or commitment to provide these requirements by a specified date will result in rejection of the contractor's bid or proposal. . After the award of a state contract, the contractor will submit to the Department a Work Force Employment Utilization Report, on the form supplied by the Department, detailing the work force actually utilized on the state contract, by ethnic background, gender and Federal Occupational Categories, as specified on the form. This Report will be submitted to the Department on a quarterly basis throughout the life of the contract. . The contractor, and any of its subcontractors, may be required to submit compliance reports relating to their operations and implementation oftheir affirmative action or equal employment opportunity program in effect as of the date the state contract is executed. Questions regarding this program should be directed to the New York State Department of State's Affirmative Action Office, 41 State Street, Albany, New York 12231,518-474-2752. To assist potential contractors, a copy of the NYS Directory of Certified Minority and Women-owned Business Enterprises is made available for inspection at the Department's Affirmative Action Office. The Department makes no representation with respect to the availability or capability of any business listed in the Directory. . . B-1 APPENDIX B Budget Budget Summary Sheet A. SALARIES, WAGES AND FRINGE $ B. TRAVEL $ C. SUPPLlES/MA TERIALS $ D. EQUIPMENT $ E. CONTRACTUAL SERVICES $ 17,500. F. OTHER $ TOTAL $17,500. The TOTAL of your BUDGET must equal the amount of your allocation as shown on the CONTRACT FACE PAGEl The BUDGET is intended to show the items ofexpense which will be funded under this Contract. Please do not show the entire cost of the project if it exceeds the amount of funding provided by this Contract. Questions regarding Budget preparation? Call 518-486-3905 . , . 8-2 Budget Detail Sheet A. SALARIES. WAGES AND FRINGE Amount Charged Title to this Proiect NA TOTAL SALARIES, WAGES AND FRINGE $ -0- B. TRAVEL Please indicate destination, purpose and cost of such travel. NA TOTAL TRAVEL $ -0- Budget Detail Sheet . . B-3 C. SUPPLIES/MATERlALS Please use general categories such as office supplies, printing supplies, small tools, building materials and like category descriptions. Indicate the cost of each category. NA TOTAL SUPPLIESIMA TERIALS $ -0- D. EQUIPMENT . Please list each item of equipment that exceeds $200.00 per item and has a useful life of one year or more. Group items ofless than $200.00 each into general categories indicating total cost per category. NA TOTAL EQUIPMENT $ -0- Budget Detail Sheet 8-4 E. CONTRACTUAL SERVICES ThIS category mcludes 11ems such as telephone, postage, lenl, util Itles, rental or repallS to equIpment, lease of equIpment, contracted services and contracted construC!lon costs Supply and install two (2) Speed Limit beacons, two (2) aluminum poles, two (2) flashing signals, two (2)speed limit signs, two (2) concrete bases, two (2) cabinets and two (2) time clocks. TOTAL CONTRACTUAL SERVICES $17,500 f, OTHER Please specify what these costs are NA TOTAL OTHER $ -0- . . . C-l APPENDIX C Payment and Reporting Schedule I. This is a cost reimbursement Agreement. The Contractor may claim and be reimbursed for eligible project costs incurred (costs of eligible project activities conducted, and goods and services received and accepted by the Contractor) within the Contract Period. The total of such reimbursement shall not exceed the Funding Amount for this Agreement and shall be claimed by the Contractor in accordance with the payment option selected below. PAYMENT OPTIONS: Circle the option to be applied to this agreement. Example: Option A Option A: Payment-In-Full For Completed Project I. In the event that the project has been completed and all eligible project costs incurred within the Contract Period and prior to the submission of this Agreement to the Department for execution, the Contractor may request a one-time payment-in-full with the submission of the Agreement. 2. Complete the contract documents in accordance with the instructions, making sure that the contract budget categories add up to the total Funding Amount regardless of the total costs to be claimed. If the total costs to be claimed are less than the Funding Amount, the claim on the Standard Voucher (A.4. below) will reflect actual expenditures. 3. Complete the Program Workplan (Appendix D) making sure it accurately describes the project activities completed and the dates of completion. If the project was on-going in nature, specify the time- frame (start and end dates) that costs were incurred. Ifthe project was for equipment, supplies or commodities purchases, specify the delivery date(s) of the item(s) purchased. 4. Complete the Standard Voucher received with the contract documents in accordance with the instructions, with the exception of Section 6. Put the following statement in Section 6: "Requesting payment-in-full for eligible project costs incurred pursuant to all terms and conditions of Contract #(insert contract number) submitted herewith." , . C-2 5. Submit the completed contract documents and voucher claiming payment-in- full in accordance with the instructions. Upon full execution of the Agreement, payment will be made pursuant to the schedule set forth in II. below, and a copy of the fully-executed Agreement will be sent to you for your records. ~ Periodic Progress Payments 1. Contractor may request periodic progress payments for eligible project costs incurred following full execution of the Agreement by both parties. 2. Complete the contract documents and submit them to the Department in accordance with the instructions. Do not submit a voucher or other payment documents at this time. 3. Upon full execution, a copy of the fully-executed Agreement and payment request documents and instructions for claiming progress payments will be sent to you. 4. Reimbursement for. eligible project costs incurred will be made upon receipt and approval of properly completed payment requests submitted in accordance with III. below. Option C: Advance and Progress Payment(s) I. Contractor may request an advance equal to twenty- five percent (25%) of the Funding Amount. 2. Complete the contract documents in accordance with the instructions. Complete the Standard Voucher in accordance with the instructions inserting the statement "25 percent advance" in Section 6. Submit the completed contract documents and advance voucher to the Department in accordance with the instructions. 3. Upon full execution of the Agreement, the advance will be issued in accordance with the schedule set forth in II. below and a copy of the fully- executed Agreement and payment request documents and instructions for claiming progress payments will be sent to you. , . C-3 4. Upon receipt of a progress payment request submitted in accordance with III. below, the Department will determine the total eligible costs, deduct 25 percent of that amount to document advance funds received, and pay the balance to the Contractor. 5. Upon termination of this contract, the full amount of undocumented advance funds shall become immediately due and owing to the Department. II. The payment-in-full provided for in LA. above or the advance provided for in I.C. above will be paid by no later than December 14,2006. In the event that the Department does not receive a properly completed contract package from the Contractor by October 13, 2006, the payment date will be recalculated to be no later than sixty (60) days following receipt of the properly completed contract package. III. Progress payment requests as provided for in I.B. and I.c. above shall be submitted to the Department's designated payment office at the following address: New York State Department of State Contract Administration Unit - LMI 41 State Street II Oth Floor Albany, New York 12231-0001 A. Payments shall be made to the Contractor upon the submission by the Contractor of properly executed progress payment requests. Each such request shall contain the following: (1) "Summary Sheet Documentation Forms" as provided by the Department, for documentation of actual and eligible expenditures; (2) a narrative progress report describing in detail all significant project accomplishments for which reimbursement is claimed, with dates of completion (NOTE: If this agreement is for the purchase of tangible goods, commodities or equipment only, a narrative is not required for payments; however, a listing of all items purchased and dates received must be detailed on the Summary Sheet Documentation Forms.); and (3) a properly completed Standard Voucher. B. Notwithstanding the above requirements, upon written notification by the Department, the Contractor may be required to submit source documentation and additional verification of allowable expenditures. , . C-4 C. Payment requests as described in 1II.A. above shall be certified by a duly authorized representative of the Contractor as accurately representing such accomplishments and expenses as recorded in the Contractor's accounting records, including, where goods or services are provided by third parties not party to this Agreement, a certification that any payment obligations arising from the provision of such goods or services have been paid by the Contractor and do not duplicate reimbursement or costs and services received from other sources. D. Claimed expenditures per cost category may exceed the amounts indicated in the Budget, Appendix B, by ten percent (10%) or $1,000, whichever is greater, without approval of the Department, provided that the Funding Amount is not exceeded. Any expenditure in excess of such 10% or $1,000 shall require an amendment to the Project Budget submitted in writing by the Contractor. NGexpenditures shall be allowed for items not set forth in the Project Budget without prior written approval of the Department. E. Any payment request for any period during which all Project activities shall have been completed shall be submitted as the Contractor's final payment request and shall be clearly labeled FINAL. I. If a final progress narrative report is required to be submitted, it must describe in reasonable detail, the nature and degree of the Project's completion and results. 2. If the Contractor has received prior payments exceeding total eligible expenditures, Contractor shall remit such excess to the Department with such FINAL request. IV. Notwithstanding the submission of timely and properly executed payment requests, the Department shall be under no obligation to make payment for expenditures incurred without the prior Department approvals and/or amendments required under this Agreement and, further, shall have the right to withhold any such payment pending the execution of such approval and/or amendment. A. Interest income earned on funds received pursuant to this Agreement shall be used to further the purpose of this Project or shall be deducted from total eligible costs to determine the net eligible costs to be reimbursed by the Department. '. . C-5 B. The Department shall have the right to conduct on-site progress assessments and reviews of the Project and Contractor's books and records during the life of this Agreement and for a reasonable time following issuance of the FINAL payment. . C. The Department shall be entitled to disallow any cost or expense, or terminate or suspend this Agreement, if found that the Contractor has misrepresented any expenditures or Project activities in this Agreement, or in any progress reports or payment requests made pursuant hereto. D. The Contractor shall maintain separate fiscal books and records for all funds received through the Department and Project activities conducted pursuant to this Agreement, and shall make all such books and records available to the Department, the Office of the State Comptroller, or their designated representatives for inspection and audit for a period of six (6) years following termination of this Agreement. '. . D-1 APPENDIX D Program Workplan Recipient Organization Name: Town of Southo1d Program Contact Person: James McMahon Daytime Phone: 631) 765-1283 Fax: (631) 765-9015 TyplI:.eq. I~tiat ve NARRATIVE (MUST BE COMPLETED FOR ALL PROJECT TYPES AND PAYMENT OPTIONS) NOTE: If payment Option A: Payment-In-Full for completed project was selected, make sure that this Narrative complies with Section:3 of Option A. Th,e Town of South old will contract with Leslie-Johnson Corp. to Install (2) School Speed Limit Flashing Sign Units, in the vicinity of the Greenport School, on Route 25, Greenport, NY. (ATTACH ADDITIONAL PAGES AS NEEDEDl '. . E-I APPENDIX E CHARITIES AND CHARITABLE TRUSTS Most not-for-profit organizations (including corporations and charitable trusts) are required to file annual financial reports with the Attorney General. This requirement is found in Article 7-A of the Executive Law and Article 8 of the Estates, Powers and Trusts Law (EPTL). Specifically, Section 8-1.4 of the EPTL states: (a) For the purposes of this section, "trustee" means (I) any individual, group of individuals, corporation or other legal entity holding and administering property for charitable purposes, whether pursuant to any will, other instrument or agreement, court appointment, or otherwise pursuant to law, over which the attorney general has enforcement or supervisory powers, (2) any non-profit corporation organized under the laws of this state for charitable purposes, and (3) any non-profit foreign corporation organized for charitable purposes, doing business or holding property in this state. Neither a foreign corporation nor a trustee acting under the will of, or any agreement executed by, a non-resident of this state shall become subject to the provisions of this section merely by reason of maintaining a bank, custody, investment or similar account in this state.' (s) A trustee shall not be qualified to make application for funds or grants or to receive such funds from any department or agency of the state without certitying compliance with paragraphs (d), (t), and (g) of this section and all applicable registration and reporting requirements of Article 7-A of the Executive Law. In addition, please note that the new Charities Registration number is a 6-digit number with a hyphen after the second and fourth digits. Pages E-2 andE-3 contain the inclusive listing of exemptions to the registration and reporting requirements of each article oflaw cited above. If the Contractor qualifies for exemption from either article oflaw, place the complete number, i.e., 2(b), of the exemption in the respective section of Box 4 on the Contract Face Page. Any questions regarding the statutory requirements or applicabi lity to your organization should be directed to: Office of the Attorney General Charities Registration Bureau 120 Broadway New York, New York 10271 212-416-8400/212-416-8401 .. I, . E-2 CHARITIES REGISTRATION EXEMPTIONS EXECUTIVE LAW, ARTICLE 7-A I. This article shall not apply to corporations organized under the religious corporations law, and other religious agencies and organizations, and charities, agencies, and organizations operated, supervised, or controlled by or in connection with a religious organization. 2. The following persons shall not be required to register with the attorney general: (a) An educational institution confIDing its solicitation of contributions to its student body, alunmi, faculty and trustees, and their families. (b) Fraternal, patriotic, social, alumni,law enforcement support organizations and historical societies chartered by the New York state board of regents when solicitation of contributions is confined to their membership. I!;l) Persons requesting any contributions for the relief of any individual, specified by name at the time of solicitation, if al) ofthecontributions collected, without any deductions whatsoever, are paid to or for the benefit ofthe named beneficiary. (d) Any charitable organization which does not intend to solicit and receive and does not actually receive contributions in excess of twenty-five thousand dollars during a fiscal year of such organization, provided none ofits fund raising functions are carried on by professional fund raisers or commercial co-venturers. However, if the gross contributions received by such charitable organization during any fiscal year of such organization shall be in excess of twenty-five thousand dollars, it shall within thirty days after the date it shall have received total contributions in excess oftwenty- fi ve thousand dollars register with the secretary as required by section one hundred seventy-two of this article. (e) Any charitable organization receiving an allocation from a federated fund, incorporated community appeal or a united way, provided such fund, appeal or united way is complying with the provisions ofthis article relating to registration and filing of annual reports with the secretary, and provided such organization does not actually receive, in addition to such allocation, contributions in excess of twenty-five thousand dollars during the fiscal year, and provided further that all the fund-raising functions of such organizations are carried on by persons who are unpaid for such services. However, ifthe gross contributions other than such allocation received by such charitable organization during any fiscal year of such organization shall be in excess of twenty-five thousand dollars, it shall within thirty days after the date it shall have received such contributions in excess of twenty-five thousand dollars register with the secretary as required by section one hundred seventy-two of this article. (I) A local post, camp, chapter or similarly designated element, or a county unit of such elements, of a bona fide veterans' organization which issues charters to such local elements throughout this state, a bona fide organization of volunteer firemen, an organization providing volunteer ambulance service (as defmed in section three thousand one of the public health law) or a bona fide auxiliary or affiliate of such organizations, provided all its fund-raising activities are carried on by members of such an organization or an affiliate thereof and such members receive no compensation, directly or indirectly, thereof. (g) An educational institution which files annual financial reports with the regents of the university of the state of New York as required by the education law or with an agency having similar jurisdiction in another state or library which files annual financial reports as required by the state education department. (h) A charitable organization which receives all or substantially all of its funds from a single governmental agency and reports annually to that agency provided such reports cOl)tain financial information substantially similar in content to that required by subdivision one of section one hundred seventy-two-b of this article; provided, however, that such organization may receive no more than twenty-fi ve thousand dollars from sources other than the government agency to which it reports. (1) Any police department, sheriffs department or other governmental law enforcement agency. (j) The state parent teachers association and any parent teachers association affiliated with an educational institution that is subject to the jurisdiction of the state education department. 3. In addition to the statutory exemptions, the following are also exempt: (a) Any Municipality. (b) FireDistricts, School Districts, and Water Districts. -----"..--,------- 'I ,. E-3 CHARITABLE TRUSTS REPORTING EXEMPTIONS ESTATES, POWERS AND TRUSTS LAWS EXECUTIVE LAW, ARTICLE 8, SECTION 8-1.4(b) The registration and reporting provisions of this section do not apply to: I. Contractor is not a Trustee as define in Section 8-1.4(a) set forth in Appendix E. 2. Government entity 3. Entity required by law to complete an annual report to either the United States Congress or the New York State Legislature; 4. Religious organizations; 5. Educational institution incorporated under the Education Law or by special act; 6. Hospital; 7. Fraternal, patnotlc, social, student, alumni, veterans, volunteer firefighters, volunteer ambulance workers' organization or historical society chartered by the New York State Board of Regents; 8. Trust or estate for which there is a corporate trustee acting as sole trustee or co-trustee under the will of a decedent who died domiciled outside New York or a trust instrument executed by a nonresident of New York State; 9. Trust or estate in which the charitable interest is delayed or contingent; 10. Officer, director or trustee of an organization exempt from registration who holds property for the religious, educational or charitable purposes of the organization; II. Cemetery corporation subject to the provisions of Article 15 of the Not-for-Profit Corporation Law; 12. The state parentteachers association CPT A") and any parent teachers association affiliated with an educational institutional that is subject to the jurisdiction of the State Education Department; and 13. Any corporation organized under Article 43 of the Insurance Law. .. . I ,. APPENDIX X Agency Code Contract Period Contract Number Funding for Period This is an AGREEMENT between THE STATE OF NEW YORK, acting by and through the New York State Department of State, having its principal office in Albany, New York (hereinafter referred to as the STATE), and (hereinafter referred to as the CONTRACTOR), for modification of Contract Number , as amended above. All other provisions of said AGREEMENT shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this AGREEMENT as of the dates appearing under their signatures. CONTRACTOR SIGNATURE By: STATE AGENCY SIGNATURE By: (pnnt name) (pnnt name) Title: Title: Date: Date: State Ae.encv CertificatIOn: "In addition to the acceptance of this Contract, I also certlfy that anginal copies of this signature page will be attached to all other exact copies of this Contract." STATE OF NEW YORK ) COUNTY OF ) ss: On this _ day of , in the year 20 , before me personally appeared , to me known, who, being by me duly sworn, did depose and say that (s)he resIdes at ; that (s)he is the of , the corporation described herein which executed the foregoing instrument; and that (s)he signed (her)his name thereto by order of the board of directors of said corporation. NOTARY PUBLIC STATE OF NEW YORK ) COUNTY OF ) ss: On this _ day of , in the year 20_, before me personally appeared , to me known and known to me to be the of , the unIncorporated association described in and which executed the above agreement; and who acknowledge to me that (s)he executed the foregoing agreement for and in behalf of said unincorporated association. NOTARY PUBLIC ALAN G. HEVESI, STATE COMPTROLLER Title: Date: APPENDIX X Agency Code Contract Period 19000 04/0 1/05 - 07/31/08 Contract Number Funding for Period M051096 $ 17,500.00 This is an AGREEMENT between THE ST ATE OF NEW YORK, acting by and through the New York State Department of State, having its principal office in Albany, New York (hereinafter referred to as the STATE), and Town of Southold (hereinafter referred to as the CONTRACTOR), for modification of Contract Number M051 096, as amended above. All other provisions of said AGREEMENT shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this AGREEMENT as of the dates appearing under their signatures. CONTRACTOR SIGN By: STATE AGE~NATURE . By: _ cc<d';j /J f.-.~'0I< to..+- (print name) Title: Supervisor Title: DIAECTOAOFFINANClALADMlNISTRATJON Date:cr;Up/EZ- .. Date: ~7:),~ol State Agency Certification: "In addItIOn to the acceptance of this Contract, I a so ce ify that original copies of this signature page will be attached to all other exact copies of this Contract." ~ Scot STATE OF NEW YORK ) COUNTY OF SUFFOLK ) 5S: On this I D . day of I'll Q~ .___.__.' in the year 20.!!2.., before me personally appeared Scot t A. Rus se 11 , to me known, who, bemg by me duly sworn, dtd depose and say that (s)he resides at eu tchogue ; that (s)he is the Superv i sor_.. of_ the Town 0 f Sou tho 1d the corporation described herein which executed the foregoing instrument; and that (s)he signed (her)his name thereto by order of the board of directors of said corporation. STATE OF NEW YORK COUNTY OF ) ) ss: ~ . / j')' {. ... /'^~"-. v __/_t.f-G'1k~ _.. , 1'fOTARY PUBLIC LINDA J COOPER NOTARY PUBLIC, State of New York NO. O. .1 C04822563, S...uffalk COUjY' Teml Eyr*ps December 31,20 (./ , in the year 20._, before me personally appeared , to me known and known to me to be the _.______ of .____... ' the unincorporated association described in and which executed the above agreement; and who acknowledge to me that (s)he executed the foregoing agreement for and in behalf of said unincorporated association. day of On this Thomas P. DiNapoli State Comptroller: NOTARY PUBLIC z:,.; 'to , :] p ;>,',j " ))I'~TH.UL \ \ ~ 2007 By: Date: ~ ..' J ~ /'Vx;,~~ 'j "m THE STATE C Im-" i t"q ~._.,:"';"--'-"-"'--""" ..... ''''if" '~g'<' ~, {" '"',,~j',J' ;.~'" .~. .~.""~;. :1 ';." ,''1';.'~.,j't(t.:'<.' .J STATE OF NEW YORK DEPARTMENT OF STATE 41 STATE STREET ALBANY, NY 12231-0001 ELIOT SPITZER GOVERNOR LORRAINE A. CORTES-VAzQUEZ SECRETARY OF STATE June 18,2007 Mr. Scott Russell, Supervisor Town of Southold PO Box 1179,53095 Main Road Southold, New York 11971 f5) ~ (C ~ ~ \VI IE fR) Ifll JUN 21m ~ SUPERVISOR'S OFFICE lOWN OF SOUTHOLD Dear Mr. Russell: RE: Community Projects Appropriation Contract # M051096 Enclosed is a copy of the approved Appendix X submitted by your organization for the above-referenced Agreement. The termination date of your contract has been extended to July 31, 2008. If you have any questions, please contact us at 518-486-3905. Sincerely, AI Q /r L George A. Lupe Supervisor of Contract Administration GL:kc Enclosure WWW.OQS.STATE.NY.US . E-MAIL: INFO@OOS.STATE.NY.US