HomeMy WebLinkAboutFishers Island Emergency Generator
Suffolk County Form 22
Contractor'sNendor'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 completing paragraphs numbered 1 through 11 below, so indicate
at paragraph number 12 below setting forth the reason for such exemption. Notwithstanding such
exempt status, you must execute this form below before a notary public.
1. Contractor'sNendor's Name
Address
City and State Zip Code
2. Contracting Department's Name
Address
3. Payee Identification or Social Security No.
4. Type of Business_Corporation _Partnership_Sole Proprietorship_Other
5. a Is contractor/vendor entering into or has contractor/vendor entered into a contract with Suffolk
County in excess of $1 ,ODD? _Yes_No.
5.b Has contractor/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
$1,000? _Yes_No.
6. Table of Organization. List names and addresses of all principals; that is, all individuals serving
on the Board of Directors or comparable body, names and addresses of all partners, and
names and addresses of all 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.)
7. 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 necessary).
8. Does contractor/vendor derive 50% or more of its total revenues from its contractual or vendor
relationship with Suffolk County? _Yes_No.
9. If you answered yes to 8 above, you must submit with this disclosure statement, a complete
financial statement listing all assets and liabilities as well as a profit and loss statement. These
statements must be certified by a Certified Public Accountant. (Strike this out if not applicable.)
10. The undersigned shall include this Contractor'sNendor's Public Disclosure Statement with the
contract. (Describe general nature of the
contract. )
11. Remedies. The failure to file a verified public disclosure 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. In
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
X 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 signed by an officer or principal of the contractorlvendor
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
to,""OI"9 ,tatemeot, 00' th't"7 ,m, to hl""e, owo koowledge, true.
Dated: Signed: ~~
Printed Name of Signer: 5 ~ # .4. I?u. <':~ e ((
Title of Signer: '5 ~ (/ (Sty"(
Name of ContractorNendor: --rcJ {IV 11 0...p- 5'0 ufl<n ( d
UNIFORM CERTIFICATE OF ACKNOWLEDGMENT
(Within New York State)
STATE OF NEW YORK)
COUNTY OF Su.~ sS.:
KIERAN M. CORCORAN
QUALIFIED IN SUFFOLK COUNTY
NOTARY #02C06119838
MY COMMISSION EXPIRES DEC. 6. 2~
t\ Olaf?
On the~ day of 1~:; ~~1/t in the year ~before me, the undersigned, personally
appearedJ0~A ( personally known to me or proved to me on the basis of
satisfactory evidence to be theindividual~) whose nameN is {aI:&) subscribed to the within
instrument and acknowledged to me that hotGAE:tl ,e, executed the same in hio/RQr(tR9ir capacity~
and that by his,'Ref/ti'leir signature(s) on the instrument, the individual(\), or the person upon behalf of
wh h the' ividual( acted, executed the instrument.
(signa ure and office of individual taking acknowledgement)
UNIFORM CERTIFICATE OF ACKNOWLEDGEMENT
(Without New York State)
COUNTY OF
)
)ss.:
)
STATE OF
On the day of in the year 2004 before me, the undersigned,
personally appeared 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/her/their 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, and that such individual(s) made such
appearance before the undersigned
in
-
(Insert the city or other political subdivision and the state or country or other place the
acknowledgement was taken)
(signature and office of individual taking
acknowledgement)
Suffolk County, New York
Department of Labor
SUFFOLK COUNTY DEPARTMENT OF LABOR - LABOR MEDIATION UNIT
UNION ORGANIZING CERTIFICATIONIDECLARA TION - SUBJECT TO AUDIT
If the following definition of "County Contractor" (Union Organizing Law Chapter 466-2) applies to the
contractor'slheneficiary's business or transaction with Suffolk County, the contractor/beneficiary must complete Sections I,
III, and IV below. If the following definitions do not apply, the contractor/beneficiary must complete Sections II, III and IV
below. Completed forms must be submitted to the awarding agency.
County Contractor: "Any employer that receives more than $50,000 in County funds for supplying goods or services pursuant to a
written contract with the County of Suffolk or any of its agencies; pursuant to a Suffolk County grant; pursuant to a Suffolk County
program; pursuant to a Suffolk County reimbursement for services provided in any calendar year; or pursuant to a subcontract with
any of the above."
Section I
The Union Organizing Law applies to this contract. IIwe hereby agree to comply with all the provisions of Suffolk
County Local Law No. 26-2003, the Suffolk County Union Organizing Law (the law) and, as such shall not use
County funds to assist, promote, or deter union organizing (Chapter 466-3 A), nor seek reimbursement from the
County for costs incurred to assist, promote, or deter union organizing. (Chapter 466-3 B)
IIwe further agree to take all action necessary to ensure that County funds are not used to assist, promote, or deter
u ion organizing. (Chapter 466-3 H)
I/we further agree that if any expenditures or costs incurred to assist, promote, or deter union organizing are made,
I1we shall maintain records sufficient to show that no County funds were used for those expenditures and, as
applicable, that no reimbursement from County funds has been sought for such costs. I/we agree that such records
shall be made available to the pertinent County agency or authority, the County Comptroller, or the County
Department of Law upon request. (Chapter 466-3 I)
I/we further affmn to the following:
. I1we will not express to employees any false or misleading information that is intended to influence the
determination of employee preferences regarding union representation;
. IIwe will not coerce or intimidate employees, explicitly or implicitly, in selecting or not selecting a bargaining
representative;
. I1we will not require an employee, individually or in a group, to attend a meeting or an event that is intended to
influence his or her decision in selecting or not selecting a bargaining representative;
. I1we understand my/our obligation to limit disruptions caused by prerecognition labor disputes through the
adoption of nonconfrontational procedures for the resolution of prerecognition labor disputes with employees
engaged in the production of goods or the rendering of services for the County; and
. I1we have or will adopt any or all of the above-referenced procedures, or their functional equivalent, to ensure
the efficient, timely, and quality provision of goods and services to the County. lIwe shall include a list of said
procedures in such certification.
I1we further agree that every County contract for the provision of services, when such services will be performed on
County property, shall include a requirement that l/we adopt a reasonable access agreement, a neutrality agreement,
fair communication agreement, no intimidation agreement, and a majority authorization card agreement.
I/we further agree that every County contract for the provision of human services, when such services are not to be
performed on County property, shall include a requirement that I/we adopt, at the least, a neutrality agreement.
I1we understand that the efficient, timely, and nondisruptive provision of goods and services is a paramount fmancial
interest of the County of Suffolk and as such, the County expects the potential County contractor to protect the
County's financial interest by adopting nonconfrontational procedures for the orderly resolution oflabor disputes,
including, but not limited to, neutrality agreements, majority authorization card agreements, binding arbitration
agreements, fair communication agreements, nonintimidation agreements, and reasonable access agreements.
DOL-Wl (6/05)
Suffolk County, New York
Department of Labor
Section II
The Union Organizing Law does not apply to this contract for the following reason(s):
D
Check if
Applicable
Contractor Phone #:
--(O/-JIL o+- 50 v.v+h () {d
f n. t50y( u'1'1
_~ tA-rf,,olc{ ;GV [('71(- (Y't)t
4>31- 1 (PS-- ( F'tf'f
Federal Employer ID#:
1l-000f 'lJ?
Section III
Contractor Name:
Contractor Address:
Amount of Assistance:
Vendor #:
Description of project or service:
Section IV
I declare under penalty 0
certification, and that th
perjury under the Laws of the State of New York that the undersigned is authorized to provide this
Dve is true and correct.
Authorized Signature
{_ [0-01
Date
,
Print Name and Title of Authorized Representa ive
vUo-1
DOL-LOI (6/05)
SUFFOLK COUNTY DEPARTMENT OF LABOR - LIVING WAGE UNIT
LIVING WAGE CERTIFICATIONfDECLARATION - SUBJECT TO AUDIT
If either of the following definitions of 'compensation' (Living Wage Law Chapter 347 - 2) applies to the contractor's/recipient's
bnsiness or transaction with Snffolk County, the contractor/recipient must complete Sections 1,3,4 below; and Form LW-I
(Nntice of Application for County Compensation). If the following definitions do not apply, the contractor/recipient must
complete Sectious 2, 3 and 4 below. Completed forms must be submitted to the awarding agency.
"Any grant, loan, tax incentive or abatement, bond fmancing subsidy or other form of compensation of more that $50,000 which is
realized hy or provided to an employer of at least ten (10) employees by or through the authority or approval of the County of Suffolk," or
"Any service contract or subcontract let to a contractor with ten (10) or more employees by the County of Suffolk for the furnishing of
services to or for the County of Suffolk (except contracts where services are incidental to the delivery of products, equipment or
commodities) which involve an expenditure equal to or greater than $10,000. For the purposes of this definition, the amount of
expenditure for more than one contract for the same service shall be aggregated. A contract for the purchase or lease of goods, products,
equipment, supplies or other property is not 'compensation' for the purposes of this definition."
The Living Wage Law applies to this contract. l/we hereby agree to comply with all the provisions of Suffolk County
ocal Law No. 12-2001, the Suffolk County Living Wage Law (the Law) and, as such, will provide to all full, part-time
or temporary employed persons who perfonn work or render services on or for a project) matter, contract or subcontract
where this company has received compensation, from the County of Suffolk as defined in the Law (compensation) a
wage rate of no less than $9.29 ($8.50 for child care providers) per hour worked with health benefits, as described in the
Law, or otherwise $10.58 ($9.75 for child care providers) per hour or the rates as may be adjusted annually in
accordance with the Law. (Chapter 347-3 B)
Section I
Check if
applicable
I/we further agree that any tenant or leaseholder of this company that employs at least ten (10) persons and occupies
property or uses equipment or property that is improved or developed as a result of compensation or any contractor or
subcontractor of this company that employs at least ten (10) persons in producing or providing goods or services to this
company that are used in the project or matter for which this company has received compensation shall comply with
all the provisions of the Law, including those specified above. (Chapter 347-2)
Section II
l/we further agree to permit access to work sites and relevant payroll records by authorized County representatives for
the purpose of monitoring compliance with regulations under this Chapter ofthe Suffolk County Code, investigating
employee complaints of noncompliance and evaluating the operation and effects ofthis Chapter, including the
production for inspection & copying of payroll records for any or all employees for the term of the contract or for five
(5) years, whichever period of compliance is longer. All payroll and benefit records required by the County will be
maintained for inspection for a similar period oftime. (Chapter 347-7 D)
The County Department of Labor shall review the records of any Covered Employer at least once every three years to
verify compliance with the provisions of the Law. (Chapter 347-4 C)
The Living Wage Law does not apply to this contract for the following reason(s):
D
Check if
applicable
Section III
Contractor Name:
Contractor Phone #:
~/,"",rr ",-f'-- )0 /A~tOtI Federal Employer ID#: L(- (p 00 (<[y!
fJ. (). /J 0 )( t (/l 7' Amount of compensation:
,SO tA-fA,o(~ ,AN U?1f-CftFfendor#:
(p)/- q(P - (Tn
Contractor Address:
Description of project or service:
Section IV
I declare under penal of perjury under the Laws of the State of New York that the undersigned is authorized to provide this certification,
and that the above . e and c ITect.
I-I 0 - 0 1
Date
v(J
LW 38 (revised 4-05, replaces forms LW2, LW3, and LW33)
Law No. !)f'~/1' -tJ(})
Disaster Preparedness/Shelters - Use of County-Owned Generator for Residents of Fishers Island
Interagency Agreement
Suffolk County Department of Fire, Rescue and Emergency Services
and
Town of Southold
This Agreement (Agreement) is between the County of Suffolk (County), a municipal corporation of the
~ State of New York, acting through its duly constituted Department of Fire, Rescue and Emergency
~11(].. Services ( "Department" and/or. "FRES"), located at Yaphank Avenue, Yaphank, New York 11980, andthe
I ttll""Town of Southold"alll.t1n1fJp::l1 axpo:4hdt1 , having Its Tow n-tfa II office at 5:!:bqs jycu-le 2S
QD. frX II '::j(j>n.l:lt2{;)14, New '/6ve 11 "l-Cf
The parties hereto desire that the Contractor's services be made available to the County to help assure for
disaster preparedness.
The parties hereto agree that the Town of South old shall be assigned, maintain, and agree to keep in good
working condition a 25 kV/20 kW generator, owned by the County of Suffolk, in the event of a declared
disaster or emergency, in order to provide temporary power to the residents of Fishers Island.
Term of Agreement: January 1, 2007 through May 31, 2011.
Total Cost of Agreement: Shall be a no-cost agreement to FRES.
Terms and Conditions: Shall be as set forth in Exhibit A entitled "Specific Terms and Conditions" and
Exhibit B entitled "General Terms and Conditions" attached and incorporated
herein.
In Witness Whereof, the parties hereto have executed this Agreement as of the latest date written below.
Town of S:zutho
By: ~ ~ J~p./
Name: ott Russell
Title: Town Supervisor
Date: (~~ lot,
County of Suffolk
By:
Paul Sabatino II
Chief Deputy County Executive
Date:
Revie
tricia A. Finne
w%t%;ey
{;J ~
,
Approved: Department of Fire Rescue &
Emergency Services
By: ~~
Ct~~~'
Date: / ?--/; I P it
,
By:
Date:
Recommended:
By: ;!~~ ~
I!lelinda Pagdanganan
Director of Emergency Management
/~/'1/f!J/
Date:
Samantha Me ac
Assistant COU% Attorney
Date: 1,:;;;.lj~ 60
Page 1 of 4
Law No.
Disaster Preparedness/Shelters - Use of County-Owned Generator for the Residents of Fishers Island
Exhibit A
Specific Terms and Conditions
1. Performance Subject to Condition
a. Pursuant to Article 2-8 of the New York State Executive Law entitled Disaster
Preparedness, the County, as the first line of defense in times of disaster has developed
disaster preparedness programs and plans.
b. "Disaster" means the occurrence or imminent threat of wide spread or severe damage,
injury, or loss of life or property resulting from any natural or man-made causes, including,
but not limited to, fire, flood, earthquake, hurricane, tornado, high water, landslide, mudslide,
wind, storm, wave action, volcanic activity, epidemic, air contamination, blight, drought,
infestation, explosion, radiological accident, water contamination, bridge failure or bridge
collapse;
c. The County's disaster preparedness plans, organizational arrangements, and response
capability must at all times be the most effective that current circumstances and existing
resources allow. The purpose of such plans shall be to minimize the effect of disasters by (i)
identifying appropriate local measures to prevent and mitigate disasters, (ii) developing
mechanisms to coordinate the use of local resources and manpower for service prior to,
during and after disasters and the delivery of services to aid citizens and reduce human
suffering resulting from a disaster, and (iii) providing for recovery and redevelopment after
disasters. In order to execute such plans during, or at imminent threat of disaster, the
County must ensure that all resources necessary and required for such implementation are
readily available to it.
d. Performance of this Agreement is contingent on the occurrence of a disaster, as this term is
defined herein and by New York State Executive Law Article 2-8. Such condition shall be
deemed in effect immediately upon the declaration of a state of emergency by the Suffolk
County Executive, or in the event of a vacancy in this office, by the Chief Deputy County
Executive or the Deputy County Executive designated to perform the administrative duties of
the County Executive during his temporary absence or disability.
2. Requirements Agreement
The parties agree that this is a Requirements Agreement and:
The FRES Commissioner is responsible for the coordination of emergency preparedness plans and the
County's response to natural or manmade disasters or emergencies; and
FRES requires and needs to guarantee the services of the Town of South old as contractor to provide,
maintain, and repair as necessary, a 25 kVAl20 kW, # 2 diesel fuel powered, sound attenuated trailer-
mounted generator, in the event of a declared disaster or emergency, to provide temporary power
services to the residents of Fishers Island located in the Town of Southold; and
This agreement is to assure that the County, as the first line of defense in the minimization of the
adverse effects to the people and property of Suffolk County in the event of a declared state of
Page 2 of 4
Law No.
Disaster Preparedness/Shelters - Use of County-Owned Generator for the Residents of Fishers Island
emergency and in the recovery and redevelopment efforts following disasters, receives all the services
described herein, to be made available by the Contractor to the County prior to the Contractor's
provision of such services to other entities, so that the County may accomplish the foregoing.
3. Term and Termination:
a. The term of this Agreement shall be as set forth on page one of this Agreement, unless
sooner terminated as provided below.
b. Performance of the Services as set forth in this agreement shall commence as of the
date of a declared state of emergency set forth in Paragraph one above and a
determination by the County that the services of the Contractor are necessary to execute
the County's emergency preparedness plans. The parties acknowledge that there may
be one or more declared states of emergency during the term of this agreement.
c. This Agreement may be terminated in whole or in part in writing by the County in the
event of failure by Contractor to fulfill any of the terms and conditions under this
agreement. The County shall also have the right to terminate this Agreement at any time
and for any reason deemed to be in its best interest.
4. Town of South old Responsibilities:
a. The Town of Southold will test said generator and conduct the maintenance on a regular
basis in order to ensure generator is in good working condition and to provide continued
temporary emergency power to a designated shelter in Fishers Island in the event of the
occurrence of a declared disaster or emergency, and for drills and exercises as mutually
agreed upon; and any other facilities as mutually agreed upon by the parties.
b. The Town of Southold shall make provisions to store and secure said generator at the
Fishers Island Fire Department located at Crescent Avenue, Fishers Island 06390.
c. The Town of Southold will pay for the usage of fuel required to power said generator.
d. The Town of Southold will transport said generator from the mainland to Fishers Island
and back, to include initial delivery and warranty and repair work as needed, at no cost
to Suffolk County.
e. The Town of Southold shall pay for expenses incurred during the repair of the generator
unit after expiration of the unit's warranty.
f. The Town of Southold will keep and maintain all maintenance records and all records of
any repair work performed with the said unit generator.
g. The Town of Southold will secure and maintain all related accessories, such as
extension cords, that are assigned with the said generator unit.
5. FRES Responsibilities:
a. FRES will coordinate the delivery of said generator and all related accessories with the
Town of Southold.
b. FRES will ensure said generator unit is fleeted and properly marked by the Suffolk
County Department of Public Works prior to delivery to Fishers Island, Town of Southold.
Page 3 of 4
Law No.
Disaster Preparedness/Shelters - Use of County-Owned Generator for the Residents of Fishers Island
6. Notices
a. Notice of Declared State of Emergency
While best efforts will be made by the County to provide written notice to the Contractor
of a declaration of a state of emergency, the parties understand that the unpredictable
nature of disasters may prevent such formal notification. In the event that such
notification is not possible, notification by telephone or messenger or other reasonable
means to the individual(s) listed below will serve as adequate notice.
Mr. Scott Russell
Town Supervisor
Town of South old
Town Hall Annex, 54375 Route 25
P.O. Box 1179
Southold, New York 11971-0959
b. All Other Notices
All other notices shall be in writing and shall be given to the County as set forth in Exhibit B,
entitled General Terms and Conditions. Notification to the Contractor shall be made to:
Mr. Ed Forrester
Director of Code Enforcement
Town of Southold
Town Hall Annex, 54375 Route 25
P.O. Box 1179
Southold, New York 11971-0959
With an additional copy to:
Mr. Scott Russell
Town Supervisor
Town of Southold
Town Hall Annex, 54375 Route 25
P.O. Box 1179
Southold, New York 11971-0959
c. Each party shall give prompt written notice to the other party of the appointment of
successor(s) to the designated contact person(s) or his or her designated successor(s).
End of text for Exhibit A
Page 4 of 4
.
Rev. 11/16/06
County of Suffolk
Department of Fire, Rescue and Emergency Services
Exhibit B
Geueral Terms and Conditions
Ceneral Payment Terms: The CSHtraetor sHall prepare afl.a rreseRt
a e1aifR fSFffi sH13plieEl 8)' tile (BURt)' aAB iipprs\'ed [<aT ]3&j'ffieat by
the Ceunty ("Sllffell~ Cel:lRtcy Paj'tneAt \'sus8er"). The sRar-ges
payable to CeRa-aeter under this Agreement are e7~ell::l.si':e effcaeral,
state aRB lee8] t,mes, the Caunf)' Being a lmIRieipality 8J(8ffiJ'lt from
payment ef sueR ta)(8S. The aeeel3tanee by the CSRtraeteT sf Rill
j3ll)'ffi8nt of all billiRgs meEts en tAe RRal Bflprs\'ed Su:ff-ell( emIRt)'
Pa-)msnt V sHeller HAder this J.greemeRt shall 8J3erate as aREI sHall be
a release to tJ:Ie rsuflt)' frem all elaiFRS Bnd Iiaeilitj' t8 the CSRtfaeter,
its Sl:IGGeSS0fS, legal repres8ntati\'8s BRB assigRs, fef ser..iees ren8erea
HAder this .^.greemeAt.
Payment of Claims: TAe CeUA!:; agrees ts pay tAe Ceatfaetor fer
Ser':isesl3rs':ided aRe sests iasUffed I3l::lrSHaRt ts this Agreemeat,
H138a reeeipt sf slaims ia SHOO fSFIH aAeI. at SHGR times as direetee by
tAe CSUFJty ami aRer aliait aRe BJ'lflrs':al hy the CeuAt)'. Claims shall
he deelimeRtee sy suffieieRt, 6sIRfletent aRe e\'iseAtial matter.
Pa)'m.eAt under tflis f.greeffieJl.t saall A8t BUfJlieate j3El)'fHeAt Hem any
ether sSllFee(s) fer CeRtFaetsr S8StS and seF'.'iees Rindes j3lirsHaAt t8
this Agreement. Payment BY the Ceunty shall lie made after appreval
BY the C.ffifJlroller .fthe COURty .fSuffolk No elaims ,hall be
payable MAtil the ContFaeter 6efHJ3lies with all reEj,uirements iA this
.A.weemeRt that sheuld ha>:e beeR eemplieel "lith en ar befere
sHBmission sf SHSA elaims BflS else 5Hbmits el'alliati';e and sush et-her
Elata iA the manner aHa fSffil as shall he re~1:lired ami aee6j:3tea by the
Department, CeuAt)', State sr Federal Gs'.'eFRffieRt. 1.ate sal3missiOt-l
Elf 61aims, "'hieh preehuJes the D6j:3artm.snt fram elaiming State Sf
feaeFaJ. reimbursement ','.'ill Ret ae hOR8Ted.
.A.greemeat Subje€t to l.ppnpriation of Fundsl This /.greement is
sliBjeet te the atHeliRt sffHl1ds ~J3raJ3riated anEt any ss13sefJsent
mesi:HeatieR5 thereef13y the Suff81k CBlinf.:)' Legislature, ana nB
liability sRall13e ineurreEt ay the Caunty unEter this Agreement
13eYBns tne amelint sf funes aj3J3Tsflriated trj' tlie LegisJatHTe far the
SeF:iees severed aj' this .'\greement.
Payments Contingent ullon StatefFedeFBI Fundiag: Payments
HRder this .A47eem.ent are Sl:iajeet te aHd e8atil1gent Hflen esntinueEl
mnaiAg bj' the State end/ar PeaeTal Cs':emment(s). If, fElr aHY
reasen, the f'-OII amelint Elf suOO fl:ffiding is net maEta a>;ailal3le t8 the
CElHnty, this .'\greement may be tel'l'fMnatee in wAale ar iR part, ar the
aHlBl:IRt payal3le te tHe CElRtraeter may be raElused, at the dissreti8R sf
the DSflaft:ffieat, I3ro', ideEt that an)' sueR terminatisn sr reduetiEln shall
Bet 8flply t8 alls',vaals sests ia6liffed by the CSRtfaetsr prier ta SHS1:l
terminatioR Elr redlistisR ta the eJ(teFlt that funEls are ava.:ilal3le t8 the
De]3artment far ]3a)'ffient 8f sHeh 68StS.
Audit Requirements: All payments, if any, made under this
Agreement are subject to audit by the Suffolk County Comptroller
pursuant to Article V ofthe Suffolk County Charter. If the
Contractor fails to cooperate with an audit by the Comptroller, the
County shall have the right to suspend or partially withhold payments
or require the repayment of amounts paid under this Agreement or
under any other agreement between the parties until such cooperation
is forthcoming. If such an audit discloses overpayments by the
County to the Contractor, within thirty (30) days after the issuance of
an official audit report by the Comptroller or his duly designated
representatives, the Contractor shall repay the amount of such
overpayment by check to the order of the Suffolk County Treasurer
or shall submit a proposed plan ofrepayment to the Comptroller. If
there is no response or if satisfactory repayments are not made, the
County may recoup 'overpayments from any amounts due or
becoming due to the Contractor from the County under this
Agreement or otherwise. The provisions of this paragraph shall
survive the expiration or tennination of the Agreement.
Contractor'sNendor's Public Disclosure Statement: The
Contractor represents and warrants that it has filed with the
Comptroller of Suffolk County the verified public disclosure
statement required by Suffolk County Administrative Code Article V,
Section A5-7 and shall file an update of such statement with the said
Comptroller on or before the 31st day of January in each year of this
Agreement's duration. The Contractor acknowledges that such filing
is a material, contractual and statutory duty and that the failure to file
such statement shall constitute a material breach of this Agreement,
fOf which the County shall be entitled, upon a determination that
such breach has occurred, to damages, in addition to all other legal
remedies, offifieen percent (15%) of the amount of the Agreement.
Required Form: Suffolk County Form SCEX 22; entitled
"Contractor'sIVendor's Public Disclosure Statement"
Living Wage Law: 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 financial assistance, (as defined) shall
provide payment of a minimum wage to employees as set forth in the
Living Wage Law. Such rate shall be adjusted annually pursuant to
the terms ofthe 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
tenninate this Agreement and to seek other remedies as set forth
therein, for violations of this Law. The Contractor represents and
warrants that it has read and shall comply with the requirements of
Suffolk County Code Chapter 347, Suffolk COURty Local Law No.
12-2001, the Living Wage Law. Required Form: Suffolk COURty
Living Wage Form LW-38; entitled "Suffolk County Department of
Labor - Living Wage Unit Living Wage Certification/Dec1aration ~
Subject To Audit"
Use of County Resources to Interfere with Collective Bargaining
Activities Local Law No. 26-2003: The Contractor represents
and warrants that it has read and is familiar with the requirements of
Chapter 466, Article I ofthe Suffolk County Local Laws. "Use of
County Resources to Interfere with Collective Bargaining Activities."
County Contractors (as defined) shall comply with all requirements
of Local Law No. 26-2003 including the following prohibitions: a.
The Contractor shall not use County funds to assist, promote, or deter
union organizing. b. No County funds shall be used to reimburse
the Contractor for any costs incurred to assist, promote, or deter
union organizing, c, The County of Suffolk shall not use County
funds to assist, promote, or deter union organizing. d. No employer
shall use County property to hold a meeting with employees or
supervisors if the purpose of such meeting is to assist, promote, or
deter union organizing. If Contractor services are perfonned on
County property the Contractor must adopt a reasonable access
agreement, a neutrality agreement, fair conununication agreement,
nonintimidation agreement, and a majority authorization card
agreement. If Contractor services are for the provision of human
services and such services are not to be perfonned on County
property, the Contractor must adopt, at the least, a neutrality
agreement. Under the provisions of Local Law No. 26-2003, the
County shaJl have the authority, under appropriate circumstances, to
Page 1 of 3
.
Rev. 11/16/06
County of Suffolk
Department of Fire, Rescue and Emergency Services
Exhibit B
General Terms and Conditions
terminate this Agreement and to seek other remedies as set forth
therein. for violations of this Law. Required Form: Suffolk County
Labor Law Form DOL-LOI; entitled "Suffolk County Department of
Labor - Labor Mediation Unit Union Organizing
CertificationIDeclaration - Subject to Audit"
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 Yark 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 detenninations with respect to the performance
of an agreement, and that the signer of this Agreement has read and is
familiar with the provisions ofLacal Law No. 32-1980 of Suffolk
County (Chapter 386 of the Suffolk County Code).
Prohibition Against Contracting with Corporations that
Reincorporate Overseas: The Contractor represents that it is in
compliance with Suffolk County Administrative Code Article IV,
~~A4-13 and A4-14, found in Suffolk County Local Law No. 20-
2004, entitled "A Local Law To Amend Local Law No. 5-1993, To
Prohibit The County of Suffolk From Contracting With Corporations
That Reincorporate Overseas." Such law provides that no contract for
consulting services or goods and services shall be awarded by the
County to a business previously incorporated within the U.S.A. that
has reincorporated outside the U.S.A.
Child Sexual Abuse Reporting Policy: The Contractor agrees to
comply with Chapter 577, Article IV, of the Suffolk County Code,
entitled "Child Sexual Abuse Reporting Policy", 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.
Non Responsible Bidder: The Contractor represents and warrants
that it has read and is familiar with the provisions of Suffolk County
Code Chapter 143, Article 11, ~~ 143-5 through 143-9. Upon signing
this Agreement the Contractor certifies that he. she, it, or they have
not been convicted ofa criminal offense within the last ten (10)
years. The tenn "conviction" shall mean a finding of guilty after a
trial or a plea of guilty to an offense covered under the provision of
Section 143-5 of the Suffolk County Code under "Nonresponsible
Bidder."
Use of Fands in PreseeutioR of Ciyill.etioBs Prohibited: Pl;lrs1:laat
to tAe Suffillk COURt)' Co.e SestioR 1599 3, tAe CORtmeter
represents tliat it sHan AElt Hse any ef tfle meneys reeeiyea Hneler this
,^.greemeHt, eitlier direstl)' ar iaElireetly. in 68Rneetisn 'yitli the
J3rsseeutioR sf an)' ei':il aetisR against the C8HRtj' sf SHffellc Elr any
of its )3rograms, fURelea by tHe CeWlty, in 138ft ar ia ',YRole, ia any
jurisdiGtisn or an:,' juaieial Elr aelmiRistrati'.'8 ferum.
Certification as to Relationships: Pursuant to the Suffolk County
Code Chapter 143, Article 11, and Suffolk County Code ~143-6(B)
specifically, the parties to this Agreement hereby certify that, other
than the funds provided in this Agreement and other valid
Agreements with the County, there is no known relationship within
the third degree of consanguinity, life parmer, or business,
commercial, economic, or financial relationship between the parties,
the signatories to this Agreement, and any partners, members,
directors, or shareholders of five percent (5%) (or more) of any party
to this Agreement.
Suffolk County Local Laws Suffolk County Local Laws, Rules
and Regulations can be found on the Suffolk County web site at
www.co.suffolk<htto://www.co.suffolk.nv.us>. Click on "Laws of
Suffolk County" under "Suffolk County Links".
Indemnification: The Contractor agrees that it shall protect,
indemnify and hold hannless the County and its officers, officials,
employees, contractors, agents and other persons from and against al]
liabilities, fines, penalties, actions, damages, claims, demands,
judgments, losses, costs, expenses, suits or actions and reasonable
attorneys' fees, arising out of the acts or omissions or the negligence
of the Contractor in connection with the services described or
referred to in this Agreement. The Contractor shall defend the County
and its officers, officials, employees, contractors, agents and other
persons in any suit, including appeals, or at the County's option, pay
reasonable attorney's fees for defense of any such suit arising out of
the acts or omissions or negligence ofthe Contractor, its officers,
officials, employees, subcontractors or agents, if any, in connection
with the services described or referred to in this Agreement.
lnsurance: a. The Contractor agrees to procure, pay the entire
premium for and maintain throughout the term of this Agreement,
insurance in amounts and types specified by the County and as may
be mandated and increased from time to time. The Contractor agrees
to require that all if its subcontractors, in connection with work
performed for the Contractor related to this Agreement, procure, pay
the entire premium for and maintain throughout the term of this
Agreement, insurance in amounts and types equal to that specified by
the County for the Contractor. Unless othelWise specified by the
County and agreed to by the Contractor, in writing, such insurance
shall be as follows: i. Commercial General Liability insurance,
including contractual liability coverage, in an amount not less than
Two Million Dollars ($2,000,000.00) per OCCurrence for bodily
injury and Two Million Dollars ($2,000,000.00) per occurrence for
property damage. ii. Automobile Liability insurance (if any vehicles
are used by the Contractor in the performance of this Agreement) in
an amount not less than Five Hundred Thousand Dollars
($500,000.00) per person, per accident, for bodily injury and not less
than One Hundred Thousand Dollars ($100,000.00) for property
damage per occurrence. iii. Workers Compensation and
Employer's Liability insurance in compliance with all applicable
New York State laws and regulations and Disability Benefits
insurance, ifrequired by law. Contractor shall furnish to the County,
prior to its execution of this Agreement, the documentation required
by the State of New York Workers' Compensation Board of coverage
or exemption from coverage pursuant to 9957 and 220 of the
Workers' Compensation Law. In accordance with General Municipal
Law 9 I 08, this Agreement shall be void and of no effect unless the
Contractor shall provide and maintain coverage during the tenn of
this Agreement for the benefit of such employees as are required to
be covered by the provisions of the Workers' Compensation Law. b.
All policies providing such coverage shall be issued by insurance
companies with an A.M. Best rating of A- or better. c. The
Contractor shall furnish to the County Declaration Pages for each
such policy of insurance and upon request, a tTUe and certified
Page 2 of 3
.
, .
Rev. 11/16/06
County of Suffolk
Department of Fire, Rescue and Emergency Services
Exhibit B
General Terms and Conditions
original copy of each such policy, evidencing compliance with the
aforesaid insurance requirements. In the case of commercial general
liability insurance, the County of Suffolk shall be named as an
additional insured and the Contractor shall furnish a Declaration
Page and endorsement page evidencing the County's status as an
additional insured on said policy, d. All such Declaration Pages,
certificates and other evidence of insurance shall provide for the
County of Suffolk to be notified in writing thirty (30) days prior to
any cancellation, nonrenewal or material change in said policies.
Such Declaration Pages, certificates, policies and other evidence of
insurance and notices shall be mailed to the Department at its address
as set forth in this Agreement in the paragraph entitled "Notices and
Contact Persons" or at such other address of which the County shall
have given the Contractor notice in writing. e. In the event
Contractor shall fail to provide the Declaration Pages or certificates
of insurance or to maintain any insurance required by this
Agreement, the County may, but shall not be required to, obtain such
policies and deduct the cost thereof from payments due Contractor
under this Agreement or any other agreement between the County
and Contractor.
Severability: It is expressly agreed that if any term or provision of
this Agreement, or the application thereof to any person or .
circumstance, shall be held invalid or unenforceable to any extent,
the remainder of this Agreement, or the application of such term or
provision to persons or circumstances other than those as to which it
is held invalid or unenforceable, shall not be affected thereby, and
every other term and provision of this Agreement shall be valid and
shall be enforced to the fullest extent permitted by law.
Set-Off Rights: The County shall have all of its common law,
equitable, and statutory rights of set-off. These rights shall include,
but not be limited to, the County's option to withhold, for the
purposes of set-off, any moneys due to the Contractor under this
contract up to any amounts due and owing to the County with regard
to this contract and/or any other contract with any County department
or agency, including any contract for a term commencing prior to the
term of this contract, plus any amounts due and owing to the County
for any other reason including, without limitation, tax delinquencies,
fee delinquencies or monetary penalties relative thereto. The County
shall exercise its set-off rights in accordance with normal County
practices including, in cases of set.off pursuant to an audit, the
finalization of such audit by the County agency, its representatives,
or the County Comptroller, and only after legal consultation with the
County Attorney.
Governing Law: This Agreement shall be governed by and
construed in accordance with the laws of the State of New York,
without regard to conflict oflaws. Venues shall be designated in
Suffolk County, New York or the United States District Court for the
Eastern District of New York.
No Intended Third Party Beneficiaries: This Agreement is entered
into solely for the benefit of County and Contractor. No third party
shall be deemed a beneficiary of this Agreement, and no third party
shall have the right to make any claim or assert any right under this
Agreement.
Notices Relating to Payments, Insurance or Other Submissions:
For the Department: By Registered or Certified Mail in Postpaid
Envelope or by Nationally Recognized Courier Service or by
personal delivery to Fire Rescue and Emergency Services, Yaphank
Avenue, Yaphank, New York 11980 Att. Belinda Pagdanganan,
Director of Emergency Preparedness, and For the Contractor: By
Registered or Certified Mail in Postpaid Envelope or by Nationally
Recognized Courier Service or by personal delivery to the contact
person set forth in Exhibit A, entitled "Specific Terms and
Conditions."
Notices Relating to Indemnification and Termination: Any
conununication or notice regarding indemnification or termination
shall be in writing and shall be given as follows: For the County: By
Registered or Certified Mail in Postpaid Envelope or by Nationally
Recognized Courier Service or by personal delivery to Fire Rescue
and Emergency Services, Yaphank Avenue, Yaphank, New York
11980, Att. Joseph F. Williams, Corrunissioner, and to Christine
Malafi, County Attorney. Suffolk County Department of Law, H. Lee
Dennison Building, 100 Veterans Memorial Highway, Hauppauge,
New Yark 11788, and For Contractor: By Registered or Certified
Mail in Postpaid Envelope or by Nationally Recognized Courier
Service or by personal delivery to the contact person set forth in
Exhibit A, entitled "Specific Terms and Conditions."
Page 3 of 3
.
SUFFOLK COUNTY DEPARTMENT OF LABOR - LIVING WAGE UNIT
NOTICE OF APPLICATION FOR COUNTY COMPENSATION (Contract)
Living Wage Law, Suffolk County Code, Chapter 347 (2001)
To Be Completed By Applicant/ Employer/Contractor
1) NAME:
TOWN OF SOUTHOLD
2) VENDOR#:
4) CONTACT:
(If known)
Edward Forrester
3) CONTRACT ID #:
(If known)
5) TELEPHONE #: 631-765-1939
6) ADDRESS: P.O. Box 1179,54375 Main Road
Southold. NY 11971-0959
7) TERM OF CONTRACT (DATES): 1/1/07 - 5/31/11
8) PROJECT NAME: (IF DIFFERENT FROM #1) Disaster Preparedness/Shelters
9) AMOUNT: N/A - provision of generator
10) AWARDING AGENCY: Suffolk County Dept. of Fire, Rescue, and
Emergency Services
11) BRIEF DESCRIPTION OF PROJECT OR SERVICE:
Town of Southald assigned a 25 kVA/20 kW generator to provide
temporary power to residents of Fishers Island in the event of an
emeLyency.
12) PROJECTED EMPLOYMENT NEEDS: (attach a statement listing, by job
classification, the total workforce dedicated to performing this contract or service, including
calculation of estimated net increase or decrease in jobs as a result of funding).
None
13) PROJECTED WAGE LEVELS: (attach a statement listing projected wage levels,
compensated days off and medical benefits for total workforce dedicated to fulfilling the terms
of this contract, broken down annually for each year of the term of the contract).
Michael Imbriglio, Assistant Emergency Management Director
P.O. Box 154, Penn insula Road, Fishers Island, NY 06390
(631-788-7090) ($3,000 annual wages)
LW-l(revised 4/05)