HomeMy WebLinkAboutSouthold Waterfront Documentary
IN WITNESS THEREOF, the parties hereto have executed or approved this AGREEMENT on the dates
below their signatures.
Contract No. T006790
CONTRACTOR
Town of SoutbO:L
By: ~ 61/l. ~ vP/
5~++ A. KU..{H ((
STATE AGENCY:
Title:
(Print Name}
<:; <If- ~ I ~J fY1
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Ul \-t I' 'I;.. . ,:.,t: \\1'\
DOS Di~~~~ of Adrninistrat~9R
Title: and Man,aqement
Date: i C! I~ \ c I
,
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."
Date:
ACKNOWLEDGMENT
State of New York )
County of <; vI.. -1"+0 ( ~ )ss:
-
On this (9+(aay of _ <:;P e/-P"- ~ , 20 Q'}before me personally came
~# ,4. 1<0, C<'~ j I to me known, who, being by me duly sworn, did depose and say that
&she/they residers) in { .{ c (if the place
ofresident is in acity, include the street and s reet number, if any, thereof); that~she/they@are) the
~~'~p .{ v; f n.-{ (title of officer or employee) of the 'Ie") oJ 1"1 0 ,+ _5'" L< IiJ/(name
of mum Ipal corporation), ~e~ ribed.in..,and which executed the above Instrument; and that he/she/they signed
---- . 1
his/her/their name(s) theret ,authonty ~/J.~'h tovern ng body of said muniCIpal corporat_N M. CORCORAN
I . Tf/ QUALIFIED IN SUFFOLK COUNTY
NOTARY #02C06119838
MY COMMISSION EXPIRES DEC. 6, 2~
NOTARY PUBLIC
Approved:
Thomas P. DiNapoli
State Comptroller
ATTORNEY GENERAL:
Title:
Date:
By:
Date:
Town of Southold - Agreement #T006790
Preparation of Southold Waterfront Documentary
Agreement Information Form
On the Face Page, is the Recipient Name and Address correct?
YES @
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WI U0-/- ? It (' rA fie 'I (Josl-
O--\:~LQ hnx \J.lhtd (.) Po.
)C ( ~ -(t( Co de-
I C 't 1 (- 0 7'
NO
If incorrect, please provide the Recipient Name and Address:
On the Face Page, is the Federal Tax ID # correct?
If incorrect (or missing) please provide the correct Federal Tax ID #:
Have any costs shown in Appendix B been incurred and/or any tasks in Appendix D began?
@NO
If any costs shown in Appendix B have been incurred and/or any tasks in Appendix D have begun, please provide brief
description:
The project began in the winter of 2007 with the writinq of the script by
Town employee, Heather Cusack, and Town Trustee, Peg Dickerson. The sites
for filmingwete researched and chosen. Various interviews and filminG was
conducted throughout the summer of 2007 by Rory MacNish of Cornell Cooperative
Extension. Most of the filming has been completed. The editing of the film
ib rlUW being worKea on. The costs that have been 1ncurred have been for salary
for Ms. Cusack and Ms. Dickerson, travel, supplies, and time/equipment that
~lill be bill~J Ly CUL!l~ll CUU~~LdLive ~xtensioIl.
Enter proposed start date for contract: J an u a r y 2007
Note: If any costs have been incurred, the start date must reflect the date you began incurring those costs
Enter proposed end date for contract:
March 2008
Printed Name of the Supervisor:
k~
<)'"'~++ A_
~
Date: Cj - (1. - 0 1
K<A <) 5' eA I
Signature of the Supervisor:
Please return Complete Agreement Address to NYS Department of State
following items (3) signed and notarized signature pages return to: Contract Administration Unit
to DOS: Signed Agreement Information Form Attn: Laurissa Parent, Coastal Resources
Signed Contract Administration Form 41 State Street - 8th Floor
Albany, NY 12231-0001
Town of Southold - Agreement #T006790
Preparation of Southold Waterfront Documentary
CONTRACT ADMINISTRATION UPDATE FORM
Please update/specifY information for up to (3) people to receive contract related correspondence from DOS and indicate which
person 'should be the primary correspondence recipient, The primary recipient must be an employee of the Town of Southold and
will receive original DOS correspondence, with attachments, The other individuals listed will receive copies of DOS transmit/al
letters, without attachments. NOTE: The Supervisor must be listed on this form, but does not need to be the primary
correspondence recipient.
o
No updates necessary
o
I'lease make the following updates:
........................................................................................................................................................................................................................................................................
. . ..
: Honorable Scott A. Russell : 0 Primary recipient of correspondence from DOS ~ Phone Number:
! Supervisor ! 0 Copy this person on correspondence from DOS !
i Town of Sonthold i i 631-765-1889
i 53095 Main Road !,..'..""'..,..,...."............"..,.."..........,...,...,.....,.."......."......,..'..'.."'..'................1"....."...."..'....".."..,..,..,..,......."..,........!
: PO Box 1179 i Email Address: ~ Fax Number: :
i South old, NY 11971- 0 9 5 9 i:
: ,scott,russell@town.southold.ny.us l 631-765-1823 !
................_.................................................................J......................................................................................................................................................................"..............
..................................................................................~......................................................................................................................................................................................
. . ..
! Ms. Peggy Dickerson ! 0 Primary recipient of correspondence from DOS l Phone Number: !
i Town Trustee ! 0 Copy this person on correspondence from DOS l '
Town of Soulhold! l
PO Box 1179! l
Southold, NY 1197l- 0 9 5 9 ~",...."........,..........,..,..............,..,"'.."..."'.......,.."',.."..,..,..'"......"..,...,..,..,.."'1"'''''''..,..'''''''''....,..,.....''......''''...'''..''''!
. .' Email Address: I"~, Fax Number: ,:,
pegdickerson16@aol.com 631-765-6641
..................................................................................J.......................................................................................................................a.............................................................
631-765-1892
......................................................................................................................................................................................................................................................................
, "
No person listed : 0 Primary recipient of correspondeuce from DOS ~ Phone Number: :
Ms. He a the r C usa c k : 0 Copy this person on correspondence from DOS l !
Environmental Technicialn l631-765-1938 !
Tow n 0 f Sou tho 1 d 1"'........'......"'................"'.................."'....................,..,......,"'.........'"........"''1'.......,..,..........''''''''''...................'........1
P.o. Box 1179 i Ematl Address: 1 Fax Number: i
..~~,~.~,~,~,~,~,~....,~~.."''''~..~,~..~,~..~.~..~,:i9 hea th er. cu sack@town. s ou t~~ ~~ ~ I 631-765 - 313 6 I
Please /ist up to (3) individuals who are authorized to execute amendments and/or sign payment requests/or this project:
Authorized for:
Amendments? [i] Payments? GJ
Amendments? D Payments? D
Name: Scott A. Russell
Title: Supervisor
Name:
Title:
Name:
Title:
Amendments? D Payments? D
~~~Date:
Cf-f <[-()1
Signature of the Supervisor:
FACE PAGE
STATE AGENCY (Name and Address):
NYS COMPTROLLER'S #:
ORIG. AGENCY CODE:
T006790
19000
NYS Department of State
41 State Street
Albany, NY 12231-0001
TYPE OF PROGRAM: Environmental Protection
Fund Act - 06 L WRP
CONTRACTOR (Name and Address):
Town of Southold
53095 Main Road
Southold, NY 11971
STATE SHARE FUNDING AMOUNT FOR
INITIAL PERIOD $7,822
LOCAL SHARE FUNDING AMOUNT FOR
INITIAL PERIOD $7,822
FEDERAL TAX IDENTIFICATION NUMBER:
11-6001939
MUNICIPALITY #
I INITIAL CONTRACT PERIOD:
FROM: TO:
APPENDICES ATTACHED TO AND PART OF THIS AGREEMENT
APPENDIX A: Standard clauses as required by the Attorney General for all state contracts
APPENDIX Al Including
Attachments I, 2, & 3 thereto: Agency-specific clauses
APPENDIX B: Budget
APPENDIX C: Payment and Reporting Schedule
APPENDIX D: Program Workplan
APPENDIX X: Modification Agreement Form (to accompany modified appendices for
changes in term or consideration on an existing period or for renewal
periods)
STATE OF NEW YORK
AGREEMENT
The 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.
WITNESSETH:
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
seIVices; 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 ST ATE and the
CONTRACTOR agree as follows:
1. Conditions of Agreement
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.
D. Subject to the availability of funds, determination by the Department that it is in the best interest of the State,
and upon mutual written consent of the parties, this AGREEMENT may be extended by up to two Contract
Periods not to exceed twelve months each.
To modify the AGREEMENT within an existing PERIOD the parties shall revise or complete the appropriate
appendix forms(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 Workplan (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 ST ATE under this AGREEMENT. No contractual relationship shall be
deemed to exist between the subcontractor and the STATE.
2
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.
B. The STATE shall make payments and any reconciliations in accordance with the Payment and Reporting
Schedule (Appendix C). The ST ATE 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 of termination to the
CONTRACTOR, if the CONTRACTOR fails to comply with the terms and conditions of tlus 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 tenns of the notice.
E. Upon receipt of notice of termination, the CONTRACTOR shall cancel, prior to the effective date of any
prospective termination, all outstanding obligations, 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 ofthe 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.
IV. Indemnification
A. The CONTRACTOR shall be solely responsible and answerable in damages for any and all accident and/or
injuries to person (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 hannless 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 indepcndent 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.
3
V. Propertv
Any equipment, furniture, supplies or other property purchased pursuant to this AGREEMENT is deemed to be
the property of the STATE except as may othelWise be governed by Federal or State laws, rules or regulations, or
as stated in Appendix AI.
VI. Safeguards for Services and Confidentialitv
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 Agreement and in conformity with applicable
provisions of laws and regulations, or specified in Appendix AI.
APPENDIX A
STANDARD CLAUSES FOR NYS 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):
1. 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 the previous consent, in writing, of the
State and any attempts to 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 Certificates of Participation pursuant to Article 5-A of
the State Finance Law.
3. COMPTROLLER'S APPROVAL. In accordance with Sec,ion 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 $50,000 (or the minimum
thresholds agreed to by the Office of the State Comptroller for certain
S.U.N.Y. and C.U.N.Y. 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 $10,000, 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 $85,000 (State Finance Law
Section 163.6.a).
4. WORKERS' COMPENSATION 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 REOUlREMENTS. To the extent
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 discriminateagainst
any employee or applicant for employment because of race, creed, color,
sex, national origin, sexual orientation, age, disability, genetic
predisposition or carrier status, or marital status. Furthermore, in
accordance with Section 220-e of the Labor 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 that neither it nor its subcontractors
shall, by reason ofrace, creed, color, disability, sex, or national origin: (a)
di:scriminate in hiring against any New York State citizen who is qualified
and available to perform the work; or(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 thereof, Contractor agrees that
June 2006
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
$50.00 per person per day for any violation of Section 220-e or Section
239 as well as possible termination 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 or a building service
contract covered by Article 9 thereof, neither 90ntractor's 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 payor provide the prevailing supplements,
including the premium rates for overtime pay, as determined by the State
Labor Department in accordance with the Labor Law.
7. NON-COLLUSIVE BIDDING CERTIFICATION. In accordance
with Section 139-d of the State Finance Law, ifthis contract was awarded
based upon the submission of bids, Contractor affirms, under penalty of
petjury, that its bid was arrived at independently and without collusion
aimed at restricting competition. Contractor further affirms that, at the
time Contractor submitted its bid, an authorized and responsible person
executed and delivered to the State a non-collusive bidding certification
on Contractor's behalf.
8. INTERNATIONAL 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 a
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
USC ApI'. 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 of the United States Commerce Department or any other
appropriate agency of the United States subsequent to the contract's
execution, such contract, amendment or modification thereto shall be
rendered 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 the Contractor under 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 tenn
commencing prior to the term of this contract, plus any amounts due and
owing to the State for any other reason including, without limitation, tax
delinquencies, fee delinquencies or monetary penalties relative thereto.
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 (hereinafter,
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 this contract, shall have access to the
Records during normal 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 term 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
inform an appropriate State official, in writing, 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 contained herein shall diminish, or in any way adversely affect,
the State's right to discovery in any pending or future litigation.
II. IDENTIFYING INFORMATION AND PRIVACY
NOTIFICATION. (a) FEDERAL EMPLOYER IDENTIFICATION
NUMBER and/or 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 rcason or reasons why the
payee does not have such number or numbers.
(b) PRlV ACY NOTIFICATION. (I) The authority to request the ahove
personal information from a seller of goods or services 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 of this information
by the seller or lessor to the State is mandatory. The principal purpose for
which the information is collected is to enable the State to identify
individuals, businesses and others who have been delinquent in filing tax
returns or may have understated their tax liabilities and to generally
identity persons affected by the taxes administered by the Commissioner
of Taxation and Finance. The infonnation will be used for tax
administration purposes and for any other purpose authorized by law.
(2) The personal information 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 information is
maintained in New York State's Central Accounting System by the
Director of Accounting Operations, Office of the State Comptroller, 110
State Street, 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 $25,000.00, whereby a
contracting agency is committed to expend or docs expend funds in return
for labor, services, supplies, equipment, materials or any combination of
the foregoing, to be performed for, or rendered or furnished to the
contracting agency; or (ii) a written agreement in excess of$IOO,OOO.OO
whereby a contracting agency is committed to expend or does expend
funds for the acquisition, construction, demolition, replacement, major
repair or renovation ofreal property and improvements thereon; or (iii) a
written agreement in excess of$1 00,000.00 whereby the owner ofa State
June 2006
A-2
assisted housing project is committed to expend or does expend funds for
the acquisition, construction, demolition, replacement, major repair or
renovation 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 affinnative action to ensure that minority group members and
women are afforded equal employment opportunities without
discrimination. Affirmative action shall mean recruitment, employment,
job assignment, promotion, upgradings, demotion, transfer, layoff, or
termination and rates of payor other forms 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 orroarital 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 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.
Contractor will include the provisions of "a", "b", and "c" above, in every
subcontract over $25,000. 00 for the construction, demol ition, replacement,
major repair, renovation, planning or design of real property and
improvements thereon (the "Work") except where the Work is for the
beneficial useofthe 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.
TIle 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 Section 312 to the extent 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.
15. LATE PAYMENT. Timeliness of payment and any interest to be
paid to Contractor for late payment shall be governed by Article II-A of
the State Finance Law to the extent required by law.
]6. 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 State of New York.
17. SERVICE OF PROCESS. In addition to the methods of service
allowed by the State 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 known address shall be sufficient.
Contractor will have thirty (30) calendar days after service hereunder is
complete in which to respond.
18. PROHIBITION ON PURCHASE OF TROPICAL
HARDWOODS. The Contractor certifies 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 orpublic 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 informed and is in compliance with
specifications and provisions regarding use of tropical hardwoods as
detailed in ~165 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), thcContractor 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 State 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.
Infonnation 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 St -- 7" Floor
Albany, New York 12245
Telephone: 518-292-5220
Fax: 518-292-5884
http://www.empire.state.ny.us
June 2006
A-3
A directory of certified minority and women-owned business enterprises
is available from:
NYS Department of Economic Development
Division of Minority and Women's Business Development
30 South Pearl St n 2nd Floor
Albany, New York 12245
Telephone: 518-292-5250
Fax: 518-292-5803
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 efforts 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 Contractor has complied with the Federal Equal Opportunity Act
of 1972 (P.L. 92-261), as amended;
(c) The Contractor agrees to make reasonable efforts to provide notification
to New York State residents of employment opportunities 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 10caLed in a
country, nalion, province, state or political subdivision that penalizes New
York Stale vendors, and if the goods or services they offer will be
substantially produced orperfonned outside New York State, the Omnibus
Procurement Act 1994 and 2000 amendments (Chapter 684 and Chapter
383, 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 current list of jurisdictions
subject to this provision.
22. PURCHASES OF APPAREL. In accordance with State Finance Law
162 (4-a), the State shall not purchase any apparel from any vendor unable
or unwilling to certifY that: (i) such apparel was manufactured in
compliancc 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),
if known, the names and addresses of each subcontractor and a list of all
manufacturing plants to be utilized by the bidder.
APPENDIX AI
Agency-Specific Clauses
I. This Agreement has been entered into pursuant to the following understandings:
A. Title II of the Environmental Protection Fund Act provides for State assistance to municipalities for
the State share of the cost of approved local waterfront revitalization projects as defined in the Act.
B. The Department of State (Department) is authorized by such Act to evaluate and determinc eligibility
of applications for funding of projects.
C. Based upon information, representations and certifications contained in Contractor's application for
funding, including the Work Program as set forth in Appendix D, the Department has made a
determination of eligibility of funding for Contractor's project under such Act.
D. State funds (Funding Amount set forth on the Face Page) for this Project (Appendix D Program
Workplan) are provided pursuant to a reappropriation of funds originally made by Title II of the
Environmental Protection Fund Act.
E. The Contractor has demonstrated its ability to finance its share of the Project and has agreed to fund
its portion of the cost of the Project.
F. The 2006 "Request for Applications" required the Applicant to budget for costs associated with
training for projects which fall under the following categories: Urban Waterfront Redevelopment,
Preparing or Implementing WaterbodyfWatershed Management Plans, Making the Most of Your
Waterfront, and Completing or Implementing a Local Waterfront Revitalization Program.
ll. General
A. For the purposes of this Agreement, the terms "State" and "Department" are interchangeable, 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 performed.
C. No liabilities are to be incurred beyond the termination date and no costs will be reimbursed for such
liabilities unless: I) funds have been reappropriated for the Project in the subsequent State fiscal
year, 2) the Department determines that it is in the best interest of the Department and the State to
provide additional time to complete the Project and 3) an extension agreement is approved in
accordance with Section IA. of the Agreement.
D. The Department shall not be liable for expenses of any kind incurred in excess of the State Funds as
set forth on the Face Page, and shall not be responsible for seeking additional appropriations or other
sources of funds for the Project.
E. The Contractor shall perform all services to the satisfaction of the Department. The Contractor shall
provide all services and meet the program objectives described in Appendix D in accordance with:
provisions of this Agreement; relevant State, federal and local laws, rules and regulations,
administrative and fiscal guidelines; where applicable, operating certificates for facilities or licenses
for an activity or program, and conditions of applicable permits, administrative orders and judicial
orders.
F. The Contractor shall submit with its request for final payment a Final Project Summary Report in the
format described in Appendix A I, Attachment I, such forms to be provided Contractor by the
Department.
Appendix AI- Page 2
G. The Contractor agrees to proceed expeditiously with the Project and to complete the Project in
accordance with the timetable set forth in the Workplan (Appendix D) as well as with the conditions
of any applicable permits, administrative orders, or judicial orders and this Agreement.
H. The Department will provide Contractor with a Quarterlv Contractor Reoort (Appendix AI,
Attachment 2) pursuant to the Department's Minority and Women-owned Business Enterprises
Program. In the event Contractor utilizes Minority and Women-owned Business Enterprises as
discussed in Section XIV in Appendix AI, such report shall be provided to the Department at the
address on the Quarterly Contractor Report.
I. The Contractor shall submit two copies of a "Project Status Report" (Appendix AI, Attachment 3)
on a six month basis for the periods ending June 30 and December 31. Reports are due no later than
30 days following the end of each reporting period.
m. Additional Requirements for Construction Proiects
A. Proj ect design, including preparation of final plans and specifications, and supervision of
construction shall be undertaken by a qualified architect and/or engineer licensed to practice in the
State of New York. The Contractor shall submit final plans and specifications to the Department for
its acceptance before initiating construction work or, if the Contractor intends to subcontract for
construction work, before the work is advertised for bidding. No change to project plans may be
made without the prior written approval of the Department. The Contractor shall also be responsible
for erecting a project sign satisfactory to the Department identifYing the Project. The project sign
shall remain in place for the useful life of the improvements undertaken pursuant to this Agreement.
Upon completion of the Project, the Contractor shall submit to the Department a proper certification
from a licensed architect or engineer.
B. Thc State shall make periodic inspections of the project both during its implementation and after its
completion to assure compliance with this Agreement. The Contractor shall allow the State
unrestricted access to work during the preparation and progress of the work, and provide for such
access and inspection by the State in all construction contracts relating to the project.
C. The Contractor shall be responsible for assuring that the project is designed and constructed in
conformance with the Uniform Federal Accessibility Standards (UFAS - Appendix A to 41 CRF part
101-19.6), the Americans with Disabilities Act Accessibility Guidelines (ADAAG - Appendix A of
Title 9 NYCRR). Where there are discrepancies among the sets of standards with regard to a
particular design/construction requirement, the one providing for the greatest degree of
accommodation for the disabled shall apply.
D. It is the Contractor's responsibility, pursuant to Section 57 of the Workers' Compensation Law, to
maintain for State audit and review either proof that they have Workers' Compensation coverage for
any employees, or a waiver statement from the New York State Department of Labor. The
Contractor must also obtain from any contractor or sub-contractor hired to provide a service pursuant
to this Agreement, similar proof or waiver from the contractor or subcontractor, and must maintain
such documentation on file for audit.
IV. Reports, Documents and MaDS
The Contractor shall, where appropriate, identifY documents, reports, and maps produced in whole or in
part under this Agreement by endorsing on said documents, reports, and maps the following: ,
"This (document, report, map, etc.) was prepared for the New York State Department of
Appendix AI- Page 3
State with funds provided under Title II of the Environmental Protection Fund Act."
V. License to use and reoroduce documents and other works:
By acceptance of this Agreement, Contractor transfers to the Department a nonexclusive license to use,
reproduce in any medium, and distribute any work prepared for or in connection with the Project,
including but not limited to reports, maps, designs, plans, analysis, and documents regardless of the
medium in which they are originally produced. Contractor warrants to the Department that it has
sufficient title or interest in such works to license pursuant to this Agreement. Such warranty shall
survive the tennination of this agreement. Contractor agrees to provide the original of each such work,
or a copy thereof which is acceptable to the Department, to the Department before payments shall be
made under this Agreement.
VI. Contractors Insurance Requirements
A. Prior to the commencement of the Work, the Contractor shall file with the Department of State,
Division of Coastal Resources, Certificates of Insurance evidencing compliance with all
requirements contained in this Agreement. Such Certificate shall be of form and substance
acceptable to the Department.
B. Acceptance and/or approval by the Department does not and shall not be construed to relieve
Contractor of any obligations, responsibilities or liabilities under the Agreement.
C. All insurance required by the Agreement shall be obtained at the sole cost and expense of the
Contractor; shall be maintained with insurance carriers licensed to do business in New York State;
shall be primary and non-contributing to any insurance or self insurance maintained by the
Department; shall be endorsed to provide written notice be given to the Department, at least thirty
(30) days prior to the cancellation, non-renewal, or material alteration of such policies, which notice,
evidenced by rcturn receipt of United States Certified Mail which shall be sent to New York State
Department of State, 41 State Street, Albany, New York 12231-0001; and shall name the People of
the State of New York and their directors officers, agents, and employees as additional insured
thereunder.
D. The Contractor shall be solely responsible for the payment of all deductibles to which such policies
are subject.
E. Each insurance carrier must be rated at least "A" Class "VII" in the most recently published Best's
Insurance Report. If, during the term of the policy, a carrier's rating falls below "A Class "VII", the
insurance must be replaced no later than the renewal date of the policy with an insurer acceptable to
the Department and ratcd at least "A" Class "VII" in the most recently published Best's Insurance
Report.
F. The Contractor shall cause all insurance to be in full force and effect as of the date of this Agreement
and to remain in full force and effect throughout the term of this Agreement and as further required
by this Agreement. The Contractor shall not take any action, or omit to take any action that would
suspend or invalidate any of the required coverages during the period of time such coverages are
required to be in effect.
G. Not less than thirty (30) days prior to the expiration date or renewal date, the Contractor shall supply
the Department updated replacement Certificates of Insurance, and amendatory endorsements.
H. Unless the Contractor self-insured, Contractor shall, throughout the term of the Agreement or as
otherwise required by this Agrcement, obtain and maintain in full force and effect the following
insurance with limits not less than those described below and as requircd by the terms of this
Appendix AI- Page 4
Agreement, or as required by law, whichever is greater (limits may be provided through a
combination of primary and umbrella/excess policies). Where Contractor is self-insured, Contractor
shall provide suitable evidence of such to the Department relating to the risks and coverage amounts
as provided hereunder.
I. Comprehensive Liability Insurance with a limit of not less than $1,000,000 each occurrence.
Such liability shall be written on the Insurance Service Office's (ISO) occurrence form CG 00 01,
or a substitute form providing equivalent coverages and shall cover liability arising from
premises operations, independent contractors, products-completed operations, broad form
property damage, personal & advertising injury, owners & contractors protective, cross liability
coverage, liability assumed in a contract (including the tort liability of another assumed in a
contract) and explosion, collapse & underground coverage.
a. If such insurance contains an aggregate limit, it shall apply separately to this location.
b. Products and Completed Operations coverage shall include a provision that coverage wilt
extend for a period of at least twelve (12) months from the date of final completion and
acceptance by the owner of all of Contractors Work.
2. Where the Project described in Appendix D includes the construction of any structure or
building, a Builder's Risk Policy until the Project is completed and accepted in the amount of the
total project cost.
3. Workers Compensation, Employers Liability, and Disability Benefits as required by New York
State. Workers Compensation Policy shall include the U.S. Longshore & Harbor Workers'
Compensation Act endorsement.
4. Comprehensive Automobile Liability Insurance with a limit of not less than $1,000,000 each
accident. Such insurance shall cover liability arising out of any automobile including owned,
leased, hired and non owned automobiles.
5. Commercial Property Insurance covering at a minimum, the perils insured under the ISO Special
Clauses of Loss Form (CP 10 30), or a substitute form providing equivalent coverages, for loss or
damage to any owned, borrowed, leased or rented capital equipment, tools, including tools of
their agents and employees, staging towers and forms, and property of DOS held in their care,
custody and/or control.
6. An Owner's Protective Liability Policy with limits no less than $1,000,000 in the name of the
Contractor.
I. Professional consultants retained by the Contractor in connection with the Project shall show
evidence of professional liability insurance with limits no less than $1 million.
VII. Propertv
A. 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 any time during the term of this Agreement and up to thirty (30) days following
the issuance of the final payment.
B. Contractor warrants that it has fee simple or such other estate or interest in the site of the Project,
where the Project is undertaken at a site, including easements and lor rights -of-way sufficient to
Appendix Al- Page 5
assure undisturbed use and possession for the purposes of construction and operation for the
estimated life of the Project. Contractor further acknowledges that where such Project is undertaken
on or involves the use of lands for active or passive recreational use, it is a material term of this
Agreement that such lands shall be available for such recreational use by the People of the State of
New York. Additionally, Contractor shall not limit access or discriminate on the operation of the
facilities against any person on the basis of place of residence, race, creed, color, national origin, sex,
age, disability or marital status.
VIII. Dateffime Warrantv
A. Contractor warrants that Product(s) furnished pursuant to this Contract shall, when used in
accordance with the Product documentation, be able to accurately process date/time data (including,
but not limited to, calculating, comparing, and sequencing) transitions, including leap year
calculations. Where a Contractor proposes or an acquisition requires that specific Products must
perform as a package or system, this warranty shall apply to the Products as a system.
B. Where Contractor is providing ongoing services, including but not limited to: i) consulting,
integration, code or data conversion, ii) maintenance or support services, iii) data entry or processing,
or iv) contract administration services (e.g. billing, invoicing, claim processing), Contractor warrants
that services shall be provided in an accurate and timely manner without interruption, failure or error
due to the inaccuracy of Contractor's business operations in processing date/time data (including, but
not limited to, calculating, comparing, and sequencing) various date/time transitions, including leap
year calculations. Contractor shall be responsible for damages resulting from any delays, errors or
untimely performance resulting there from, including but not limited to the failure or untimely
performance of such services.
C. This Dateffime Warranty shall survive beyond termination or expiration of this Contract through: a)
ninety (90) days or b) the Contractor's or Product manufacturer/developer's stated date/time warranty
term, whichever is longer. Nothing in this warranty statement shall be construed to limit any rights
or remedies otherwise available under this Contract for breach of warranty.
lX. Fees
The Contractor may charge a reasonable fee for the use of any facility which is part of the project.
A. Except for the imposition of a differential fee schedule for non-residents of the municipality in which
the project is located, the establishment of any preferential user fee for any person or entity is
prohibited. Fees charged to non-residents shall not exceed twice those charged to residents.
B. Where there is no charge for residents but a fee is charged to non-residents, non-resident fees cannot
exceed fees charged for residents at comparable State or local public facilities.
C. Reservation, membership or annual permit systems available to residents must also be available to
non-residents and the period of availability must be the same for both residents and non-residents.
D. This provision does not apply to non-residents' fishing and hunting license fees.
X. Alienation
Where the Project is undertaken on or involves parklands or public waterfront land, the following
additional provisions apply:
Appendix AI- Page 6
A. The Contractor shall not at any time sell or convey any facility or any portion of the Project acquired
or developed pursuant to this Agreement or convert such facility or any portion of the Project to
other than public park or public waterfront purposes without the express authority of an act of the
Legislature, which shall provide for the substitution of other lands of equal fair market value and
reasonably equivalent usefulness and location to those to be discontinued, sold or disposed of, and
such other requirements as shall be approved by State.
B. The Contractor agrees to own a property interest sufficient to maintain and operate the project in
perpetuity. The Contractor shall not authorize the operation of the project, or any portion thereof,
by any other person, entity, or organization pursuant to any management agreement, lease or other
arrangement without first obtaining the written approval of the State.
XI. Subcontracting Requirements
A. The Contractor may subcontract for all or any portion of the activities covered by this Agreement as
provided for in Appendix D, subject to prior written approval by the Department of any
subcontractor and the terms of any subcontract. Subcontractors shall comply with all applicable
requirements of the Agreement between the Contractor and the State.
XII. Compliance with Procurement Requirements
A. All contracts by municipalities for professional services, all contracts for construction involving not
more than $20,000 and all purchase contracts involving not more than $10,000 are subject to the
requirements of General Municipal Law ~ 104-b, which requires such contracts to comply with the
procurement policies and procedures of the municipality involved. All such contracts shall be
awarded after and in accordance with such municipal procedures, subject to any additional
requirements imposed by the State as set forth in Appendix D hereof.
B. The municipal attorney, chief legal officer or financial administrator of the Contractor shall certify to
the Department of State that applicable public bidding procedures of General Municipal Law ~ I 03
were followed for all construction contracts involving more than $20,000 and more than $10,000 for
purchase contracts. In the case of construction contracts involving not more than $20,000, purchase
contracts involving not more than $10,000, and contracts for professional services, the municipal
attorney, chief legal officer or financial administrator shall certify that the procedures of the
municipality established pursuant to General Municipal Law ~ 104-b were fully complied with.
XIII. Requirements for Contract GIS Products (2104)
A. GENERAL MAP PRODUCT REQUIREMENTS - The following general cartographic
requirements must be adhered to by the Contractor:
1. Map Products -- The Division requires delivery of digital map products, unless otherwise
specified in the Request for Proposal (RFP), that meet the specifications outlined in this
GENERAL MAP PRODUCT REQUIREMENTS section and the ADDITIONAL DIGITAL
CARTOGRAPHIC FILE REQUIREMENTS section. If analog map products are required by the
RFP, they must meet specifications outlined in this GENERAL MAP PRODUCT
REQUIREMENTS section and the ADDITIONAL DIGITAL-READY MAP PRODUCT
REQUIREMENTS section.
2. Deliverable Format -- All digital map and attribute table files must be provided in MapInfo Tab
file format on Recordable CD or DVD, 3.5" floppy diskette media, external hard drive, via e-
mail attachment (preferably in a WinZIP file) or downloadable from an ftp site on the Internet.
Appendix AI- Page 7
Alternatively, the digital products may be provided in ArcInfo/GIS export format (.eOO) or
ArcView shape file format on the same media types upon approval of the Division. All other
digital formats require prior approval of the Division. Coordination with the Division prior to
submission of digital media is required to ensure compatibility of the delivered materials.
3. Documentation -- A data dictionary must be included along with the map files describing file
contents and file names, as well as metadata for each file including map projection, horizontal
and vertical datums used, coordinate system, RMS accuracy and log sheet, information sources
and dates, the map maker and date of preparation, and creation methodology. Data provided
under federal funds must be provided in a manner which meets Digital Geospatial Federal
Geographic Data Committee Metadata Standard as executed by Executive Order 12906, April II,
1994, "Coordinating Geographic Data Acquisition and Access: the National Spatial Data
Infrastructure" .
4. Map Accuracy -- Unless otherwise stated in the RFP, all deliverable map products must conform
to National Map Accuracy Standards for horizontal and vertical accuracy as established by the
United States Bureau of the Budget, June 10, 1941, revised June 17, 1947. For example, for
maps at I :20,000 or smaller, not more than 10% of the well-defined map points tested must be
more than 1/50 inch (0.508 mm) out of correct position. At I :24,000, this tolerance translates to
a required horizontal accuracy of 40 feet. If by prior agreement with the Division the map
product does not conform to National Map Accuracy Standards, then a statement of actual map
accuracy should be included in the Documentation above. Furthermore, hydrographic surveys
and maps should conform to recommended accuracy standard proposed in the joint USGS, NOS,
Coastal Mapping Handbook, 1978, Melvin Ellis editor, U.S. GOvernment Printing Office,
Appendix 6.
5. Datums -- Unless otherwise specified in the RFP, all map products should be referenced to the
North American Horizontal Datum of 1983 (NAD83) and the National Geodetic Vertical Datum
of 1988 (NGVD88).
B. ADDITIONAL DIGITAL CARTOGRAPHIC FILE REQUIREMENTS - The following
cartographic construction requirements must be adhered to by the Contractor:
I. Edge-matching -- All map sheets must be both visually and coordinate edge-matched with
adjacent map sheets. No edge-match tolerance will be allowed. Attributes for splitable features
must also be identical.
2. Common Boundaries -- All features that share a common boundary, regardless of map layer,
must have exactly the same coordinate position of that feature in all common layers.
3. Point Duplication -- No duplication of points that occur within a data string is permitted.
4. Connectivity -- Where graphic elements visually meet, they must also digitally meet. All
confluences of line and polygon data must be exact; I1overshoots", "undershoots", "slivers", or
"offshoots" are NOT permitted.
5. Line Quality -- A high quality cartographic appearance must be achieved. Transitions from
straight lines to curvilinear elements must be smooth, with angular inflections at the point of
intersection. The digital representation must not contain extraneous data at a non visible level.
There should be no jags, hooks, or zero lcngth segments. Any lines that are straight, or should be
straight, should be digitized using only two points that represent the beginning and ending points
of the line.
Appendix A 1- Page 8
6. Polygon Closure -- For area features being digitized, the last coordinate pair must be exactly
(mathematically) equal to the first coordinate pair. No line or polygon must cross itself except to
join at an actual confluence. All digitized features across map boundaries must be edited to
effect smooth and continuous lines.
7. Graphic Precision -- Positional coordinates for all digital graphic elements should not be reported
to a level of precision greater than one thousandth (.00 I) of a foot.
8. Digitizer Accuracy -- The required RMS error for digitizer accuracy must be 0.003 or better for
digital map registration.
C. ADDITIONAL DIGITAL-READY MAP PRODUCT REQUIREMENTS - The following
requirements for large scale, non-digital map products must be followed to facilitate the future
conversion of the maps to digital map products. All large format, non-digital map products must be
provided on stable base material at a scale stipulated in the RFP. The map products must include an
index map to all map sheets and thorough descriptions of all the cartographic elements portrayed on
the maps.
I. Base Map Media -- All maps must be created on mylar or other stable base material.
2. Map Scale -- All maps of a similar series should be created using the same base scale. Unless
otherwise stated by the Division, all maps should be compiled at I :24,000. If other map scales
are approved by the Division, where possible they will conform to standard map scales such as
1:9600; 1:50,000; 1:75,000; or 1:100,000.
3. Map Registration -- The maps must provide a minimum of four (4) corner and four (4) interior
ti"cks tied to USGSINYSDOT quadrangle Lat/Long or NYTM coordinates. The maps must be
geometrically correct and should register when overlaid on the appropriatc USGSINYSDOT
quadrangle control ticks.
4. Map Title and Legend -- The maps must provide a title and legend block describing the
information contained on the maps, and including the Documentation and Datums information
requested in the GENERAL MAP PRODUCT REQUIREMENTS above and the map scale.
5. Cartographic Quality -- The quality of all map line work and symbolization must conform to
items I - 6 in the map criteria set forth in the ADDITIONAL DIGITAL CARTOGRAPHIC FILE
REQUIREMENTS section outlined above.
D. CONTRACT DATABASE STANDARDS
I. Delivery Media - All database and tabular files must be provided on digital media as specified
above in Deliverable Fonnat.
2. Software Format - Database and tabular files can be provided in Corel Quattro, Microsoft Excel
or Microsoft Access format. Other formats that are convertible to one of the aforementioned
formats may be used with prior approval of the Division.
3. Geographic Attributes -- Database and tabular files that contain 'elemcnts with a geographic
refercnce must provide a corresponding data field and a geographic coordinate pair for each
feature location.
xrv. Pavment and Records Retention
Appendix AI- Page 9
A. Payments shall be made as set forth in Appendix C.
B. The Contractor shall maintain, at its principal place of business, detailed books and accounting
records supported by original documentation relating to the incurring of all expenditures, as well as
payments made pursuant to this Agreement. The Contractor shall make such records available for
review by the Department upon request at any time. The Department shall have the right to conduct
progress assessments and review books and records as necessary. The Department shall have the
right to conduct an on-site review of the Project and/or books and records of the Contractor prior to,
and for a reasonable time following, issuance of the FINAL payment. The Department shall be
entitled to disallow any cost or expense, and/or terminate or suspend this Agreement, if the
Contractor has misrepresented any expenditures or Proj ect activities in its application to the
Department, or in this Agreement, or in any progress reports or payment requests made pursuant
hereto. The Contractor shall maintain such books and accounting records in a manner so that reports
can be produced therefrom in accordance with generally accepted accounting principles. The
Contractor shall maintain separate fiscal books and records for all funds received through the
Department pursuant to this Agreement.
C. During the term of this Agreement and for a period of six years after its termination, the Contractor
shall make all such books and records available to the Department and the Office of the State
Comptroller, or their designated representatives, for inspection and audit.
XV. Equal Employment Opportunitv
The Contractor hereby assures that it is, and shall be for the duration of this Agreement, in compliance
with the Federal Equal Employment Opportunity Act of 1972 (Public Law 92-261), as amended.
XVI. Article 15-A of The 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 Quarterlv Contractor Reoort is required to be submitted to the
Minority and Women-owned Business Program of the Department on forms provided by the Department,
as set forth in Appendix AI, Attachment 2.
Article 15-A requires that rules and regulations be established for contracts entered into by the
Department. In accordance with Article 15-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 for
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, reported by ethnic background, gender, and Federal Occupational Categories.
Appendix AI- Page 10
After a bid opening and prior to the award of a state contract, the contractor will submit an Equal
Emplovment Opportunitv mEO) Policv 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 will agree to the following stipulations and will include them in the EEO Policv
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 will undertake or continue existing programs of affirmative action to ensure
that minority group members and women are afforded equal employment opportunities without
discrimination because of race, 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 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 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 Policv 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 Policv 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 Workforce
Emplovment 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 of their 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 Department's Minority and Women,owned
Business Program by calling (518) 474-5741. Potential contractors can access the NYS Directory of
Certified Minoritv and Women-owned Business Enterprises on-line through the Empire State
Appendix AI- Page II
Development website at: http://www.empire.state.nv.us. double click (left column) on: NY v BIZ (Doing
Business in New York); put the curser over: Small and Growing Business and, from that menu, click on:
Minority and W omen-Owned Business. From the center column, highlighted in blue, click on the bullet:
"Search the Directory of Certified Minority- and Women-Owned Business Enterprises."
The Department makes no representation with respect to the availability or capability of any business
listed in the Directorv.
XVII. Notice of Public Proceedings
The Contractor agrees to provide the Department with prompt and timely written notice at least two
weeks in advance of all public proceedings, including, but not limited to; public meetings or hearings,
relating to the Project.
XVIII. Submission of all correspondence and documentation
A. The Contractor agrees to provide the Department with original and two copies of all documentation
relating to this Project, including, but not limited to: notices of public meetings, products described
in Appendix D, and payment request documentation as described in Appendix C.
B. All information as described in A. above shall include the NYS Comptroller's # as indicated on the
Face Page of this Agreement.
XIX. Environmental Review
A. Contractor agrees to provide the Department, in a timely manner, with all documentation, including
but not limited to, pennit applications, environmental assessments, designs, plans, studies,
environmental impact statements, findings, and detenninations, relating to the Project.
B. Contractor acknowledges that compliance with the State Environmental Quality Review Act is a
material term and condition of this Agreement. In no event shall any payments be made under this
Agreement until Contractor has provided Department with appropriate documentation that contractor
has met any requirements imposed on Contractor by the State Environmental Quality Review Act.
XX. Default and Tennination
A. The Department may tenninate the Agreement in accordance with the terms and conditions in
Section III.
B. In addition to whatever other reserved rights it has to tenninate the Agreement, the Department may
terminate the Agreement when it is in the best interests of the State or (I) for cause, (2) for
convenience, or (3) due to unavailability of funds.
C. If the Department dctennines the Contractor has breached a term of the Agreement and if the
Department detennines the defect can be remedied, it may issue a written notice providing the
Contractor with a minimum of 30 days to correct the defect and the notice may include a prospective
termination date. If the Contractor fails to correct the defect or fails to make a good faith effort to do
so as determined by the Department to the Departmcnt's satisfaction, the Department may tenninate
the Agreement for cause.
D. The Department shall also have the right to postpone or suspend the Agreement or deem it
abandoned without this action being a breach of the Agreement. The Department shall provide
written notice to the Contractor indicating the Agreement has been postponed, suspended or
Appendix AI- Page 12
abandoned. During any postponement, suspension or abandonment the Contractor agrees not to do
any work under the Agreement without prior written approval of the Department.
E. In the event the Agreement is postponed, suspended, abandoned or terminated, the Department shall
make a settlement with the Contractor upon an equitable basis in good faith and under the general
compensation principles and rates established in the Agreement by the Department. This settlement
shall fix the value of the work which was performed by the Contractor to the Department's
satisfaction prior to the postponement, suspension, abandonment or termination of the Agreement.
F. Any funds paid to the Contractor by the Department which are not expended under the terms of the
Agreement shall be repaid to the Department.
XXI. 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.
AI, Attachment I
FINAL PROJECT SUMMARY REpORT
Pinal payment of the grant is dependent upon the satisfactory completion and acceptance by the Department of State, Division
of Coastal Resources oflhis FINAL PROJECT SUMMARY REpORT along with the requisite documentation. In addition to the
other requirements of the contract, the grant recipient is responsible to relay the imoortance. the sillnificance and the value of
the comoleted oroject to the community. the rel!ion and the state through the completion of the report.
The following outline should be used to complete the FINAL PROJECT SUMMARY REpORT:
1. Project Title:
2. Name of Municipality:
3. Actual Project Costs:
a. State funds expended (identity source, ego EPF, Clean Water/ Clean Air
Bond Act, etc.):
b. Local funds expended:
C. Other funds expended:
4. Project Manager: Name:
Title:
Mailing address:
Tel. number:
Fax number:
E-mail address:
(
(
)
)
5. Federal Tax Identification Number:
6. Project Background (briefly explain in a short paragraph why this project was necessary, what its value is and/or its
importance to the community):
7. Project Work (briefly describe the work that was done to complete the project):
8. Project Descriptions (use the following guidelines to describe the project and please be concise in the description):
a. For a Planning Project describe the findings or recommended strategies.
b. For a Design Project describe what is to be built.
C. For a Construction Project descrihe what was huilt.
9. Project Documentation: The Department of State, Division o/Coastal Resources requires a visual documentation of the
Environmental Protection Fund projects. Project products should be visually documented using a 35mrn camera or a
digital camera. The 35mm color slides and/or digital camera disc should be labeled and dated when submitted along with
the completed FINAL PROJECT SUMMARY REpORT.
Visuals should illustrate the final project product and, as appropriate, activities undertaken to complete the project. For
example, some projects would call for visuals that include photographs of volunteers participating in a wetland restoration
project (planting Spartina); photographs of historical signs markers, kiosks, etc. being placed; or photographs of an artist's
rendering of a waterfront design.
Design, planning, and construction projects call for different visual documentation. Therefore, the following guidelines
are suggested:
IJ For design projects, visuals of renderings and/or graphics that depict the final product.
[!] For planning projects, visuals of any graphics, where appropriate, that illustrate the final product.
[!] For construction projects, visuals of work in progress and the finished project.
In addition to the 35mm color slides/digital camera disc, a video (vhs format) of the project with a verbal description is
desirable hut not mandatory. The video may be used in a future documentary.
A I, Attaclunent 2
NYS Department of State . Minority and Women-owned Business Enterprises Program
41 State Street Albany NY 12231-0001 . (518) 474 - 5741
Minority and Women-owned Business Enterprises (MWBE) Program
Quarterly Contractor Report
INSTRUCTIONS:
1. Please prepare reports based on calendar quarters, or prepare one annual report.
2. Use a separate Report sheet for each contract or program area
3. Record the amount paid for each service/product for the time period identified below.
4. Send completed reports to the Minority and Women-owned Business Enterprises Program at the above address.
REPORT PERIOD
Report should cover a calendar quarter OR the program year. FROM: TO:
Enter the inclusive dates of the quarter or for the program year. '" '" '"
CONTRACTOR NAME PROGRAM DOS CONTRACT NUMBER
CONTRACTOR ADDRESS Service Area of Contract Work
( )
NAME and TITLE of CONTACT PERSON (Please Print) TELEPHONE NUMBER
TYPE of DESCRIPTION of AMOUNT PAID
VENDOR NAME and ADDRESS VENDOR SERVICE/PRODUCT THIS PERIOD COMMENTS
o MBE $
o WBE
o MBE
o WBE
o MBE
o WBE
o MBE
o WBE
o MBE
o WBE
o MBE
oWBE
o MBE
oWBE
o MBE
oWBE
o MBE
o WBE
PAGE 1 of
Al - Attachment 3
Project Status Form
RECIPIENT
PROJECT TITLE
CONTRACT #
Status Report Date:
Task
#
Brief Task
Description
Date of Percent of
Aff Completion Completion
Task Accomplishments
Product
Submitted
to DOS
ADJUSTMENTS - Please indicate proposed adjustment(s) to work program/schedule, reason(s) for the proposed
adjustment(s), and any other problems encountered durin!! this reportin!! period:
Person to contact if we have questions about the information provided on this form:
Name:
Email Address:
Title:
Affiliation:
Phone:
Fax:
Appendix B
BUDGET SUMMARY
A. Salaries & Wages (including Fringe Benefits)
B. Travel
C. Supplies/Materials
D. Equipment
E. Contractual Services
F. Other
$5,000.00
$444.00
$200.00
$0.00
$10,000.00
$0.00
TOTAL PROJECT COST
$15,644.00
Total State Funds (50% of Total)
Total Local Share (50% of Total)
$7,822.00
$7,822.00
B-2
Appendix B (Budget Detail Sheet)
A. SALARIES & WAGES
TITLE ANNUAL AMOUNT
SALARY CHARGED TO THIS
PROJECT
Environmental Technician $56,241.90 $5,000.00
SUBTOTAL $ 5,000.00
B. TRAVEL
Travel associated with filming documentary video at locations throughout Town:
1,000 miles x $0.445 = $444
SUBTOTAL $ 444.00
C. SUPPLIES/MATERIALS
Supplies for copying draft and final storyboards and scripts
SUBTOTAL $ 200.00
D. EQUIPMENT
SUBTOTAL $ 0.00
E. CONTRACTUAL SERVICES
Script and storyboard development, filming, editing, and completion of a broadcast quality, 30-
minute educational video
SUBTOTAL $ 10,000.00
II F. OTHER II
SUBTOTAL $ 0.00
APPENDIX C
Payment and Reporting Schedule
1. Pavment Schedule
A. The Department shall make interim payments for eligible costs incurred up to an amount not to exceed
90% of the State Share Funding Amount. The final payment will be made upon satisfactory completion
of the Project.
B. Not more frequently than once every 30 days, a properly executed payment request, on forms as
prescribed by the Department documenting total project costs incurred to date, may be submitted.
1. Payment provided above shall be made to the Contractor upon the submission by the Contractor
of properly executed payment request. Such request shall contain the following: (I) "Summary
Sheet Documentation Forms" as provided by the Department, for reimbursement of actual and
eligible expenditures, (2) the required work products, and (3) a properly executed State Voucher.
2. Payment requests will be reviewed in accordance with the terms and conditions of this
Agreement to detennine total allowable project costs incurred and the number and percentage of
allowable project tasks completed to date. For the purpose of detennining the level of
reimbursement, otherwise allowable project costs may be reduced if the percentage of task
completion is deemed insufficient.
3. Total allowable project costs, adjusted pursuant to 2. above, will be prorated between State Share
and Local Share costs in the same proportions as Total State Share is to Total Local Share as set
forth on the Face Page.
4. Interim payments will be issued in amounts equal to the State Funds calculated in 3. above, less
outstanding advance payments.
5. The final payment will be issued upon receipt and approval of a payment request marked
"FINAL" documenting all project costs incurred and tasks completed and submission of the Final
Project Summary Report. Such final payment request shall be submitted within 60 days
following the ending date of this Agreement.
II. Reoorting
A. Payment requests as described in 1.B. 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.
C-2
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. Payment requests shall be submitted to:
New York State Department of State
Contract Administration Unit - LWRP
41 State Street - 10th Floor
Albany, New York, 12231-0001
D. Claimed expenditures per cost category may not exceed the amounts indicated in the Budget, Appendix
B, by ten percent (10%) without approval of the Department, provided that the Total Project Cost as set
forth in Appendix B, Budget Summary is not exceeded. Any expenditure in excess of such 10% or that
changes the State Share or Local Share funding amount shall require an amendment to the Project
Budget submitted in writing by the Contractor and approved by the Department. No expenditures shall
be allowed for items not set forth in the Project Budget without written approval of the Department.
III. Other
A. 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.
B. 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 cost to detennine the net eligible costs to
be reimbursed by the Department.
C. 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. The Contractor shall furnish proper facilities, where
necessary or useful, for such access and inspection.
D. The Department shall be entitled to disallow any cost or expense, or tenninate or suspend this
Agreement, if found that the Contractor has misrepresented any expenditures or project activitics in this
Agreement, or in any progress reports or payment requests made pursuant hereto.
E. 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 years following tennination of this
Agreement.
APPENDIX D
PROGRAM WORK PLAN
Contractor:
Program Contact Person:
Phone: (Office)
(Fax)
Town of Southold
Peggy Dickersou, Town Trustee
(631) 765-1892
(631) 765-6641
Preparation of Southold Waterfront Documentary
1. Proiect Description
The Town of Southold (the Contractor) will prepare a broadcast quality, 30-minute educational video
that will be used to explain through public television the values of Long Island's estuaries and the need
for shoreline regulations, The documentary will be filmed at a variety of shoreline locations in the Town
of Southold, and be based on a script and storyboard that will be developed by a combination of Town
staff, a project advisory committee of local stakeholders with relevant expertise, and contractual services,
The video will emphasize the value of shoreline habitat and explain the need for regulating shoreline
activities under the Town's Local Waterfront Revitalization Program, As a result of this project, the
public will have a better understanding of Town regulations and its Local Waterfront Revitalization
Program,
2. Proiect Attribution and Number of Copies
The Contractor must ensure that all materials printed, constructed, and/or produced acknowledge the
contributions of the Division of Coastal Resources to the project. The materials must include the
following acknowledgment:
"This (document, report, map, etc.) was prepared for the New York State Department of State
Division of Coastal Resources with funds provided under Title 11 of the Environmental
Protection Fund."
The contributions of the Division of Coastal Resources must also be acknowledged in community press
releases issued for the project. Project press releases shall be submitted to the Division of Coastal
Resources for review and approval prior to release to ensure appropriate attribution,
The Contractor must submit to the Division of Coastal Resources three copies of all written reports and
supporting graphics, videos, final design documents, and other printed materials,
3. Compliance with Procurement Requirements
The municipal attorney, chief legal officer, or financial administrator for the municipality (Contractor)
shall certify to the Division of Coastal Resources that applicable public bidding procedures of General
Municipal Law III 03 were followed for all construction contracts involving more than $20,000 and more
than $10,000 for purchase contracts, In the case of construction contracts involving not more than
$20,000, purchase contracts involving not more than $10,000, and contracts for professional services, the
municipal attorney, chief legal officer, or financial administrator shall certify that the procedures of the
municipality established pursuant to General Municipal Law III 04-b were fully complied with,
D-2
4. Proiect Comnonents
Task 1: Initial Project Scoping Meeting
The Contractor. the ~ivision of Coastal Resources (OCR), project partners and any other
appropriate entities shall hold an initial meeting to review the project scope, project
requirements, roles and responsibilities of project partners, the selection process for procuring
consultant services for the project, the techniques for public involvement proposed for the
project, and any other information which would assist in project completion. In addition, the
format of the video, and composition of a project advisory committee to assist with script
development and review of materials shall be discussed during initial project scoping. The
Contractor, or a designated project partner, shall prepare and distribute to all project partners a
brief meeting summary clearly indicating the agreements/understandings reached at the meeting.
Work on subsequent tasks shall not proceed prior to OCR approval of the proposed approach as
outlined in the meeting summary.
Products:
Scoping meeting with appropriate parties. Written meeting summary outlining
agreements/understandings reached.
Task 2:
Project Advisory Committee
The Contractor shall establish a project advisory committee to oversee all aspects of the project
in cooperation with municipal officials and the project consultant(s), if applicable. The
committee include project stakeholders with expertise relevant for developing and reviewing the
content of the video, such as representatives of State and municipal agencies with jurisdiction
over the coastal area and/or resources, and local non-governmental organizations and community
groups. A draft list of proposed members shall be circulated to OCR for review and approval
prior to establishment of the committee.
Products:
Oraft and final list of proposed members of project advisory committee. Project
advisory committee established.
Task 3:
Request for Proposals (if applicable)
The Contractor shall draft a Request for Proposals (RFP) including a complete project
description with site conditions, expected final results, a schedule for completion, and criteria for
selecting a preferred proposal. The Contractor shall submit the RFP to OCR for review and
approval prior to release for solicitation of proposals.
Products:
Approved RFP released through advisement in local papers, the New York State
Contract Reporter, and other appropriate means.
Task 4:
Consultant Selection (if applicable)
In consultation with OCR, theContractor and an appropriate review committee shall review all
proposals received as a result of the RFP. At a minimum, the following criteria are suggested for
use in evaluating consultant responses:
Task 5:
Task 6:
D-3
Quality and completeness of the response.
Understanding of the proposed scope of work.
Applicability of proposed alternatives or enhancements to information requested.
Cost-effectiveness of the proposal.
Qualifications and relevant experience with respect to the tasks to be performed.
Reputation among previous clients.
Ability to complete all project tasks within the allotted time and budget.
Incomplete proposals that do not address all of the requested components should not be accepted
for review and consideration.
For preparation/certification of final designs and construction documents, and for supervision of
construction, a professional engineer or licensed architect/landscape architect is required.
The municipal attorney, chief legal officer or financial administrator of the municipality shall
certify in writing to the OCR that applicable provisions of General Municipal Law were fully
complied with.
The Contractor's procurement record and consultant selection is subject to approval by DCR.
Products:
Consultant(s) selected and approved by OCR. Written certification of
procurement procedures.
Subcontract Preparation and Execution
The Contractor shall prepare a draft subcontract or subcontracts to conduct project work with the
consultant(s) selected. The subcontract(s) shall contain a detailed work plan with adequate
opportunity for review at appropriate stages of project completion, a payment schedule
(payments should be tied to receipt of products), and a project cost. The subcontract(s) shall
specify the composition of the entire consultant team, including firm name and area of
responsibility/expertise, and those professionals from the consultant team or consulting firm that
will be directly involved in specific proj ect tasks. The Contractor shall submit the draft
subcontract(s) to OCR for review and approval, and shall incorporate OCR's comments in the
final subcontract(s). A copy of the final, executed subcontract(s) shall be submitted to OCR.
Products:
Oraft and final, executed consultant subcontracts.
Second Project Scoping Meeting
In consultation with OCR, the Contractor shall hold a second project scoping meeting with the
consultant(s), the project advisory committee, and other project partners as appropriate, to review
project requirements and roles and responsibilities; identify new information needs and next
steps; and transfer any information to the consultant(s) which would assist in completion of the
project. The consultant(s) shall prepare and distribute a brief meeting summary clearly
indicating the agreements/understandings reached at the meeting. Work on subsequent tasks
shall not proceed prior to OCR approval of the proposed approach as outlined in the meeting
summary.
Products:
Scoping meeting with appropriate parties. Written meeting summary outlining
agreements/understandings reached.
D-4
Task 7:
Draft Script and Storyboard for Educational Video
In consultation with DCR and the project advisory committee, the Contractor or its consultant(s)
shall develop a draft script and storyboard for the educational video that will focus on the values
of coastal habitats and the need for regulating activities in the Town's coastal zone through its
Local Waterfront Revitalization Program. The draft script and storyboard shall be submitted to
OCR for review and comment, and OCR comments on these materials shall be addressed to the
satisfaction of the OCR prior to finalization and initiation of filming.
Products:
Oraft and final scripts/storyboards submitted to OCR for review and approval.
Task 8:
Filming and Completion of Or aft Educational Video
In consultation with OCR, the contractor or its consultant(s) shall conduct the necessary filming
and develop a draft educational video based on the approved script/storyboard produced under
the previous task. Interim footage and a draft of the video will be provided to OCR and the
project advisory committee for review and approval. OCR comments on draft footage and/or the
draft completed video shall be addressed to the satisfaction of the OCR prior to finalization of
the video.
Products:
Oraft video submitted to OCR for review and approval.
Task 9:
Final Broadcast-quality Educational Video
The contractor shall provide to OCR three copies ofthe final broadcast-quality educational video
(in a format(s) agreed upon during the initial project scoping meeting) which will include the
OCR acknowledgement described in Section 2 of this Work Plan.
Products:
Copies (3) of final video.
Task 10:
Semi -annual Reporting
The Contractor or its consultant(s) shall submit to the OCR semi-annual reports (every six
months) on the form provided, including a description of the work accomplished, any problems
encountered, and any assistance needed. The report may be submitted as part of a payment
request.
Products:
Semi-annual reports during the life of the contract.
Task II:
Measurable Results
The Contractor or its consultant(s) shall work with the OCR project manager to complete the
Measurable Results Form. Final payment shall not be authorized until the Measurable Results
Form has been completed and filed with project deliverables.
Products:
Completed Measurable Results Form.
D-5
5. Proiect Manal!ement Responsibilities
For this project, the primary contact for the Contractor is Peggy Dickerson, Town Trustee, or hislher
representative or successor. The primary contact shall administer the grant, execute a contract with
DCR, and ensure the completion of work in accordance with the approved Work Plan. Unless otherwise
specified in the Project Description or under Project Components, the Contractor and/or its approved
consultant(s) or subcontractor(s) shall conduct all work as described in the component tasks.
Tbe Contractor:
will be responsible for conducting all project work in conformance with the Work Plan included
in the executed contract with the DCR.
will be responsible for all project activities including drafting request for proposals and
managing subcontracts with consultants and subconsultants.
. will certify to the DCR that the procurement record for project consultants and subcontractors
complies with the applicable provisions of General Municipal Law.
will receive approval from the DCR for any and all consultant subcontracts before beginning
project work.
will be responsible for submission of all products and payment requests.
will be responsible for coordinating participation and soliciting comments from local government
personnel, project volunteers, and the public.
will keep the DCR informed of all important meetings for the duration of this contract.
will receive approval from the DCR before purchase of any equipment.
will secure all necessary permits and perform all required environmental reviews.
will ensure that all materials printed, constructed, and/or produced reflect the Division of Coastal
Resources logo, feature the Secretary of State and the Governor, and acknowledge the
contributions of the Division to the project.
will ensure that all products prepared as a part of this agreement shall include the NYS
Comptroller's Contract # as indicated on the Face Page of this Agreement.
will ensure the project objectives are being achieved.
will ensure that comments received from the DCR and the project advisory committee, or other
advisory group, are satisfactorily responded to and reflected in subsequent work.
will recognize that payments made to consultants or subcontractors covering work carried out or
products produced prior to receiving approval from the DCR will not be reimbursed unless and
until the DCR finds the work or products to be acceptable.
will participate, if requested by DCR, in a training session or sessions focused on developing and
implementing revitalization strategies. The purpose of the training session(s) is to build
knowledge and provide support to community leaders to advance revitalization efforts and
complete priority projects.
The Division of Coastal Resources:
will review and approve or disapprove of subcontracts between the Contractor and consultant(s)
and any other subcontractor(s).
will participate in initial project scoping and attend meetings that are important to the project.
will review all draft and final products and provide comments as necessary to meet the
objectives.
must approve any and all design, site plan, and preconstruction documents before construction
may begin.
APPENDIX X
Agency Code: 19000
Contract Period:
Contract No.: T006790
Funding for Period: $7,822
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 at 41 State Street, Albany, New York, 12231 (hereinafter referred to as the STATE), and Town of
Southold (hereinafter referred to as the CONTRACTOR), for modification of Contract Number T006790, as amended above and
in attached Appendice(s)
Terms and conditions of this amendment are subject to continued availability of funds for this contract.
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:
By:
(print name)
(print name)
Title:
Title:
Date:
Date:
State Agency 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."
State of New York
County of
)ss:
On this _ day of , 20_, before me personally came to me
known, who, being by me duly sworn, did depose and say that he/she/they reside(s) in
(if the place of resident is in a city, include the street
and street number, if any, thereof); that he/she/they is(are) the
(title of officer or employee) of the
(name of municipal corporation), described in and which executed the above instrument;
and that he/she/they signed his/her/their name(s) thereto by authority of the governing body of said municipal corporation.
NOTARY PUBLIC
Approved:
Thomas P. DiNapoli
State Comptroller
By:
Date:
-\
NEW YORK STATE DEPARTMENT OF STATE
Division of Coastal Resonrces
RECORD KEEPING AND PAYMENT GUIDE
Ge!heral Accoun"n!! Requirements
Aclequate financial accounts and records must be established and consistently maintained in accordance with generally
accepted accounting principles and practices in effect during the term of the Agreement. The Recipient must also keep a
cost ledger for costs incurred for work performed under the Agreement.
The financial accounts, records and cost ledger may be audited by appropriate State agencies ba~ed upon applicable
federal and State regulations and contractual provisions in effect during the term of the Agreement. The financial
accounts, records and cost ledger, including supporting documentation, must be kept intact and be readily available for
the period indicated in the Agreement.
Written procedures and internal-controls for the accounting system must be maintained to provide consistency in
recording transactions.
The accounting and control responsibilities must be segregated from the project operations. The Recipient is ultimately
responsible for the accounting and control responsibilities.
The minimum requirements for an acceptable accounting system are:
The system must include a cost ledger (general ledger) and appropriate subsidiary ledgers in which all
financial transactions related to the Agreement must be recorded (i.e., disbursements, revenues). A separate
cost ledger and subsidiary ledgers are required for each Agreement. The accounts and records must clearly
identify eligible and ineligible costs incurred by approved budget categories.
Disbursements (costs) and revenues (advances, reimbursements) must be recorded in subsidiary ledgers
established for each approved budget category as they are received or incurred and summarized in the cost
ledger monthly.
Each entry in the accounting records must be supported by appropriate documentation. The documentation
can be generated from outside the Recipient's organization (i.e., invoices), and/or it can be internally
generated (i.e., payroll registers). The files of supporting documentation must be coded and cross-referenced
in such a way that transactions can be traced from any document dealing with the transaction back to the
initiation of that transaction and forward to the entry or entries in the accounting system.
General Payment Request Requirements
All payment requests must be prepared, documented and submitted in accordance with this guide. If requests are not in
accordance with this guide or if they contain errors or are illegible, it may cause processing delays, payment deduction or
a rejection of the request. In the event that a payment request is denied or partially paid, the State will provide written
notice of the reasons for partial payment or denial to the Recipient.
Claims for payment consist of Summary Sheet Documentation Forms and a New York State Standard Voucher. Invoices,
receipts, timesheets and other financial backup information do not need to be submitted, as the Agreement requires that
'his information be kept in the Recipient's project file. Generally, payments will be made approximately 4-6 weeks from
-eceipt of an acceptable claim, provided that all other contractual obligations are being met.
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Draft or final products associated with completed project tasks should already have been submitted to DOS for review
and approval prior to initiating a payment request for the related work. If these P1'Oducts have not been previously
submitted to DOS, they should be submitted with the payment request. However, please note that reimbursement may be
delayed because the products will need to be reviewed and approved before the payment request can be processed.
PaYJIlent requests will be reviewed in accordance with the terms and conditions of this Agreement to determine total
allo~able project costs incurred and the number and percentage of allowable project tasks completed to date. For the
purpose of determining the level of reimbursement, otherwise allowable project costs may be reduced if the percentage of
task completion is deemed insufficient, or if products have not yet been approved by DOS. The Department shall make
interim payments for eligible costs incurred up to an amount not to exceed 90% of the State Funds Requested.
The final payment request must be submitted within 60 days of the. expiration date of the Agreement or the completion of
the scope of work in the Agreement, whichever occurs first. The final payment request will not be processed until all
work products are received and determined acceptable by the State.
When preparing payment requests, please note the following:
Items detailed must match those in the approved budget and be shown in the same budget categories.
The amounts shown on the Standard Voucher, the Summary Sheet, and Detail Sheets must all agree.
Since supporting documentation is not required, it is very important that the forms be completed as
accurately and detailed as possible.
Care should be taken to ensure all forms are legible, completely filled out and do not contain math errors.
The use of Other, Etcetera or Miscellaneous is not allowable in documenting expenditures.
No estimated costs are allowed. Also, costs should not be rounded to the nearest dollar.
Forms with white out cannot be accepted.
Requests for payment will not be accepted more frequently than montWy.
You will soon be able to download payment forms from our website:
http://www.nvswaterfronts.comlfonns.asp.
Draft payment requests can be sent for review and comment prior to fonnal submission. You can fax your draft payment
request to (518) 473-2464 or email to Iparentlaldos.state.nv.us. Completed payment requests should be mailed to:
New York State Department of State
ATTN: Coastal Resources - 8'. Floor
Contract Administration Unit
41 State Street
Albany, New York 12231-00(1l
If you have any questions, please call (518) 474-5559 or (518) 474-6000.
Completinl! the Summarv Sheet Documentation Forms
FORM 1: Summary Sheet
SECTION I:
Please fill out all items in this section - Recipient, Contract #, Projcct Titlc, Payment Request #, indicate whether this is
an interim or final payment and provide the time period that costs documented on this request were incurred.
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SECTION II:
Column #1
Insert the budget amounts from the approved budget of the Agreement.
Column #2
I
Column #3
Reflects the expenditures being documented on Forms 2 through 4 of this payment request.
Represents the cumulative expenditures documented to date (this payment request plus previous
payment requests). If this is the first payment request, Columns #2 and #3 will be the same.
Column #4
Calculate by subtracting the Cumulative Documented Expenditures (Column #3) from the
Approved Budget Amount (Column #1).
NOTE:
Category F. Other is broken down by "Reimbursable Costs" and "Local Share Only". The "Reimbursable
costs" line is used when costs have actually been incurred, such as for training, printing or advertising.
The "Local Share Only" line is used when a value has been placed on an item or service, such as
volunteer services, donated professional services, or equipment usage. Exception: In EPF Agreements,
land acquisition can only be used as local share.
*Make sure to fill in the total for each column.
NOTE:
Costs in any budget category cannot exceed the budgeted amount by more than 10% or $1 ,000,
whichever is greater. Any expenditure in excess of this requires a budget amendment request to be
submitted in writing by the Recipient and approved by the Department before reimbursement will be
made.
SECTION ill:
This section must have an original signature by the municipality's responsible authorized representative, as indicated on
the Recipient's most recently submitted Contract Administration Update Form. Be sure to fill in the sections for printed
name, title, affiliation and daie; as well as the name, title, affiliation, telephone number and email address of the person to
contact if DOS has questions about the payment request.
FORM 2: Proiect Status Form
Please fill out all items in the top section - Recipient, Contract #, Project Title, and Status Report Date. In the next
section, list each task from the work plan of the Agreement and provide corresponding information for each.
Task # and Brief Task Pescription should agree with the tasks listed in the work plan ofthe Agreement.
AfT should indicate if Pate of Completion is the Actual completion date or the current Target Date for
completion of the task.
Percent of Completion is the percentage that the task is complete as of the Status Report Date.
Task Accomplishments should be brief, but describe specific accomplishments for each task.
Product Submitted should be "Draft" if the draft product has been submitted to DOS (or is being submitted with
this report), "Final" if the final product has been submitted to DOS (or isbeing submitted with this report),
"None" if product has not yet been submitted, or "N/A" ifnot applicable. Alternatively, the specific product(s)
submitted may be listed.
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Important things to consider when filling out this section of the Status Report Form:
.f
Tasks should match those in the work plan of the Agreement with DOS (not a subcontractor agreement).
All tasks (including subtasks) in the work plan of the Agreement must be listed on each report submitted.
All columns must be completed for every task.
A task c~ot be considered 100% complete until the required product is submitted to and approved by DOS.
Task accomplishments should be as specific as possible (but brief). Status reports submitted with generic
accomplishment entries will take longer to review by DOS and may not be accepted. Here are some tips on how
accomplishment entries can be improved:
Generic accomplishment entry: Specific accomplishment entry:
Advisory committee established. 8 person advisory committee was established and has met (6) times to date.
RFP issued;, RFP was released through local papers and NYS Contract Reporter.
Consultant Selected. 5 responses were received and ABC Construction Company, Inc. was selected.
Certification of procurement procedures have been provided to DOS.
Final designs. Final Design & Construction Drawings (incorporating DOS comments of
11/5/05) were approved by DOS.
Pennits. Pennit applications have been submitted to DEC and COE, copies are included
with this report.
In the ADJUSTMENTS section - Indicate proposed adjustments to the budget, work program, or project schedule, ~nd
the reason why the adjustment is necessary. If any problems have been encountered during this reporting period, they
should also be indicated here. Keep in mind that the information listed in this section should refer to this reporting period
onlv.
If an extension is requested on this form, the reasons provided should be detailed and specific. For example, requesting
an extension to "complete the project" or "allow time to finish remaining tasks" is not acceptable. The information
provided in this section should indicate specific reasons that tasks were delayed and/or problems were experienced.
On the bottom of the sheet, please provide the Name, Affiliation, Email Address, Phone Number, and Fax Number ofthe
person to contact if we have questions on the information provided on this form.
FORM 3: Proiect Narrative
Please describe the activities undertaken during the period covered by the payment request and how they relate to the
expenditures documented on the request. The description should be detailed and specific.
FORMS 4 and 5: Detail Sheets
<\. Salaries & Waees (Including Fringe Benefits)
List the title of each of the Recipient's employees who incurred costs working on the project, the amount charged
to the project for each title, and the time period during which these costs were incurred. The amount charged
should be reasonable in terms of the work performed.
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Examples:
Deputy Director
Coastal Resources Specialist
June I, 2005 - December 31, 2005
August 1,2005 - September 30,2005
$566.25
$357.65
Notes:
Reimbursement for direct salary costs is limited to tbe titles and salaries in tbe approved budget.
Titles must be listed for each. Do. not list names of the individuals.
Changes to tbe approved titles and/or salaries must be made in writing and approved by DOS.
Salaries of elected officials are not an eligible cost.
Salary costs incurred by subcontractors (whether by subcontract, retainer, or Intermunicipal Agreement)
should be listed in E. Contractual Services.
Record Keepinl!
The Recipient's project file should include a record of tbe time spent by each employee witb tbe following
information:
title and name of each individual
salary of each individual expressed as an hourly rate
dates worked for each individual and hours worked each day
fringe benefit rates for each time period
task(s) to which work is attributable
B. Travel
The following information should be provided for each of the Recipient's employees for each trip:
title Qf each i.ndividual
date and purpose of trip
origin and destination of travel
costs for lodging, transportation and/or meals
Example:
Project Assistant traveled from City, NY to Albany, NY to attend the Coastal Resources
conference on 3/1/06. Lodging $94, Car rental $50, Meals $49. Total cost for trip: $193.
Similar trips made claiming mileage only may be combined. Example:
Site visits to construction site from March 2004 to August 2004:
25 trips x 10 miles each x .445 per mile ~ $1 I I .25
Note: This category is for costs incurred by the Recipient only. Travel costs incurred by subcontractors are
listed in E. Contractual Services.
Record Keepinl!
The Recipient's project file should include travel cost documentation forms, as well as receipts for lodging,
meals, transportation, etc. for each traveler.
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C. Supplies/Materials
List the different types of supplies and materials purchased and the cost of each.
Examples:
Office Supplies (Copy paper, envelopes)
150 gallons of fuel @ $3/gallon
30 Trees @$IO each
$100
$450
$300
Note: This category is for costs incurred by the Recipient only. Supply costs incurred by subcontractors are
listed in E. Contractual Services.
Record Keeping
The Recipient's project file should include copies of receipts, purchase orders and/or checks issued.
D. Equipment
List each piece of equipment purchased and the cost of each piece. Also provide some description of the
equipment such as make, year, model number, etc.
Examples:
HP Officejet 5610v All-in-one printer, copier, scanner, fax machine
Troy-Bilt Chipper/ShredderNacuum Model #24B-060F766
Mowing system, Pro Mow Model #FL58
$200
$549.99
$1299.99
Note: This category ,is for costs incurred by the Recipient only. Equipment costs incurred by subcontractors are
listed in E. Contractual Services.
Record Keeping
The Recipient's project file should include copies of receipts, purchase orders and/or checks issued. Records
should also include a description of each piece of property, serial and model numbers, and its location.
Inventories should be verified by physical inventory counts.
E. Contractual Services
List the name of each subcontractor procured by the Recipient, the amount being documented for each, the time
period for which these costs were incurred (not the date of the subcontractor's invoice), and the service provided.
Examples:
LPS Construction Co. Jan 2002 - June 2002 $3,000
Dock construction at Evie-Joe's Marina
WJM Engineering Svcs. Jan 2002 - June 2002 $5,000
JMF Equipment Rentals Jan 2002 - June 2002 $200
Final design & bid documents
Pick-up truck rental
Only subcontractors who contract directly with the Recipient should be listed here. If the Recipient's
subcontractor(s) procure the services of others, this should not be broken down separately on the forrn. Also,
costs incurred by the subcontractor do not need to be broken down by the type of costs or by invoice.
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Example:
The Recipient hires LPS Construction Company to construct a dock. LPS Construction
Company contracts with JMF Equipment Rentals for the rental of a backhoe. In this example,
costs incurred are:
Invoice #]
Construction Supervisor's time:
Laborers' time:
Construction Supplies:
$1,300
$7,500
$500
Invoice #2
Construction Supervisor's time:
Laborers' time:
Travel for site inspections:
Construction Supplies:
Contract with JMF Equipment Rentals:
$1,700
$11,000
$45
$800
$1,400
This would be documented as follows:
LPS Construction Company Jan 2002 - June 2002 $24,245
- For construction of dock at Evie-Joe's Marina
Note: The Recipient must have procured the subcontractor in accordance with the Agreement requirements and
all applicable statutes, rules, and regulations. The municipal attorney, chief legal officer or financial
administrator of the Recipient must certify in writing that applicable provisions of General Municipal
Law were fully complied with. Before reimbursement for Contractual Services will be made, the ,.
procurement certification and the executed subcontract must be submitted to DOS.
For Agreements requiring attendance at Quality Communities Workshops and Training, the Recipient would
have received an advance from DOS to pay the registration fees for those sessions. The Recipient should have
then forwarded payment for these registration fees to NHT. This cost should be documented on your first
payment request.
Example:
Natural Heritage Trust
Mar 2004 - June 2004
$5,000
$5,000
QC Workshops
QC Training
Natural Heritage Trust
Mar 2004 - June 2004
Record Keeping
The Recipient's project file should include copies of invoices, purchase orders and/or checks issued. Invoices
should be detailed and related directly to work program tasks. The Recipient's project file should also include a
copy of the procurement record, the executed subcontract for each subcontractor, and a copy of the written
approval issued by DOS to execute each subcontract.
F. Otber
The other category may include items such as volunteer services, professional/donated services, use of municipal
owned equipment, and other items which do not fit in the categories above. The type of service provided and
amount claimed should be indicated.
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Examples:
.
Land Acquisition
Printing of the L WRP
$]00,000
$800
f For items that have a value rather than a cost (equipment usage, volunteer time, etc.), a breakdown of how the
amount was detennined is required.
Examples:
Use of backhoe 50 hours x $20 per hour
Advisory Committee 8 people x 3 meetings x 2 hours per meeting x$15 per hour
Reviewed products submUted by consultant
County Planning Dept. - Junior Planning Technician 20 hours X $25 per hour
Provide GIS data & preparation of maps
Donated services by construction contractor to design kayak launch
$1,000
$720
$500
$5,000
For Agreements requiring attendance in the Community Training Program, the Recipient would have received an
advance from DOS to pay the registration fees for the training sessions. The Recipient should have forwarded
payment for these registration fees to SUNY ESF within two weeks of receiving the advance. This cost should
be documented on your first payment request.
Example:
SUNY ESF - Registration fees for (4) training sessions at $125 each
$500
Record Keeping
The Recipient's projec,t file should include copies of receipts, purchase orders and/or checks issued. Depending
on the costs/values documented, the Recipient's project file should also include:
Land Acquisition - Copy of filed deed and appraisal.
Equipment Usage - Dayslhours spent and cost per daylhour for each piece of equipment.
Volunteer Services - Number of volunteers and hours spent, hourly rate charged (rate will be
listed in the budget of Agreement), and activities undertaken. Volunteer Services contributed by
elected officials are not an eligible cost unless the services provided are outside the performance
of their official duties.
Donated Professional Services - Name of agency/company who provided services, hours spent
and hourly rate charged, and activities undertaken.
::ompleting the NYS Standard Voucher
rhe Recipient should onlv complete numbered blocks 3 through 7 on the Standard Voucher.
Block 3:
Block 4:
Block 5:
Block 6:
Recipient's Federal Tax ill number.
Recipient's name and address as it appears on the Contract Face Page.
Reference to be printed on the OSC issued check (optional).
List each category that is being documented and indicate the dollar amount expended for each category.
The total should be the total amount documented. The 'Discount' and 'Net' boxes should be len blank.
This section must have an original signature by the Recipient's responsible authorized representative.
Make sure the title, date, and name of company sections are completed.
Block 7:
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'orm I - Summary Sheet
. PROJECTIPAYMENTlNFORMATION
RECIPIENT
CONTRACT #
PROJECT TITLE
V
Payment Request #
Type of Request
(Interim)
and
(Final)
Costs documented on this payment request were incurred during the time period of
[. BUDGETIEXPENDlTUREDATA
Approved
Budget Amount
Expenditures
Documented
this Report
Cumulative
Documented
Expenditures
Available
Balance to
Document
~:"?,,,I..~.~.s..~.~..g~~..............................:....j..L...........................:.......j..~......................................h......................................J..L..................................
3. Travel i $ ~ j $ i $ i $
;::~:~~~;;:;~:~:~~:;~~~:I:~::::::::::::::::.::::::::::::I;.:::::::::::::::::::::::::::::::::::::r~:::::::::::::::::::::::::::::::.:::::r~:::::::::::::::::::::::::::::::::::::r~:::::::::::::::::::::::::::::::::::::
):..I'9.u.iP.I1!~Il.t.....nn......n..........n............n...j.J....n................................j..L............................n....jn~.........n.............___...........j..L.................................
o. Contractual Services : $ : $ : $ : $
...............n_.....n.........................n_..........__.....:................nn......................;.................................n.......-:.........._n...hn......................;....n.............................._n..
.. Other - Reimbursable costs' i $ i $ i $ j $
.::;~;~:::~~~~;:;~~~;:;~;~;::::::::::::.:::::):;:::::::::::::::::::::::::.:::::::::::T~:::::::::::::::::::::::::::::::::::T~:::.:::::::::::::::::::::::::::::::::T~::::::::::::::::::::~:::::::::::::::
rOTAL i $ i $ i $ i $
~ ~ ; ;
'ee the Record Keeping and Payment Guide for more information
. CERTIFICATION
,rtifY that:
the above claim as detailed on attached fanns is just, true and correct; that the amount claimed accurately represents the expenses as
recorded in our accounting records;
the attached status repon and project narrative accurately represents current project status;
we are in compliance with all applicable provisions of the above-referenced Agreement;
documented expenditures have been made solely for the purposes of the project as described in the work program 9fthe above-referenced
Agreement;
persons not parties to the above-referenced Agreement who performed work under the Agreement have been compensated or will be
compensated; and
I am the responsible representative authorized to certify this claim.
;nature:
Contact Person:
Title of Contact:
inted Name:
Ie:
Affiliation of Contact:
Phone of Contact:
filiation:
Email of Contact:
te:
AST Al\CofltractsICofllracIFonfls\PR fonns\Docsum _.New. wpd
'orm 2 - Project Status Form
RECIPIENT
PROJECT TITLE
CONTRACT #
Status Report Date:
I
** See payment guidelines for directions on completing this form **
'ask
#
Brief Task
Description
Aff
Date of
Completion
Percent of
Completion
Task Accomplishments
Product
Submitted
to DOS
lJUSTMENTS - Please indicate proposed adjustment(s) to work program/schedule, reason(s) for the proposed
justment(s), and any other problems eucountered durin!! this reportin!! period:
orson to contact if we have questions about the information provided on this form:
:une:
Email Address:
tIe:
Affiliation:
lone:
Fax:
)AST AL\ConlraclS\ContrilcIForms~R fonn~\OOCSUln _ New _wpd
!?orm 3 - Project Narrative
'lease describe the activities undertaken during the period covered by the payment request and how they
"elate to the expenditures documented on the request. This description should be detailed and specific.
I
)AST AL\Contracts\Con!racIFonnsIf'R forms\DocsUffi_New_wpd
'orm 4 - Detail Sheet 1. See payment guidelines for instructions on how to document expenditures
A. SALARIES AND WAGES (Including Fringe Benefits)
PAY PERIODS AMOUNT CHARGED
TITLE FROM - TO TO THIS PROJECT
1. ! $
2. $
-
3. $ -
4. $
5. $
6. $
7. $
SUBTOTAL $
I. TRAVEL
SUBTOTAL $
SUPPLIESIMA TERIALS
SUBTOTAL $__
As-rAl \Conlrncls\ContracIFonnsIPR fomlS\Docsuln _New.wpd
Form 5 - Detail Sheet 2. See payment guidelines for instructions on how to document expenditures
D. EQUIPMENT
SUBTOTAL $
E. CONTRACTUAL SERVICES
Name
Amount
Service Provided
Dates of Service
SUBTOTAL $
OTHER
SUBTOTAL $
)AST AL\ConlraClsIConlracIFomlst'PR fonns\DocsulTl_ New. wpd
"orm 1 .. Summary Sheet
.'"
. PROJECTIPAYMENT INFORMATION
RECIPIENT
PROJECT TITLE
I
Payment Request #
CONTRACT #
Type of Request
(Interim)
and
(Final)
Costs documented on this payment request were incurred during the time period of
[. BUDGETIEXPENDITUREDATA
Approved
Budget Amount
Expenditures
Documented
this Report
Cumulative
Documented
Expenditures
Available
Balance to
Document
. . . .
. . . .
. . . .
~:..~~l~!:i.,-~..~.~~g~~...................................;..$...............................:.......p......................................;..~.:....................................;.J....................................
~. Travel i $ . j $ i $ 1 $
................................................-..............-.......~......................................n.."l.........................................."!.__.....................n................"!.........................................
=.:.!>.up.p.!.je.~..~.!\:'-~!~!:i.a.~~..._.._.........__........._..!..$...._.......................-.........-!..L.....-.................-...........!..~....................................--l-J....._............................_.
):..~9.u_P.~~I1.t...._.................._............_.........-L$......_................_...............j.J.....................................LL..........._.......................L~_....................................
;- Contractual Services i $ ! $ i $ ! $
......................---............................--..........--...;-.........................................;-........................................'1..........................................1.........................................
-. Other - Reimbursable costs' ! $ ! $ i $ i $
.............--.........-............................---.........--...1....----......--......................---.1............-.............0...............1".-............---...--......0....--_.....1........................;............_.n
..Q~!!~!.-:J,Q,~L$-h~r.~h9.'!!Y_~mm.....mh...hj_J....hm..h..hmh_hmh..h..+-Ji.hh--..hhmhh........hm_mj..Ji..mhm_h_hh.._h..hm_.._..+-L..hhm_hmhhm.hhmhh
rOTAL I $ I $ I $ ! $
'ee the Record Keeping and Payment Guide for more iriformation
. CERTIFICATION
'rtify that
the above claim as detailed on attached fonns is just, true and correct; that the amount claimed accurately represents the expenses as
recorded in our accounting records;
the attached status report and project narrative accurately represents current project status;
we are in compliance with aU applicable provisions of the above-referenced Agreement;
documented expenditures have been made solely for the purposes of the project as described in the work program of the above-referenced
Agreement;
persons not parties to the above-referenced Agreement who performed work under the Agreement have been compensated or will be
compensated; and
I am the responsible representative authorized to certify this claim.
~nature:
Contact Person:
inted Name:
Title of Contact:
Ie:
Affiliation of Contact:
filiation:
Phone of Conlact
tc:
Email of Contact:
AST AL\Conlracts\ConlracIFonns\VR fonns\Docsum _New. wpd
~orm 2 - Project Status Form
RECIPIENT
PROJECT TITLE
CONTRACT #
Status Report Date:
I
** See payment guidelines for directions on completing this form **
'ask
#
Brief Task
Description
Aff
Date of
Completion
Percent of
Completion
Task Accomplishments
Product
Submitted
to DOS
lmSTMENTS - Please indicate proposed adjustment(s) to work program/scbedule, reason(s) for tbe proposed
justment(s), and any otber problems encountered durin!! tbis reportin!! period:
'rson to contact if we have questions about the information provided on this form:
lme:
Email Address:
tie:
Affiliation:
tone:
Fax:
)ASTAL\ContraCIs\ContractFonns~R ronns\Oocsum__ New. wpd
!'orm 3 - Project Narrative
>Iease describe the activities undertaken during the period covered by the payment request and how they
'elate to the expenditures documented on the request. This description should be detililedand specific.
>A5T AI,\Contracls\ConlracIFonns'lJ'R rorms\Docsum _New. wpd
'orm 4 - Detail Sheet 1. See payment guidelines Jorinstructions on how to document expenditures
A. SALARIES AND WAGES (Including Fringe Benefits) ,
PAY PERIODS .
AMOUNT CHARGED
TITLE FROM - TO TO THIS PROJECT
l. I $
. $
2.
3. $
4. $
. $
5.
6. $
.
7. $
SUBTOTAL $
I. TRAVEL
SUBTOTAL $
SUPPLlESIMA TERIALS
SUBTOTAL $
AST Al.\ConlraCls\ConlracIForms\JPR fomlslDocsuln _New .wpJ
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Form 5 - Detail Sheet 2. See payment guidelines for instructions on how to document expenditures
D. EQUIPMENT
f
SUBTOTAL $
E. CONTRACTUAL SERVICES
Name Amount
Dates of Service
Service Provided
SUBTOTAL $
OTHER
SUBTOTAL $
)AST ALIConlrnCls\Coiltr3CIForms{PR rormslDocsum _New. wpd
!orm 1 .. Summary Sheet
,
PROJECT/PAYMENT INFORMATION
RECIPIENT
CONTRACT #
PROJECT TITLE
i
Payment Request #
Type of Request
(Interim)
and
(Final)
Costs documented on this payment request were incurred during the time period of
[. BUDGETIEXPENDITUREDATA
Approved
Budget Amount
Expendi tures
Docinnented
this Report
Cumulative
Documented
Expenditures
Available
Balance to
Document
. . . .
\..s."!"!:i.~~..~.:-v...g~~.............__...........____:....L$...............................:.......L~......................................L~.:....................................1.J....................................
3. Travel i $ .! $ i $ ! $
................n....n.......................n......................"l...nn...................................."!.............n....................nn...-!n.....................n.............hn-!.............n....n....................
~:..S.~.P.p.l.j.~~..~.~...!~!:i.a.I.~...__..........__............!..$.......................................LL................................__.L~.....__...............................LL..................................
):__~9.u.!P.~~I1.!..............____..........____.....n____...LL...............____................L~..................n...........----...L~...--....__.....n....................LL..................................
:. Contractual Services i $ i $ ! $ ! $
.......h...............hhU......._.........n._n.....__nn_.....!....n..................................--:............................___..h.......;n..........n............................!...................................._....
-. Other - Reimbursable costs' 1 $ 1 $ : $ 1 $
.::~;~~;.:;:~:~~~;:;~~~~:;~;~;:.:::::.::....--.....r;:::::::::::.:::::::::::::::::::::::::T;::::::::::.::'::::::::::::::::.::::-::;::;::.::::::::::::::':::::::::::::::::::T;::::::::::::::::::::~:::::::::::::::
rOTAL I $ I $ I $ I $
'ee the Record Keeping and Payment Guide for more information
. CERTIFICATION
:rtify that:
the above claim as detailed on attached forms is just, true and correct; that the amount claimed accurately represents the expenses as
recorded in OUT accounting records;
the attached status report and project narrative accurately represents current project status;
we are in compliance with aJl applicable provisions of the above-referenced Agreement;
documented expenditures have been made solely for the purposes of the project as described In the work program of the above-referenced
Agreement;
persons not parties to the above~referenced Agreement who performed work under the Agreement have been compensated or will be
compensated; and
I am the responsible representative authorized to certify this claim.
~nature:
Contact Person:
inted Name:
Title of Contact:
Affiliation of Contact:
Ie:
filiation:
Phone of Contact:
Ie:
Email of Contact:
AST AL\Conlr<lCls\ConlraclFonlls\I'R fonllS\Doc$um _.New, wpd
lonn 2 - Project Status Form
RECIPIENT
PROJECT TITLE
CONTRACT #
Status Report Date:
I
** See payment guidelines for directions on completing this form **
'ask
#
Brief Task
Description
AfT
Date of
Completion
Percent of
Completion
Task Accomplishments
Product
Submitted
to DOS
lJUSTMENTS - Please indicate proposed adjustment(s) to work program/schedule, reason(s) for the proposed
justment(s), and any other problems encountered durin!! this reportin!! period:
:.son 10 contact if we havc questions about the information providcd on this form:
:tme:
Email Address:
tIe:
Affiliation:
tone:
Fax:
)AST AL\ConlractslConlraclFonnsWR rormslDocsllnJ_ New. wpd
, .
!1orm 3 - Project Narrative
>Iease describe the activities undertaken during the period covered by the payment request and how they
"elate to the expenditures documented on the request. This description should be detailed and specific.
I
}AST AL\Conlracts\ConlractFonnsif>R forms\Docsum _New. wpd
'orm 4 - Detail Sheet 1. See payment guidelines for instructions on how to document expenditures
A. SALARIES AND WAGES (Including Fringe Benefits)
PAY PERIODS AMOUNT CHARGED
TITLE FROM - TO TO THIS PROJECT
l. , $
2. $
3. $
4. $
5. $
6. $
7. $
SUBTOTAL $
I. TRAVEL
SUBTOTAL $
SUPPLIESIMA TERIALS
SUBTOTAL $
AST AL\Contracls\ConlracIFonnsIYR romls\DocstJIn _New.wpd
Form 5 - Detail Sheet 2. See payment guidelines for instructions on how to document expenditures
D. EQUIPMENT
I
SUBTOTAL $
E. CONTRACTUAL SERVICES
Name Amount
Dates of Service
Service Provided
SUBTOTAL $
OTHER
SUBTOTAL $
)AST AL\Contracts\ContractFomlsWR ronns\Docsum ~ New .wpd
AC 92 (Rev 6/94)
SEE INSTRUCTIONS ON REVERSE SIDE BEFORE COMPLETING
OF STANDARD VOUCHER Voucher No.
NEW YORK
2J Originating Agency T Orig. Agency Code Interest Eligible (Y/N) ~ P-Contract
Payment Date (MM) (DO) (VY) OSC Use Only Liability Date (MM) (DO) (YY)
I I I I
IT Payee 10 Additional I Zip Code I Route Payee Amount I MIR Oat. (MM) (DO) (YY)
I I
IT Payee Name (Limit to 30 spaces) IRS Code IRS Amount
Payee Name (Limit to 30 spaces) Stat Type Statistic Indicator-Dept. I Indicator-Statewide
Address (Limit to 30 spaces) W Refllnv. No. (Limit to 20 spaces)
Address (Limit to 30 spaces) Refllnv. Date (MM) (DO) (YY)
I I
City (Limit to 20 spaces) (Limit to 2 spaces) 7 State 1 Zip Code
@J Purchase Description of Material/Service
Order No. If items are too numerous to be incorporated into the block below, Quantity Unit Price Amount
and Date use FormAC 93 and carry total forward.
I
2J Payee Certification:
I certify that the above bill is just, true and correct; that no part therof has been paid except as stated and that Total
the balance is actually due and owing, and that taxes from which the State is exempt are excluded.
Discount
~ Payee's Signature in Ink Title %
Date Name of Company Net
FOR AGENCY USE ONLY STATE COMPTROLLER'S PRE-AUDIT
Merchandise Received I certify that this voucher is correct and just, and payment is approved, and the goods or services Certified For Payment
rendered or furnished are for use in the performance of the official functions and duties of this of
agency. Verified Net Amount
Date
AuthorizedSi9nature Audited
Page No
By Date Title Special Approval By
rasRA<luired\
Expenditure Liquidation
Cost Center Code Accum
Object Amount Orig. Agency PO/Contract Line FIP
Dept. Cost Center Unit Var. Ye. Dept. Statewide
,
,
,
,
,
STATE
osc
D Check if Continuation
form is attached
Project Status Form
RECIPIENT
PROJECT TITLE
CONTRACT #
Status Report Date:
** See guidelines on reverse side for completing this form **
'ask
#
Brief Task
DescriDtion
Aff
Date of
COffiDletion
Percent of
COffiDletion
Task AccoffiDlishments
Product
Submitted
to DOS
JUSTMENTS - Please indicate proposed adjustment(s) to work program/schednle, reason(s) for the proposed
ustment(s), and any other problems enconntered durin!! this reportin!! period:
rson to contact if we have questions about the information provided on this form:
me:
Email Address:
Affiliation:
Ie:
)ne:
Fax:
ASTAL\CODtracIS\cOl1lnK:tFonns\P,R forms\slalus_bfanlc..wpd
Guidelines for completing the Project Status Form
lease fill out all items in the top section - Recipient, Contract #, Project Title, and Status Report Date. In the next section, list
ICh task from the work plan of the Agreement and provide corresponding information for each.
Task # and Brief Task Description should agree with the tasks listed in the work plan of the Agreement.
All' should indicate if Date of Completion is the Actual completion date or the current Target Date for completion of
the task.
Percent of Completion is the percentage that the task is complete as of the Status Report Date.
Task Accomplishments should be brief, but describe specific aecomplislunents for each task. If no aecomplislunents
have yet been made for a task, the aeeomplislunent column should be left blank for this task.
Product Submitted should be "Draft" if the draft product has been submitted to DOS (or is being submitted with this
report), "Final" if the final product has been submitted to DOS (or is being submitted with this report), "None" if
product has not yet been submitted, or "N/ A" if not applicable. Alternatively, the specific produet(s) submitted may
be listed.
.portant things to consider when filling out this section of the Status Report Form:
Tasks should match those in the work plan of the Agreement with DOS (not a subcontractor agreement).
All tasks (including subtasks) in the work plan of the Agreement must be listed on each report submitted.
All columns must be completed for every task.
A task cannot be considered 100% complete until the required product is submitted to and approved by DOS.
Task accomplislunents should be as specific as possible (but brief). Status reports submitted with generic
accomplislunent entries will take longer to review by DOS and may not be accepted. Here are some tips on how
accomplislunent entries can be improved:
Generic accomplishment entrv: Specific accomplishment entrv:
Advisory connnittee established. 8 person advisory connnittee was established and has met (6) times to date.
RFP issued. RFP was released through local papers and NYS Contract Reporter.
Consultant Selected. 5 responses were received and ABC Construction Company, Inc. was selected.
Certification of procurement procedures have been provided to DOS.
Final designs. Final Design & Construction Drawings (incorporating DOS comments of
11/5/05) were approved by DOS.
Permits. Permit applications have been submitted to DEC and COE, copies are included
with this report.
1e ADJUSTMENTS section - Indicate proposed adjustments to the budget, work program, or project schedule, and the
on why the adjustment is necessary. If any problems have been encountered during this reporting period, they should also
ndicated here. Keep in mind that the information listed in this section should refer to this revorting period onlv.
1 extension is requested on.this form, the reasons provided should be detailed and specific. For example, requesting an
nsion to "complete the project" or "allow time to finish remaining tasks" is not acceptable. The information provided in
section should indicate specific reasons that tasks were delayed and/or problems were experienced.
he bottom of the sheet, please provide the Name, Affiliation, Email Address, Phone Number, and Fax Number of the person
mtact if we have questions on the information provided on this form.
u submit this form by fax or email, there is no need to forward the original bv maiL We only need to receive one copy of
eport.
u have any questions, please contact Laurissa Parent at (518) 474-5559 or your DOS project manager at (518) 474-6000.
.$T AL\Contr.actS\COOlr.JCtForms\PR forms\status _blank. wpd
Project Status Form
RECIPIENT
PROJECT TITLE
CONTRACT #
Status Report Date:
** See guidelines on reverse side for conlpleting this form **
'ask
#
Brief Task
Descriotion
Af[
Date of
Comoletion
Percent of
Comoletion
Task Accomolishments
Product
Submitted
to DOS
JUSTMENTS - Please indicate proposed adjustment(s) to work program/schedule, reason(s) for the proposed
ustment(s), and any other problems encountered durin!! this reportin!! period:
rson to contact if we have questions about the information provided on this form:
me:
Email Address:
Ie:
Affiliation:
)fie:
Fax:
ASTAL\Contracls\ContractForms\PR fonns\$tatus blank.wpd
, -
Guidelines for completing the Project Status Form
lease fill out all items in the top section - Recipient, Contract #, Project Title, and Status Report Date. In the next section, list
Ich task from the work plan of the Agreement and provide corresponding information for each.
Task # and Brief Task Description should agree with the tasks listed in the work plan of the Agreement
AfT should indicate if Date of Completion is the Actual completion date or the current Target Date for completion of
the task.
Percent of Completion is the percentage that the task is complete as of the Status Report Date.
Task Accomplishments should be brief, but describe specific accomplishments for each task. If no accomplishments
have yet been made for a task, the accomplishment column should be left blank for this task.
Product Submitted should be "Draft" if the draft product has been submitted to DOS (or is being submitted with this
report), "Final" if the final product has been submitted to DOS (or is being submitted with this report), "None" if
product has not yet been submitted, or "N/A" ifnot applicable. Alternatively, the specific product(s) submitted may
be listed.
'portant things to consider when filling out this section of the Status Report Form:
Tasks should match those in the work plan of the Agreement with DOS (not a subcontractor agreement).
All tasks (including subtasks) in the work plan of the Agreement must be listed on each report submitted.
All columns must be completed for every task.
A.task cannot be considered 100% complete until the required product is submitted to and approved by DOS.
Task accomplishments should be as specific as possible (but brief). Status reports submitted with generic
accomplishment entries will take longer to review by DOS and may not be accepted. Here are some tips on how
accomplishment entries can be improved:
Generic accomplishment entrv: Specific accomplishment entrv:
Advisory committee established. 8 person advisory committee was established and has met (6) times to date.
RFP issued. RFP was released through local papers and NYS Contract Reporter.
Consultant Selected. 5 responses were received and ABC Construction Company, Inc. was selected.
Certification of procurement procedures have been provided to DOS.
Final designs. Final Design & Construction Drawings (incorporating DOS comments of
11/5/05) were approved by DOS.
Pennits. Pennit applications have been submitted to DEC and COE, copies are included
with this report.
le ADJUSTMENTS section - Indicate proposed adjustments to the budget, work program, or project schedule, and the
on why the adjustment is necessary. If any problems have been encountered during this reporting period, they should also
ndicated here. Keep in mind that the information listed in this section should refer to this reporting period onlv.
I extension is requested on.this form, the reasons provided should be detailed and specific. For example, requesting an
nsion to "complete the project" or "allow time to finish remaining tasks" is not acceptable. The infoffilation provided in
section should indicate specific reasons that tasks were delayed and/or problems were experienced.
he bottom of the sheet, please provide the Name, Affiliation, Email Address, Phone Number, and Fax Number of the person
IOtact if we have questions on the information provided on this form.
u submit this form by fax or email, there is no need to forward the original bv mail. We only need to receive one copy of
eport.
u have any questions, please contact Laurissa Parent at (518) 474-5559 or your DOS project manager at (518) 474-6000.
lSTAL\ContfilCls\ContractFonns\PR forms\status _ btank.wpd
Project Status Form
RECIPIENT
CONTRACT #
PROJECT TITLE
Status Report Date:
** See guidelines on reverse side for conrpleting this form **
'ask
#
Brief Task
Description
AIT
Date of
Completion
Percent of
Completion
Task Accomplishments
Product
Submitted
to DOS
JUSTMENTS - Please indicate proposed adjustment(s) to work program/schedule, reason(s) for the proposed
nstment(s), and any other problems encountered durin!': this renortin!': neriod:
rson to contact if we have questions about the information provided on this form:
me:
Email Address:
Ie:
Affiliation:
:>ne:
Fax:
I\STAL\Contracls\Contl3ctforms\P,R rorms\status_blank..wpd
Guidelines for completing the Project Status Form
lease fill out all items in the top section - Recipient, Contract #, Project Title, and Status Report Date. In the next section, list
lch task from the work plan of the Agreement and provide corresponding inlormation for each.
Task # and Brief Task Description should agree with the tasks listed in the work plan of the Agreement.
Aff should indicate if Date of Completion is the Actual completion date or the current Target Date for completion of
the task.
Percent of Completion is the percentage that the task is complete as of the Status Report Date.
Task Accomplishments should be brief, but describe specific accomplislunents for each task. If no accomplislunents
have yet been made for a task, the accomplislunent column should be left blank for this task.
Product Submitted should be "Draft" if the draft product has been submitted to DOS (or is being submitted with this
report), "Final" if the final product has been submitted to DOS (or is being submitted with this report), "None" if
product has not yet been submitted, or "N/ A" if not applicable. Alternatively, the specific product(s) submitted may
be listed.
Iportant things to consider when filling out this section of the Status Report Form:
Tasks should match those in the work plan of the Agreement with DOS (not a subcontractor al'Teementl.
All tasks (including subtasks) in the work plan of the Agreement must be listed on each report submitted.
All columns must be completed for every task.
A task cannot be considered 100% complete until the required product is submitted to and approved by DOS.
Task accomplislunents should be as specific as possible (but briel). Status reports submitted with generic
accomplislunent entries will take longer to review by DOS and may not be accepted. Here are some tips on how
accomplislunent entries can be improved:
Generic accomplishment entrv: Specific accomplishment entrv:
Advisory committee established. 8 person advisory committee was established and has met (6) times to date.
RFP issued. RFP was released through local papers and NYS Contract Reporter.
Consultant Selected. 5 responses were received and ABC Construction Company, Inc. was selected.
Certification of procurement procedures have been provided to DOS.
Final designs. Final Design & Construction Drawings (incorporating DOS comments of
11/5/05) were approved by DOS.
Permits. Permit applications have been submitted to DEC and COE, copies are included
with this report.
le ADJUSTMENTS section - Indicate proposed adjustments to the budget, work program, or project schedule, and the
on why the adjustment is necessary. If any problems have been encountered during this reporting period, they should also
ndicated here. Keep in mind that the infoffi13tion listed in this section should refer to this reporting period onlv.
I extension is requested on this form, the reasons provided should be detailed and specific. For example, requesting an
nsion to "complete the project" or "allow time to finish remaining tasks" is not acceptable. The infoffi13tion provided in
section should indicate specific reasons that tasks were delayed and/or problems were experienced.
he bottom of the sheet, please provide the Name, Affiliation, Email Address, Phone Number, and Fax Number of the person
llItact if we have questions on the information provided on this form.
u submit this form by fax or email, there is no need to forward the original bv mail. We only need to receive one copy of
eport.
u have any questions, please contact Laurissa Parent at (518) 474-5559 or your DOS project manager at (518) 474-6000.
LST Al \Contl"3cts\ComractForms\P1t. fonns\s;latus _blank. wpd