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RESOLUTION 2007-555
ADOPTED
DOC ill: 2973
THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2007-555 WAS
ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON
JUNE 19,2007:
RESOLVED that the Town Board ofthe Town of Southold hereby authorizes and directs
Supervisor Scott A. Russell to execute an Interal!encv Al!reement with the Countv of
Suffolk throul!h its dulv constituted Department of Fire. Rescue and Emerl!encv Services
and the Town of South old for the provision of an emergency generator for the Town of
Southold at no cost to the Town, subject to the approval of the Town Attorney.
;f7RrUfa2f~~L..
Elizabeth A. Neville
South old Town Clerk
RESULT: ADOPTED [UNANIMOUS]
MOVER: Thomas H. Wickham, Councilman
SECONDER: Louisa P. Evans, Justice
A YES: Krupski Jr., Edwards, Ross, Wickham, Evans, Russell
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Law No. //-~S. -OZ':;'
Disaster Preparedness/Shelters - Use of County-Owned Generator for Residents of Southold
ORIGINAL
Interagency Agreement
Suffolk County Department of Fire, Rescue and Emergency Services
and
Town of Southold
This Agreement (Agreement) is between the County of Suffolk (County), a municipal corporation of the State
of New York, acting through its duly constituted Department of Fire, Rescue and Emergency Services (
"Department" and/or "FRES"), located at Yaphank Avenue, Yaphank, New York 11980, and the Town of
Southold, a municipal corporation, having its principal office at 53095 Rt. 25, Southold, NY 11968.
The parties hereto desire that the Contractor's services be made available to the County to help assure for
disaster preparedness.
The parties hereto agree that the Town of South old shall be assigned, maintain, and agree to keep in good
working condition a 25 kV/20 kW generator, owned by the County of Suffolk, in the event of a declared disaster or
emergency, in order to provide temporary power to the residents of Southold.
Term of Agreement: January 1,2007 through May 31,2011.
Total Cost of Agreement: Shall be a no-cost agreement to FRES.
Terms and Conditions: Shall be as set forth in Exhibit A entitled "Specific Terms and Conditions" and
Exhibit B entitled "General Terms and Conditions" attached and incorporated
herein.
In Witness Whereof, th parties hereto have executed this Agreement as of the latest date written below.
Town of Southold ~ County of Suffolk f
By: Sco se~ By: ;1~rS:~)ic' ~
Town Supervisor Name:" ",~_...
Deputy County Executive
{.51-0S
Date:
lO-d"!-n1
Date:
, ~<( .-r
APp~ved: Dept. of Fi: Rescue & Emergency Svcs.
By: /-
Joseph F ~ams
commlss/io";,Z ~/)
Date: If /0
,
Date: ---L( - rl. I - 0 1
Approved as to Legality:
Christine Malafi, Suffolk County Attorney
Recommended:
Date:
Edward c neye
Director of Emerge
l\ 121\ {&q
By:
By:
J~e'l.lA ; II(. ~.J7i.
Assi!ltan County ~ttorney
I z.G::J n
Date:
Page 1 of7
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Law No.
Disaster Preparedness/Shelters - Use of County-Owned Generator for the Residents of South old
Exhibit A
Specific Terms and Conditions
1. Performance Subject to Condition
a. Pursuant to Article 2-8 of the New York State Executive Law entitled Disaster
Preparedness, the County, as the first line of defense in times of disaster has developed
disaster preparedness programs and plans.
b. "Disaster" means the occurrence or imminent threat of wide spread or severe damage,
injury, or loss of life or property resulting from any natural or man-made causes, including,
but not limited to, fire, flood, earthquake, hurricane, tornado, high water, landslide, mudslide,
wind, storm, wave action, volcanic activity, epidemic, air contamination, blight, drought,
infestation, explosion, radiological accident, water contamination, bridge failure or bridge
collapse;
c. The County's disaster preparedness plans, organizational arrangements, and response
capability must at all times be the most effective that current circumstances and existing
resources allow. The purpose of such plans shall be to minimize the effect of disasters by (i)
identifying appropriate local measures to prevent and mitigate disasters, (ii) developing
mechanisms to coordinate the use of local resources and manpower for service prior to,
during and after disasters and the delivery of services to aid citizens and reduce human
suffering resulting from a disaster, and (iii) providing for recovery and redevelopment after
disasters. In order to execute such plans during, or at imminent threat of disaster, the
County must ensure that all resources necessary and required for such implementation are
readily available to it.
d. Performance of this Agreement is contingent on the occurrence of a disaster, as this term is
defined herein and by New York State Executive Law Article 2-8. Such condition shall be
deemed in effect immediately upon the declaration of a state of emergency by the Suffolk
County Executive, or in the event of a vacancy in this office, by the Chief Deputy County
Executive or the Deputy County Executive designated to perform the administrative duties of
the County Executive during his temporary absence or disability.
2. Requirements Agreement
The parties agree that this is a Requirements Agreement and:
The FRES Commissioner is responsible for the coordination of emergency preparedness plans and
the County's response to natural or manmade disasters or emergencies; and
FRES requires and needs to guarantee the services of the Town of Southold as contractor to
provide, maintain, and repair as necessary, a 25 kVAl20 kW, # 2 diesel fuel powered, sound
attenuated trailer-mounted generator, in the event of a declared disaster or emergency, to provide
temporary power services to the residents of the Town of Southold; and
This agreement is to assure that the County, as the first line of defense in the minimization of the
adverse effects to the people and property of Suffolk County in the event of a declared state of
Page 2 of 7
Law No.
Disaster Preparedness/Shelters - Use of County-Owned Generator for the Residents of Southold
emergency and in the recovery and redevelopment efforts following disasters, receives all the
services described herein, to be made available by the Contractor to the County prior to the
Contractor's provision of such services to other entities, so that the County may accomplish the
foregoing.
3. Term and Termination:
a. The term of this Agreement shall be as set forth on page one of this Agreement, unless
sooner terminated as provided below.
,
b. Performance of the Services as set forth in this agreement shall commence as of the
date of a declared state of emergency set forth in Paragraph one above and a
determination by the County that the services of the Contractor are necessary to execute
the County's emergency preparedness plans. The parties acknowledge that there may
be one or more declared states of emergency during the term of this agreement.
c. This Agreement may be terminated in whole or in part in writing by the County in the
event of failure by Contractor to fulfill any of the terms and conditions under this
agreement. The County shall also have the right to terminate this Agreement at any time
and for any reason deemed to be in its best interest.
4. Town of Southold Responsibilities:
a. The Town of Southold will test said generator and conduct the maintenance on a regular
basis in order to ensure generator is in good working condition and to provide continued
temporary emergency power to a designated shelter in Southold in the event of the
occurrence of a declared disaster or emergency, and for drills and exercises as mutually
agreed upon; and any other facilities as mutually agreed upon by the parties.
b. The Town of South old shall make provisions to store and secure said generator at the
Southold Town police Station 41405 Route 25 Main Ro d
peconic, New York 11958
('Address where generator will be stored)
c.
The Town of Southold will pay for the usage of fuel required to power said generator.
(f d.
The Town of Sol1!bold will transport said generator from location designated in
Paragraph 4, part'y, to iASI!,t811 iFlilial 811livery and warranty and repair work as needed,
at no cost to Suffolk County.
e.
The Town of South old shall pay for expenses incurred during the repair of the generator
unit after expiration of the unit's warranty.
f.
The Town of South old will keep and maintain all maintenance records and all records of
any repair work performed with the said generator and send a copy to FRES.
g.
The Town of Southold will secure and maintain all related accessories, such as
extension cords, that are assigned with the said generator unit.
Page 3 of7
Law No.
Disaster Preparedness/Shelters - Use of County-Owned Generator for the Residents of South old
h. The Town of Southold understands that this equipment can be recalled at any time, as
seen necessary by the County Executive, designee, Commissioner of Fire, Rescue and
Emergency Services or designee.
5. FRES Responsibilities:
a. FRES will coordinate the delivery of said generator and all related accessories with the
Town of Southold.
b. FRES will ensure said generator unit is fleeted and properly marked by the Suffolk
County Department of Public Works prior to delivery to the Town of Southold.
6. Notices
a. Notice of Declared State of Emergency
While best efforts will be made by the County to provide written notice to the Contractor
of a declaration of a state of emergency, the parties understand that the unpredictable
nature of disasters may prevent such formal notification. In the event that such
notification is not possible, notification by telephone or messenger or other reasonable
means to the individual(s) listed below will serve as adequate notice.
Mr. Scott Russell
Town Supervisor
Town of South old
PO Box 1179
Southold, NY 11971
b. All Other Notices
All other notices shall be in writing and shall be given to the County as set forth in Exhibit B,
entitled General Terms and Conditions. Notification to the Contractor shall be made to:
Carlisle Cochran, Jr.
Deputy Emergency Manager
PO Box 1179
Southold, New York 11971
With an additional copy to:
Mr. Scott Russell
Town Supervisor
Town of Southold
PO Box 1179
Southold, New York 11971
c. Each party shall give prompt written notice to the other party of the appointment of
successor(s) to the designated contact person(s) or his or her designated successor(s).
End of text for Exhibit A
Page 4 of 7
Law No.
Disaster Preparedness/Shelters - Use of County-Owned Generator for the Residents of Southold
Audit Requirements: All payments made under this Agreement are
subject to audit by the Suffolk County Comptroller pursuant to Article
V of the Suffolk County Charter. If the Contractor fails to cooperate
with an audit by the Comptroller, the County shall have the right to
suspend or partially withhold payments or require the repayment of
amounts paid under this Agreement or under any other agreement
between the parties until such cooperation is forthcoming. If such an
audit discloses overpayments by the County to the Contractor, within
thirty (30) days after the issuance of an official audit report by the
Comptroller or his duly designated representatives, the Contractor shall
repay the amount of such overpayment by check to the order of the
Suffolk County Treasurer or shall submit a proposed plan of repayment
to the Comptroller. If there is no response or if satisfactory repayments
are not made, the County may recoup overpayments from any amounts
due or becoming due to the Contractor from the County under this
Agreement or otherwise. The provisions of this paragraph shall survive
the expiration or termination of the Agreement.
Contractor'sNendor's Public Disclosure Statement: The
Contractor represents and warrants that it has filed with the
Comptroller of Suffolk County the verified public disclosure
statement required by Suffolk County Administrative Code Article V,
Section A5.7 and shall file an update of such statement with the said
Comptroller on or before the 31st day of January in each year of this
Agreement's duration. The Contractor acknowledges that such filing is a
material, contractual and statutory duty and that the failure to file
such statement shall constitute a material breach of this Agreement,
for which the County shall be entitled, upon a determination that
such breach has occurred, to damages, in addition to all other legal
remedies, oftifieen percent (15%) of the amount of the Agreement.
Required Form: Suffolk County Form SCEX 22; entitied
"Contractor'sNendor's Public Disclosure Statement"
Living Wage Law: This Agreement is subject to the Living Wage Law
of the County of Suffolk. The law requires that, unless specific
exemptions apply, all employers (as defined) under service contracts
and recipients of County financial assistance, (as defined) shall provide
payment of a minimum wage to employees as set forth in the Living
Wage Law. Such rate shall be adjusted annually pursuant to the terms of
the Suffoik County Living Wage Law ofthe County ofSuffoik. Under
the provisions of the Living Wage Law, the County shall have the
authority, under appropriate circumstances, to terminate this Agreement
and to seek other remedies as set forth therein, for violations of this
Law. The Contractor represents and warrants that it has read and shall
comply with the requirements of Suffolk County Code Chapter 347,
Suffolk County Local Law No. 12-2001, the Living Wage Law.
Required Form: Suffolk County Living Wage Form L W-38; entitled
"Suffolk County Department of Labor - Living Wage Unit Living
Wage Certification/Declaration - Subject To Audit"
Use of County Resources to Interfere with Collective Bargaining
Activities Local Law No. 26.2003: The Contractor represents
and warrants that it has read and is familiar with the requirements of
Chapter 466, Articie I ofthe Suffoik County Locai Laws, "Use of
County Resources to Interfere with Collective Bargaining Activities."
County Contractors (as defined) shall comply with all requirements
of Local Law No. 26-2003 including the following prohibitions: a.
The Contractor shall not use County funds to assist, promote, or deter
union organizing. b. No County funds shall be used to reimburse
the Contractor for any costs incurred to assist, promote, or deter
union organizing. c. The County of Suffolk shall not use County
funds to assist, promote, or deter union organizing. d. No employer
shall use County property to hold a meeting with employees or
supervisors if the purpose of such meeting is to assist, promote, or
deter union organizing. If Contractor services are performed on
County property the Contractor must adopt a reasonable access
agreement, a neutrality agreement, fair communication agreement,
non-intimidation agreement, and a majority authorization card
agreement. If Contractor services are for the provision of human
services and such services are not to be performed on County
property, the Contractor must adopt, at the least, a neutrality
agreement. Under the provisions of Local Law No. 26-2003, the
County shall have the authority, under appropriate circumstances, to
tenninate this Agreement and to seek other remedies as set forth
therein, for violations of this Law. Required Form: Suffolk County
Labor Law Form DOL-LO 1; entitied "Suffoik County Department of
Labor - Labor Mediation Unit Union Organizing
Certification/Declaration - Subject to Audit"
Gratuities: The Contractor represents and warrants that it has not
offered or given any gratuity to any official, employee or agent of
Suffolk County or New York State or of any poiitical party, with the
purpose or intent of securing an agreement or securing favorable
treatment with respect to the awarding or amending of an agreement or
the making of any determinations with respect to the perfonnance of an
agreement, and that the signer ofthis Agreement has read and is
familiar with the provisions of Local Law No. 32~ 1980 of Suffolk
County (Chapter 386 of the Suffolk County Code).
Prohibition Against Contracting with Corporations that
Reincorporate Overseas: The Contractor represents that it is in
compliance with Suffolk County Administrative Code Article IV,
~~A4-13 and A4-14, found in Suffolk County Local Law No. 20-2004,
entitled"A Local Law To Amend Local Law No. 5-1993, To Prohibit
The County of Suffolk From Contracting With Corporations That
Reincorporate Overseas." Such law provides that no contract for
consulting services or goods and services shall be awarded by the
County to a business previously incorporated within the U.S.A. that has
reincorporated outside the U.S.A.
Child Sexual Abuse Reporting Policy: The Contractor agrees to
comply with Chapter 577, Article IV, of the Suffolk County Code,
entitled "Child Sexual Abuse Reporting Policy", as now in effect or
amended hereafter or of any other Suffolk County Local Law that may
become applicable during the tenn of this Agreement with regard to
child sexual abuse reporting policy.
Non Responsible Bidder: The Contractor represents and warrants that
it has read and is familiar with the provisions of Suffolk County Code
Chapter 143, Article 11, ~~ 143-5 through 143-9. Upon signing this
Agreement the Contractor certifies that he, she, it, or they have not been
convicted ofa criminal offense within the last ten (10) years. The term
"conviction" shall mean a finding of guilty after a trial or a plea of
guilty to an offense covered under the provision of Section 143~5 of the
Suffolk County Code under "Non responsibie Bidder."
Page 5 of 7
Law No.
Disaster Preparedness/Shelters - Use of County-Owned Generator for the Residents of Southold
Certification as to Relationships: Pursuant to the Suffolk County
Code Chapter 143, Article II, and Suffolk County Code gI43-6(8)
Specifically, the parties to this Agreement hereby certify that, other than
the funds provided in this Agreement and other valid Agreements with
the County, there is no known relationship within the third degree of
consanguinity, life partner, or business, commercial, economic, or
financial relationship between the parties,
the signatories to this Agreement, and any partners, members, directors,
or shareholders of five percent (5%) (or more) of any party to this
Agreement.
Suffolk County Local Laws Suffolk County Local Laws. Rules and
Regulations can be found on the Suffolk County web site at
www.co.suffolk<httD:llwww.co.suffolk.nv.us>. Click on "Laws of
Suffolk County" under "Suffolk County Links".
Indemnification: The Contractor agrees that it shall protect, indemnify
and hold harmless the County and its officers, officials, employees,
contractors, agents and other persons from and against all liabilities,
fines, penalties, actions, damages, claims, demands, judgments, losses,
costs, expenses, suits or actions and reasonable attorneys' fees, arising
out of the acts or omissions or the negligence of the Contractor in
connection with the services described or referred to in this Agreement.
The Contractor shall defend the County and its officers, officials,
employees, contractors, agents and other persons in any suit, including
appeals, or at the County's option, pay reasonable attorney's fees for
defense of any such suit arising out of the acts or omissions or
negligence of the Contractor, its officers, officials, employees,
subcontractors or agents, if any, in connection with the services
described or referred to in this Agreement.
Insurance: a. The Contractor agrees to procure, pay the entire
premium for and maintain throughout the term of this Agreement,
insurance in amounts and types specified by the County and as may be
mandated and increased from time to time. The Contractor agrees to
require that all if its subcontractors, in connection with work performed
for the Contractor related to this Agreement, procure, pay the entire
premium for and maintain throughout the term ofthis Agreement,
insurance in amounts and types equal to that specified by the County for
the Contractor. Unless otherwise specified by the County and agreed to
by the Contractor, in writing, such insurance shall be as follows: i.
Commercial General Liability insurance, including contractual
liability coverage, in an amount not less than Two Million Dollars
($2,000,000.00) per occurrence for bodily injury and Two Million
Dollars ($2,000,000.00) per occurrence for property damage. ii,
Automobile Liability insurance (if any vehicles are used by the
Contractor in the performance of this Agreement) in an amount not less
than Five Hundred Thousand Dollars ($500,000.00) per person, per
accident, for bodily injury and not less than One Hundred Thousand
Dollars ($100,000.00) for property damage per occurrence. iii,
Workers Compensation and Employer's Liability insurance in
compliance with all applicable New York State laws and regulations
and Disability Benefits insurance, if required by law. Contractor shall
furnish to the County, prior to its execution of this Agreement, the
documentation required by the State of New York Workers'
Compensation Board of coverage or exemption from coverage pursuant
to gg57 and 220 of the Workers' Compensation Law. In accordance
with General Municipal Law ~ 1 08, this Agreement shall be void and of
no effect unless the Contractor shall provide and maintain coverage
during the tenn ofthis Agreement for the benefit of such employees as
are required to be covered by the provisions of the Workers'
Compensation Law. b. All policies providing such coverage shall be
issued by insurance companies with an A.M. Best rating of A- or better.
c. The Contractor shall furnish to the County Declaration Pages for each
such policy of insurance and upon request, a true and certified original
copy of each such policy, evidencing compliance with the aforesaid
insurance requirements. In the case of commercial general liability
insurance, the County of Suffolk shall be named as an additional
insured and the Contractor shall furnish a Declaration Page and
endorsement page evidencing the County's status as an additional
insured on said policy. d. All such Declaration Pages, certificates and
other evidence of insurance shall provide for the County of Suffolk to
be notified in writing thirty (30) days prior to any cancellation,
nonrenewal or material change in said policies. Such Declaration
Pages, certificates, policies and other evidence of insurance and notices
shall be mailed to the Department at its address as set forth in this
Agreement in the paragraph entitled "Notices and Contact Persons" or
at such other address of which the County shall have given the
Contractor notice in writing. e. In the event Contractor shall fail to
provide the Declaration Pages or certificates of insurance or to maintain
any insurance required by this Agreement, the County may, but shall
not be required to, obtain such policies and deduct the cost thereof from
payments due Contractor under this Agreement or any other agreement
between the County and Contractor.
Severability: It is expressly agreed that if any term or provision of this
Agreement, or the application thereof to any person or circumstance,
shall be held invalid or unenforceable to any extent, the remainder of
this Agreement, or the application of such term or provision to persons
or circumstances other than those as to which it is held invalid or
unenforceable, shall not be affected thereby, and every other term and
provision ofthis Agreement shall be valid and shall be enforced to the
fullest extent permitted by law.
Set-Off Rights: The County shall have all of its common law,
equitable, and statutory rights of set.off. These rights shall include, but
not be limited to, the County's option to withhold, for the purposes of
set-off, any moneys due to the Contractor under this contract up to any
amounts due and owing to the County with regard to this contract
andlor any other contract with any County department or agency,
including any contract for a term commencing prior to the term of this
contract, plus any amounts due and owing to the County for any other
reason including, without limitation, tax delinquencies, fee
delinquencies or monetary penalties relative thereto. The County shall
exercise its set-off rights in accordance with nonnal County practices
including, in cases of set-off pursuant to an audit, the finalization of
such audit by the County agency, its representatives, or the County
Comptroller, and only after legal consultation with the County
Attorney.
Governing Law: This Agreement shall be governed by and construed
in accordance with the laws of the State of New York, without regard to
conflict oflaws. Venues shall be designated in Suffolk County, New
York or the United States District Court for the Eastern District of New
York.
No Intended Third Party Beneficiaries: This Agreement is entered
into solely for the benefit of County and Contractor. No third party
shall he deemed a beneficiary ofthis Agreement, and no third party
shall have the right to make any claim or assert any right under this
Agreement.
Page 6 of 7
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Law No.
Disaster Preparedness/Shelters - Use of County-Owned Generator for the Residents of Southold
Notices Relating to Payments, Insurance or Other Submissions: For
the Department: By Registered or Certified Mail in Postpaid Envelope
or by Nationally Recognized Courier Service or by personal delivery to
Fire Rescue and Emergency Services, Yaphank Avenue, Yaphank, New
York 11980 Alt. Edward Schneyer, Director of Emergency
Preparedness, and For the Contractor: By Registered or Certified Mail
in Postpaid Envelope or by Nationally Recognized Courier Service or
by personal delivery to the contact person set forth in Exhibit A, entitled
"Specific Terms and Conditions."
Notices Relating to Indemnification and Termination: Any
communication or notice regarding indemnification or termination shall
be in writing and shall be given as follows: For the County: By
Registered or Certified Mail in Postpaid Envelope or by Nationally
Recognized Courier Service or by personal delivery to Fire Rescue and
Emergency Services, Yaphank Avenue, Yaphank, New York 11980,
Att. Joseph F. Williams, Commissioner, and to Christine Malafi,
County Attorney, Suffolk County Department of Law, H. Lee Dennison
Building, 100 Veterans Memorial Highway, Hauppauge, New York
11788, and For Contractor: By Registered or Certified Mail in Postpaid
Envelope or by Nationally Recognized Courier Service or by personal
delivery to the contact person set forth in Exhibit A, entitled "Specific
Terms and Conditions."
End of Text Exhibit B
Page 7 of 7
Suffolk County Form 22
ContractorsNendOl's Public Disclosure Statement
Pursuant to Section A5-7 of the Suffolk County Administrative Code, this Public Disclosure Statement
must be completed by all contractors/vendors that have a contract with Suffolk County. In the event
contractor/vendor is exempt from completing paragraphs numbered I through II below, so indicate at
paragraph number 12 below setting forth the reason lor such exemption. Notwithstanding such exempt
status, you must execute this form below before a notary public.
1. Contractor'sNendor's Name Town of Southo1d
Address P.O. Box 1179;53095 Main Road
City and State Southo1d, NY _Zip Code 11971-0959
2. Contracting Department's Name____
Address
3. Payee Identification or Social Security No.
4. Type of Business_Corporation _ Partnership_Sole Proprietorship_Other
S.a Is contractor/vendor entering into or has contractor/vendor entered into a contract with Suffolk
County in excess of$I,0007 _Yes_No.
S.b Has contractor/vendor entered into threc or more contracts, including the one for which you are
now completing this form, with Suffolk County, any three of which, when combined, exceed
$1,0007 Yes No.
6. Table of Organization. List names and addresses of all principals; that is, all individuals serving
on the Board of Directors or comparable body, names and addresses of all partners, and names
and addresses of all corporate officers. Conspicuously identify any person in this table of
organization who is also an officer or an employee of Suffolk County. (Attach additional sheet if
necessary.)
-- -
7. List all names and addresses of those individual shareholders holding more than five percent
(5%) interest in the contractor/vendor. Conspicuously identify any shareholder who is also an
officer or an employee of Suffolk County. (Attach additional sheet if necessary).
8. Does contractor/vendor derive 50% or more of its total revenues from its contractual or vendor
relationship with Suffolk County7__ Yes_No.
9. If you answered yes to 8 abovc, you must submit with this disclosure statement, a complete
financial statement listing all assets and liabilities as well as a profit and loss statement. These
statements must bc certified by a Certified Public Accountant. (Strike this out ifnot applicable.)
10. The undersigned shall include this Contractor'slVendor's Public Disclosure Statement with the
contract. (Describe general nature of the contract.)
Page 1 of 3 Publie Disclosure Form
11. Remedies. The failure to file a verified public disclosure statement as required under local law
shall constitute a material breach of contract. Suffolk County may resort, use or employ any
remedies contained in Article II of the Uniform Commercial Code of the State of New York. In
addition to all legal remedies, Suffolk County shall be entitled, upon a determination that a
breach has occurred, to damages equal to fifteen percent (15%) of the amount of the contract.
12. If you are one of the entities listed below at a) through c) or you qualify under d) below, you are
exempt from completing paragraphs numbered I through I ] herein:
_ a) Hospital
~ b) Educational or governmental entities
_ c) Not-for-profit corporations
- d) Contracts providing for foster care, family day-care providers or child protective
services
Please check to the left side of the appropriate exemption.
Dated:
Printed Name of Signer:
Title of Signer:
Name of ContractorN endor:
13. Verification. This section must be signed by an officer or principal of the contractor/vendor
authorized to sign for the company for the purpose of executing contracts. The undersigned
n, affirms under the penalties of perjury, that he/she has read and understood the
tatem ts and t at they are, to hislher own knowledge, true.
1~o1
to ~d Signed:
Scott A. Russell
Supervisor
Lown or 00u~nOLa
UNIFORM CERTIFICATE OF ACKNOWLEDGMENT
(Within New York State)
STATE OF NEW YORK)
COUNTY OF SUFFOLK) SS.:
On the~~'aay of 0 c t obe r in the year 2007 before me, the undersigned, personally appeared
Scott A. Rlilssell personally known to me or proved to me on the basis of satisfactory evidence
to be the individual!\) whose nameCliJ is C~ subscribed to the within instrument and acknowledged to
me that he/€A@/tlisy executed the same in his/ller/tA8ir capacity(M.) and that by his/Ii"r./th...iF-Signature(~
o he' er ,the in ividuaIC~), or the person upon behalf of which the individuaIC\) acted, executed
th . strumen.
I
nature nd office of individual taking acknowledgement)
KIERAN M. CORCORAN
QUALIFIED IN SUFFOLK COUNTY
NOTARY #-02C06119638 wi
MY COMMISS'ON EXPIRES DEC. 6, 2....!!2S
Page 2 of 3 Public Disclosure Form
UNIFORM CERTIFICATE OF ACKNOWLEDGEMENT
(Without New York State)
STATE OF
)
)ss.:
)
COUNTY OF
On the day of in the year 2007 before me, the undersigned, personally
appeared_. personally known to me or proved to me on the basis of
satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument
and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies) and that by
his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the
individual(s) acted, executed the instrument, and that such individual(s) made such appearance before
the undersigned in
(Insert the city or other political subdivision and the state or country or other place the acknowledgement
was taken)
(signature and office of individual taking acknowledgement)
Contraetor'sNendor's Public Disclosure Statement Form (Rev. 3/04)
Page 3 of 3 Publie Disclosure Form
U:\SC OEM\Colltracf Forms\SuffCo Exhibit Pub Disc Form 07.doc
.
S'uffolk County, New York
Dl:partment of Llbor
SUFFOLK COUNTY DEPARTMENT OF LABOR - LABOR MEDIA TlON UNIT
UNION ORGANIZING CERTlFICA TlON/DECLARA TlON - SUBJECT TO AUDIT
If the following definition of "County Contractor" (Union Organizing Law Chapter 466-2) applies to the
contractor's/beneliciary's business or transaction with Suffolk County, the contractor/beneficiary must complete Sections I,
III, and IV below. If the following definitions do not apply, the eon tractor/beneficiary mnst complete Sections II, III and IV
below. Completed forms mnst be submitted to the awarding agency.
County Contractor: "Any employer that receives more than $50,000 in County funds for supplying goods or services pursuant to a
written contract with the County of Suffolk or any of its agencies; pursuant to a Suffolk County grant; pursuant to a Suffolk County
program; pursuant to a Suffolk County reimbursement for services provided in any calendar year; or pursuant to a subcontract with
auy of the above."
Sectiou I
The Union Organizing Law applies to this contract. I/we hereby agree to comply with all the provisions of Suffolk
County Local Law No. 26-2003, the Suffolk County Union Organizing Law (the law) and, as such shall not use
County funds to assist) promote, or deter union organizing (Chapter 466-3 A), nor seek reimbursement fyom the
County for costs incuned to assist, promote, or detcr union organizing. (Chapter 466-3 B)
Check if l/we further agree to take all action necessary to ensure that County tunds are not used to assist, promote, or deter
Applicable union organizing. (Chapter 466-3 H)
g1/we further agree that if any expenditures or costs incurred to assist, promote, or deter union organizing are made,
I/we shall maintain records sufficient to show that no County funds were used for those expenditures and, as
applicable, that no reimbursement from County funds has been sought for such costs. I/we agree that such records
shall be made available to the pertinent County agency or authority, the County Comptroller, or the County
Department of Law upon request. (Chapter 466-3 I)
I/we fUlther affirm to the following:
. I/we will not express to employees any false or misleading information that is intended to influence the
determination of employee preferences regarding union representation;
. J/we will not coerce or intimidate employees) explicitly or implicitly, in selecting or not selecting a bargaining
representative;
. IIwe will not require an employee, individually or in a group, to attend a meeting or an event that is intended to
influence his or her decision in selecting or not selecting a bargaining representative;
. l/we understand my/our obligation to limit disruptions caused by prerecognition labor disputes through the
adoption of non confrontational procedures for the resolution of prerecognition labor disputes with employees
engaged in the production of goods or the rendering of services for the County; and
. l/we have or will adopt any or all of the above-referenced procedures, or their Functional equivalent, to ensure
the efficient, timely, and quality provision of goods and services to the County. l/we shall include a list of said
procedures in such certification.
l/we further agree that every County contract for the provision of services, when such services will be performed on
County property, shall include a requirement that I/we adopt a reasonable access agreement, a neutrality agreement,
fair communication agreement, no intimidation agreement, and a majority authorization card agreement.
Uwe further agree that every County contract for the provision of human services) when such services are not to be
perfOlmed on County property, shall include a requirement that l/we adopt, at the least, a neutrality agreement.
l/we undersland that the efficient, timely, and nondisruptive provision of goods and services is a paramount financial
Interest of the County of Suffolk and as such, the County expects the potential County contractor to protect the
County's financial interest by adopting nonconfrontational procedures for the orderly resolution of labor disputes,
including, but not limited to, neutrality agreements, majority authorization card agreements, binding arbitration
agreements, fair communication agreements, nonintimidation agreements, and reasonable access agreements.
DOL-LOl (6105)
" S"u'folk Co"unty, New York
Depal1mcnt of Labor
Section II
The Union Organizing Law does not apply to this contract for the following reason(s): _~~
D
Check if
Applicable
Section III
Contractor Name:
Town of Southo1d
Federal Employer ID#:
11-6001939
Contractor Address:
P.O. Box 1179
Amount of Assistance:
SOllrholrl, NY
11.9Jl-OgSg
Vendor #:
Contractor Phone #:
(631) 765-1889
Description of project or service:
Section IV
I declare under
certification, an
of the State of New York that the undersigned is authorized to provide this
Authorized Signature
Scott A. Russell, Supervisor
/O-d?-O 1
Date
Print Name and Title of Authorized Representative
DOL-LO 1 (6/05)
SUFFOLK COUNTY DEPARTMENT OF LABOR - LIVING WAGE UNIT
NOTICE OF NON-APPLICABILITY
OF LIVING WAGE LAW
Living Wage Law, Suffolk County Code, Chapter 347 (2001)
To Be Completed By The Living Wage Unit
REC'D NOV 27 2007
DATE: November 23. 2007
TO: Keri Pisani. Dept. of Fire. Rescue and Emereencv Services
da Rosenber Director
EMPLOYER: Town of South old
VENDOR #: 11-6001939
REF.: Emereencv Generator Use
You are hereby notified that the response from Town of South old has been evaluated by the
Living Wage Unit of the Suffolk County Department of Labor. We find that this employer is not
covered by the Suffolk County Living Wage Law (Local Law #12-2001), and that the
requirements of this law as currently constituted do not constrain this contractor at this time.
Brenda Rosenberg
Director of Living Wage Compliance
Suffolk County Department of Labor
LW-26
SUFFOLK COUNTY DEPARTMENT OF LABOR - LIVING WAGE UNIT
LIVING WAGE CERTIFICATIONIDECLARATION - SUBJECT TO AUDIT
If either of the following definitions of "compensation' (Living Wage Law Chapter 347 _ 2) applies to the contractor's/recipient's
business or transaction with Suffolk County, the contractor/recipient must complete Sections 1,3,4 below; and Form LW-l
(Notice of Application for County Compensation). If the following definitions do not apply, the contr-actor/recipient must
complete Sections 2, 3 and 4 below. Completed forms must be submitted to the aWlIrding agency.
"Any grant, loan, tax incentive or abatement, bond financing subsidy or other form of compensation of more that $50,000 which is
realized by or provided to an employer of at least tcn (10) employees by or through the authority or approval of the County of Suffolk," or
"Any service contract or subcontract let to a contractor with ten (10) or more employees by the County of Suffolk for the fumishing of
services to or for the County of Suffolk (except contracts where services are incidental to the delivery of products, equipment or
commodities) which involve an expenditure equal to or greater than $10,000. for the purposes of this definition, the amount of
expenditure for more than one contract for the same service shall be aggregated. A contract for the purchase or lease of goods, products,
equipment, supplies or other property is not 'compensation' for the purposes of this definition."
Section] The Living Wage Law applies to this contract. I/we hereby agree to comply with all the provisions of Suffolk County
g Local Law No. 12-2001, the Suffolk County Living Wage Law (the Law) and, as such, will provide to all full, part-time
or temporary employed persons who perfonn work or render services on or for a project, matter, contract or subcontract
where this company has received compensation, from the County of Suffolk as defined in the Law (compensation) a
wage rate of no less than $10.02 ($9.25 for child care providers) per hour workcd with health henefits, as described in
the Law, or otherwise $11.41 ($10.50 for child care providers) per hour orthe rates as may be adjusted annually in
accordance with the Law. (Ch:lpter 347-3 B)
Check if
applicable
l/we further agree thai any tenant or leaseholder of this company that employs at least ten (10) persons and occupies
property or uses equipment or property that is improved or developed as a result of compensation or any contractor or
subcontractor of this company that employs at least ten (l0) persons in producing or providing goods or services to this
company that are lIsed in the project or matter for which this company has received compensation shall comply with
all the provisions of the Law, including those specified above. (Chapter 347~2)
Section II
l/we further agree to permit access to work sites and relevant payroll records by authorized County representatives for
the purpose of monitoring compliance with regulations under this Chapter of the Suffolk County Code, investigating
employee complaints of noncompliance and evaluating the operation and effects of this Chapter, including the
production for inspection & copying of payroll records for any or all employees for the term of the contract or for five
(5) years, whichever period of compliance is longer. All payroll and benefit records required by the County will be
maintained for inspection for a similar period of time. (Chapter 347-7 D)
The County Department of Labor shall review the records of any Covered Employer at least once every three years to
verify compliance with the provisions of the Law. (Chapter 347-4 C)
The Living Wage Law does not apply to this contract for the following reason(s):___
D
Check if
applicable
Section III
Contractor Name:
Town of Southold
Federal Employer ID#:
11-6001939
Contractor Address:
P.O._Box 1179
Southo1d, NY
Amount of compensation:
11971-0959
Vendor #:
Contractor Phone #:
631-765-1889
Description of project or service:
Section IV
I declare under pel of perjury under the Laws of the State of New York that the undersigned is authorized to provide this certification,
and that the abo s ~ue a~rect. ~d _ _
-- ~~- -------- 10 d l 01
6.uthorized Ignature D
S~ott A. Russell, Supervisor me
Print Name and Title of Authorized Representative -------..-
LW 38 (revised 6-06, replaces forms LW2, LW3, and LW33)
'SUFFOLK COUNTY DEPARTMENT OF LABOR - LIVING WAGE UNIT
NOTICE OF APPLICATION FOR COUNTY COMPENSATION (Contract)
Living Wage Law, Suffolk County Code, Chapter 347 (2001)
To Be Completed By Applicant/ Employer/Contractor
I) NAME: Town of Southo1d
.
2) VENDOR #:
4) CONTACT:
3) CONTRACT ID #:
(ffknowll)
Edward Forrester
(Irknown)
5) TELEPHONE #: 631-765-1939
6) ADDRESS:
P.O. Box 1179, 53095 Main Road
~()l1t-hfllnr NY l1c)71-0Qr:;Q
7) TERM OF CONTRACT (DATES): 1/1/07 through 5/31/11
8) PROJECT NAME: (IF DIFFERENT FROM #1) Disaster Preparedness/Shelter
9) AMOUNT: $0 - provision of generator
10) AWARDING AGENCY:
Suffolk County Dept. of Fire, Rescue, and Emer-
gency SerVlces
11) BRIEF DESCRIPTION OF PROJECT OR SERVICE:
Town of Southo1d assigned a 25K VA/20 KW generator to provide
temporary power services to the residents of the Town of Southold.
12) PROJECTED EMPLOYMENT NEEDS: (attach a statement listing, by job
classification, the total workforce dedicated to performing this contract or service, including
calculation of estimated net increase OJ' decrease in jobs as a result of funding).
N/A
13) PROJECTED WAGE LEVELS: (attach a statement listing projected wage levels,
compensated days off and medical benefits for total workforce dedicated to fulfilling the terms
of this contract, broken down annually for each year of the term of the contract).
$2,500 stipend issued to Edward Forrester
L W -1 (revised 4/05)
SUFFOLK COUNTY DEPARTMENT OF LABOR
NOTICE OF APPLICATION TO CERTIFY COMPLIANCE WITH FEDERAL LAW
(8 U.S.C. SECTION 1324A)
WITH RESPECT TO LA WFUL HIRING OF EMPLOYEES
VERIFICATION OF SUBMISSION OF LAWFUL HIRING OF EMPLOYEES
Suffolk County Code, Chapter 234 (2006)
To Be Completed By the Local Law Compliance Unit
REC'D NOV 27 2007
DATE: November 23. 2007
TO: Keri Pisani. Dept. of Fire. Rescue and Emen!encv Services
FROM' nda Rosenber Director
TELE HONE #: 853-5630
EMPLOYER: Town of Southold
VENDOR #: 11-6001939
REF.: Emerl!encv Generator Use
You are hereby notified that the submission from Town of South old has been received by
the Lawful Hiring of Employees Unit of the Suffolk County Department of Labor. We find
that this submission is complete and is in compliance with the requirements set forth by the
Suffolk County Lawful Hiring of Employees Law (Local Law #52-2006),.
LHE-3
(01107)
.. SUFFOLK COUNTY DEPARTMENT OF LABOR
NOTICE OF APPLICATION TO CERTIFY COMPLIANCE WITH FEDERAL LAW
(8 U.S.c. SECTION I324A)
WITH RESPECT TO LAWFUL lImING OF EMPLOYEES
Suffolk County Code, Chapter 234 (2006)
To Be Completed By Applicant/ Covered Employer//Owncl'
EMPLOYERlCORP.lBUSINESS/COMPANY NAME: Town of Sou thold
1) ADDRESS: P.O. Box 1179, 53095 Main Road
Southold, NY 11971-0959
2) NOT-FOR-PROFIT:
YES_ NO-"L (SUBMIT CERTIFICATE OF INCORPORATION)
3) VENDOR #:
(If known)
5) CONTACT: Edward Forrester
4) CONTRACT !D:
(If known)
6) TELEPHONE #: 631-765-1939
7) TERM OF CONTRACT OR EXTENSION (I'ROV!DEDATES): 1/1/07 through 5/31/11
8) BRlEFDESCRII'TIONOFCOMPENSATION,PROJECTORSERVICE Town of Southold
assiqned a 25k VA/20 KW generator .to provide temporary power services
to the residents of the Town of Southold.
SUBCONTRACTOR: N/A
1) ADDRESS:
2) VENDOR#:
3) TELEPHONE #:
4) CONTACT:
5) DESCIUPTIONOF COMPENSATION,PROJECT OR SERVICE 25K VA/20 kw generator
to provide temporary power services to residents of Southold Town.
EVIDENCE OF COMPLIANCE:
COPIES OF THE FOLLOWING MUST BE MAINTAINED BY COVERED EMPLOYERS OR THE
OWNERS THEREOF FOR EACH EMPLOYEE FOR THE TIME PERIODS SET FORTH IN SUFFOLK
COUNTY CODE SECTION ( ):
A. United States passport; or
B. resident alien card or alien registration card; or
C. birth certificate indicating that person was born in thc United States; or
D. (1) a driver's license, if it contains a photograph of the individual; and
(2)a social security account numbcr card (other than such a card which
specifies on its face that the issuance ofthe card docs not authorize
employmcnt in the United States); or
E. employment authorization documents such as an H-IB visa, H-2B visa,
and L-I visa, or other work visa as may be authorized by the United
States Government at the time the County contract is awanled for all
covered em ployees.
AFFIDAVIT OF COMPLIANCE
WITH THE REQUIREMENTS OF
II U.S.C. SECTION 1324a
WITH RESPECT TO LAWFUL HIRING OF EMPLOYEES
State of New York
)
ss:
County of
Suffolk
)
Edward Forrester
(Print Name of Deponent)
, being duly sworn, deposes and says:
1. I am the owner/authorized representative of
(Circle one)
the Town of Southold
(Name of Corp. , Business, Company)
2. I certify that I have complied, in good faith, with the requirements of Title 8 of the United
States Code (V. S.C.) Section 1324a (Aliens and Nationality) with respect to the hiring of
covered employees and with respect to the alien and nationality status of the owners thereof, as
set forth in Suffolk County Code Chapter234.
~
worn to before me this ~ay
KIERAN M. CORCORAN
QUALIFIED IN SUFFOLK COUNTY
NOTARY #02C06119838 pI
MY COMMISSION EXPIRES DEC. 6. 21.1\.