HomeMy WebLinkAboutIntermunicipal Agreement - Hazard Mitigation Plan
Town of Southold - Letter
T~'
Board Meeting of November 8, 2006
RESOLUTION 2006-873
ADOPTED
Item # 36
DOC ID: 2279
THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2006-873 WAS
ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON
NOVEMBER 8, 2006:
RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs
Supervisor Scott A. Russell to execute the Intermunicipal Al!:reement for Services between
the Town of Southold and the County of Suffolk. Dept. of Fire Rescue and Emerl!:encv
Services in connection with the Multi-Jurisdictional, Multi-Hazard Mitigation Plan, subject to
the approval of the Town Attorney.
a;ltl~a~r il..
Elizabeth A. Neville
Southold Town Clerk
RESULT: ADOPTED [UNANIMOUS]
MOVER: Albert Krupski Jr., Councilman
SECONDER: William P. Edwards, Councilman
AYES: Evans, Wickham, Ross, Edwards, Russell, Krupski Jr.
Generated November 9, 2006
Page 44
' ~, Rev. 2/20/08; Law No. 08-FS-002A
First Amendment of Agreement
Amendment of Agreement
County of Sui
By:
Jeffrey
Deputy ~
This First Amendment of 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"), located at Yaphank Avenue, Yaphank, New York 11980; and
The Town of Southold ("Municipality" and/or "Contractor"), a municipal corporation organized underthe
State of New York, located at Town Hall, 53095 Route 25, Southold, New York, 11971-0959.
The parties hereto desire to amend the Term of the Agreement to commence effective as of September 14,
2005, in accordance with Suffolk County Legislative Resolution 184-2006.
Amended Term of Agreement: Shall be September 14, 2005 through September 13, 2007, or such later
date as may be set forth in a letter issued by the County in accordance with paragraph 2.e of Exhibit D of the
Agreement.
Total Cost of Agreement: Shall not exceed $113,086.50, as set forth in original Agreement.
Amended Terms and Conditions: Shall be as set forth in Exhibits A though G of the Agreement and Exhibits
A-1, B-1, C-1 and F-1, attached hereto and made a part of this First Amendment
of Agreement.
In Witness Whereof, the parties hereto have executed this First Amendment of Agreement as of the latest
date written below.
Town of Southold
BY: c~~~.CA-tlrfu~
Scott .Russell
Town Supervisor
Fed. Taxpayer ID #: 11-6001939
Date:
Approved as t Legality:
Christine Malafi
Suffolk County Attorney
BY: r:~ PG~..c~~
Cynthia .Parry _
Assistant County Attorney
Date:
ORIGINAL
Chief of Staff
Date: ~I ~ S I 0 0
Approved:
Recomme
By:
Thomas F. O'Hara
Proj~t~M a br
Date:
1 of 9
Department of Fire, Rescue and Emergency
. Rev. 2/20/08; Law No. 08-FS-002A
First Amendment of Agreement
Exhibit A-1
Amended Terms and Conditions
Whereas, the County and Municipality have entered into an Agreement (Law No. OB-FS-002), last signed by
Paul Sabatino, Chief Deputy County Executive and dated February 21,2007 for a term from September 1,
2006 through September 13, 2007 for coordination services in the development of a Multi-Jurisdictional, Multi-
Hazard Mitigation Plan; and
Whereas, the parties hereto desire to amend the Term of the Agreement to commence effective as of
September 14, 2005, in accordance with the grant period for the pass-through funds to the County from the
NYS Emergency Management Office, as set forth in the fifth whereas clause of Suffolk County Resolution No.
184-2006 (Exhibit F-1. attached);
Now, Therefore, in consideration of the covenants, promises and consent herein contained, the parties hereto
agree as follows:
1. Amended Term of Agreement
The Term of Agreement is amended to commence effective as of September 14,2005 and continue
through September 13, 2007, or such later date as may be set forth in a letter issued by the County in
accordance with paragraph 2.e of Exhibit D of the Agreement.
2. Suffolk County Legislative Requirements Exhibit
The Exhibit entitled "Suffolk County Legislative Requirements," Exhibit B-1, attached, is effective as of
the date of execution of this First Amendment of Agreement.
3. Suffolk County Notices and Contact Persons Exhibit
The Exhibit entitled "Suffolk County Notices and Contact Persons," Exhibit C-1, attached, is effective as
of the date of execution of this First Amendment of Agreement.
4. Except as herein amended, all other representations, terms and conditions of the Agreement, including
any and all amendments or budget modifications executed prior to the date hereof, are hereby ratified
and confirmed to be in full force and effect according to their terms.
End of Exhibit A-1
20f9
Rev. 2/20/08; Law No. 08-FS-002A
First Amendment of Agreement
Exhibit B-1
Suffolk County Legislative Requirements
1. 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, of fifteen percent (15%)
of the amount of the Agreement.
Required Form:
Suffolk County Form SCEX 22; entitled "Contractor'sNendor's Public Disclosure
Statement"
2. 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 seNice 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 Suffolk
County Living Wage Law of the County of Suffolk. Under the provisions of the Living Wage Law, the
County shall have the authority, under appropriate circumstances, to terminate this Agreement and to
seek other remedies as set forth therein, for violations of this Law.
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 Forms:
Suffolk County Living Wage Form LW-1; entitied "Suffolk County Department of
Labor- Living Wage Unit Notice of Application for County Compensation
(Contract)"
Suffolk County Living Wage Form LW-38; entitled "Suffolk County Department of
Labor - Living Wage Unit Living Wage CertificationlDeclaration - Subject To
Audit"
3. Use of County Resources to Interfere with Collective Bargaining Activities
Local Law No. 26.2003
The Contractor represents and warrants that it has read and is familiar with the requirements of Chapter
466, Article 1 of the Suffolk County Local Laws, "Use of County Resources to Interfere with Collective
Bargaining Activities." County Contractors (as defined) shall comply with all requirements of Local Law
No. 26-2003 including the following prohibitions:
a. The Contractor shall not use County funds to assist, promote, or deter union organizing.
b. No County funds shall be used to reimburse the Contractor for any costs incurred to assist,
promote, or deter union organizing.
c. The County of Suffolk shall not use County funds to assist, promote, or deter union organizing.
3 of 9
Rev. 2/20/08; Law No. 08-FS-002A
First Amendment of Agreement
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 terminate this Agreement and to seek other remedies as set forth therein, for
violations of this Law.
Required Form: Suffolk County Labor Law Form DOL-L01; entitled "Suffolk County Department of
Labor - Labor Mediation Unit Union Organizing CertiflcationlDeclaration -
Subject to Audit"
4. Lawful Hiring of Employees Law
This Agreement is subject to the Lawful Hiring of Employees Law of the County of Suffolk (Local Law
52-2006). It provides that all covered employers, (as defined), and the owners thereof, as the case may
be, that are recipients of compensation from the County through any grant, loan, subsidy, funding,
appropriation, payment, tax incentive, contract, subcontract, license agreement, lease or other financial
compensation agreement issued by the County or an awarding agency, where such compensation is
one hundred percent (100%) funded by the County, shall submit a completed swom affidavit (under
penalty of perjury), the form of which is attached, certifying that they have complied, in good faith, with
the requirements of Title 8 of the United States Code Section 1324a with respect to the hiring of
covered employees (as defined) and with respect to the alien and nationality status of the owners
thereof. The affidavit shall be executed by an authorized representative of the covered employer or
owner, as the case may be; shall be part of any executed contract, subcontract, license agreement,
lease or other financial compensation agreement with the County; and shall be made available to the
public upon request.
All contractors and subcontractors (as defined) of covered employers, and the owners thereof, as the
case may be, that are assigned to perform work in connection with a County contract, subcontract,
license agreement, lease or other financial compensation agreement issued by the County or awarding
agency, where such compensation is one hundred percent (100%) funded by the County, shall submit
to the covered employer a completed swom affidavit (under penalty of perjury), the form of which is
attached, certifying that they have complied, in good faith, with the requirements of Title 8 of the United
States Code Section 1324a with respect to the hiring of covered employees and with respect to the
alien and nationality status of the owners thereof, as the case may be. The affidavit shall be executed
by an authorized representative of the contractor, subcontractor, or owner, as the case may be; shall be
part of any executed contract, subcontract, license agreement, lease or other financial compensation
agreement between the covered employer and the County; and shall be made available to the public
upon request.
An updated affidavit shall be submitted by each such employer, owner, contractor and subcontractor no
later than January 1 of each year for the duration of any contract and upon the renewal or amendment
of the contract, and whenever a new contractor or subcontractor is hired under the terms of the contract.
The Contractor acknowledges that such filings are a material, contractual and statutory duty and that
the failure to file any such statement shall constitute a material breach of this agreemer.t.
4 of 9
Rev. 2/20/08; Law No. 08-FS-002A
First Amendment of Agreement
Under the provisions of the Lawful Hiring of Employees Law, the County shall have the authority to
terminate this Agreement for violations of this Law and to seek other remedies available under the law.
The Contractor represents and warrants that it has read, is in compliance with, and shall comply with the
requirements of Suffolk County Code Chapter 234, Suffolk County Local Law No. 52-2006, the Lawful
Hiring of Employees Law.
Required Forms:
Suffolk County Lawful Hiring of Employees Law Form LHE-1; entitled "Suffolk
County Department of Labor -"Notice Of Application To Certify Compliance With
Federal Law (8 U.S.C. SECTION 1324a) With Respect To Lawful Hiring of
Employees"
'~',i.
"Affidavit Of Compliance With The Requirements Of 8 U.S.C. Section 1324a
With Respect To Lawful Hiring Of Employees" Form LHE-2.
5. Gratuities
The Contractor represents and warrants that it has not offered or given any gratuity to any official,
employee or agent of Suffolk County or New York State or of any political party, with the purpose or
intent of securing an agreement or securing favorable treatment with respect to the awarding or
amending of an agreement or the making of any determinations with respect to the performance of an
agreement, and that the signer of this 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).
6. Prohibition Against Contracting with Corporations that Reincorporate Overseas
The Contractor represents that it is in compliance with Suffolk County Administrative Code Article IV,
SSA4-13 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.
7. Child Sexual Abuse Reporting Policy
The Contractor agrees to comply with Chapter 577, Article IV, of the Suffolk County Code, entitled
"Child Sexual Abuse Reporting Policy", as now in effect or amended hereafter or of any other Suffolk
County Local Law that may become applicable during the term of this Agreement with regard to child
sexual abuse reporting policy.
8. 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 II, SS143-5 through 143-9. Upon signing this Agreement the
Contractor certifies that he, she, it, or they have not been convicted of a 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
"Nonresponsible Bidder."
9. Use of Funds in Prosecution of Civil Actions Prohibited
Pursuant to the Suffolk County Code Section S590-3, the Contractor represents that it shall not use any
5 of 9
Rev. 2/20/08; Law No. 08-FS-002A
First Amendment of Agreement
of the moneys received under this Agreement, either directly or indirectly, in connection with the
prosecution of any civil action against the County of Suffolk or any of its programs, funded by the
County, in part or in whole, in any jurisdiction or any judicial or administrative forum.
10. Suffolk County Local Laws
Suffolk County Local Laws, Rules and Regulations can be found on the Suffolk County'web site at
www.co.suffolk<http://www.co.suffolk.ny.us>.Click on "Laws of Suffolk County" under "Suffolk County
Links."
End of Text for Exhibit B-1
60f9
Rev. 2/20/08; Law No. 08-FS-002A
First Amendment of Agreement
Exhibit C-1
Notices and Contact Persons
1. Operational Notices
Any communication, notice, claim for payment, reports, insurance, or other submission necessary or
required to be made by the parties regarding this Agreement shall be in writing and shall be given to the
County or the Contractor or their designated representative at the following addresses or at such other
address that may be specified in writing by the parties and must be delivered as follows:
For the Department:
By First Class and Certified Mail in Postpaid Envelope or by
Courier Service or by Fax or by Email
Fire Rescue and Emergency Services
Yaphank Avenue
Yaphank, New York 11980
Att. Thomas O'Hara, Project Manager
For the Consultant:
By First Class and Certified Mail in Postpaid Envelope or by
Courier Service or by Fax or by Email
At the address set forth on page one of this Agreement, attention of the person who executed this
Agreement or such other designee as the parties may agree in writing.
2. Notices Relating to Termination and/or Litigation
In the event the Consultant receives a notice or claim or becomes a party (plaintiff, petitioner,
defendant, respondent, third party complainant, third party defendant) to a lawsuit or any legal
proceeding related to this Agreement, the Consultant shall immediately deliver to the County Attorney,
at the address set forth below, copies of all papers filed by or against the Consultant.
Any communication or notice regarding termination shall be in writing and shall be given to the County
or the Consultant or their designated representative at the following addresses or at such other
addresses that may be specified in writing by the parties and must be delivered as follows:
For the County:
By First Class and Certified Mail in Postpaid Envelope or by
Nationally Recognized Courier Service or
Personally and by First Class Mail
7 of 9
Rev. 2/20/08; Law No. 08-FS-002A
First Amendment of Agreement
Christine Malafi, County Attorney
Suffolk County Department of Law
H. Lee Dennison Building
100 Veterans Memorial Highway
P.O. Box 6100
Hauppauge, New York 11788
and
Fire Rescue and Emergency Services
Yaphank Avenue
Yaphank, New York 11980
Atl. Joseph F. Williams, Commissioner
For Consultant:
By First Class and Certified Mail in Postpaid Envelope or by
Nationally Recognized Courier Service or
Personally and by First Class Mail
At the address set forth on page one of this Agreement, attention of the person who executed this
Agreement or such other designee as the parties may agree in writing.
3. Notices shall be deemed to have been duly delivered (i) if by mail, upon the seventh business day after
the mailing thereof; or (iI) if by nationally recognized overnight courier service, upon the first business
day subsequent to the transmittal thereof; or (ili) if personally, pursuant to New York Civil Practice Law
and Rules Section 311; or (iv) if by fax or email, upon the transmittal thereof. "Business Day" shall be
defined as any day except a Saturday, a Sunday, or any day in which commercial banks are required or
authorized to close in Suffolk County, New York.
4. 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 C-1
80f9
Rev. 2/20/08; Law No. 08-FS-002A
First Amendment of Agreement
Exhibit F-1
Suffolk County Resolution No. 184.2006
9 of 9
Intro Res. No. 1183-2006 Laid on Table 2/7/2006
Introduced by Presiding Officer, on request of the County Executive and Legislator Romaine
RESOLUTION NO. 184- 2006, ACCEPTING AND APPROPRIATING 75% FEDERAL PASS-
THROUGH GRANT FUNDS FROM THE NYS EMERGENCY MANAGEMENT OFFICE TO
THE SUFFOLK COUNTY DEPARTMENT OF FIRE, RESCUE AND EMERGENCY
SERVICES FOR A FY2005 PRE DISASTER MITIGATION PLANNING (PDMC) GRANT AND
TO EXECUTE GRANT RELATED AGREEMENTS
WHEREAS, the NYS Office of Emergency Management has awarded 75% federal grant ft!j'hds to the
Department of Fire, Rescue and Emergency Services for a FY2005 Pre-Disaster Mitigation Planning Grant in the amount of
$1,117,904.25; and
WHEREAS, these funds will be used to engage in the process of multi-jurisdictional mitigation planning and
produce a local multi-jurisdictional mitigation plan satisfying the requirements of 44 CFR Part 201 for Suffolk County and its
local communities including the Town of Babylon; Town of Huntington; Town of Riverhead; Town of Shelter Island; Town of
Smithtown; Town of Southold; Village of Asharoken; Village of Bellport; Village of Huntington Bay; Village Lake Grove; and
Village of Northport; and
WHEREAS, Suffolk County and it's town and villages have experienced numerous natural and man-made
losses including six (6) presidential declared disasters costing over $16 million dollars since 1985 and according the National
Flood Insurance Program, Suffolk County ranks second in New York State in repetitive losses; and
WHEREAS, it is the desire of the County of Suffolk and all participating municipalities to fully conform with the
United States Disaster Act of 2000, which calls for each political subdivision within the United States to have a pre-approved
mitigation plan prior to federal mitigation fund awards; and
WHEREAS, this FY2005 PDMC grant is for a two (2) year period beginning September 14, 2005 through
September 13, 2007 in which the County will received 75% funding in the amount of $1,117,904.25; and
WHEREAS, the remaining 25% local match in the amount of $372,634.75 is identified as pre-existing costs,
leaving no additional costs to the County ($151 ,217) or any of the municipal partners ($221,417.75); and
WHEREAS, $1,097,852.25 of said funds have not been included in the 2006 Operating Budget, and $20,052
has been included in the 2006 Operating Budget; now, therefore be it
151 RESOLVED, that the County Comptroller and County Treasurer be and that they hereby are authorized to
accept $ 1,117,904, including $20,052 in 001-PLN-8020-110 and fringes and appropriate said grant funds as follows:
REVENUES:
AMOUNT
001-FRE-4374 Pre-Disaster Mitigation Grant
001-PLN-4374 Pre-Disaster Mitigation Grant
$ 1,097,852.25
$20,052.00
ORGANIZATIONS:
Department of Fire, Rescue & Emergency Services
Pre-Disaster Mitigation Grant
001-FRE-3408 - $1,072,988.25
1000 - Personal Services
1100 Permanent Salaries
$ 70.767.00
$ 70,767.00
4000 - Contractual Expenses
45GO Fees for Services-Non Employees
----------....---..-..----.
$1.002.221.25
$337,968.00
4980 Contracted Agencies
XXXX - Town of Huntington
XXXX - Town of Riverhead
XXXX - Town of Shelter Island
XXXX - Town of Smithtown
XXXX - Town of Southold
XXXX - Town of Babylon
XXXX - Village of Asharoken
XXXX - Village of Bellport
XXXX - Village of Huntington Bay
XXXX - Village of Lake Grove
XXXX - Village of Northport
$664,253.25
$108,299.25
$82,191.75
$42,491.25
$88,200.00
$113.086.50
$125,863.50
$22,601.25
$19,674.75
$22,601.25
$16,642.50
$22,601.25
Employee Benefits
Social Security
- $5,414
Emplovee Benefits
8330 - Social Security
$5,414
$5,414
Employee Benefits
Retirement
- $9,363
Emplovee Benefits
8280 - Retirement
$9,363
$9,363
Employee Benefits
Welfare Fund
$1,281
Emplovee Benefits
8380 - Welfare Fund Contribution
$1.281
$ 1,281
Interfund Transfer
Transfer to Employee Medical Health Plan
0 - $8,806
Emplovee Benefits
9600 Transfer of Funds
$ 8.806
$ 8,806
2nd RESOLVED, that the following interfund revenues for Employee Medical Health Plan be accepted and
appropriated as follows:
REVENUES
039-IFT-R0001 Transfer from General Fund
$8,806
ORGANIZATION
Employee Benefits
Major Medical Claim
039-EMP-9060
Emplovee Benefits
8360 - Health Insurance
$8.806
$8,806
3'd RESOLVED, that the following position be and they hereby are created in the Department of Fire, Rescue
& Emerqencv Services as follows:
.---
Department of Fire, Rescue & Emergency Services
Pre-Disaster Mitigation Grant
001-FRE-3408
Position No. Spec No.
3408-0100-0001 1510
Position Title
Planning Aide
JC
C
Grade No. Created
17 1
and be it further
4th RESOLVED, that the County Executive's Budget Office is authorized to assign appropriate pseudo codes
as necessary; and be it further
S'h RESOLVED, that nothing contained herein shall be construed as obligating or committing the County of
Suffolk to continue the employment of the individuals filling the position created by this Resolution at the conclusion of the grant
funding provided for such position created by said grant; and be it further
6'h RESOLVED, that this Legislature being the lead agency under SEQRA and Chapter 279 of the Suffolk
County Code, hereby determines that this resolution constitutes a Type Ii action; and be it further
7'h RESOLVED, that the Reporting Category for the County Integrated Financial Management System (IFMS)
is EM21.
DATED: March 14, 2006
APPROVED BY:
Isl Steve Levy
County Executive of Suffolk County
Date: March 27, 2006
Suffolk Couuty Form 22
Contractor'sNendor's Public Disclosure Statement
Pursuant to Section A5-7 of the Suffolk County Administrative Code, this Public Disclosure Statement
must be completed by all contractors/vendors that have a contract with Suffolk County. In the event
contractor/vendor is exempt from completing paragraphs numbered I through 11 below, so indicate at
paragraph number 12 below setting forth the reason for such exemption. Notwithstanding such exempt
status, you must execute this form below before a notary public.
1. Contractor'sNendor's Name
Address
City and State Zip Code
2. Contracting Department's Name
Address
3. Payee Identification or Social Security No.
4. Type of Business_Corporation _Partnership_Sole Proprietorship_Other
5.3 Is contractor/vendor entering into or has contractor/vendor entered into a contract with Suffolk
County in excess of$I,OOO? _Yes_No.
5.b Has contractor/vendor entered into three or more contracts, including the one for which you are
now completing this form, with Suffolk County, any three of which, when combined, exceed
$1,000? _Yes_No.
6. Table of Organization. List names and addresses of all principals; that is, all individuals serving
on the Board of Directors or comparable body, names and addresses of all partners, and names
and addresses of all corporate officers. Conspicuously identify any person in this table of
organization who is also an officer or an employee of Suffolk County. (Attach additional sheet if
necessary. )
7. List all names and addresses of those individual shareholders holding more than five percent
(5%) interest in the contractor/vendor. Conspicuously identify any shareholder who is also an
officer or an employee of Suffolk County. (Attach additional sheet if necessary).
8. Does contractor/vendor derive 50% or more of its total revenues from its contractual or vendor
relationship with Suffolk County? _Yes_No.
9. If you answered yes to 8 above, you must submit with this disclosure statement, a complete
financial statement listing all assets and liabilities as well as a profit and loss statement. These
statements must be certified by a Certified Public Accountant. (Strike this out if not applicable.)
10. The undersigned shall include this Contractor'sNendor's Public Disclosure Statement with the
contract. (Describe general nature of the contract.)
Page 1 of 3 Public 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%) ofthe amount ofthe contract.
12. If you are one of the entities listed below at a) through c) or you qualify under d) below, you are
exempt from completing paragraphs numbered 1 through 11 herein:
_ a) Hospital
_X _ b) Educational or goverrunental 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 ofthe appropriate exemption.
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
being sworn, affirms under the penalties of peIjury, t t he/she has read and understood the
foregoing statements and that they are, to his/her own owledge, true.
Dated: -,-<+-1 ~nr Signed:
Printed Name of Signer: Scott A. Russell
Title of Signer: Town Supervisor _
Name ofContractorNendor: Town of Southold
UNIFORM CERTIFICATE OF ACKNOWLEDGMENT
(Within New York State)
STATE OF NEW YORK)
COUNTY OF SUFFOLK ) ss.:
On t~ day of * I~ ( in the year 20~before me, the undersigned, personally appeared
.3('-"" . f' {./ cIi' ersonally known to me or proved to me on the basis of satisfactory evidence
to be the individual(Xl whose name(~ is (~ subscribed to the within instrument and acknowledged to
me t at he/-Il\:t8/t\:tey executed the same in his/fler.'t\:tGir capacity(~ and that by his/.lli!l;it\:teir signature(\)
on t instrument, the individual(\), or the person upon behalf of which the individual~) acted, executed
the stru t. ~
(si
ffice of individual taking acknowledgement)
KIERAN M. CORCORAN
QUALIFIED IN SUFFOLK COUNTY
MY COMM7i'~6~Y :~~~o:~ 19~~8 6, 2 Vr-
Page 2 of 3 Public Disclosure Form
UNIFORM CERTIFICATE OF ACKNOWLEDGEMENT
(Without New York State)
STATE OF )
)ss.:
COUNTY OF SUFFOLK )
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)
Contractor'sNendor's Public Disclosure Statement Form (Rev. 3/04)
Page 3 of 3 Public Disclosure Form
Suffolk County, New York
Department of Labor
SUFFOLK COUNTY DEPARTMENT OF LABOR - LABOR MEDIATION UNIT
UNION ORGANIZING CERTIFICATION/DECLARATION - SUBJECT TO AUDIT
If the following definition of "County Contractor" (Union Organizing Law Chapter 466-2) applies to the
eontractor's/beneficiary's business or transaction with Suffolk County, the contractor/beneficiary must complete Sectinns I,
III, and IV below. If the following definitions do not apply, the contractor/beneficiary must complete Sectious II, III and IV
below. Completed forms must be submitted to the awarding agency.
County Contractnr: "Any employer that receives more than $50,000 in Couuty funds for supplying goods or services pursuant to a
written contract with the County of Suffolk or any of its agencies; pursuant to a Suffolk County grant; pursuant to a Suffolk County
program; pursuant to a Suffolk County reimbursement for services provided in any calendar year; or pursuant to a subcontract with
any of the above." .
Section I
Check if
Applicable
D
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 !lot use
County funds to assist, promote, or deter union organizing (Chapter 466-3 A), nor seek reimbursement from the
County for costs incurred to assist, promote, or deter union organizing. (Chapter 466-3 B)
I/we further agree to take all action necessary to ensure that County funds are not used to assist, promote, or deter
union organizing. (Chapter 466-3 H)
I/we further agree that I will not use County property to hold meetings to assist, promote, or
deter union organizing. (Chapter 466-3E)
I/we further agree that if any expenditures or costs incuned 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 further affilm to the following as to the goods and/or services that are the subject of the contract with the
County of Suffolk:
. 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;
. I/we will not coerce or intimidate employees, explicitly or implicitly, in selecting or not selecting a bargaining
representative;
. I/we will not require an employee, individually or in a group, to attend a mceting or an event that is intended to
influence his or her decision in selecting or not selecting a bargaining representative;
. I/we understand my/our obligation to lintit disruptions caused by prerecognition labor disputes through the
adoption of nonconfrontational procedures for the resolution of prerecognition labor disputes with employees
engaged in the production of goods or the rendering of services for the County; and
. I/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. IIwe shall include a list of said
procedures in such certification.
I1we further agree that every County contract for the provision of services, when such services will be performed on
County property with respect to those services and/or the use of County funds, shall iuclude a requiremeut that
I/we adopt a reasonable access agreement, a neutrality agreement, fair communication agreement,
no intimidation agreement, and a majority authorization card agreement.
I/we further agree that every County contract for the provision of human services, when such services are not to be
performed on Couuty property, shall include a requirement that IIwe adopt, at the least, a neutrality agreement with
respect to those services and/or the use of County funds.
I/we understand 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 Couuty 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 agrecments, majority authorization card agreements, binding arbitration
agreements, fair communication agreements, nonintimidation agreements, and reasonable access agreements.
DOL-LOI (Rev. 9/26/07)
Suffolk County, New York
Department of Labor
Section II
The Union Organizing Law does not apply to this contract for the following reason(s):
D
Check if
Applicable
Section III
Contractor Name:
Town of Southold
Federal Employer ID#: 11-6001939
Contractor Address: Town Hall, 53095 Route 25
Amount of Assistance: _$113,086.50
Southold, New York, 11971-0959
Vendor #:
ContractorPhone#: 6317651939
Description of project or service: Grant funded development of Multi-Jurisdictional Multi-Hazard Pre-Disaster Mitigation
Plan
Section IV
I declare under pe
certification, and
ty of perjury under the Laws of the State of New York that the undersigned is authorized to provide this
t the above' true and correct.
Authorized ignature
Date
,+-1-0 r
Scott A. Russell. Town Supervisor
Print Name and Title of Authorized Representative
DOL-WI (Rev. 9/2(,/07)
SUFFOLK COUNTY DEPARTMENT OF LABOR - LIVING WAGE UNIT
NOTICE OF APPLICATION FOR COUNTY ASSISTANCE (Contract)
Living Wage Law, Suffolk County Code, Chapter 347 (200])
To Be Completed By Applicant/ Employer/Contractor
1) NAME: Town of South old
2) VENDOR #: 11-6001939
4)
(If known)
CONTACT: Ed Forrester
3) CONTRACT ID #:_08-FS-002A_
(lrknown)
5) TELEPHONE #: 631 765 1939_
6) ADDRESS: Town Hall, 53095 Route 25
South old, New York, 11971-0959
7) TERM OF CONTRACT (DATES): Sept 14, 2005 to Sept 13, 2007
8) PROJECT NAME: (IF DIFFERENT FROM #1) Disaster Mitigation Plan_
9) AMOUNT: $113,086.50
10) A WARDING AGENCY: Suffolk Co Dept Fire Rescue & Emergency Service
11) BRIEF DESCRIPTION OF PROJECT OR SERVICE: Grant funded development of
Multi-Jurisdictional Multi-Hazard Pre-Disaster Mitigation Plan
12) PROJECTED EMPLOYMENT NEEDS: (attach a statement listing, by job
classification, the total workforce dedicated to performing this contract or service, including
calculation of estimated net increase or decrease in jobs as a result of funding).
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 ofthe contract).
LW-I (revised 4/04)
SUFFOLK COUNTY DEPARTMENT OF LABOR - LIVING WAGE UNIT
LIVING WAGE CERTlFICA TJON/DECLARA TlON - 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). ]f the following definitions do not apply, the contractor/recipient must
complete Sections 2,3 and 4 below. Completed forms must be submitted to the awarding 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 ten (10) employees by or through the authority or approval of the County of Suffolk," or
"Any service contract or subcontract Jet to a contractor with ten (10) or more employees by the County of Suffolk for the fUl1lishing 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 pruperty is not 'compensation' for the purposes of this definition."
Section I
~
Check If
applicable
Section 11
D
Check if
applicable
Section III
Contractor Name:
The Living Wage Law applies to this contract. l/we hereby agree to comply with all the provisions of Suffolk County
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 $1 OAO ($9.25 for child care providers) per hour worked with health benefits, as described in
the Law, or otherwise $11.84 ($10.50 for child care providers) per hour or the rates as may be adjusted annually in
accordance with the Law. (Chapter 347-3 B)
I/we further agree that any tenant or leaseholder of this company that employs at least ten (10) persons and occupies
property or uses equipment or property that is improved or developed as a result of compensation or any contractor or
subcontractor of this company that employs at least ten (10) persons in producing or providing goods or services to this
company that are used in the project or matter for which this company has received compensation shall comply with
all the provisions of the Law, including those specified above. (Chapter 347-2)
I/we further agree to pennit 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 tenn 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):
I o~..l cF S00Tt-IOL.t"l
I ,." .,.., \-V.l-L 5?J 0'15 "K, 25
.
$...,n-PL.D, ~'i \\'111-0<159
Federal Employer 1D#: II", (.,.rx')1 '1 ?l)
Amount of compensation: $ II ?>.O~'!:f::-
Vendor #:
Contractor Address:
Contractor Phone #:
Gttil....... F.;....
under the Laws of the State ofNcw York that the undersigned is authorized to provide this certification,
Teet.
r.f-1-or
Date
AuthollZca sl~e c:::::
..s~,,-=;.:. ". u~,Sc.=-J..~__~.l..L.V..lJI'FNI'Sae
Pnn! Name and TItle of Authonzed RepresentatIve
I.W .\S (reVised 6-07, replaces forms I.W2, I.W3, and I.W33)
SUFFOLK COUNTY DEPARTMENT OF LABOR
NOTICE OF APPLICATION TO CERTIFY COMPLIANCE WITH FEDERAL LAW
(8 U.S.C. SECTION 1324a)
WITH RESPECT TO LAWFUL IDRING OF EMPLOYEES
Suffolk County Code, Chapter 234 (2006)
To Be Completed By Applicant! Covered Employer//Owner
EMPLOYER/CORP.IBUSINESS/COMPANY NAME: Town of South old
1) ADDRESS: Town Hall, 53095 Ronte 25, Southold, New York, 11971-0959_
2) NOT-FOR-PROFIT:
YES_X_ NO_ (SUBMIT CERTIFICATE OF INCORPORATION)
3) VENDOR #: 11-6001939
(If known)
5) CONTACT: Scott A. Russell
4) CONTRACT ID:_08-FS-002A
(If known)
6) TELEPHONE #: 6317651939
7) TERM OF CONTRACT OR EXTENSION (pROVIDE DATES): 9/14/05 _ 9/13/07
8) BRIEF DESCRIPTION OF COMPENSATION, PROJECT OR SERVICE_ Grant fnnded development of
Multi-Jurisdictional Multi-Hazard Pre-Disaster Mitigation Plan
SUBCONTRACTOR:
1) ADDRESS:
2) VENDOR#:
3) TELEPHONE #:
4) CONTACT:
5) DESCRIPTION OF COMPENSATION, PROJECT OR SERVICE
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 234-5:
A. United States passport; or
B. resident alien card or alien registration card; or
C. birth certificate indicating that person was born in the United States; or
D. (1) a driver's license, if it contains a photograph of the individnal; and
(2) a social security acconnt nnmber card (other than such a card which
specifies on its face that the issuance of the card does not authorize
employment in the United States); or
E. employmeut authorization documents such as an H-IB visa, H-2B visa,
and L-l visa, or other work visa as may be authorized by the United
States Government at the time the County contract is awarded for all
covered employees.
Form LIH:-l
AFFIDAVIT OF COMPLIANCE
WITH THE REQUIREMENTS OF
8 U.S.c. SECTION 1324a
WITH RESPECT TO LAWFUL HIRING OF EMPLOYEES
State of New York
)
ss:
County of _Suffolk
)
Scott A. Russell
(Print Name of Deponent)
, being duly sworn, deposes and says:
1.
Town of South old
- -
(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 (U.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 Chapter 234.
Sw rn to before me this 2f!::. day
KIERAN M. CORCORAN
QUALIFIED IN SUFFOLK COUNTY
NOTARY #02C061 "19031\
MY COMMISSION EXPIRES DEe I. ~K
Form LHE-2
B U.S.C. SECTION 1324A1
WITH RESPECT TO LAWFUL HIRING OF EMPLOYEES
County Code, Chapter 234 (2006)
To Be Completed By the Local Law Compliance Unit
DATE: Auril 16, 2008
TO: Bob Sheron, S. C. Deat. of Fire, Rescue and Emergency Services
FRO • nda Rosenber Director
TEL PHONE #: 631 853-3808
EMPLOYER: Town of Southold
VENDOR #: 11-6001939
REF.: Disaster Mitigation Plan
You are hereby notified that the submission from Town of Southold 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
(01/07)