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HomeMy WebLinkAboutYouth Services ProgramSouthold Town Board - Letter Board Meeting of July 15, 2008 RESOLUTION 2008-690 ADOPTED Item # DOC ID: 4059 THIS IS TO CERTIFY THAT THE FOLLOVVING RESOLUTION NO. 2008-690 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JULY 15, 2008: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Scott A. Russell to execute an Agreement with Suffolk County in connection the 2008 Southold Youth Services Program, in the amount of $10,449, all in accordance with the approval of the Town Attorney. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Vincent Orlando, Councilman SECONDER: AIbertKrupskiJr., Councilman AYES: Ruland, Orlando, Krupski .Ir., Wickham, Evans, Russell Generated July 17, 2008 Page 40 No. 08-YO2-0002 IFMS No. SCS EXE 08000002839 Implementing Agency:Youth Development Delinquency Prevention Program Law Agreement This Agreement ("Agreement") is between the County of Suffolk ("County"), a municipal corporation of the State of New York, acting through its duly constituted Youth Bureau (Department), having · its principal office at H. Lee Dennison Building-3rd Floor, 100 Veterans Memorial Highway, Hauppauge, New York (Mailing Address: Box 6100 Hauppauge, New York 11788-0099), and Town of Southold (Contractor), a New York Municipal Corporation, having its principal place of business at Southold Town Hall, Main Street, Southold, New York 11971, acting through its duly constituted agency, and Family Service League (Implementing Agency), a New York not-for-profit corporation, having its principal place of business at 790 Park Avenue, Huntington, New York 11743. The parties hereto desire to make various delinquency prevention programs available to the County through the Contractor and its Implementing Agency as listed in the attached Exhibit V (Contractor Programs). Term of Agreement: January 1, 2008 through December 31,2008. State Aid Percentage: 18% Percentage of Advance: 0% Total Cost of Agreement: Shall not exceed $10,449.00, as set forth in Exhibit VI, attached. Terms and Conditions: Shall be as set forth in Exhibits I through VI, attached hereto and made a part hereof. In Witness Whereof, the parties hereto have executed this Agreement as of the latest date written below. BY: Name: Title: Fed. Taxpayer Date: County of Suffolk Name / / / J=~mm=YW SZASO Deputy County Executwe ......... Date: Fam~ague~./,/~ By:- V~J-~~''~ . , Name~.t/.-~ -/~7,~C'.~ ~ Title: ~ ~ ~,/~ ~ ~ ~ ~ Fed. Taxpayer I~:~ ~X~-~/[~2 Date: ~/~) ~ Approved as to Legally: Christin~, CounW A~orney ~atficia M. ~o~ Assistan~°rT~ Date: . ~/~0~ ~a M.S.W. ! YO2(6/18/08) · 1 of 28 Daoes La,w No. 08-YO2- IFMS No, SCS EXE 0800000 I .mplementing Agency:Youth Development Delinquency Prevention Program List of Exhibits Exhibit I General Terms and Conditions 1. Contractor Responsibilities a. Services b. Qualifications and Licenses c. Engineering Certificate d. County Review 2, Term and Termination a. Term b. Termination for Cause c. Termination for Emergencies d. Termination for Convenience e. Payments Upon Termination 3. Indemnification a. General b. Federal (~opyright Act 4. Insurance 5. Independent Contractor 6. Severability 7. Merger; No Oral Changes 8, Set-Off Rights 9. Non-Discrimination in Services 10. Nonsectarian Declaration 11, Governing Law 12. No Implied Waiver 13. Conflicts of Interest 14. Cooperation on Claims 15. Confidentiality 16. Assignment and Subcontracting 17. No Intended Third Party Beneficiaries 18. Certification as to Relationships 19. Publications and Publicity 20. Copyrights and Patents a, Copyrights b. Patents 21. 22. 23. 24. Certificate of Incorporation; Board Meetings Lawful Hiring of Employees Law in Connection with Contracts for Construction or Future Construction Contractor's Staff Human Services Division Technical Assistance and Training Exhibit II Suffolk County Legislative Requirements Contractor's/Vendor's Public Disclosure Staiement Living Wage Law Use of County Resources to Interfere with Collective Bargaining Activities Local Law No. 26-2003 Lawful Hiring of Employees Law Gratuities YO2(6/18/08) 2 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 I .mi~lementing Agency:Youth Development Delinquency Prevention Program 7. 8. 9. 10. 11. Prohibition Against Contracting with Corporations that Reincorporate Overseas Child Sexual Abuse Reporting Policy Non Responsible Bidder Use of Funds in Prosecution of Civil Actions Prohibited Work Experience Participation Suffolk County Local Laws Website Address Exhibit III Notices and Contact Persons Exhibit IV General Payment Terms and Conditions 5. 6. 7 8. 10. 11.' General Payment Terms and Conditions Agreement Subject to Appropriation of Funds Specific Payment Terms and Conditions a. Limit of County's Obligations b. Budget c. Payment of Claims d. Payment Vouchers; Monthly reports e. Payments Limited to Actual Net Expenditures f. Advance Payment Schedule (If Applicable) g. Final Voucher h. Travel Costs I. Salaries j. Salary Increases k. Actual Fringe Benefit Costs I. Budget Deficiency Plan m. Taxes n. Final Report and Claim o. Payments Contingent Upon Receipt of Aid p. Payments Contingent Upon State/Federal Funding Accounting Procedures Audit Personnel Salaries, Pension and Employee Benefit Plans, Rules and Procedures Financial Statements and Audit Requirements Furniture, Fixtures, Equipment, Materials, Supplies a. Purchases, Etc. Requiring Prior Approval b. Purchase Practices c. Proprietary Interest of County d. Inventory Records, Controls and Reports e. Protection of Property in Contractor's Custody f. Disposition 0f Property in Contractor's Custody Lease or Rental Agreements Loan Approval Statement of Other Contracts Exhibit V Description of Services or Program Exhibit VI Budget Y02(6/18/08) 3 of 28 pages L~w No. 08-YO2- IFMS No. SCS EXE 0800000 I ,rnplementing Agency:Youth Development Delinquency Prevention Program Exhibit I General Terms and Conditions Contractor Responsibilities a. Services The Contractor shall provide the services described in Exhibit V, entitled "Description of Services." All references in this Agreement to Contractor shall be deemed to refer to the Contractor and to the Implementing Agency, except as otherwise indicated; provided that all provisions relating to Contractor's staff shall be deemed to apply only to the Implementing Agency. b. Qualifications and Licenses To the extent applicable, the Contractor specifically represents and warrants that it has and shall possess, and that, to the extent applicable, its employees, agents and subcontractors have and shall possess, the required education, knowledge, experience and character necessary to qualify them individually for the particular duties they perf?rm and that the Contractor has and shall have, and, to the extent applicable, its employees, agents and subcontractors have and shall have, all required authorization(s), certificates(s); certifications(s), registration(s), license(s), permit(s) or other approval(s) required by the State, County or local authorities for the services provided in accordance with this Agreement. c. Engineering Certificate In the event that this Agreement requires any engineering services, the Contractor shall submit, prior to, or along with, any plans, reports, specifications, permits or other applications, analyses or 0the[ engineering work required to be submitted to the Department for approval under this Agreement, the Certificate(s) of Authorization, issued pursuant to §7210 of the New York Education Law, of its consultants, subcontractors, subcontractors, and/or any other entity (including, but not limited to, the Contractor and any of its subsidiaries, divisions, affiliates or an entity under the control of the Contractor) performing all or part of the engineering services necessary hereunder. Failure to file, submit or maintain said Certificate(s) shall be grOunds for rejection of any plans, reports, specifications, permits or other applications, analyses or other engineering work submitted for approval under the terms of this Agreement. d. County Review It is agreed that the nature and extent of the services provided pursuant to this Agreement shall be subject to the general supervision of the County and that the Department, through its duly authorized representatives, has the dght to monitor and evaluate the program. The Youth Bureau shall be the sole arbiter as to what constitutes acceptable performance in meeting the aforementioned responsibilities. 2. Term and Termination a. Term This Agreement shall cover the period set forth on page one of this Agreement, unless sooner terminated as provided below. Upon receipt of a Termination Notice, as that term is defined YO2(6/18/08) 4 of 28 pages La.w No. 08-YO2- IFMS No. SCS EXE 0800000 I.mplementing Agency:Youth Development Delinquency Prevention Program below, the Contractor shall promptly discontinue ail Services affected, unless otherwise di'rected by the Termination Notice. b. Termination for Cause Failure to maintain the amount and types of insurance required by this Agreement may result in immediate termination of this Agreement, in the sole discretion of the County. ii. Failure to comply with federal, state or local laws, rules, regulations, or County policies or directives, may result in immediate termination of this Agreement, in the sole discretion of the County. iii. If the Contractor becomes bankrupt or insolvent or falsifies its records or reports, or misuses its funds from whatever source, the County may terminate this Agreement in whole or with respect to any identifiable part of the program, effective immediately, or, at its option, effectiv~ at a later date specified in the notice of such termination to the Contractor. In the event of a failure on the part of Contractor to observe any of the other terms and conditions of this Agreement, this Agreement may be terminated in whole or in part in writing by the County provided that no such termination shall be effective unless Contractor is given five (5) calendar days' (or longer, at the County's option) written notice of intent to terminate ("Notice of Intent to Terminate"), delivered in accordance with the Exhibit entitled "Notices and Contact Persons." During such five (5) day period, (or longer, at the County's option) the Contractor will be given an opportunity for consultation with the County and an opportunity to cure all failures of its obligations prior to termination by the County. In the event that the Contractor has not cured ali its failures to fulfill its obligations to the satisfaction of the County by the end of the (5) day period (or longer, at the Cm)nty's option), the County may issue a written termination notice ("Termination Notice"), effective immediately. c. Termination for Emergencies An emergency or other condition involving possible loss of life, threat to health and safety, destruction of property or other condition deemed to be dangerous, in the sole discretion of the County, may result in immediate termination of this Agreement, in whole or with respect to any identifiable part of the program, in the sole discretion of the County. d. Termination for Convenience The County shall have the right to terminate this Agreement at any time and for any reason deemed to be in its best interest, provided that no such termination shall be effective unless the Contractor is given thirty (30) calendar days' prior written termination notice ("Termination Notice"). In such event of termination, the County shall pay the Contractor for the services rendered through the date of termination. e. Payments upon Termination Upon receiving a Termination Notice, the Contractor shall promptly discontinue all services affected unless otherwise directed by the Termination Notice. YO2(6/18/08) 5 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 Implementing Agency:Youth Development Delinquency Prevention Program ii. The County shall be released from any and all responsibilities and obligations arising from the services provided in accordance with this Agreement, effective as of the date of termination, but the County shall be responsible for payment of all claims for services provided and costs incurred by the Contractor prior to termination of this Agreement, that are pursuant to, and after the Contractor's compliance with, the terms and conditions of this Agreement. iii, Upon termination, the Contractor agrees to promptly reimburse to the County, by check payable to the Suffolk County Treasurer, the balance of any funds advanced to the Contractor by the County. Upon termination, any funds paid to the Contractor by the County which were used by the Contractor in a manner that failed to comply with the terms and conditions of this Agreement must be promptly reimbursed. If there is no response or if satisfactory repayments are not made, the County may recoup such payments from any amounts due or becoming due to the Contractor from the County under this Agreement or otherwise. The provisions of this subparagraph shall survive the expiration or termination of the Agreement. Indemnification a. General The Cont'ractor agrees that it shall protect, indemnity 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 attorneys' 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. b. Federal Copyright Act The Contractor hereby represents and warrants the Contractor will not infringe upon any copyrighted work or material in accordance with the Federal Copyright Act during the performance of this Contract. Furthermore, the Contractor agrees that it shall protect, indemnify and hold harmless the County and its officers, officials, employees, contractors, agents and other persons frown 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, ager~ts and other persons in any suit, including appeals, or, at the County's option, pay reasonable attorneys' fees for defense of any such suit arising out of the acts or omissions or negligence of the Contractor, its officers, officials, employees, subcontractors, lessees, licensees, invitees 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 YO2(6/18/08) 6 of 28 pages Law No. 08-YO2- IFMS No, SCS EXE 0800000 Im, plementing Agency:Youth Development Delinquency Prevention Program 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 of its subcontractors, in connection with work performed for the Contractor related to this Agreement, procure, pay the entire premium for and maintain throughout the term of this Agreement insurance in amounts and types equal to that specified by the County for the Contractor. Unless otherwise specified by the County and agreed to by the Contractor, in writing, such insurance shall be as follows: 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 §§57 and 220 of the Workers' Compensation Law. In accordance with General Municipal Law §108, this Agreement shall be void and of no effect unless the Contractor shall provide and maintain coverage during the term of this Agreement for the benefit of such employees as are required to be covered by the provisions of the Workers' Compensation Law. iv. Professional Liability insurance in an amount not less than Two Million Dollars ($2,000,000.00) on either a per occurrence or claims made coverage basis. {Delete this clause if not applicable) All policies providing such coverage shall be issued by insurance companies with an A.M. Best rating of A- or better. Co 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 a.foresaid insurance requirements. In the case of commercial general liability insurance, the County of Suffolk shall be named as an additional insured and the Contractor sl~all furnish a Declaration Page and endorsement page evidencing the County's status as an additional insured on said policy. Any such Declaration Page, certificate of insurance, policy, endorsement page or other evidence of insurance supplied to the County 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. Suoh Declaration Page, certificate of insurance, policy, endorsement page, other evidence of insurance, and any notice of nonrenewal or material change shall be malted 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 the Contractor shall fail to provide the Declaration Page, certificate of insurance, Y02(6/18/08) 7 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 · Implementing Agency:Youth Development Delinquency Prevention Program policy, endorsement page or other evidence of insurance, or fail 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 the Contractor under this Agreement or any other agreement between the County and the Contractor. If the Contractor is a town or other municipal corporation and has a self-insurance program under which it acts as a selfqnsurer for any Of such required coverage, it may provide self- funded coverage and certificates or other evidence of such self-insurance in lieu of insurance issued by insurance companies. 5. Independent Contractor It is expressly agreed that the Contractor status hereunder is that of an independent contractor. Neither the Contractor, nor any person hired by the Contractor shall be considered employees of the County for any purpose. 6. Severability It is expressly agreed that if any term or provision of this Agreement, or the application thereof to any person or circumstance, shall be held invalid or unenforceable to any extent, the remainder of this Agreement, or the application of such term or provision to persons or circumstances other than those as to which it is held invalid or unenforceable, shall not be affected thereby, and every other term and provision of this Agreement shall be valid and shall be enforced to the fullest extent permitted by taw. 7. Merger; No Oral Changes It is expressly agreed that this Agreement represents the entire agreement of the parties, that all previous understandings are merged in this Agreement. No modification of this Agreement shall be valid unless written in the form of an Amendment and executed by both parties. 8. Set-Off Rights The County shall have all of its common law, equitable, and statutory rights of set-off. These rights shall inc!ude, but not be limited to, the County's Option to withhold, for the purposes of set-off, any moneys due to the Contractor under this contract up to any amounts due and owing to the County with regard to this contract and/or any other contract with any County department or agency, including any contract for a term commencing prior to the term of this contract, plus any amounts due and owing to the County for any other reason including, without limitation, tax delinquencies, fee delinquencies or monetary penalties relative thereto. The County shall exercise its Set-off rights in accordance with normal County practices including, in cases of set-off pursuant to an audit, the finalization of such audit by the County agency, its representatives, or the County Comptroller, and only after legal consultation with the County Attorney. 9, Non-Discrimination in Services During the performance of this Agreement: a. The Contractor shall not, on the grounds of race, creed, color, national origin, sex, age, disability, sexual orientation, military status or marital status: i. deny any individual any services or other benefits provided pursuant to this Agreement; or Y02(6/18/08) 8 of 28 pages Law No. 08-YO2~ IFMS No. SCS EXE 0800000 · Irpplementing Agency:Youth Development Delinquency Prevention Program ii. provide any services or other benefits to an individual that are different, or are provided in a different manner, from those provided to others pursuant to this Agreement; or iii. subject an individual to segregation or separate treatment in any matter related to the individual's receipt of any service(s) or other benefits provided pursuant to this Agreement; or iv. restrict an individual in any way in the enjoyment of any advantage or privilege enjoyed by others receiving any services or other benefits provided pursuant to this Agreement; or v. treat an individual differently from others in determining whether or not the individual satisfies any eligibility or other requirements or condition which individuals must meet in order to receive any aid, care, service(s) or other benefits provided pursuant to this Agreement. The Contractor shall not utilize criteria or methods of administration which have the effect of subjecting individuals to discrimination because of their race, creed, color, national origin, sex, age, disability, sexual orientation, military status or marital status, or have the effect of defeating or substantially impairing accomplishment of the objectives of this Agreement in respect to individuals of a particular race, creed, color, national origin, sex, age, disability, sexual orientation, military status or marital status, in determining: i. the types of service(s) or other benefits to be provided, or ii. the class of individuals to whom, or the situations in which, such service(s) or other benefits will be provided; or iii. the class of individuals to be afforded an opportunity to receive services. ' 10. Nonsectarian Declaration The Contractor agrees that all services performed under this Agreement are secular in nature, that no funds received pursuant to this Agreement will be used for sectarian purposes or to further the advancement of any religion, and that no services performed under this program will discriminate on the basis of religious belief. Furthermore, the Contractor agrees that all program services are and will be available to all eligible individuals regardless of religious belief or affiliation. 11 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 of laws. Venues shall be designated in Suffolk County; New York or the United States District Court for the Eastern District of New York. 12. No Implied Waiver No waiver shall be inferred from any failure or forbearance of the County to enforce any provision of this Agreement in any particular instance or instances, but the same shall otherwise remain in full force and effect notwithstanding any such failure or forbearance. 13. Conflicts of I~iterest The Contractor agrees that it will not during the term of this Agreement engage in any activity that is contrary to and/or in conflict with the goals and purposes of the County. YO2(6/18/08) 9 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 I .mplementing Agency:Youth Development Delinquency Prevention Program 14, 15. 17. 18. 19. bu The Contractor is charged with the duty to disclose to the County the existence of any such adverse interests, whether existing or potential. This duty shall continue so long as the Contractor is retained on behalf of the County. The determination as to whether or when a conflict exists or may potentially exist shall ultimately be made by the County Attorney after full disclosure is obtained. Cooperation on Claims The Contractor hereto agrees to render diligently to the County, without additional compensation, any and all cooperation, that may be required to defend the County, its employees and designated representatives against any claim, demand or action that maybe brought against the County, its employees or designated representatives in connection with this Agreement. Confidentiality Any records, reports or other documents of the County or any of its agencies used by the Contractor pursuant to this Agreement or any documents created as a part of this Agreement shall remain the property of the County and shall be kept confidential in accordance with applicable laws, rules and regulations. Assignment and Subcontracting Except to the extent necessary or appropriate for the Implementing Agency contracts under this Agreement, the Contractor shall not assign, transfer, convey, sublet, or otherwise dispose of this Agreement, or any of its right, title or interest therein, or its power to execute the Agreement, or assign ail or any portion of the monies that may be due or become due hereunder, to any other person or corporation, without the prior consent in wdting of the County, and any attempt to do any of the foregoing without such consent shall be of no effect. No Intended Third Party Beneficiaries This Agreement is entered into solely for the benefit of the County and the Contractor. No third party shall be deemed a beneficiary of this Agreement, and no third party shall have the right to make any claim or assert any right under this Agreement. Certification as to Relationships 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, commemial, 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. Publications and Publicity The Contractor shall not issue or publish any book, article, report or other publication related to the Services provided pursuant to this Agreement without first obtaining written prior approval from the County. Any such printed matter or other publication shall contain the following statement in clear and legible print: YO2(6/18/O8) 10 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 · Implementing Agency:Youth Development Delinquency Prevention Program "This publication is fully or partially funded by the Suffolk County Executive's Office." The Departmen~ shall have the right of p~' or approval of press releases and any other information provided to the media, in any form, concerning the Services provided pursuant to this Agreement. 20. Copyrights and Patents a. Copyrights If the work of the Contractor under this Agreement should result in the production Of original books, manuals, films or other materials for which a copyright may be granted, the Contractor may secure copyright protection. However, the County reserves, and the Contractor hereby gives to the County, and to any other municipality or government agency or body designated by the County, a royalty-free, nonexclusive license to produce, reproduce, publish, translate or otherwise use any such materials. b. Patents If the Contractor under this Agreement makes any discovery or invention in the course of or as a result of work performed under this Agreement, the Contractor may apply for and secure for itself patent protection. However, the County reserves, and the Contractor hereby gives to the County, and to any other municipality or government agency or body designated by the County, a royalty-free, nonexclusive license to produce or otherwise use any item so discovered or patented. 21. Certificate of Incorporation; Board Meetings a. The Contractor shall furnish the Department with certified copies of its Certificate of Incorporation and by-laws, including any amendments thereto, at the time it signs this Agreement, to the extent not already on file with the Department, and any amendments thereto during the term of this Agreement promptly upon their adoption, and a list of the board members governing the Contractor from time to time. The Contractor shall not dissolve any existing corporation or establish any new corporation with the responsibility for the operation Of the program without the prior written approval of the Department. b. Minutes of the Contractor's annual board meeting and one other board meeting, no longer than six (6) months thereafter, should be forwarded to the Department within two (2) weeks after the conclusion of the meetings. 22. Lawful Hiring of Employees Law in Connection with Contracts for Construction or Future Construction In the event that this Agreement is subject to the Lawful Hiring'of Employees Law of the County of Suffolk, Suffolk County Code Chapter 234, as more fully set forth in the Exhibit entitled "Suffolk County Legislative Requirements." In accordance with this law, Contractor or employer, as the case may be, and any subcontractor or owner, as the case may be, agree to maintain the documentation mandated to be kept by this law on the Construction Site at all times. Contractor or employer, as the case may be, and any subcontractor or owner, as the case may be, further agree that employee sign-in sheets and register/log books shall be kept on the Construction Site at all times during working hours and all covered employees, as defined in the law, shall be required to sign such sign-in sheets/registedlog books to indicate their presence on the Construction Site during such working hours. YO2(6/18/O8) 11 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 · Implementing Agency:Youth Development Delinquency Prevention Program 23. Contractor's Staff a. Prior Approval The County shall have the right to prior approval of the filling of any position now vacant or hereafter becoming vacant and may, in the exercise of that right, promulgate reasonable regulations involving position control which shall, when promulgated, be deemed to be incorporated by reference in and be made part of this Agreement. b. Current Procedures Resumes The Contractor, at its own expense, agrees to furnish to the Department resumes of all personnel to be hired for the program referred to in this Agreement, prior to their being hired. Resumes shall include, but not be limited to: (i) Previous job titles(s) of the individual employee and the length of employment under each title; and/or (ii) Previous experience and length of previous experience with a task or tasks similar or equal to the program· Contractor Letters The Contractor agrees to furnish to the County letter(s) regarding all personnel to be hired for the program. The letter(s) shall include, but not be limited to: (i) The specific tasks to be performed by the individual employees during the course of the program; (ii) Salaries and hours to be worked by the individual employees during the course of the program. County Approval The County reserves the right to approve principal program personnel proposed by the Contractor at the time of entering into this Agreement. Reasons for the County not approving said personnel shall be for lack of qualification or lack of demonstration by the Contractdr that said proposed personnel will not have a deleterious effect on the proper and efficient operation of the program. Job Descriptions, Qualifications The Contractor will nominate to the Department a project director chosen on the basis of the job description below. The Director of the Department shall review such nominations and may confirm them. Other staff positions prOVided for in this Agreement will be filled in accordance with written job descriptions as provided below. Employment of any staff member under the terms of this Agreement shall be subject to ongoing review for competency and aptitude of the staff member by the Director of the Department or his/her designees. The Depa~ment may recommend dismissal or suspension of any staff member under this Agreement, and may discontinue or suspend reimbursement for claims upon thirty days notice to the Contractor if the Contractor does not comply with such recommendations. YO2(6/18/08) 12 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 · Implementing Agency:Youth Development Delinquency Prevention Program Project Director (i) Qualifications: Graduation from an accredited college and/or university with a Master's Degree in Social Work; or a Bachelor's Degree (4-year college degree) plus 2 years experience in Human Services. (ii) Duties: Responsible for overall project; hires and fires staff; chairs youth advisory committee; administers and directs all Contractor programs; is responsible to Board of Directors of the Contractor and has immediate charge of and responsibility for facility and youth services program; renders direct services to clients as required; selects, trains and supervises program aides, nonprofessional staff and volunteers; has charge of a petty cash account; makes purchases and expends funds under the direction of the treasurer of the corporation or such other officers as the Board of the corporation may direct. Youth Worker (i) Qualifications: Bachelor's Degree (4-year college degree from an accredited college). (ii) Duties: Provides counseling, group work Services, and professional supervision in lounge activities, is responsible to the project director. Also shall keep written records and reports of work accomplished; shall demonstrate ability to learn, ability to relate successfully to clients and the community, and capacity for development in professional use of self in relationships. Program Aides (i) Qualifications: High School Diploma and preferably some paid experience in youth work. (ii) Duties: Report to project director; shall carry out assignments as paraprofessionals; shall keep written records and reports of work accomplished; shall demonstrate ability to learn, ability to relate successfully to clients and community, and capacity for development in professional use of self in relationships. c. The above procedures may be modified in the event of notification under a County budget deficiency plan as provided in Exhibit VI, the pa~'agraph headed "Budget Deficiency Plan." 24. Human Services Division Technical Assistance and Training: a. The Contractor agrees to participate in the Human Services Division Technical Assistance and Training Program. Such agreed participation will include staff training on the topic of HIV/AIDS and not more than three (3) days-per-year attendance at training on topics that may include, but not be limited to, contract financial reporting, the setting of service goals and objectives, and program development. b. The Contractor may participate, at its election, in any additional training made available by the Human Services Division. End of Text for Exhibit I YO2(6/18/08) 13 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 · Implementing Agency:Youth Development Delinquency Prevention Program. Exhibit II Suffolk County Legislative Requirements Contractor's/Vendor'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 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 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; entitled "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 Certification/Declarafion - 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 wi[h the requirements of Chapter 466, Adicle 1 of the Suffolk County Local Laws, "Use of County Resources to Inten~ere 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. 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. YO2(6/18/08) 14 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 · Implementing Agency:Youth Development Delinquency Prevention Program 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, nonintimidation agreement and a majority authorization card agreement. If Contractor services are for the provision of human services and such services are not to be 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-LO1; entitled "Suffolk County Department of Labor- Labor Mediation Unit Union Organizing Certification/Declaration - 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 sworn 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 sworn 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. YO2(6/18/08) 15 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 · Implementing Agency:Youth Development Delinquency Prevention Program The Contractor acknowledges that such filings are a material, contractual and statutory duty and that the failure to file any such statement s'hall constitute a material breach of this 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. This Agreement is subject to the Lawful Hiring of Employees Law of the County of Suffolk, Suffolk County Code Chapter 234, as more fully set forth in the Exhibit collectively referred to as the "Suffolk County Legislative' Requirements." In accordance with this law, Contractor or employer, as the case may be, and any subcontractor or owner, as the case may be, agree to maintain the documentation mandated to be kept by this law on site at ali times. Contractor or employer, as the case may be, and any subcontractor or owner, as the case may be, further agree that employee sign-in sheets and register/logbooks shall be kept on site at all times during working hours and all covered employees, as defined in the law, shall be required to sign such sign in sheets/register/log books to indicate their presence on the site during such working hours. 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" "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, §§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. 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 YO2(6/18/08) 16 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 · Implementing Agency:Youth Development Delinquency Prevention Program 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, §§143-5 through 143-9. Upon signing this Agreemer~t 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 §590-3, the Contractor represents that it shall not use any 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. Work Experience Participation If the Contractor is a nonprofit or governmental agency or institution, each of the Contractor's locations in Suffolk County at which services are provided under this Agreement shall be a work site for public- assistance clients of Suffolk County pursuant to Local Law No. 15-1993 at all times during the t~rm of this Agreement. If no Memorandum of Understanding ("MOU") with the Suffolk County Department of Labor for work experience is in effect at the beginning of the term of this Agreement, the Contractor, if it is a nonprofit or governmental agency or institution, shall enter into such MOU as soon as possible after the execution of this Agreement and failure to enter into or to perform in accordance with such MOU shall be deemed to be a failure to perform in accordance with this Agreement, for which the County may withhold payment, terminate this Agreement or exercise such other remedies as may be appropriate in the cimumstances. 11. Suffolk County Local Laws Website Address 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 II Y02(6/18/O8) 17 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 . Implementing Agency Youth Development Delinquency Prevention Program Exhibit III Notices and Contact Persons Notices Relating to Payments, Reports, Insurance, or Other Submissions Any communication, notice, claim for payment, report, 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, Return Receipt Requested in Postpaid Envelope or by Courier Service or by Fax or by Email Suffolk County Youth Bureau H. Lee Dennison Building- 3rd Floor 100 Veterans Memorial Highway, P.O Box 6100 Hauppauge, NY 11788 Attention: Patrick Policastre For the Contractor: By First Class and Certified Mail, Return Receipt Requested in Postpaid Envelope o...[r by Courier Service o...[r 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 Contractor 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 Contractor shall immediately deliver to the County Attorney, at the address set forth below, copies of all papers filed by or against the Contractor. Any communication or notice regard ng termination 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 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, Return Receipt Requested in Postpaid Envelope or by Nationally Recognized Courier Service o.~r Personally and by First Class Mail Suffolk County Youth Bureau H. Lee Dennison Building- 3rd Floor 100 Veterans Memorial Highway, P.Q Box 6100 Hauppauge, NY 11788 Attention: Patrick Policastro and Christine Malafi, County Attorney Y02(6/18/08) 18 of 28 pages Law No. 08-YO2- iFMS No. SCS EXE 0800000 · Implementing Agency:Youth Development Delinquency Prevention Program Suffolk County Department of Law H. Lee Dennison Building 100 Veterans Memorial Highway Hauppauge, New York 11788 For Contractor: By First Class and Certified Mail in Postpaid Envelope o_[r by Nationally Recognized Courier Service o.~r Personally and by First Class Mail At the address set forth on page one of this Agreement, attention to the person who executed this Agreement or such other designee as the parties may agree in writing. Notices shall be deemed to have been duly delivered (i) if mailed, upon the seventh business day after the mailing thereof; or (ii) if by nationally recognized overnight courier service, upon the first business da¢ subsequent to the transmittal thereof; or (iii) 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. Each party shall give prompt written notice to the other party of the appointment of successor(s) to the designated contact )erson(s) or his or her designated successor(s). End of Text for Exhibit ill YO2(6/18/08) 19 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 · Im. plementing Agency:Youth Development Delinquency Prevention Program Exhibit IV General Payment Terms and Conditions 1. General Payment Terms The Contractor shall prepare and present a claim form supplied by the County and approved for payment by the County ("Suffolk County Payment Voucher"). Claims shall be documented by sufficient, competent and evidential matter. Payment by the County will be made within thirty (30) days after approval by the Comptroller of the County of Suffolk. The Contractor agrees that it shall be entitled to no more than the fees set forth in this Agreement for the completion of all work, labor and services contemplated in this Agreement. The acceptance by the Contractor of payment of all billings made on the final approved Suffolk County Payment Voucher under this Agreement shall operate as and shall be a release to the County from all claims and liability to the Contractor, its successors, legal representatives and assigns, for services rendered under this Agreement. 2. Agreement Subject to Appropriation of Funds This Agreement is subject to the amount of funds appropriated and any subsequent modifications thereof by the Suffolk County Legislature, and no liability shall be incurred by the County under this Agreement beyond the amount of funds appropriated by the Legislature for the Services covered by this Agreement. 3. Specific Payment Terms and Conditions Limit of County's Obligations The maximum amount to be paid by the County as set forth on the cover page of this Agreement shall constitute the full obligation of the County in connection with this Agreement and any matter arising therefrom. b. Budget The Contractor expressly represents and agrees that the Budget, to the extent applicable, lists all personnel and/or all other costs of services to be rendered by the Contractor under this Agreement. c. Payment of Claims The County, at it's option, may agree to pay the Contractor in advance an amount not to exceed one fourth (1/4) of the Total Cost of Agreement for services provided and costs incurred pursuant to this Agreement upon receipt of a claim voucher for that amount as approved by the County. Payment under this Agreement shall not duplicate payment from any other source(s) for Contractor costs and services funded pursuant to this Agreement. Payment by the County shall be made within thirty (30) days after approval by the Comptroller of the County of Suffolk. d. Payment Vouchers; Monthly Reports i. The Contractor shall submit a standard Suffolk County Payment Voucher listing all YO2(6/18/08) 20 of 28 pages LaW No. 08-YO2- IFMS No. SCS EXE 0800000 Im. plementing Agency:Youth Development Delinquency Prevention Program information regarding the services and other items for which expenditures have been or will be made in accordance with this Agreement. Either ~Xith the Agreement (for services already rendered and expenditures already made), and/or not more than 30 days after the expenditures were made and in no event after the 31st day of January fo/lowing the end Of the term of this Agreement, the Contractor shall furnish the Department with detailed documentation in support of the payment for services or expenditures under this Agreement, e.g. dates of Service, worksite locations and activities, hours worked and pay rate and/or by program budget categories in accordance with this Agreement. Disbursements made by the Contractor in accordance with this Agreement must be documented and must comply with accounting procedures as set forth by the Suffolk County Department of Audit and Control, including any other form(s) required by the Department or the Suffolk County Department of Audit & Control and shall be furnished to the Department pursuant to, and as limited by, the Regulations for Accounting Procedures for Contract Agencies of the Suffolk County Department of Audit and Control. The Contractor shall be entitled to no more than compensation and/or reimbursement as provided in this Agreement for the completion of all work, labor and services contemplated in this Agreement, and in full reimbursement of all travel and other expenses of every nature and kind whatsoever, notwithstanding the total amount of time expended or expenses actually incurred. In addition to any other remedies that the County may have, failure to supply the required documentation will disqualify the Contractor from any further County contracts. ii, The Contractor shall submit monthly statistical and activity reports along with monthly vouchers for reimbursement of expenditures. Should these reports not be submitted as requested, the County reserves .the right to delay processing claims until such reports are received. Payments Limited to Actual Net Expenditures The Contractor agrees that if, for any reason whatsoever, the Contractor shall spend during the term of the Agreement for the purposes set forth in this Agreement an amount less than, or receive amounts more than, provided in the Budget, the total County payment under this Agreement shall be reduced to the net amount of approved actual Contractor expenditures made for such purposes, and that the total amount to be paid by the County shall not exceed the lesser of (i) approved actual net expenditures or (ii) the Total Cost of the Agreement on the cover page and in the Budget. Upon termination or expiration of this Agreement, if the Contractor's total amount of allowable expenses are less than the total amount of the payments made during the term, the Contractor shall prepare a check payable to the order of the Suffolk County Treasurer for the difference between the two amounts and include such payment with the claim voucher submitted to the County. Advance PaYment Schedule (If Applicable) Notwithstanding the foregoing provisions, if a Schedule of Payments is annexed to the Budget, an amount equal to the Percentage of Advancement of the Total Cost of Agreement as set forth on the cover page of this Agreement or of any amendment/extension thereof shall be advanced to the Contractor for guarantees of availability of services and as consideration, and shall be recouped, as provided in the Schedule of Payments and in the subparagraph below headed, "Final Voucher". Y02(6/18/08) 21 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 · Im. plementing Agency:Youth Development Delinquency Prevention Program g. Final Voucher UISon termination or expiration of this Agreement, or prior to the payment of reimbursement for actual expenses of the last month of the Budget Period, or prior to any payment for a subsequent Budget Period or under a subsequent agreement between the parties, a determination shall be made of the totat amount of the payments (initial advance plus reimbursements, net of recoupments of advance) made during the Budget Period and the total amount of the allowable expenditures (net of program income or other deductions) incurred during the same Budget Period. The determination shall result in one of the following: i. If the Contractor's total net expenses are greater than the total amount of the payments made during the Budget Period, the claim form will be processed for the balance due the Contractor. ii. If the Contractor's total net expenses are less than the total amount of the payments made during the Budget Period, the Contractor shall prepare a check payable to the order of the Suffolk County Treasurer for the difference between the two amounts and promptly deliver such check to the County with a claim form (standard Suffolk County Payment Voucher) describing the repayment. Travel Costs The Contactor agrees that reimbursement for travel costs will not exceed amounts allowed County employees. i. Salaries Salary reimbursement shall be exclusive of and separate from employee share of withholding taxes. Withholding taxes are reimbursable only upon proof of deposit or payment to the Federal/State governments. j. Salary Increases No salary, wage or other compensation for services shall be increased over the amount stated in the Budget without the prior written approval of the County. k. Actual Fringe Benefit Costs Fringe benefits claims should be based on actual costs. However, if the Contractor pays some or all fringe benefits on a quarterly, semiannual or annual basis, it may make monthly claims for such fringe benefits based on an estimated percentage of each eligible individual's salary, except that the claim submitted for the last month of each Budget Period must include an adjustment for fringe benefit expense changing it from estimated to actual cost, or the Contractor may include such adjustment in its supplementary claim submitted not more than thirty (30) days after the end of the Budget Period. If such adjustment is not submitted with the claim for the last month of the Budget Period, the Department may place such claim in reserve pending receipt and audit of the fringe benefit adjustment claim. The County may recoup any overpayment from any subsequent claim, or the Contractor shall promptly repay to the County any overpayment on demand. Furthermore, the Contractor agrees that all payments received by the Contractor for all items, including employee benefits, under this Agreement, are subject to adjustment as finally determined by audit, and that no indirect or overhead charges or any interest costs are to be included, unless specifically included in the Budget. YO2(6/18/08) 22 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 · Implementing Agency:Youth Development Delinquency Prevention Program I. Budget Deficiency Plan The County has imposed and may impose a budget deficiency plan(s). Upon written notification from the Department, the Contractor shall comply with the same restrictions as are imposed upon the Department, a copy of which will be furnished with such notification and shall thereupon be deemed to be incorporated by reference in and made part of this Agreement. m. Taxes The charges payable to the Contractor under this Agreement are exclusive of federal, state and local taxes, the County being a municipality exempt from the payment Of such taxes. n. Final Report and Claim Unless otherwise directed by the Department, the Contractor shall submit a final report no later than two (2) months after the dose of each Budget Period, summarizing the conduct of the Program and indicating the total number of individuals participating in each of its components for the entire Budget Period, together with a final accounting and a final request for payment of all approved expenditures then remaining unpaid. o. Payments Contingent Upon Receipt of Aid If a state or federal government department or agency is funding this Agreement and should fail to approve aid in reimbursement to the County for payments made hereunder by the County to the Contractor for expenditures made dudng the term of this Agreement because of any act, omission or negligence on the part of the Contractor, then the County may deduct and withhold from any payment due to the Contractor an amount equal to the reimbursement denied by the Regulatory Agency or such department or agency, and the County's obligation shall be reduced by any such amounts. In such an event, if there should be a balance due to the County after it has made a final payment to the Contractor, the Contractor agrees promptly to reimburse the County the amount of the balance due the County by check to the order of the Suffolk County Treasurer. The provisions of this subparagraph shall survive the expiration or termination of the Agreement· p. Payments Contingent Upon State/Federal Funding Payments under this Agreement may be subject to and contingent upon continued funding by the state and/or federal Government(s). If, for any reason, the full amount of such funding is not made available to the County, this Agreement may be terminated in whole or in part, or the amount payable to the Contractor may be reduced, at the discretion of the Department, provided that any such termination or reduction shall not apply to allowable costs 'incurred by the Contractor prior to such termination or reduction to the extent that funds are available to the Department for payment of such costs. 4. Accounting Procedures The Contractor agrees to maintain accounts, records, documents, and other evidence and accounting procedures and pCactices which sufficiently and properly reflect all'direct and indirect costs of any nature expended in the performance of.the Agreement in accordance with generally accepted accounting principles and as may be promulgated by the Suffolk County Department of YO2(6/18/08) ' 23 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 Implementing Agency:Youth Development Delinquency Prevention Program Audit and Control and any financial directives promulgated by the Department. The Contractor agrees to retain all accounts, records and other documents relevant to this Agreement for seven (7) years after final payment. Federal, State and/or County auditors and any persons duly authorized by the County shall have full access and the right to examine any of said materials during said period. 5. Audit All payments made under this Agreement are subject to audit by the Suffolk County Comptroller pursuant to Article V of the Suffolk County Charter. The Contractor further agrees that the County Comptroller and the Department shall have access to and the right to examine, audit, excerpt, copy or transcribe any pertinent transactions or other records relating to services under this Agreement. If the Contractor fails to cooperate with an audit by the Comptroller, the County shall have the right to suspend or partially withhold payments under this Agreement or under any other agreement between the parties until such Cooperation is forthcoming. If such an audit discloses overpayments by the C9unty 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 subparagraph shall survive the expiration or termination of the Agreement. 6. Personnel Salaries, Pension and Employee Benefit Plans, Rules and Procedures Whenever requested by the Department or the Department of Audit and Control, the Contractor shall submit to the Department a certified copy of its current salary scale for all positions listed in the Budget, a copy of its personnel rules and procedures and any subsequent modifications thereof, a copy of its pension plan and any other employee benefit plans or arrangements, and any amendments thereto, for review and approval, and such additional financial information in connection therewith, as may reasonably be requested by the Department or the Department of Audit and Control. The Contractor shall not be entitled to reimbursement for costs under any such plans or arrangements that are unreasonable in the opinion of the Suffolk County Comptroller when compared to current market costs for similar plans or arrangements between unrelated parties. In the case of any such plan or arrangement that is self-funded by the Contractor directly or by payments to a related entity, upon request by the Department or the Department of Audit and Control, the Contractor shall submit a reconciliation of the total amount claimed for reimbursement of payments under such plan or arrangement with actual cost incurred, and any auditable administrative or. claims processing expenses, by the Contractor or related entity on behalf of the Contractor and its employees. 7. Financial Statements and Audit Requirements Notwithstanding any other reporting or certification requirements of Federal, State or local authorities, the Contractor shall obtain the services of an independent licensed public accountant or certified public accountant (the "Auditor") to audit its financial statements for each contract fiscal year in which the Contractor has received, or will receive, $300,000 or more from the County, whether under this Agreement or otherwise, and shall submit a report on the overall financial condition and operations of the Contractor, including a balance sheet and statement of income and expenses, attested by the Auditor as fairly and accurately reflecting the accounting records of the Contractor in accordance with generally accepted accounting principles. The YO2(6/18/08) 24 of 28 pages Law No. 08-YO2- IFMS No, SCS EXE 0800000 · Implementing Agency:Youth Development Delinquency Prevention Program Contractor is encouraged to solicit requests for proposals (RFPs) from a number of qualified accounting firms and to review carefully the costs of, and qualifications for, this type of work before selecting the Auditor. b. The Auditor should be required to meet the following minimum requirements: i. a current license issued by the New York State Education Department; ii.sufficient auditing experience in the nonprofit, governmental or profit-making areas, as applicable; and ..; m. a satisfactory peer review issued within not more than three years prior to the date when the Auditor was selected to conduct the audit. c. The audit must be conducted in accordance with generally accepted governmental auditing standards (GAGAS). Financial statements must dearly differentiate between County-funded programs and other programs that the Contractor may be operating. The use of subsidiary schedules should be encouraged for this purpose. The Auditor must also prepare a management letter based on the audit. d. Furthermore, if the Contractor is a non-profit organization or unit of local government and expends $500,000 or more of Federal monies, whether as a recipient expending awards received directly from Federal awarding agencies, ow as a subrecipient expending Federal awards received from a pass-through entity, such as New York State or Suffolk County, during any fiscal period within which it receives funding under this Agreement ("fiscal year"), the audit must be conducted, and the audit report ("Single Audit Report") must be, in accordance with OMB Circular No. A-133 (revised June 27, 2003). Single Audit Reports must also be submitted to the designated clearinghouse, cognizant agency and/or pass-through entity, to the extent required by the OMB Circular just referred to. e. The Contractor must submit a statement in writing, certified by its chief financial officer, which states the amount of Federal funding expended by the Contractor during such fiscal year. The Contractor must mail or deliver the certified statement to the Department and to Executive Director of Auditing Services, Suffolk Cou. nty Department of Audit and Control, H. Lee Dennison Building, 100 Veterans Memorial Highway, P. O. Box 6100, Hauppauge, New York 11788-0099, as soon as possible after the end of the Contractor's fiscal year. The statement should include ALL Federal funding received directly from the Federal government and ALL Federal funds passed through from the County and other pass-through entities. f. Copies of all financial statements, management letters, Single Audit Reports (if applicable) and other audit reports, if required, must be transmitted to the Department and to the Executive Director of Auditing Services at the address just set forth. The reports must be submitted within thirty' (30) days after completion of the audit, but in no event later than nine (9) months after the end of the Contractor's fiscal period to which the audit relates. g. These requirements do not preclude the Department or the Suffolk County Comptroller or their authorized representatives or Federal or State auditors from auditing the records of the Contractor. Therefore, the records of the Contractor must be made available to authorized representatives of Federal, State or County government for that purpose. The provisions of the foregoing subparagraphs a through g of this paragraph shall survive the expiration or termination of this Agreement. YO2(6/18/O8) 25 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 ·Im. plementing Agency:Youth Development Delinquency Prevention Program 8. Furniture, Fixtures, Equipment, Materials, Supplies Purchases, Etc. Requiring Prior Approval Prior to placing any order to pumhase, rent or lease any furniture, fixtures, or equipment (i) valued in excess of three hundred dollars ($300.00) per unit, or (ii) included but not itemized in the Budget, the Contractor shall submit to the County a written request for approval to make such a proposed purchase, rental or lease, with a list showing the quantity and description of each item, its intended location and use, estimated unit price or cost, extended price or cost and estimated total cost of the proposed order. Written approval of the County shall be required before the Contractor may proceed with such proposed purchase, rental or lease of furniture, fixtures or equipment. All items purchased must be new unless specifically described otherwise in the Budget. b· Purchase Practices The Contractor agrees to follow all of the general practices that are designed to obtain furniture, fixtures, equipment, materials or supplies at the most reasonable price or cost possible. The County reserves the right to purchase or obtain for the Contractor furniture, fixtures, equipment, materials or supplies which shall be in accordance with the programmatic needs of this Agreement. If the County exercises this right, the amount budgeted for the items so purchased or obtained by the County for the Contractor shall not be available to the Contractor for any purpose whatsoever. Title to any such items purchased or otherwise obtained by the County for the Program and entrusted to the Contractor shall remain in the County, and the Contractor shall attach labels indicating the County's ownership if the County has not done so. c. Proprietary Interest of County The County shall retain a proprietary interest in all furniture, removable fixtures, equipment, materials or supplies purchased or obtained by the Contractor and paid for or reimbursed to the Contractor pursuant to the terms of this Agreement or any prior agreement. Upon the termination of this Agreement, or of any renewal thereof, the discontinuance of the business of the Contractor, the failure of the Contractor to comply with the terms of this Agreement, the bankruptcy of the Contractor, an assignment for the benefit of its creditors, or the failure of the Contractor to satisfy any judgment against it within thirty (30) days of filing, the County shall have the right to take title to and possession of all such furniture, removable fixtures, equipment, materials and supplies, and the same shall thereupon become the property of the County without any claim for reimbursement on the part of the Contractor. As directed by the County, the Contractor shall attach identifying labels on all furniture, removable fixtures and equipment indicating the proprietary interest of the County. d. Inventory Records, Controls and Reports The Contractor shall maintain proper and accurate inventory records and controls for all such furniture, removable fixtures and equipment acquired pursuant to this Agreement and all prior agreements, if any, covering the Program. Three (3) months before the termination date of this Agreement, the Contractor shall make a physical count of all items of furniture, removable fixtures and equipment in its custody, checking each item against the aforesaid inventory 'records. A report setting forth the results of such physical count shall be prepared by the Contractor on a form or forms designated by the County, certified and signed by an authorized official of the Contractor, and one (1) copy thereof shall be delivered to the County within five (5) Y02(6/18/O8) 26 of 28 pages Law No. 08-YO2- IFMS No. SCS EXE 0800000 · Implementing Agency:Youth Development Delinquency Prevention Program days after the date set for the aforesaid physical count. Within five (5) days after the termination date of this Agreement, the Contractor shall submit to the County six (6) copies of the same report updated to the termination date of this Agreement, certified and signed by an authorized official of the Contractor, based on a physical count of all items of furniture, removable fixtures and equipment on the aforesaid termination date, and revised, if necessary, to include any inventory changes during the last three (3) months of the term of this Agreement. e. Protection of Property in Contractor's Custody The Contractor shall maintain vigilance and take all reasonable precautions to protect the furniture, fixtures, equipment, material or supplies in its custody against damage or loss by fire, burglary, theft, disappearance, vandalism or misuse. In the event of burglary, theft, vandalism or disappearance of any item of furniture, fixtures, equipment, material or supplies, the Contractor shall immediately notify the police and make a record thereof, including a record of the results of any investigation which may be made thereon. In the event of loss of or damage to any item of furniture, fixtures, equipment, materials or supplies from any cause, the Contractor shall immediately send the County a detailed written report thereon. f. Disposition of Property in Contractor's Custody Upon termination of the County's funding of the Program covered by this Agreement or by any renewal hereof, or at any other time that the County may direct, the Contractor shall make access available and render all necessary assistance for physical removal by the County or its designee of any or all furniture, removable fixtures, equipment, materials or supplies in the Contractor's custody in which the County has a proprietary interest, in the same condition as such property was received by the Contractor, reasonable wear and tear excepted. Any disposition, settlements or adjustments connected with such property shall be in accordance with the rules and regulations of the County and the State of New York. 9. Lease or Rental Agreements If lease payments or rental costs are included in the Budget as an item of expense reimbursable by the County, the Contractor agrees to submit to the Department, on request, any lease and/or rental agreement that the Contractor has entered into for space, furniture, fixtures or equipment for the program and, in advance, any such new or renewal lease or agreement during the term of this Agreement, accompanied (in the case of a lease of space) by a detailed layout of the premises, which indicates the space that is to be occupied 'by the County funded program. 10. Loan Approval The Contractor agrees that, in the event that the County provides funding (under this Agreement and otherwise) exceeding in the aggregate 20 percent of the Contractor's total funding for all of its operations from all sources, then the Contractor must secure the prior approval of the County for any loan in excess of $5,000.00. 11. ' Statement of Other Contracts The Contractor has attached, and in the event of any change, will attach to any extension agreement/amendment of this Agreement, a Statement of Other Contracts in the form annexed to this Agreement. The Contractor represents and warrants that any such Statement of Other Contracts is and will be a complete list of all other contracts (i) which are currently in effect or (ii) which have expired Y02(6/18/08) 27'of 28 pages Law No. 08-YO2- IFMS No, SCS EXE 0800000 · Implementing Agency:Youth Development Delinquency Prevention Program with'in the past 12 months and have not been renewed, and under which funds have been, are being or will be received by the Contractor from any department or agency of the County, the United States of America, the State of New York or other municipalities or organizations. End of Text for Exhibit IV YO2(6/18/O8) 28 of 28 pages INDIVIDUAL PROGRAM APPLICATION Funding Category: YDDP/SERVICE Municipality: ~) Couhty~ Inlpiementirt~l Total -- Agency, ~ OF SO--Om Program Bu4get* TEle: ~O~ YO~ S~ Reque~ed $ f~o~ of total) /-- Agen6y Program Code: 08470010S004 15971 Zip Code Federal ID #: 11-6001939 Charities Reg ¢: NOt AppliCable From, 01/01/08 To: 12~31/08 Mr. Scott Russell, Superviso~ (~1) 765-1881 ~-~ Executive Director '~ Board Chairperson Telephone NumEe, · Mr. JAME~ ~dlvia~DN DIRECTOR (1~'~!) 765-1283 PROGRAM SITES - Most Significant (3 Maximum} NYC ONLY Assembly ' NYS Senate Local City Council Type Address (Street,City,Stat~,Zip) Dist. No. Dist No. Plan'g Bd. District OFF~ ~ ~ ~ ~ 1 ~LD 11971 PROGRAM SUMMARY: (MAXIMUM OF 350 CHARACTERS - approximately 45 W0~ds) U~OGP3~q IS DESI(K~ED TO D.~,TVER IlqDIVIDUAL ~,T~D AND CRISIS IN'I~V~ATEICN ~VICES TO 50 YO[YFH. PROGRAM PROFILE Problem/ Need Primary 519 Secondary Target Population · 840 Number of Youth Service M~thods To be Served 524 I 530 ~ 50 I ..... [] Direct Services willAIol De proviaecl ~ this p~og[pm Sex of program participants Male: 45% Female: . 55% Ethnicity - Whites: 80. % Black: 10~ % Hispanic; 10. % Native American: __ ' A~e- 0-4: 0. % S-9~ 0. % 10-15: 0 % 16-20: 0 % PrOblem Need:' BEHAVIOR PROBLEMS //q HCHE Taz~jet Populat%on: ServiceMethc~s: ~sTORY OF nwonv~m~ ~/~ueT/~a~am CRISIS IN'I'~i~VfNTZON COUNSELING UndupliCated Count of YoUth and Clients S6rved · (All A~,tlvitles) 5O 0 .% Asian: 0% Other: 0 % OCFS-$10T (Rev. 03/2002) FRONT NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES PROGRAM BUDGET APPENDrX B PROGRAM CODE: [ O I (~ I ¢' I ? I ¢ CONTRACT NUMBER: ] [ AGENCY/ML~NICIPALfTY: Town of Southold I I I I I I PROGRAM TITLE: Southold Youth S~rvices ' FUNDTYF'E; PERSONAL SERVICES: POSITION TITLE RATE OF BASIS PAY TOTAL OCFS PROGRAM AMOUNT (1) TOTAL OCFS FUND~ REQUESTED FOR THIS PROGRAM $ $ TOTAL SALARIES AND WAGES TOTAL FRINGE BENEFITS TOTAL PERSONAL SERVICES CONTRACTED sERVIcES AND sTIpENDS TOTAL CONTRACTED SERVICES (2) TOTAL MAINTENANCE & OPERATION (3) LIST EQUIPMENT TO BE PURCHASED OR RENTED: (UNIT COST OVER $500 AND LIFE EXPECTANCY OF OVER TWO YEARS) PI~OGRAM SITE ADDRESS TOTAL FACILITY REPAIRS (4) $ ~ ~:~ ---- TOTAL OCFS PROGRAM AMOUNT -t- TOTAL O~FS FUNDS REQUESTED LIST OF OTILIER FUNDING SOURCES REIMBLJRSABLE TOTAL OTHER SOURCES · USEAN ASTERISK NI~T TO THE FIGURES LISTED TO IDENTIFY 7HOSE ITEMS FOR WHICH OCF$ REIMBURSEMENT IS NOT BEING REQUESTED. USE (IK) TO IDENTIFY ONLY IN KING SERVICES, EQUIPMENT, ETC DONATED TO PROGRAM, WHERE ALLOWED. Suffolk County Form 22 Contractor's/Vendor's Publ/c 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 con, actor/vendor is exempt from completing paragraphs numbered 1 through 11 below, so indicate at paragraph number 12 below setting forth the reason for such exemption· Notwithstanding such exempt status, you must execute this form below before a notary public. Contractor, sN_endOr, s Na~ gt~q;/~/~ef~L'/~Z'y{ ~0~" city and state ~{IL,~M(r/~J~/ v(J{/.d'y0~ ZirC°de~/I !gJ 2. Contracting Depuutment s Nam Address 3. Payee Identification or Social SecmSty No. 4. Type of Business__Corporation~Partuership__Sole Proprietorship__Other 5.a Is contractor/vendor entedug into or has contractor/vendor entered into a contract with Suffolk County in excess of $1,000? Yes No. 5.b Has contractor/vendor entered into three or more contracts, including the one for wtfich 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 Cable of organization who is also an officer or an employee of Suffolk County. (Attach additional sheet if necessary.) 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). 10. Does contractor/vendor derive 50% Or more of its total revenues from its contractual or vendor relationship with Suffolk County? Yes No. 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 · - · ' applicable·) statements must be certified by a Certified Pubhc Accountant. (Strike this out if not The undersigned shall include this Contractor's/Vendor'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%) 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 tSom completing paragraphs numbered 1 through 11 herein: a) Hospital _~ cb} Educational or governmental entities Not-for-profit corporations - d) Contracts providing for foster care, family day-care providers o~ child protective services Please check to the left side of the appropriate exemption. 13. Verification. This section must be signed by an officer or principal of the contraCtor/vendor .authorized to sign for the company for the purpose o.f executing contracts. The undersigned being sworn, affirms under the penalti6s of perjury,/~hat he/she has read and understood the foregoing statements and that they are, to his/her o~, ~e~ Dated: 7/3o(~ Sit~led' jg~,---t--,-'---n~- PrintedNa~teof'Signer: ~h/.-'{- )~_ ff-~oCcs'e~/[ ' Title of Signer: ~'~,_.~"~.,t t,/2 c ~ NameofContractor/Vendor: ~r-~o ~' t~.Q .~7~ t.x'~ fin[' UNIFORM CERTIFICATE OF ACKNOWLEDGMENT. (Within New York State) STATE OF NEW YORK) comcrY 'On the _~O day.~of ~_T~c~ in the year 2008 before me, the undersigned, personally appeared ~,~'4~_ ~t~ce~//personally known to me or proved to me on the basis of satisfactory evidence io-be/fie indivi'd~tal(~ ~v)~ose name(~ is (~r-e-)~ubscnbed to the vathin instrument and acknowledged to me that he/sha/lt~ executed the same in his/he, r, tth~ic- capacity(6~s'} and that by his~ignamre(~) on the instrument, the individual(~ or the person upon behalf of which the individual(X~ acted, executed the instrument. (signature and offic~ df individdal taking ac~owledgem ) LINDA J COOPER NOTARY PUBLIC, State of New York NO. 01CO4822563, Suffolk Cour~ Term Expires December 31, 20 Page 2 of 3 Public DisclOsure Form UN~ORM CERTIFICATE OF ACKNOWLEDGEMENT (without New York State) STATE OF COUNTY OF On the day of )SS..' ) in the year 2008 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(les) 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 instnunent, 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's/Vendor's Public Disclosure Statement Form (Rev. 3/04) Page 3 of 3 Public Disclosure Form Suffolk County Form 22 · Contractor's/Vendor'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 ~ 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. City and State ,~_D _O~fi~; Contracting Department's Name Address 4. 5.a 5.b Zip Code Payee Identification or Social Security No. Type of Business Corporation Partnership__Sole Proprietorship._Other Is contractor/vendo--r entering int~ or has contractor/vendor entered into a contract with Suffolk County in excess of $1,0007 Yes No. 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 $1,0007 Yes No. 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.) 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). 10. Does contractor/vendor derive 50% Or more of its total revenues from its contractual or vendor relationship with Suffolk County? Yes No. 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.) The undersigned shall include tlfis Contractor's/Vendor'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 determ[nation that a breach has occurred, to damages equal to fifteen percent (15%) of the amount of the contract. 12. If you are one of the entities listed below'at a) through c) or you qualify under d) below, you are exempt from completing paragraphs numbered 1 through 11 herein: ~_ba~ Hospital Educational or governmental entities c) Not-for-profit corporations d) Contracts providing for foster care, family day-care providers or child protective services Please check to the left side of the appropriate exemption. 13. Verification. This section must be signed, by an officer or principal of the contractor/vendor authorized to sign for the company for the purpose of exequting contracts. The undersigned being sworn, affirms under the penalties of perjury, that he/she has read and understood the foregoing statements and that they are, t° hisPaer 7f~"/n_,,,.t~Wz~d~e;~' Dated: Printed Name of'Signer: Title of Signer: _ Name of Contractor/Vendor: UNIFORM CERTIFICATE OF ACKNOWLEDGMENT (Within New York State) STATE OF NEW YORK) COUNTY OF_StX~-<~(ss.: On the ~ da.;/of .yt.t c~ in the year 2008 before me, the undersigned, personally appeared .~Ca~-~t.(-- ,gl t~ttx s~¢e.J'/personally known to me or proved to me on the basis of satisfactory evidence to be the individual(~) whose name(l) is ¢a~) subscribed to the within instmment and acknowledged to me that h~ execiated the same in his/l~r4~h~,~ capacity(i~) and that by hisg~cr,'tkc'~ signature(~) on the instrument, the individual(~), or the person upon behalf of which the individualO0 acted, executed the instrument. (signature and oflsce ofin/iividual t,{king acknowledgement) UNDA J COOPER NOTARY PUBLIC, State of New York NO. 01C04822563, Suffolk Cou~y Term Expires December 31, 20./.~._ 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 2008 before me, the undersigned, personally appeared personally knoWn to me or pr°red 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 instmmant, 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 Deparanent 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 contractor's/baneficiary's business or transaction 'with Suffolk County, the contractor/beneficiary must complete Sections I, III, and IV below. If the following definitions do not apply, the contractor/beneficiary must complete Sections II, III and IV below. Completed forms must be submitted to the awarding agency. County Contractor: "Any employer that receives more than $50,000 in County funds for supplying goods or services pursuant to a written contract with the County of Suffolk or any of its agencies; pursuant to a Suffolk County grant; pursuant to a Suffolk County program; pursuant to a Suffolk County reimbursement for services provided in any calendar year; or pursuant to a subcontract with any of the above." Section I Check if Applicable The Union Organi:~ng 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 to the goods and/or services that are the subject of the contract with the County of Suffolk shall not use County fimds to assist, promote, or deter union organizing (Chapter 466-3 A), nor seek reimbursement f~om the County for costs incurred to assist, promote, or deter union organizing. (Chapter 466-3 B) [/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 l/we further agree that I/we will not use County property to hold meetings to assist, promote, or deter union organizing. (Chapter 466-3E) l/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 pertin4nt County agency or authority, the County Comptroller, or the County Department of Law upon request. (Chapter 466-3 I) [/we further affirm 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 intinfidate employees, explicitly or implicitly, in selecting or not selecting a bargaining representative; · ' [/we 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; · [/we understand my/our obligation to limit disruptions caused by prerecognition labor disputes through the adoption ofnonconffontational procedures for the resolution ofprerecognition 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 th9 efficient, timely, and quali~y provision of goods and services to the County. I/we shall incinde a list of said procedures in such certification. Section H Check if Applicable The Union Organizing Law does not apply to this contract for the following reason(s): DOL-LO1 (3/5/08) Suffolk County, New York D%partrnent of Labor Section ITl ConWactor Na~ae: Contractor Address: Contractor Phone #: (/- oo[737 Description of project or service: Section IV In the event any part of the Union Organizing Law, Chapter 466 of the Laws of Suffolk County~ is found by a court of competent jurisdiction to be preempted by federal and/or state law, this certification/declaration shall be void ab initio. Section V I declare under penalty ~perjury under the Laws of the State of New York ~at the undersigned is authorized to provide this Authorized Sign~are Date Print Name and ~ffie of A~thorized Re~resuntat~/e DOL-LO1 (3/5/08) CONTRACTOR NAME ADDRESS STATEMENT OF OTI~R CONTRACTS CONTACT PROGRA1Vi PHONE NUMBER AGREEM~ENT NUMBER TEPSVI OF AGREEMENT Indicate (a) type of Organization - County, Stat~, Federal or Other and (b).name of Department, Agency or'Organization. Suffolk 'County, New York D'~partment 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 contractor's/beneficiary's business or transaction with Suffolk County, the contractor/beneficiary must complete Sections I, HI, and IV below. If the following definitions do not apply, the contractor/beneficiary must complete Sections H, IT1 and lV below. Completed forms must be submitted to the awarding agency. County Contractor: "Any employer that receives more than $50,000 in County funds for supplying goods or services pursuant to a written contract with the County of Suffolk or any of its agencies; pursuant to a Suffolk County grant; pursuant to a Suffolk County program; pursuant to a Suffolk County reimbursement for services provided in any calendar year; or pursuant to a subcontract with any of the above." Section I  The Union Organizing Law applies to this contract. 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 to the goods and/or se~wices that are the subject of the contract with the County of Suffolk shall not use County funds to assist, promote, Check if or deter union organizing (Chapter 466-3 A), nor seek reimbursement from the County for costs incurred to assist, Applicable 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/we will not use County property t9 bold meetings to assist, promote, or deter union organizing. (Chapter 466-3E) l/we further agree that if uny expenditures or costs incurred to assist, promote, or deter union organizing are made, I/we shall maintain records sufficient to show that n~ County funds were used for those expenditures and, as applicable, that no reimbursement from County fand~ 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 1) I/we further affirm 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 meeting 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 limit disruptions caused by prerecognition labor disputes through the adoption ofnonconfrontational procedures for the resolution of prerecognition labor disputes with employees engaged in the production of goods or the rendering of services for tho County; and · I/we have or will adopt any or all of the above-referenced procedures, or their functional equivalent, to ensurc th~ efficient, timely, and quality provision of goods and services to the County. I/we shall include a list of said procedures in such certification. Section II Cheek if Applicable The Union Organizing Law does not apply to this contract for the following reason(s): d DeL-Lei (3/5/08) Suffolk ~ounty, New York DeDartment of Labor Section III Contractor Name: Contractor Address: Contractor Phone #: Description of project or service: Section IV In the event any part of the Union Organizing Law, Chapter 466 of the Laws of Suffolk County, is found by a corot of competent jurisdiction to be preempted by federal and/or state law, this certification/declaration shall be void ab initio. Section V I d~clare under penalty ~erjury under the Laws of the State of New York that the undersigned is authorized to provide this certification, and~ve~ /~/~ Authorized Signat~are Date Print Name and Titl~ of Authorize~l Representa~(ve ~r DOL-LO1 (3/5/08)