HomeMy WebLinkAboutWorksite MemorandumRESOLUTION 2008-689
ADOPTED
DOC ID: 4058
THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2008-689 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 the Worksite Memorandum of Understandin~
A~reement between the Town of Southold and the Suffolk County Department of Labor in
connection with the work experience programs for eligible Suffolk County residents and other
pertinent programs operated by the Department of Labor, for a term that will expire on June 30,
2013, subject to the approval of the Town Attorney.
Elizabeth A. Neville
Southold Town Clerk
RESULT: ADOPTED [UNANIMOUS]
MOVER: William Ruland, Councilman
SECONDER: Vincent Orlando, Councilman
AYES: Ruland, Orlando, Krupski Jr., Wickham, Evans, Russell
ROBERT W. DOW, JR.
COMMISSIONER
DEPARTMENT OF LABOR
726 VETERANS MEMORIAL HIGHWAY
HAUPPAUGE, N.Y. 11788
COUNTY OF SUFFOLK
STEVE LEVY
SUFFOLK COUNTY EXECUTIVE
ADDRESSCORRESPONDENCETO:
P.O. BOX 1319
SMITHTOWN, N.Y. 11787-0895
e-mall:sc.dol(~)s uffolkcou ntvnv.(Iov
FAX # (631) 853-6510
www.suffolkcou ntyny.gov/labor
October 3, 2008
Town of Southold
53095 Route 25
Southold, NY 11971-0959
Attn: Scott Russell, Supervisor
Dear Supervisor Russell:
Please find enclosed, for your records, a fully executed Worksite Memorandum
of Understanding for your agency. Any questions please call me at 853-3870.
Very truly yours,
EL/km
Enclosure
Eric Lopez, Director
Suffolk Works Employment Program
Worksite Development Unit
Rev. 11/02107; Law No. 13-LB-025
Worksite MOU - WIA and/or SWEP
Worksite Memorandum of Understanding (MOU)
This Agreement ("Agreement") is between the County of Suffolk ("County"), a municipal
corporation of the State of New York, acting through its duly constituted Department of Labor
("Department"), located at Building 17, North County Complex, 725 Veterans Memorial Highway,
Hauppauge, New York 11788; and
Town of Southold ("Contractor"), having its principal place of business at 53095 Route 25,
Southold, NY '1"197f-0959
The parties hereto desire to make available for eligible Suffolk County residents an employment and
training program that includes work experience under the Workforce Investment Act (WIA) or the Suffolk Works
Employment Program (SWEP), and other pertinent programs operated by the Department, and to establish the
conditions, limitations and work rules to be observed by the Contractor and the Department under this
Agreement.
Term of Agreement: July ], 2008 through June 30, 2013.
' Total Cost of Agreement: No payments to Contractor. 'Payments to trainees as provided in
Exhibit D, attached.
Terms and Conditions: Shall be as set forth in Exhibits A through D; attached hereto and made a
part hereof.
In Witness Whereof, the parties hereto have executed this Agreement as of the latest date written below.
Insert Name of Contractor
y:
Title: Supervisor
Fed. Tax II;) # 'l'l-600f 939
Date:
Approved as to Legality:
Christine M~af~, Cou~ Attorney
Cynthia Kay Parry
^ssistantlCounty~Attomey
Date: ~
County of Suffolk
BV: _~~. ~.'
CounW Executive
Oeputy
Date:
Approya0: Department of Labor/
Robert W. Dow, Jr. /
Commissioner
Date:
Page 1 of 19 Pages
Rev. 11102/07; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
List of Exhibits
Exhibit A General Terms and Conditions
1. Contractor Responsibilities
2. Term and Termination
3. Indemnification
4. Insurance
5. Independent Contractor
6. Severability
7. Merger; No Oral Changes
8. Set-Off Rights
9. Governing Law
10. No Implied Waiver
11. Conflicts of Interest
12. Cooperation on Claims
13. Confidentiality
14. Assignment and Subcontracting
15. Certification as to Relationships
16. Publications and Publicity
Exhibit B Suffolk County Legislative Requirements
5.
6.
7.
8.
9.
10.
Contractor'sNendor's Public Disclosure Statement
Living Wage Law
Use of County Resources to Interfere with Collective Bargaining Activities
Local Law No. 26-2003
Lawful Hiring of Employees Law
Gratuities
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
Suffolk County Local Laws Website Address
Exhibit C Notices and Contact Persons
Exhibit D Procedures and Requirements
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Compliance with the Worksite Manual
Law, Rules and Regulations
Fraud, Abuse and Other Criminal Activity
Screening of Personnel
Political Activities
Sectarian Activities
Nondiscrimination
Certifications
Payroll Procedures/Fringe Benefits
Reporting of Injuries
Termination of Trainees
Responsibility for Wages
Contractor Assurances and Certification
Page 2of19 Pages
Rev. 11102107; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
14. Maintenance of Effort
15. Union Concurrence
16. Trainee Evaluations
17. ' Self-Monitoring
18. State Liability
19. Agreement Subject to Appropriation of Funds
20. Payments Contingent Upon State/Federal Funding
21. Audit, Inspections and Records
22. Conflict of Interest/Nepotism
Page 3 of 19 Pages
Rev. 1'1102/07; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
Exhibit A
General Terms and Conditions
Contractor Responsibilities
The Contractor shall provide the Services, as more particularly described in Exhibit D, entitled
"Procedures and Requirements."
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 perform 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 other authorities for the Services provided.
2. Term and Termination
a. Term
bo
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
below, pursuant to the following paragraphs, the Contractor shall promptly discontinue all
Services affected, unless otherwise directed by the Termination Notice.
Termination for Cause
This Agreement may be terminated in whole or in part in writing by the County in the event of
failure by Contractor to fulfill any of the terms and conditions under this Agreement; provided that
no such termination shall be effective unless Contractor is given five (5) calendar days' written
notice of intent to terminate ("Notice of Intent to Terminate"), delivered in accordance with the
Exhibit in this Agreement entitled "Notices and Contact Persons." During such five (5) day
period, 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. Prior to issuance of a written
termination notice ("Termination Notice") by the County, the Contractor shall be given an
additional five (5) days to cure all failures to fulfill its obligations under this Agreement. In the
event that the Contractor has not cured all its failures to fulfill its obligations to the satisfaction of
the County by the end of the combined ten (10) day period, the County may issue a Termination
Notice, effective immediately.
c. 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' written notice of termination. Upon giving of a notice
pursuant to the foregoing sub-paragraph, the Contractor shall promptly discontinue all services
affected unless otherwise directed by the notice of termination. In such event of termination,
payments to trainees shall be made for the period through the date of termination.
Page 4 of 19 Pages
Rev. '11102107; Law No. '13-LB
Worksite MOU - WIA and/or SWEP
3. Indemnification
a. General
The Contractor agrees that it shall protect, indemnify and hold harmless the County and its
officers, officials, employees, contractors, agents and other persons from and against ali
liabilities, fines, penalties, actions, damages, claims, demands, judgments, losses, costs,
expenses, suits or actions and reasonable attorneys' fees, arising out of the acts or omissions or
the negligence of the Contractor in connection with the services described or referred to in this
Agreement. The Contractor shall defend the County and its officers, officials, employees,
contractors, agents and other persons in any suit, including appeals, or at the County's option,
pay reasonable attorney's fees for defense of any such suit arising out of the acts or omissions
or negligence of the Contractor, its officers, officials, employees, subcontractors or agents, if
any, in connection with the services described or referred to in this Agreement.
b. Federal Copyright Act
The Contractor hereby represents and warrants the Contractor, will not infringe upon any
copyrighted work or matedal in accordance with the Federal Copyright Act dudng 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 from and against all liabilities, fines, penalties, actions, damages, claims,
demands, judgments, losses, costs, expenses, suits or actions and reasonable attorney's fees,
arising out of the acts or omissions or the negligence of the Contractor in connection with the
services described er referred to in this Agreement. The Contractor shall defend the County and
its officers, officials, employees, contractors, agents and other persons in any suit, including
appeals, or, at the County's option, pay reasonable attorney's fees for defense of any such suit
arising out of the acts or omissions or negligence of the Contractor, its officers, officials,
employees, subcontractors, lessees, licensees, invitees or agents, if any, in connection with the
services described or referred to in this Agreement.
4. Insurance
The Contractor agrees to procure, pay the entire premium for and maintain throughout the term
of this Agreement, insurance in amounts and types specified by the County and as may be
mandated and increased from time to time, The Contractor agrees to require that all 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.
Page 5 of 19 Pages
Rev. 11102107; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
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.
All policies providing such coverage shall be issued by insurance companies with an A.M. Best
rating of A- or better.
The Contractor shall furnish to the County Declaration Pages for each such policy of insurance
and upon request, a true and certified original copy of each such policy, evidencing compliance
with the aforesaid insurance requirements. In the case of commercial general liability insurance,
the County of Suffolk shall be named as an additional insured and the Contractor shall furnish a
Declaration Page and endorsement page evidencing the County's status as an additional
insured on said policy.
All such Declaration Pages, certificates and other evidence of insurance shall provide for the
County of Suffolk to be notified in writing thirty (30) days prior to any cancellation, nonrenewal or
material change in said policies. Such Declaration Pages, certificates, policies and other
evidence of insurance and notices shall be mailed to the Department at its address as set forth
in this Agreement in the paragraph entitled "Notices and Contact Persons" or at such other
address of which the County shall have given the Contractor notice in writing.
In the event Contractor shall fail to provide the Declaration Pages or certificates of insurance or
to maintain any insurance required by this Agreement, the County may, but shall not be required
to, obtain such policies and deduct the cost thereof from payments due Contractor under this
Agreement or any other agreement between the County and Contractor.
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 law.
Page 6 of 19 Pages
Rev. 11/02/07; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
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
include, but not be limited to, the County's option to withhold, for the purposes of set-off, any moneys
due to the Contractor under this contract up to any amounts due and owing to the County with regard to
this contract and/or any other contract with any County department or agency, including any contract for
a term commencing prior to the term of this contract, plus any amounts due and owing to the County for
any other reason including, without limitation, tax delinquencies, fee delinquencies or monetary
penalties relative thereto. The County shall exercise its set-off rights in accordance with normal County
practices including, in cases of set-off pursuant to an audit, the finalization of such audit by the County
agency, its representatives, or the County Comptroller, and only after legal consultation with the County
Attorney.
9. 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.
10. No Implied Waiver
11.
12.
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.
Conflicts of Interest
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, 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
Each of the parties hereto agrees to render diligently to the other party, without additional
compensation, any and all cooperation, that may be required to defend the other party, its employees
and designated representatives against any claim, demand or action that may be brought against the
other party, its employees or designated representatives in connection with this Agreement.
13. Confidentiality
Any records, reports or other documents of the County or any of its agencies used by 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
Page7of19 Pages
Rev. 11/02/07; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
regulations.
14. Assignment and Subcontracting
ao
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 all 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 writing of the County, and any attempt to do
any of the foregoing without such consent shall be of no effect.
The Contractor shall not enter into subcontracts for any of the work contemplated under this
Agreement without obtaining prior written approval of the County. Such subcontracts shall be
subject to all of the provisions of this Agreement and to such other conditions and provisions as
the County may deem necessary, provided, however, that notwithstanding the foregoing, unless
otherwise provided in this Agreement, such prior written approval shall not be required for the
pumhase of articles, supplies, equipment and services which are incidental to, but necessary for,
the performance of the work required under this Agreement. Ne approval by the County of any
subcontract shall provide for the incurrence of any obligation by the County in addition to the
total agreed upon price. The Contractor shall be responsible for the performance of any
subcontractor for the delivery of service.
15. 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, commercial, economic, or financial relationship between the
part!es, the signatories to this Agreement, and any partners, members, directors, or shareholders of five
percent (5%) (or more) of any party to this Agreement.
16. 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:
"This publication is fully or partially funded by the Suffolk County Executive's Office."
The Department shall have the right of prior approval of press releases and any other
information provided to the media, in any form, concerning the Services provided pursuant to
this Agreement.
End of Text for Exhibit A
Page 8 of 19 Pages
Rev. 11102/07; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
Exhibit B
Suffolk County Legislative Requirements
1. 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.
Requimd 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/Declaration - Subject To
Audit"
Use of County Resources to Interfere with Collective Bargaining Activities
Local Law No. 26-2003
The Contractor represents and warrants that it has read and is familiar with the requirements of Chapter
466, Article 1 of the Suffolk County Local Laws, "Use of County Resoumes to Interfere with Collective
Bargaining Activities". County Contractors (as defined) shall comply with all requirements of Local Law
No. 26-2003 including the following prohibitions:
a. The Contractor shall not use County funds to assist, promote, or deter union organizing.
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.
Page 9 of t9 Pages
Rev. 11102107; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
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, contrac{, 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.
The Contractor acknowledges that such filings are a material, contractual and statutory duty and that
Page 10 of 19 Pages
Rev. 1'1102107; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
the failure to file any such statement shall 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.
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
sexual abuse reporting policy.
Page 11 of 19 Pages
Rev. 11102107; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
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 Agreement the
Contractor certifies that he, she, it, or they have not been convicted of a criminal offense within the last
ten (10) years. The term "conviction" shall mean a finding of guilty after a trial or a plea of guilty to an
offense covered under the provision of Section 143-5 of the Suffolk County Code under
"Nonresponsible Bidder."
9. Use of Funds in Prosecution of Civil Actions Prohibited
Pursuant to the Suffolk County Code Section §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. Suffolk County Local Laws
Suffolk County Local Laws, Rules and Regulations can be found on the Suffolk County web site at
www.co.suffolk<http://www.co.suffolk.ny.us>. Click on "Laws of Suffolk County" under "Suffolk County
Links."
End of Text for Exhibit B
Page t2 of 19 Pages
Rev. 11102107; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
Exhibit C
Notices and Contact Persons
1. Operational Notices
Any communication, notice, claim for payment, reports, insurance, or other submission necessary or
required to be made by the parties regarding this Agreement shall be in writing and shall be given to the
County or the Contractor or their designated representative at the following addresses or at such other
address that may be specified in writing by the parties and must be delivered as follows:
For the Department:
By First Class or Certified Mail in Postpaid Envelope or by
Courier Service or by Fax or by Email
Suffolk County Department of Labor
Building 17, North County Complex
725 Veterans Memorial Highway
Hauppauge, New York 11788
Att. Raymond O'Rourke
For the Contractor:
By First Class or Certified Mail in Postpaid Envelope or by
Courier Service or by Fax or by Email
At the address set forth on page one of this Agreement, attention of the person who executed
this Agreement or such other designee as the parties may agree in writing.
2. Notices Relating to Termination and/or Litigation
In the event the 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 regarding 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 in Postpaid Envelope or by
Nationally Recognized Courier Service or Personally and by First Class Mail
Suffolk County Department of Labor
Building 17, North County Complex
725 Veterans Memorial Highway
Hauppauge, New York 11788
Att. Robert W. Dow, Jr. Commissioner
and
Page 13 of 19 Pages
Rev. 11/02107; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
Christine Malafi, County Attorney
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 or by
Nationally Recognized Courier Service or Personally and by First Class Mail
At the address set forth on page one of this Agreement, attention 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 by registered or certified mail, upon
the seventh business day after the mailing thereof; or (ii) if by nationally recognized overnight courier
service, upon the first business day subsequent to the transmittal thereof; or (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 person(s) or his or her designated successor(s).
End of Text for Exhibit C
Page 14 of 19 Pages
Rev. '11102107; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
Exhibit D
Procedures and Requirements
Compliance with the Worksite Manual
The Contractor shall comply with the requirements of the applicable Worksite Manual. The Contractor
hereby certifies and acknowledges having had the opportunity to review the manual and understands
the applicable requirements, as well as the terms therein specified, and agrees to adhere to and comply
with them.
2. Laws, Rules and Regulations
The Contractor shall comply with all applicable federal, state and local laws, rules, and regulations
which deal with or relate to the employment of persons who perform work or are trained under this
Agreement, including, but not limited to, the Workforce Investment Act 0NIA) of 1998, subsequent
amendments, and the regulations and policies thereunder, the provisions of the various public
assistance employment programs, the provisions of the Fair Labor Standards Act, the Equal
Opportunity Clauses of the Civil Rights Act of 1964 and any subsequent amendments, and the health
and safety standards established under State and Federal law and applicable to the working conditions
of trainees.
3. Fraud, Abuse and Other Criminal Activity
For programs funded under the WIA, all information and complaints involving fraud, abuse, other
criminal activity, or violations of law, shall be reported directly and immediately to the:
Office of the Inspector General
United States Department of Labor
Room S-5506
200 Constitution Avenue, N.W.
Washington, D.C. 20210
4. Screening of Personnel
If (i) the Contractor performs or provides day care services (whether or not it has a contract with the
Suffolk County Department of Social Services) and (ii) the activities of the trainees under this
Agreement may be anticipated to bring them into contact with children receiving day care services, the
Contractor shall comply with the requirements of Local Law No. 1-1985, as amended (Suffolk County
Code Chapter 256) as now in effect or as amended hereafter or of any other Suffolk County Local Law
that may become applicable during the term of this Agreement with regard to the screening of personnel
in connection with day care services.
5. Political Activities
It is agreed that the work performed under this Memorandum of Understanding shall in no way or to any
extent be used in the conduct of political, partisan or election campaign activities, nor shall any trainee
be selected, rejected, promoted or discriminated against in any way based on political belief or
affiliation.
6. Sectarian Activities
The Contractor agrees that trainees shall not be utilized on the construction, operation or maintenance
Page 15 oft9 Pages
Rev. 11102107; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
of any podion of any facility as is used or to be used for sectarian instruction or as a place of religious
worship. Additionally, no trainees shall be placed in any capacity to free any other person for the
performance of such duties or activities.
7. Nondiscrimination
In accordance with Article 15 of the Executive Law (also known as the Human Rights Law) and all other
County, State and Federal administrative, statutory and constitutional nondiscrimination provisions, the
Contractor shall not discriminate against any employee or applicant for employment and/or trainee in
any program covered by this Agreement, because of race, creed, religion, color, sex, national origin,
age, disability, sexual preference, political affiliation, marital status, prior criminal records, or Vietnam
era or other veteran status.
In addition, the Contractor shall not discriminate against any individual who is a participant in a program
or activity that receives funds under Title I of the Workforce Investment Act solely because of the status
of the individual as a participant. Participation in programs or activities receiving funds under Title I of
the Workforce Investment Act shall be available to citizens and nationals of the United States, lawfully
admitted permanent resident aliens, refugees, asylees, and parolees, and other immigrants authorized
by the Attorney General to work in the United States.
8. Certifications
Together with this MOU and as a condition precedent to its execution by the County, the Contractor
shall have executed and delivered to the Department the Certification Regarding Lobbying, Debarment,
Suspension, and Other Responsibility Matters, and the Drug-Free Workplace Requirements. The
Contractor shall promptly advise the County of any material change in Ineligibility and Voluntary
Exclusion - Lower Tier Covered Transactions, as required by Federal Department of Labor Regulations.
The Contractor shall promptly advise the County of any material change in any of the information
reported on such Certification(s) and shall otherwise comply with, and shall assist the County in
complying with, said Regulations as now in effect or as amended during the Term of the Agreement.
9. Payroll Procedures/Fringe Benefits
Trainees entitled to wages under the applicable federal/state program shall be paid by the Department
through the Suffolk County biweekly payroll system. Public Assistance recipients obtaining work
experience will be credited for work performed at either the minimum wage or the prevailing wage for
comparable work, whichever is higher. The Contractor shall maintain individual records of time worked
by trainees on time sheets approved by the Department. Time records shall be maintained on a daily
basis and shall document actual hours worked. Proper maintenance of time cards shall be the
responsibility of the Contractor. The Contractor shall ensure that records ara properly completed and
validated, by signature of the trainee and the worksite supervisor, within collection procedures and time
frames established by the Department for processing of input documents through the payroll system.
Trainees in wage paying programs shall be paid no less than the Federal or State minimum wage,
whichever is greater.
Trainees shall work in those occupational titles identified by the Contractor and approved by the
Department. Fringe benefits provided by the Department shall include, as appropriate and applicable,
FICA, Workers' Compensation, General Liability, Unemployment Insurance and other such benefits as
are determined by the Department to be in accordance with local law and relevant Federal and State
regulations.
Page 16 of 19 Pages
Rev. 11102107; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
10. Reporting of Injuries
In the event that a trainee is injured and the injury either causes the trainee to lose time at work or to
obtain medical attention, the Contractor must immediately notify the Department of ~he injury by phone.
Within one working day, the Contractor must provide to the Department a written report of the injury on
letterhead paper and containing information as to:
a. Name of the trainee.
b. When, where, how and why the injury occurred.
c. Nature of the injury.
d. Witnesses to the injury.
e. Whether the trainee was sent home, to a hospital or to a physician.
f. If medical treatment was given, the name and address of the physician.
g. The name, title and phone number of the person who prepared the report.
If the immediate supervision of the trainee is provided by the Department, the above-mentioned items
shall be the responsibility of the Department's on-site supervisor.
11. Termination of Trainees
Trainees may be terminated by the Contractor for reasonable cause at any time during the term of th'is
Agreement following verbal approval by the Department. When appropriate, prior to termination which is
deemed necessary by the Contractor, trainees shall be granted reasonable opportunity for correction of
attitudes or improvement of performance. Following termination of a trainee, a full bill of padiculars
should be submitted to the Department at the above-stated address within two (2) weeks of the
termination date.
Responsibility for Wages
In the event that it is finally determined that a trainee was terminated or suspended without just cause,
and if such termination or suspension was initiated by the action of the Contractor without authorization
from the Department, then the Contractor, at its sole cost and expense shall make payment to the
trainee of any award to which the trainee may be entitled under the applicable program.
Contractor Assurances and Certification
The Contractor certifies:
a. That sufficient staff and administrative capability is available to operate the activities of the
applicable employment and training programs.
b. That only time actually worked by a trainee shall be certified on his/her time sheet, and that a
current time sheet shall be maintained for each trainee.
c. That there is sufficient, meaningful work to occupy all the trainees assigned during the hours
Page 17 of'19 Pages
12.
13.
Rev. 11/02/07; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
they are at the site.
d. That worksite supervisors shall attend training sessions, provided by the Department, as
appropriate.
e. That trainees are adequately protected against hazards or activities which may adversely affect
their health or safety.
f. That any special clothing, specific tools or equipment which may be required for the trainees to
perform the work assigned shall be provided by the Contractor.
14. Maintenance of Effort
The Contractor shall ensure that:
a. No trainees shall be used to replace or perform any work ordinarily and actually performed by
regular employees (including partial displacement such as a reduction in the hours of non-
overtime work, wages or employment benefits), or to replace or to perform any work which wou~d
ordinarily be performed by craft or trade unions in private employment.
b. No program shall impair existing contracts for services or collective bargaining agreements.
c. No trainee shall be employed or job opening filled (1) when any individual is on layoff from the
same or a substantially equivalent job, or (2) when the employer has terminated the employment
of any regular employee or otherwise reduced its workforce with the effect of filling the vacancy
so created by hiring a trainee.
d. No jobs shall be created in a promotional line that will infringe in any way upon the promotional
opportunities of currently employed individuals.
e. Work performed by trainees under this Memorandum of Understanding shall only be in addition
to work which would otherwise be provided by the Contractor without assistance under the
applicable program.
f. The work experience assignment shall not result in the filling of any established unfilled position
vacancy by a trainee,
15. Union Concurrence
When an activity authorized by the Department would be inconsistent with a collective bargaining
agreement, written union concurrence must be obtained before placement of the trainee(s) in the
Contractor's organization.
16. Trainee Evaluations
The Contractor shall provide performance evaluations of trainee(s) on forms provided by the
Department. Evaluations shall be submitted at intervals specified by the Department.
17. Self-Monitoring
The Contractor agrees to establish self-monitoring procedures to ensure compliance with program
operations, the applicable regulations and the provisions of this Agreement.
Page 18 of 19 Pages
Rev. 11/02107; Law No. 13-LB
Worksite MOU - WIA and/or SWEP
18. State Liability
19.
20.
21.
Unless the Contractor is a department or agency of the State of New York, the State of New York is not
a party to this Memorandum of Understanding and has no legal liability thereunder, either under the
terms and conditions stipulated herein, or with regard to any such liability, legal actions, or disputes as
may arise under this Memorandum between the Department and the Contractor.
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 Program covered by this
Agreement.
Payments Contingent Upon State/Federal Funding
Payments under this Agreement are 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.
Audit, Inspections and Records
The Contractor agrees that for a period of seven (7) years it shall maintain and have available for audit
and inspection by the Department and/or its designee any books, documents, papers and records
pertaining to each and every trainee's payroll record and personnel file.
22. Conflict of Interest/Nepotism
To avoid conflict of interest, the Contractor agrees that no trainee will be hired under this Agreement
who is a member of the immediate family of any person employed in an administrative or supervisory
capacity by the Contractor. Immediate family shall include wife, husband, daughter, son, mother, father,
brother, brother-in-law, sister, sister-in-law, son-in-law, daughter-in-law, mother-in-law father-in-law,
aunt, uncle, niece, nephew, stepparent and stepchild.
End of Text for Exhibit D
Page t9 of 19 Pages
CERTIFICATION REGARDING LOBBYING, DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY
MATTERS, AND DRUG-FREE WORKPLACE REQUIREMENTS
Applicant should refer to the regulations cited below to determine the certification included in the regulations before completing the
form. Signature of this form provides for compliance with certification requirements under 34 CFR Part 82, "New Restrictions on
Lobbying," and 34 CFR Part 85, "Government-wide Debarment and Suspension (Non-Pmcurament) and representation of fact upon
which reliance will be placed when the Department of Labor determines to award the covered transaction grant, or cooperative
1. LOBBYING
As required by Section 1352, Title 31 of the U.S.
Code and implemented at 34 CFR Part 82 for
pemons entering into a grant or cooperative
agreement over $100,000, as defined at 34 CFR
Part 82, Section 82.105 and 82.110, the applicant
certifies that:
(a)
No Federal appropriated funds have been paid or
will be paid, by or on behaif of the undemigned, to
any persons for influencing or attempting to
influence an officer or employee of any agency, a
Member of Congress, an officer or employee of
Congress, or an employee of a Member of
Congress in connection with the making of any
Federal grant, the entering into of any cooperative
agreement, and the extension, continuation,
renewal, amendment, or modification of any
Federal grant or cooperative agreement.
(b)
If any funds other than federally appropriated funds
have been paid or will be paid to any person for
influencing or attempting to influence an officer or
employee of a member of Congress in connection
with the making of any Federal grant, the entering
into of any cooperative agreement, and the
extension, continuation, renewal, amendment, or
modification of any Federal grant or cooperative
agreement.
(c)
The undemigned shall require that the language of
this certification be included in the award
documents for all subawards at all tiers (including
subgrants, contracts under grants and cooperative
agreements and subcontracts) and that all
subrecipients shall certify and disclose accordingly.
DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS
of or had a civil judgement rendered
against them for commission of fraud or
a criminal offense in connection with
obtaining, attempting to obtain, or
performing a public (Federal, State or
local) transaction or contracts under a
public transaction, violation of federal or
State antitrust statutes or commission of
embezzlement, their, forgery, bribery,
falsification or destruction of records,
making false statements, or receiving
stolen property;
(c)
Are not presently indicated or otherwise
criminally or civilly charged by a
Government entity (Federal, State or
local) with commission of any of the
offenses enumerated in paragraph A (b)
of the certification; and
(dj
Have not within a three-year period
preceding this application had one or
more public transactions (Federal, State
and local) for cause or default; and
Where the applicant is unable to certify to
any of the statements in this certification,
he or she shall attach and explanation to
this application.
DRUG-FREE WORKPLACE (GRANTEES
OTHER THAN INDIVIDUALS)
As required by the Drag-Fmc Workplace Act of
1988, and implemented at 34 CFR part 85, Subpart
F, for grantees, as defined at 34 CFR Part 85,
Sections 85.605 and 85.610.
The applicant that it will or will continue
to provide a drug-fi~ee workplace by:
As required by Executive Order 12549,
Debarments and Suspension, and implemented at
34 CFR Part 85, for prospective participants in
primary covered transactions, as defined at 34 CFR
part 85, Sections 83.105 and 85.110.
The applicant certifies that it and its
principals:
(a)
Are not presently debarred, suspended,
proposed for debarment, declared
ineligible, or voluntarily excluded from
covered transactions by any Federal
department of agency;
(b)
GM 50 (1-92)
Have not within a throe-year period
preceding this application been convicted
(a)
(b)
Publishing a statement notifying
employees that the manufacture,
distribution, dispensing, possession, or
use of a controlled substance is
prohibited in the grantee's workplace and
specifying the actions that will be taken
against employees for violation of such
prohibition;
Establishing an on-going drag-free
awareness program to inform employees
about:
The dangers ofdmg abuse in the
workplace;
~c)
(d)
(e)
(0
The grantee's policy of maintaining a
drug-free workplace;
Any available drug counseling,
rehabilitation, and employee assistance
program; and
The penalties that may be imposed upon
employee for drag abuse violation
occurring in the workplace:
Making it a requirement that each
employee to be engaged in the
performance of the grant be given a copy
of the statement required by paragraph
(a);
Notifying the employee in the statement
required by paragraph (a) that as a
condition of employmant under the grant,
the employee will:
Abide by the terms of the statement and;
Notify the employer in writing of his or
her conviction for a violation of a
criminal drag statute occurring in the
workplace no later than five calendar
days at~er such conviction;
Notifying the agency, in writing within
10 calendar days after having received
notice under subparagraph (dx2) from an
employee or otherwise receiving actual
police of such conviction. Employem of
convicted employees must provide
notice, including position title, to:
Director, Grants Management Bureau,
State Office Building Campus, Albany,
New York 12240. Notice shall include
the identification number(s) of each
affected grant.
Taking one of the following action,
within 30 calendar days of recoiving
notice under subparagraph (dx2), with
respect to any employee who is so
convicted:
Taking appropriate personnel action
against such an employee, up to and
including termination, consistent with the
Requirements of the Rehabilitation Act
of 1973, as amended; or
Requiring such employee to participate
satisfactorily in a drug abuse assistance
or rehabilitation program approved for
such purpose by a Federal, State or local
health, law enforcement, or other
appropriate agency;
making a good faith effort to continue to
maintain a drug-free workplace through
implementation of paragraphs (a), (b),
(c), (d), (e), (f),
The grantee may insert in the space
provided below the site(s) for the
performance of work done in connection
with this specific grant.
Place of Performance (street, address,
city, county, state, zip code).
DRUG-FREE WORKPLACE (GRANTEES WHO
ARE INDIVIDUALS)
As required by the Drug-Free Workplace Act of
1988, and implemented at 34 CFR part 85, Subpart
F, for grantees, as defined at 34 CFR Part 85,
Sections 85.605 and 85.610.
As a condition of the grant, I certify that I
will not engage in the unlawful
manufacture, distribution, dispensing,
possession, or use ora controlled
substance in conducting any activity with
the grant; and
If convicted of a criminal drug offense
resulting from a violation occurring
during the conduct of any grant activity, I
will report the conviction, in writing,
within 10 calendar days of the
conviction, to: Director, grants
Management Bureau, State Office
Building Campus, Albany, NY 12240.
Notice shall include the identification
number(s) of eanh affected grant.
Check if there are workplaces on file that are not identified here.
As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above
certifications.
Town of Southold
Name of ApplicentJGrantee/Subgrantee
Scott Russell, Super~or
~ ~Printed Name andTitl~,,~Orized Re sentative
Signature
GM 50 (1-92)
Suffolk County Legislative Requirements Exhibit for Contracts
This exhibit is attached to and is made part of the contract executed with the County.
II
III
IV
Suffolk County Living Wage Requirements
"Suffolk County Living Wage Requirements" Exhibit (2 pages); rev 5/05
Suffolk County Department of Labor - Living Wage Unit
Certification/Declaration - Subject to Audit
Form LW-38 (consists of 1 page); rev. 6/07
Contractor's/Vendor's Public Disclosure Statement Form SCEX 22; rev. 3130/04
(form consists of three pages; requires signature & notarization)
Note: The Contractor'sNendor's Public Disclosure Statement Form SCEX 22; rev.
3/30/04,
Union Organizing Certification/Declaration - Subject to Audit; rev, 9/07
Form LO1 (consists of 2 pages)
Lawful Hiring Compliance Requirements
Notice of Application to Certify Compliance with Federal Law (8 U.S,C. Section 1324A)
with Respect to Lawful Hiring of Employees (consists of 1 page) Form LHE-1
Affidavit of Compliance with the Requirements of) 8 U.S.C. Section 1324A) with
Respect to Lawful Hiring of Employees (consists of 1 page) Form LHE-2
Notice of Non-Applicability for compliance with Federal Law (8 U.S.C. Section 1324A )
with Respect to Lawful Hiring of Employees (consists of 1 page) Form LHE-6
I
Suffolk County Living Wage Documents
Suffolk County Living Wage Requirements Exhibit
As Last Revised by the Suffolk County Department of Labor in 6~07
Pursuant to Section 6 of Chapter 347 of the Suffolk County Local Law No. 12-2001, "A Local Law to
Implement Living Wage Policy for the County of Suffolk" (the "Living Wage Law"), all RFPs, County
contracts and financial compensation agreements subject to the law shall contain the following two
paragraphs or substantially equivalent language:
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 compensations, (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.
Forms for Completion and/or Sig nature (as applicable)
Suffolk County Department of Labor- Living Wage Unit
Notice of Application for County Compensation (Contract)
Form LW-1 (consists of 1 page)
Suffolk County Department of Labor - Living Wage Unit
Certification/Declaration - Subject to Audit
Form LW-38 (consists of I page) (Replaces LW2, LW3 and LW33)
Suffolk County Department of Labor - Living Wage Unit
Request for General Living Wage Exemption
Form LW-4 (consists of I page)
'Suffolk County Department of Labor- Living Wage Unit
Request for Specific Living Wage Exemption
Form LW-5,(consists of 2 pages)
t of 2 pages
Suffolk County Living Wage Requirements Exhibit
As Last Revised by the SuffOlk County Department of Labor in 6~07
Note: Pursuant to Section 7 of Local Law No.18- 2002, "A Local Law to Implement Living
Wage Policy for County of Suffolk", all covered employers subject to the provisions of the
Living Wage Law shall submit a completed and sworn (under penalty of perjury)
Certification/Declaration - Subject to Audit Form LW-38, signed by an authorized
representative, as part of an executed contract with the County of Suffolk. The complete
(~,ertifica'tion/Declaration - Subject to Audit Form LW-38 shall be made a part of any executed
contract or project agreement and made available to the public upon request.
To certify Living Wage compliance: Return Forms LW-1 and LW-38.
or
To certify non-applicability of LiVing Wage law: Return Form LW-38.
or
To request and document a general living wage exemption: Return Forms LW-I
LW-38 and LW-4.
or
To request and document a specific living wage exemption: Return Forms LW-,
LW-38 and LW-5.
In the event that there is a change in circumstances, it is the Contractor's
responsibility to submit to the County additional Living Wage forms which either
replace or supplement prior submissions of Living Wage forms.
Living Wage Law Information Fact Sheet, text of the Local Law, Frequently Asked
Questions, Forms, and Rules and Regulations can be found on the Suffolk County web
site at www.co.suffolk.ny.us
Click: Department Directory
Labor
Living Wage Law Info
Suffolk County Department of Labor Living Wage Unit Tel. (631) 853-3808
End of Text for Suffolk County Living Wage Requirements Exhibit
As Last Revised by the Suffolk County Department of Labor in 6/07
2 of 2 pages
SUFFOLK COUNTY DEPARTMENT OF LABOR - LIVING WAGE UNIT
LIVING WAGE CERTIFICATION/DECLARATION - SUBJECT TO AUDIT
If either of the following definitions of 'compensation' (Living Wage Law Chapter 347 - 2) applies to the contractor's/racipieut's
business or transaction with Suffolk County, the eoutractor/recipient must complete Sections 1, 3, 4 below; and Form LW-I
(Notice of Application for County Compensation). If the following definitions do not apply, the contractor/recipient must
complete Sections 2, 3 and 4 below. Completed forms must be submitted to the awarding agency.
"Any grant, loan, tax incentive or abatement, bond financing subsidy or other form of compensation of more that $50,000 which is
realized by or provided to an employer of at least ten (10) employees by or through the authority or approval of the County of Suffolk," or
"Any service contract or subcontract let to a contractor with ten (10) or more employees by the County of Suffolk for the furnishing of
services to or for the County of Suffolk (except contracts where services are incidental to the delivery of products, equipment or
commodities) which involve an expenditure equal to or greater than $10,000. For the purposes of this definition, the amount of
expenditure for more than one contract for the same service shall be aggregated. A contract for the purchase or lease of goods, products,
equipment, supplies or other property is not 'compensation' for the purposes of fins definition."
Section I The Living Wage Law applies to this contract. I/we hereby agree to comply with all the provisions of Suffolk County
Local Law No. 12-2001, the Suffolk County Living Wage Law (the Law) and, as such, will provide to all full, part-time
or temporary employed persons who perform work or render services on or for a project, mat~er, cuntract or subcontract
--~ where this company has received compensation, from the County of Suffolk as defined in the Law (compensation) a
wage rate of no less than $10.40 ($9.25 for child care providers) per hour worked with health benefits, as described in
the Law, or otherwise $11.84 ($10.50 for child care providers) per hour or the rates as may be adjusted annually in
accordance with the Law. (Chapter 347-3 B)
Check if
applicable I/we furxher agree that any tenant or leaseholder of this company that employs at least ten (10) persons and occupies
property or uses equipment or property that is improved or developed as a result of compensation or any contractor or
subcontractor of this company that employs at least ten (10) persons in producing or providing goods or services to this
company that are used in the project or mat~er for which this company has received compensation shall comply with
all the provisions of the Law, including those specified above. (Chapter 347-2)
Section II
I/we fu~her agree to permit access to work sites and relevant payroll records by authorized County representatives for
the purpose of monitoring compliance with regulations under this Chapter of the Suffolk County Code, investigating
employee complaints of noncompliance and evaluating the operation and effects of this Chapter, including the
production for inspection & copying of payroll records for any or all employees for thc term of the conUact or for five
(5) years, whichever period of compliance is longer. All payroll and benefit records required by the County will be
maintained for inspection for a similar period of time. (Chapter 347-7 D)
The County Department of Labor shall review the records of any Covered Employer at least once every three years to
verify compliance with the provisions oftha Law. (Chapter 347-4 C)
The Living Wage Law does not apply to this contract for the following reason(s):.
No County Funds Exoended
Check if
applicable
Section HI
Contractor Name:
Contractor Address:
Contractor Phone #:
Town of Southhold
53095 Route 25 //P.O. Box 1179
Southold, NY 11971-0959
765-1889
Federal Employer ID#:
Amount of compensation:
Vendor #:
11-6001939
Description of project or service: Provision of work experience to eligible program oarticinants.
Section IV
I declare under penalty of p~ury under the Laws of the State of New York that the undersigned is authorized to provide this certification,
and that the above is true,/i'd correct' /~ ~'"
Authorized Sig~atu~ ' ~ Date ' ·
Scott Russell~ Supervisor
Print Name and Title of Authorized Representative
LW 38 (revised 6-07, replaces forms LW2, LW3, and LW33)
II
Contractor's/Vendor's Public Disclosure
Statement Documents
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 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.
5.b
Contractor's/Vendor' s Name
Address
City and State
Contracting Department's Name
Address
Zip Code
Payee Identification or Social Security No.
Type of Business Corporation__Partnership__Sole Proprietorship__Other
Is contractor/vendo---r entering into 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).
go
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 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.
12.
X
a)
b)
c)
d)
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.
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: Hospital
Educational or governmental entities
Not-for-profit corporations
Contracts providing for foster care, family day-care providers or child protective
services.
Please check to the left side of the appropriate exemption.
13.
Dated:
Printed Name Bf Signer:
Title of Signer:
Name of Contractor/Vendor:
Verification. This section must be signed by an officer or principal of the contractor/vendor
authorized to sign for the company for the purpose of executing contracts. The undersigned
being sworn, affirms under the penalties of perjury, that he/she has read and understood the
foregoing statements and that they are, to his/h~wl~
Signed:
Scott Russell
Supervisor
Town of Southold
UNIFORM CERTIFICATE OF ACKNOWLEDGMENT
(Within New York State)
STATE OF NEW YORK)
COUNTY OF ) ss.:
On the d/:~V~ay of (~ ~ in the year 2008 before me, the undersigned, personally appeared
SCoTt ~ - £~$~t'cc ~/ personally known to me or proved to me on the basis of satisfactory evidence
to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to
me that he/she/they executed the same in his/her/their capacity(ies) and that by his/her/their signature(s)
on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed
the instrument.
(signatu~~ ~f indi~knowledgement)
LINDA d COOPE~
NOTARY PUBLIC ~.;~r~, ~f New
NO. 01COz~82£553, c ~?,~)unty
Term Expires Decemu:~ ,~ i,
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 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 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
C:\Documents and Settings\kmancini'uMy Documents\MOU Surf Co Exhibit Pub Disc Form 22-1.doc
III
Union Organizing Certification/Declaration
Suffolk County, New York
Department of Labor
SUFFOLK COUNTY DEPARTMENT OF LABOR - LABOR MEDIATION UNIT
UNION ORGANIZING CERTIFICATION/DECLARATION - SUBJECT TO AUDIT
If the following definition of "County Contractor" (Union Organizing Law Chapter 466-2) applies to the
contractor's/beneficiary's business or transaction with Suffolk County, the contractor/beneficiary must complete Sections I,
III, and IV below. If the following definitions do not apply, the contractor/beneficiary must complete Sections II, III and IV
below. Completed forms must be submitted to the awarding agency.
County Contractor: "Any employer that receives more than $50,000 in County funds for supplying goods or services pursuant to a
written contract with the County of Suffolk or any of its agencies; pursuant to a Suffolk County grant; pursuant to a Suffolk County
program; pursuant to a Suffolk County reimbursement for services provided in any calendar year; or pursuant to a subcontract with
any of the above."
Section I
-~ The Union Organizing Law applies to this contract. 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 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 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,
l~we shall maintain records sufficient to show that no County funds were used for those expenditures and, as
applicable, that no reimbursement from County funds has been sought for such costs. I/we agree that such records
shall be made available to the pertinent County agency or authority, the County Comptroller, or the County
Department of Law upon request. (Chapter 466-3 I)
I/we further affirm to the following as to the goods and/ur 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;
· Fwe will not require an employee, individually or in a group, to attend a meeting or an evem 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 prerecognitinn labor disputes through the
adoption of nonconfrontatinnal procedures for the resolution of prerecognition labor disputes with employees
engaged in the production of goods or the rendering of services for the County; and
· I/we have or will adopt any or all of the above-referenced procedures, or their functional equivalent, to ensure
the efficient, timely, and quality provision of goods and services to the County. Fwe shall include a list of said
procedures in such certification.
Section II
Check if
Applicable
The Union Organizing Law does not apply to this contract for the following reason(s):
No County Funds Expended
DOL-LOI (3/5/08)
Suffo. lk County, New York
Department of Labor
Section III
Contractor Name:
Contractor Address:
Contractor Phone:
Descril~tion of project or service:
Town of Southold
53095 Route 25 # P.O. Box 1179
Southold, NY 11971-0959
765-1889
Federal Employer ID#:
Amount of Assistance:
Vendor #:
Provision of work experience to eligible program participants.
11-6001939
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 penally' of perjury under the Laws of the State of New York that the undersigned is authorized to provide this
certification, and ~gtrj~'le above is tru.~md correct.
Authorized Signature t' Date
Scott Russell, Supervisor
Print Name and Title of Authorized Representative
DOL-LO1 (3/5/08)
SUFFOLK COUNTY DEPARTMENT OF LABOR
NOTICE OF NON-APPLICABILITY FOR COMPLIANCE WITH FEDERAL LAW
(8 U.S.C. SECTION 1324A)
WITH RESPECT TO LAWFUL HIRING OF EMPLOYEES
Suffolk County Code, Chapter 234 (2006)
To Be Completed By Awardin~ A~enc~,
The Lawful Hiring of Employees Law does not apply to the covered employer, contractor or sub-
contractor, listed below. Please check the appropriate box to indicate the basis for non-applicability.
Contractor Name: Town of Southold Federal Employer ID# 11-6001939
Contractor Address: 53095 Route 25
Southold, NY 11971-0959
Contractor Phone #: 765-1889
Description of project or service: Provision of work experience to eligible oro~,ram oarticipants.
1) x
Recipients of compensation from the County, through any grant, loan, subsidy, agreement, lease
or other financial compensation agreement issued by the County or awarding agency, where such
compensation is NOT one hundred percent (100%) funded by the County.
2) [] This law shall not apply to the subcontractors of not-for-profit corporations.
Authorized County Signature
Patrieia Wiener~ Labor Specialist IV
Print Name and Title of Authorized County Representative
Date
LHE-6
(01/07)
SUFFOLK COUNTY DEPARTMENT OF LABOR- LIVING WAGE UNIT
NOTICE OF NON-APPLICABILITY
OF LIVING WAGE LAW
Living Wage Law, Suffolk County Code, Chapter 347 (2001)
To Be Completed By The Living Wage Unit
DATE: August 12, 2008
TO: Jennifer Stavola~ S. C. Dept of Labor
FROM.'~enda ROsenberg, Director
TELEPHONE #: 853-3808
(Awarding Agency)
(Living Wage Uni0
EMPLOYER: Town of Southold
VENDOR #: 11-6001939
REF.: Work Experience
You are hereby notified that the response t~om Town of Southold has been evaluated by
the Living Wage Unit of the Suffolk County Department of Labor. We find that this
employer is not covered by the Suffolk County Living Wage Law (Local Law #12-2001),
and that the requiremems of this law as currently constituted do not constrain this
contractor at this time.
Brenda Rosenberg
Director of Living Wage Compliance
Suffolk County Department of Labor
LW-26
SUFFOLK COUNTY DEPARTMENT OF LABOR
NOTICE OF APPLICATION TO CERTIFY COMPLIANCE WITIa FEDERAL LAW
(8 U.S.C. SECTION 1324Al
WITH ItESPECT TO LA WFUL HIRING OF EMPLOYEES.
VERIFICATION OF SUBMISSION OF LAWFUL HIRING OF EMPLOYEES
Suffolk County Code, Chapter 234 (2006)
To Be COmpleted By the Lawful Hiring of Employees Unit
DATE: ~
TO: Jennifer Stavola~ S. C. Dept of ~l,ahor
FROM:~
TELEP~IONE #: 853-3808
EMPLOYER: Town of Southold
VENDOR #: 11-6001939
(Awarding Agency)
(Living Wage Unit)
You are hereby notified that the submission from Town of Southold has been received by
the Lawful Hiring of Employees Unit of the Suffolk County Department of Labor. We fred
that this submission is complete and is in compliance with the requirements set forth by the
Suffolk County Lawful Hiring of Employees Law (Local Law #52-2006),.
LHE-3
(01/07)