HomeMy WebLinkAboutHashamomuck Pond Watershed Management Plan ImplementationFACE PAGE
STATE AGENCY (Name and Address):
NYS Department of State
One Commerce Plaza
99 Washington Avenue - Suite 1010
Albany, NY 12231-0001
CONTRACTOR (Name and Address):
Town of Southold
53095 Main Road
PO Box 1179
Southold, NY 11971 - 0959
FEDERAL TAX IDENTIFICATION NUMBER:
11-6001939
NYS COMPTROLLER'S #: C006880
ORIG. AGENCY CODE: 19000
TYPE OF PROGRAM:
Environmental Protection Fund Act - 2007 LWRP
STATE SHARE FUNDING AMOUNT FOR
INITIAL PERIOD $341,000.00
LOCAL SHARE FLrNDING AMOUNT FOR
INITIAL PERIOD $341,000.00
INITIAL CONTRACT PERIOD:
FROM: April 1,2009 TO: March31,2012
MUNICIPALITY #
APPENDICES ATTACHED TO AND PART OF THIS AGREEMENT
APPENDIX A: Standard clauses as required by the Attorney General for all state contracts
APPENDIX Al:
Including
Agency-specific clauses
Attachment 1 - Final Project Summary Report
Attachment2- Minority and Women-owned Business Enterprises (MWBE) Program
Quarterly Contractor Report
Attachment 3 - Project Status Form
Attachment 4 - Procurement Certification
APPENDIX B: Budget
APPENDIX C: Payment and Reporting Schedule
APPENDIX D: Program Work Plan
APPENDIX F: Notices
APPENDIX G: Electronic Payments
APPENDIX X: Modification Agreement Form (to accompany modified appendices for changes in term or
consideration on an existing period or for renewal periods)
IN WITNESS THEREOF, the parties hereto have executed or approved this AGREEMENT on the dates below
their signatures.
CONTRACTOR /~' ~
Town of Southoicl. / ~'~'~~
By: ,,..~ ~~ -
Title:
Date:
Contract No. C006880
STATE AGENCY:
New York State Department of State
By: /"~a~._ et -.~,,~ ~
Title: ~ Manaqemen~
State Agency Ce~ification
"~ addition to the acc~tance of this contract, I
also ce~ify ~at original copies of this signat~e
page will be attached to all other exact copies of
· is con~act."
ACKNOWLEDGMENT
State of New York
County of ..~ C~-~'O/x~ < )
)SS:
Onthis I~Lx'fk dayof /~t.~cj~4,-~ , in the year 20 [ ~ , before me personally appeared
..~"~/~. l~u,3-5~[! , to me known, who being by me duly sworn, did depose and say that
he/M~isthe _ffccgge~c"O'[.-ror'~ of-~r.~',,'7 r;>'4% .~obt'/z;/o/o/,theorganization
described in and w[ich executed the above instrument; and that heMae has the authority to sign on behalf of
said organization; and that hedoh¢ executed the foregoing agreement for and on behalf of said organization.
rx ~,1 /') / ~ JENNIFER ANDALORO
~/~ ( ~ ~~ NOTARY 4~UBUC, State of New York
Qualified in Suffolk County ~ ..,,
Commission Expires January 12, 203.__~
Titl
Date:
Approved:
Thomas P. DiNapoli
State Comptroller
By: .
Date:
STATE OF NEW YORK
AGREEMENT
This AGREEMENT is hereby made by and between the State of New York agency (STATE) and the public or
private agency (CONTRACTOR) identified on the Face Page hereof.
WITNESSETH:
WHEREAS, the STATE has the authority to regulate and provide funding for the establishment and operation of
program services and desires to contract with skilled parties possessing the necessary resources to provide such services;
and
WHEREAS, the CONTRACTOR is ready, willing and able to provide such program services and possesses or can
make available all necessary qualified personnel, licenses, facilities and expertise to perform or have performed the
services required pursuant to the terms of this AGREEMENT;
NOW, THEREFORE, in consideration of the promises, responsibilities and covenants herein, the STATE and the
CONTRACTOR agree as follows:
I. Conditions of Agreement
A. This AGREEMENT may consist of successive periods (PERIOD), as specified within the AGREEMENT or
within a subsequent Modification Agreement(s) (Appendix X). Each additional or superseding PERIOD shall be on
the fom~s specified by the particular State agency, and shall be incorporated into this AGREEMENT.
B. Funding for the first PERIOD shall not exceed the funding amount specified on the Face Page hereof. Funding
for each subsequent PERIOD, if any, shall not exceed the mount specified in the appropriate appendix for that
PERIOD.
C. This AGREEMENT incorporates the Face Page attached and all of the marked appendices identified on the Face
Page hereof.
D. For each succeeding PERIOD of this AGREEMENT, the parties shall prepare new appendices, to the extent that
any require modification, and a Modification Agreement (the attached Appendix X is the blank form to be used).
Any terms of this AGREEMENT not modified shall remain in effect for each PERIOD of the AGREEMENT.
To modify the AGREEMENT within an existing PERIOD, the parties shall revise or complete the appropriate
appendix form(s). Any change in the amount of consideratian to be paid, or change in the term, is subject to the
approval of the Office of the State Comptroller. Any other modifications shall be processed in accordance with
agency guidelines as stated in Appendix Al.
E. The CONTRACTOR shall perform all services to the satisfaction of the STATE. The CONTRACTOR shall
provide services and meet the program objectives summarized in the Program Work Plan (Appendix D) in
accordance with: provisions of this AGREEMENT; relevant laws, roles and regulations, administrative and fiscal
guidelines; and where applicable, operating certificates for facilities or licenses for an activity or program.
F. If the CONTRACTOR enters into subcontracts for the performance of work pursuant to this AGREEMENT, the
CONTRACTOR shall take full responsibility for the acts and omissions of its subcontractors. Nothing in the
subcontract shall impair the fights of the STATE under this AGREEMENT. No contractual relationship shall be
deemed to exist between the subcontractor and the STATE. ~.
G. Appendix A. (Standard Clauses as required by the Attorney General for all State contracts) takes precedence over
all other parts of this AGREEMENT.
2
IL Payment and Reporting
A. The CONTRACTOR, to be eligible for payment, shall submit to the STATE's designated payment office
(identified in Appendix C) any appropriate documentation as required by the Payment and Reporting Schedule
(Appendix C) and by agency fiscal guidelines, in a manner acceptable to the STATE.
B. The STATE shall make payments and any reconciliations in accordance with the Payment and Reporting
Schedule (Appendix C). The STATE shall pay the CONTRACTOR, in consideration of contract services for a given
PERIOD, a sum not to exceed the amount noted on the Face Page hereof or in the respective Appendix designating
the payment amount for that given PERIOD. This sum shall not duplicate reimbursement from other sources for
CONTRACTOR costs and services provided pursuant to this AGREEMENT.
C. The CONTRACTOR shall meet the audit requirements specified by the STATE.
III. Terminations
A. This AGREEMENT may be terminated at any time upon mutual written consent of the STATE and the
CONTRACTOR.
B. The STATE may terminate this AGREEMENT immediately, upon written notice of termination to the
CONTRACTOR, if the CONTRACTOR fails to comply with the terms and conditions of this AGREEMENT and/or
with any laws, rules, regulations, policies or procedures affecting this AGREEMENT.
C. The STATE may also terminate this AGREEMENT for any reason in accordance with provisions set forth in
Appendix A 1.
D. Written notice of termination, where required, shall be sent by personal messenger service or by certified mail,
return receipt requested. The termination shall be effective in accordance with terms of the notice.
E. Upon receipt of notice of termination, the CONTRACTOR agrees to cancel, prior to the effective date of any
prospective termination, as many outstanding obligations as possible, and agrees not to incur any new obligations
after receipt of the notice without approval by the STATE.
F. The STATE shall be responsible for payment on claims pursuant to services provided and costs incurred pursuant
to terms of this AGREEMENT. In no event shall the STATE be liable for expenses and obligations arising from the
program(s) in this AGREEMENT after the tenrdnation date.
IV. Indemnification
A. The CONTRACTOR shall be solely responsible and answerable in damages for any and all accidents and/or
injuries to persons (including death) or property arising out of or related to the services to be rendered by the
CONTRACTOR or its subcontractors pursuant to this AGREEMENT. The CONTRACTOR shall indemnify and
hold harmless the STATE and its officers and employees from claims, suits, actions, damages and costs of every
nature arising out of the provision of services pursuant to this AGREEMENT.
B. The CONTRACTOR is an independent contractor and may neither hold itself out nor claim to be an officer,
employee or subdivision of the STATE nor make any claim, demand or application to or for any right based upon any
different status.
3
V. Property
Any equipment, furniture, supplies or other property purchased pursuant to this AGREEMENT is deemed to be the
property of the STATE except as may otherwise be governed by Federal or State laws, roles or regulations, or as
stated in Appendix A 1.
VI. Safeguards for Services and Confidentiality
A. Services performed pursuant to this AGREEMENT are secular in nature and shall be performed in a manner that
does not discriminate on the basis of religious belief, or promote or discourage adherence to religion in general or
particular religious beliefs.
B. Funds provided pursuant to this AGREEMENT shall not be used for any partisan political activity, or for
activities that may influence legislation or the election or defeat of any candidate for public office.
C. Information relating to individuals who may receive services pursuant to this AGREEMENT shall be maintained
and used only for the purposes intended under this Agreement and in conformity with applicable provisions of laws
and regulations, or specified in Appendix Al.
AppENDIX A
STANDARD CLAUSES FOR NYS CONTRACTS
Thc parties to the attached contract, license, lease, amendment or
other agreement of any kind (hereinafter, "the contract" or "this
contract") agree to be bound by the following clauses which arc
hereby made a part of the contract (the word "Contractor" herein
refers to any party other than the State, whether a contractor,
licenser, licensee, lessor, lcsscc or any other party):
1. EXECUTORY CLAUSE. In accordance with Section 41 of thc
State Finance Law, the State shall have no i/ability under this
contract to the Contractor or to anyone else beyond funds
appropriated and available for this contract.
2. NON-ASSIGNMENT CLAUSE. In accordance with Section
138 of the State Finance Law, this contract may not be assigned by
the Contractor or its right, title or interest therein assigned,
transferred, conveyed, sublet or otherwisc disposed of without the
State's previous written consent, and attempts to do so are null and
void. Notwithstanding the foregoing, such prior written consent of
an assignment of a contract let pursuant to Article XI of the State
Finance Law may be waived at the discretion of the contracting
agency and with the concurrence of the State Comptroller where the
original contract was subject to the State Comptroller's approval,
where the assignment is due to a reorganization, merger or
consolidation of the Contractor's business entity or cntarprise. The
State retains its right to approve an assignment and to require that
any Contractor demonstrate its responsibility to do business with
the State. The Contractor may, however, assign its right to receive
payments without the State's prior written consent unless this
contract concerns Certificates of Participation pursuant to Article
S-A of the State Finance Law.
3. COMPTROLLER'S APPROVAL. In accordance with Section
112 of the State Finance Law (or, if this contract is with the State
University or City University of New York, Section 355 or Section
621 $ of the Education Law), if this contract exceeds $50,000 (or
the minimum thresholds agreed to by the Office of the State
Comptroller for certain S.U .N .Y. and C .U .N.Y. contracts), or if this
is an amendment for any amount to a contract which, as so
amended, exceeds said statutory amount, or if, by this contract, the
State agrees to give something other than money when the value or
reasonably estimated value of such consideration exceeds $10,000,
it shall not be valid, effective or binding upon the State until it has
been approved by the State Comptroller and filed in his office.
Comptroller's approval of contracts let by the Office of General
Services is required when such contracts exceed $115,000 (State
Finance Law Section 163.6.a).
4. WORKERS' COMPENSATION BENEFITS. In accordance
with Section 142 of the State Finance Law, this contract shall be
void and of no force and effect unless thc Contractor shall provide
and maintain coverage during the life of this contract for the benefit
of such employees as are required to be covered by the provisions
of the Workers' Compensation Law.
5, NON-DISCRIMINATION REQUIREMENTS, To the extent
required by Article 15 of the Executive Law (also known as the
Human Rights Law) and all other State and Federal statutory and
constitutional non-discrimination provisions, the Contractor will
not discriminate against any employee or applicant for employment
because of race, creed, color, sex, national origin, sexual
orientation, age, disability, genetic predisposition or carrier status,
or marital status. Furthermore, in accordance with Section 220-e
of the Labor Law, if this is a contract for the cons~uctiun, alteration
or repair of any public building or public work or for the
manufacture, sale or distribution of materials, equipment or
supplies, and to thc extent that this contract shall bc performed
within the State of New York, Contractor agrees that neither it nor
its subcontractors shall, by reason of race, creed, color, disability,
sex, or national origin: (a) discriminate in hiring against any New
York State citizen who is qualified and available to perform thc
work; or (b) discriminate against or intimidate any employee hired
for thc performance of work under this contract. If this is a
building service contract as defined in Section 230 of thc Labor
Law, then, in accordance with Section 239 thereof, Contractor
agrees that neither it nor its subcontractors shall by reason of race,
creed, color, national origin, age, sex or disability: (a) discriminate
in hiring agail~st any New York State citizen who is qualified and
available to perform the work; or (b) discriminate against or
intimidate any employee hired for the performance of work under
this contract. Contractor is subject to fines of $50.00 per person
per day for any violation of Section 220-e or Section 239 as well as
possible termination of this contract and forfeiture of all moneys
due hereunder for a second or subsequent violation.
6. WAGE AND HOURS PROVISIONS. If this is a public work
contract covered by Article 8 of the Labor Law or a building
service contract covered by Article 9 thereof, neither Contractor's
employees nor the employees of its subcontractors may bc required
or permitted to work more than thc number of hours or days stated
in said statutes, except as otherwise provided in the Labor Law and
as set forth in prevailing wage and supplement schedules issued by
the State Labor Department. Furthermore, Contractor and its
subcontractors must pay at least the prevailing wage rate and pay
or pro vide the prevailing supplements, including the premium rates
for overtime pay, as determined by the State Labor Department in
accordance with the Labor Law. Additionally, effective April 28,
2008, if this is a public work contract covered by Article 8 of the
Labor Law, the Contractor understands and agrees that the filing of
payrolls in a manner consistent with Subdivision 3-e of Section 220
of the Labor Law shall be a condition precedent to payment by the
State of any State approved sums due and owing for work done
upon the project.
7. NON-COLLUSIVE BIDDING CERTIFICATION. In
accordance with Section 139-d of the State Finance Law, if this
contract was awarded based upon thc submission of bids,
Contractor affirms, under penalty of perjury, that its bid was arrived
at independently and without collusion aimed at restricting
competition. Contractor further affirms that, at the time Contractor
submitted its bid, an authorized and responsible person executed
and delivered to the State a non-collusive bidding certification on
Contractor's behalf.
8. INTERNATIONAL BOYCOTT PROHIBITION. In accordance
with Section 220-fofthe Labor Law and Section 139-h of the State
Finance Law, if this contract exceeds $5,000, the Contractor agrees,
as a material condition of the contract, that neither the Contractur
nor any substantially owned or affiliated person, firm, partnership
or corporation has participated, is participating, or shall participate
in an international boycott in violation of the federal Export
Administration Act of 1979 (50 USC App. Sections 2401 et seq.)
or regulations theraunder. If such Contractor, or any of the
aforesaid affiliates of Contractor, is convicted or is otherwise found
to have violated said laws or regulations upon the final
determination of the United States Commerce Department or any
other appropriate agency of the United States subsequent to the
contract's execution, such contract, amendment or modification
thereto shall be rendered forfeit and void. The Contractor shall so
notify the State Comptroller within five (5) business days of such
conviction, determination or disposition of appeal (2NYCRR
105.4).
9. SET-OFF RIGHTS. The State shall have all of its common law,
equitable and statutory rights of set-off. These rights shall include,
but not be limited to, the State's option to withhold for fha purposes
ofset-offany moneys due to the Contractor under this contract up
to any amounts due and owing to the State with regard to this
contract, any other contract with any State department or agency,
including any contract for a term commancing prior to the term of
this contract, plus any amounts due and owing to the State for any
other reason including, without limitation, tax delinquencies, fee
delinquencies or monetary penalties relative thereto. The State
shall exercise its set-off rights in accordance with normal State
practices including, in cases of set-off pursuant to an audit, the
finalization of such audit by the State agency, its rapresantatives, or
the State Comptroller.
10. RECORDS. The Contractor shall establish and maintain
complete and accurate books, records, documents, accounts and
other evidence directly pertinent to performance under this contract
(hereinafter, collectively, "the Records"). The Records must be
kept for the balance of the calendar year in which they were made
and for six (6) additional years thereafter. The State Comptroller,
the Attorney General and any other person or entity authorized to
conduct an examination, as well as the agency or agencies involved
in this contract, shall have access to the Records during normal
business hours at an office of the Contractor within the State of
New York or, if no such office is available, at a mutually agreeable
and reasonable venue within the State, for the term specified above
for thc purposes of inspection, auditing and copying. The State
shall take reasonable steps to protect from public disclosure any of
thc Records which are exempt from disclosure under Section 87 of
the Public Officers Law (the "Statute") provided that: (i) the
Contractor shall timely inform an appropriate State official, in
writing, that said records should not be disclosed; and (ii) said
records shall be sufficiently identified; and (iii) designation of said
records as exempt under the Statute is reasonable. Nothing
contained harcin shall diminish, or in any way adversely affect, the
State's right to discovery in any pending or future litigation.
1 1. IDENTIFYING INFORMATION AND PRIVACY
NOTIFICATION. (a) FEDERAL EMPLOYER
IDENTIFICATION NUMBER and/or FEDERAL SOCIAL
SECURITY NUMBER. All invoices or New York State standard
vouchers submitted for payment for the sale of goods or services or
the lease of real or personal property to a New York State agency
must include the payee's identification number, i.e., the seller's or
lessor's identification number. The number is either the payee's
Federal employer identification number or Federal social security
number, or both such numbers when tha payee has both such
numbers. Failure to include this numbar or numbers may delay
payment. Where the payee does not have such number or numbers,
the payee, on its invoice or New York State standard voucher, must
give the reason or reasons why the payee does not have such
number or numbers.
(b) PRIVACY NOTIFICATION. (1) The authority to request the
above personal information from a seller of goods or services or a
lessor of real or personal property, and the authority to maintain
such information, is found in Section 5 of the State Tax Law.
Disclosure of this information by the seller or lessor to the State is
mandatory. The principal purpose for which the information is
collacted is to enable the State to identify individuals, businesses
and others who have been delinquent in filing tax returns or may
have understated their tax liabilities and to generally identify
persons affected by the taxes administered by the Commissioner of
Taxation and Financa. The information will be used for tax
administration purposes and for any other purpose authorized by
law. (2) The personal information is requested by the purchasing
unit of the agency contracting to purchase the goods or services or
lease the real or personal property covered by this contract or lease.
The information is maintained in New York Stata's Central
Accounting System by the Director of Accounting Operations,
Office of the State Comptroller, 110 Statu Street, Albany, New
York 12236.
12. EQUAL EMPLOYMENT OPPORTUNITIES FOR
MINORITIES AND WOMEN. In accordance with Section 312 of
the Executive Law and 5 NYCRR 143, if this contract is: (i) a
written agreement or purchase order instrumant, providing for a
total expenditure in excess of $25,000.00, whereby a contracting
agency is committed to expend or does expend funds in return for
labor, services, supplies, equipment, materials or any combination
of tha foregoing, to be performed for, or rendered or furnished to
the contracting agency; or (ii) a written agreement in excess of
$100,000.00 whereby a contracting agency is committad to expend
or does expend funds for the acquisition, construction, demolition,
replacement, major repair or renovation of raal property and
improvements thereon; or (iii) a written agreement in excess of
$100,000.00 whereby the owner of a State assisted housing project
is committed to expend or does expend funds for the acquisition,
construction, demolition, replacement, major repair or ranoi, ation
of real properly and improvements thereon for such project, then
the following shall apply and by signing this agreement the
Contractor certifies and affirms that it is Contractor's equal
employment opportunity policy that:
(a) The Contractor will not discriminate against employees or
applicants for employment because of race, creed, color, national
origin, sex, age, disability or marital status, shall make and
document its conscientious and active efforts to employ and utilize
minority group members and women in its work force on State
contracts and will undertake or continue existing programs of
affirmative action to ensure that minority group members and
women are afforded equal employment opportunities without
discrimination. Affirmative action shall mean recruitment,
employment, job assignment, promotion, upgradings, demotion,
transfer, layoff, or termination and rates of pay or other forms of
compensation;
(b) at the request of the contracting agency, the Contractor shall
request each employment agency, labor union, or authorized
representative of workers with which it has a collective bargaining
or other agrecmant or understanding, to furnish a written statement
that such cmploymcnt agency, labor union or representative will not
discriminate on the basis ofrnce, creed, color, national origin, sex,
age, disability or marital status and that such union or
representative will affirmatively cooperate in thc implementation
of the Contractor's obligations herein; and
(c) the Contractor shall state, in all solicitations or advertisements
for employees, that, in the performance of the State contract, all
qualified applicants will be afforded equal employment
opportunities without discrimination because of race, creed, color,
national origin, sex, age, disability or marital status.
Contractor will include the provisions of "a", "b", and "c" above,
in every subcontract over $25,000.00 for the construction,
demolition, replacement, major repair, renovation, planning or
design of real property and improvements thereon (the "Work")
except where the Work is for the beneficial use of the Contractor.
Section 312 does not apply to: (i) work, goods or services
unrelated to this contract; or (ii) employment outside New York
State. The State shall consider compliance by a contractor or
subcontractor with the requirements of any federal law concerning
equalemployment opportunity which effectuates the purpose of this
section. The contracting agency shall determine whether the
imposition of the requirements of the provisions hereof duplicau~
or conflict with any such federal law and if such duplication or
conflict exists, the contracting agency shall waive the applicability
of Section 312 to the extent of such duplication or conflict.
Contractor will comply with all duly promulgated and lawful rules
and regulations of the Department of Economic Development's
Division of Minority and Women's Business Development
pertaining hereto.
13. CONFLICTING TERMS. In the event ora conflict between
the terms of the contract (including any and all attachments thereto
and amendments thereof) and thc terms of this Appendix A, thc
terms of this Appendix A shall control.
14. GOVERNING LAW. This contract shall be governed by the
laws of the State of New York except where the Federal supremacy
clause requires otherwise.
15. LATE PAYMENT. Timeliness of payment and any interest to
be paid to Contractor for late payment shall be governed by Article
1 I-A of the State Finance Law to the extent required by law.
16. NO ARBITRATION. Disputes involving this contract,
including the breach or alleged breach thereof, may not bc
submitted to binding mbitration (except where statatorily
authorized), but must, instead, be heard in a court of competent
jurisdiction of the State of New York.
17. SERVICE OF PROCESS. In addition to the methods of
service allowed by the State Civil Practice Law & Rules ("CPLR"),
Contractor hereby consents to service of process upon it by
registered or certified mail, return receipt requested. Service
hereunder shall be complete upon Contractor's actual receipt of
process or upon the State's receipt of the return thereof by the
United States Postal Service as refused or undeliverable.
Contractor must promptly notify the State, in writing, of each and
every change of address to which service of process can be made.
Service by the State to thc last known address shall be sufficient.
Contractor will have thirty (30) calendar days after service
hereunder is complete in which to respond.
18. PROHIBITION ON PURCHASE OF TROPICAL
HARDWOODS. The Contractor certifies and warrants that all
wood products to be used under this contract award will be in
accordance with, but not limited to, the specifications and
provisions of Section 165 of the State Finance Law, ~sc of
Tropical Hardwoods) which prohibits purchase and use of tropical
hardwoods, unless specifically exempted, by the State or any
governmental agency or political subdivision or public benefit
corporation. Qualification for an exemption under this law will be
thc responsibility of the contractor to establish to mcct with the
approval of the State.
In addition, when any portion of this contract involving the use of
woods, whether supply or installation, is to be performed by any
subcontractor, the prime Contractor will indicate and certify in the
submitted bid proposal that the subcontractor has been informed
and is in compliance with specifications and provisions regarding
use of tropical hardwoods as detailed in § 165 State Finance Law.
Any such use must meet with the approval of the State; otherwise,
the bid may not be considered responsive. Under bidder
certifications, proof of qualification for exemption will be the
responsibility of the Contractor to meet with the approval of the
State.
19. MACBRIDE FAIR EMPLOYMENT PRINCIPLES. In
accordance with the MacBride Fair Employment Principles
(Chapter 807 of the Laws of 1992), the Contractor hereby stipulates
that the Contractor either (a) has no business operations in Northern
Ireland, or (b) shall take lawful steps in good faith to conduct any
business operations in Northern Ireland in accordance with the
M acB ride Fair Employment Principle s (as described in Section 165
of the New York State Finance Law), and shall permit independent
monitoring of complinnce with such principles.
20. OMNIBUS PROCUREMENT ACT OF 1992. It is the policy
of New York State to maximize opportunities for the participation
of New York State business enterprises, including minority and
women-owned business enterprises as bidders, subcontractors and
suppliers on its procurement contracts.
Information on the availability of New York State subcontractors
and suppliers is available from:
NYS Department of Economic Development
Division for Small Business
30 South Pearl St -- 7th Floor
Albany, New York 12245
Telephone: 518-292-5220
Fax: 518-292-5884
http://www.empire.state.ny.us
A directory of certified minority and woman-owned business
enterprises is available from:
NYS Department of Economic Development
Division of Minority and Women's Business Development
30 South Pearl St -- 2nd Floor
Albany, New York 12245
Telephone: 518-292-5250
Fax: $ I g-292-5803
http://www .empire.state.ny.us
The Omnibus Procurement Act of 1992 requires that by signing this
bid proposal or contract, as applicable, Contractors certify that
whenever the total bid amount is greater than $1 million:
(a) The Contractor has made reasonable efforts to encourage the
participation of New York State Business Enterprises as suppliers
and subcontractors, including certified minority and women-owned
business enterprises, on this project, and has retained the
documentation of these efforts to be provided upon request to the
State;
(b) The Contractor has complied with the Federal Equal
Opportunity Act of 1972 (P.L. 92-261), as amended;
(c) The Contractor agrees to make reasonable efforts to provide
notification to New York State residents of employment
opportunities on this project through listing any such positions with
the Job Service Division of the New York State Department of
Labor, or providing such notification in such manner as is
consistent with existing collective bargaining contracts or
agreements. The Contractor agrees to document these efforts and
to provide said documentation to the State upon request; and
(d) The Contractor acknowledges notice that the State may seek to
obtain offset credits from foreign countries as a result of this
contract and agrees to cooperate with the State in these efforts.
21. RECIPROCITY AND SANCTIONS PROVISIONS.
Bidders are hereby notified that if their principal place of business
is located in a country, nation, province, state or political
subdivision that penalizes New York State vendors, and if the
goods or services they offer will be substantially produced or
performed outside New York State, thc Omnibus Procurcmant Act
1994 and 2000 amendments (Chapter 684 and Chapter 383,
respectively) require that they be denied contracts which they
would otherwise obtain, NOTE: As of May 15, 2002, the list of
discriminatory jurisdictions subject to this provision includes thc
states of South Carolina, Alaska, West Virginia, Wyoming,
Louisiana and Hawaii. Contact NYS Department of Economic
Development for a current list of jurisdictions subject to this
provision.
22. COMPLIANCE WITH NEW YORK STATE INFORMATION
SECURITY BREACH AND NOTIFICATION ACT. Contractor
shall comply with the provisions of the New York State
Information Security Breach and Notification Act (General
Business Law Section 899-aa; State Technology Law Section 208).
23. COMPLIANCE WITH CONSULTANT DISCLOSURE
LAW. If this is a contract for consulting services, defined for
purposes of this requirement to include analysis, evaluation,
research, training, data processing, computer programming,
engineering, environmental, health, and mental health services,
accounting, auditing, paralegal, legal or similar services, then, in
accordance with Section 163 (4-g) of the State Finance Law (as
amended by Chapter 10 of the Laws of 2006), the Contractor shall
timely, accurately and properly comply with the requirement to
submit an annual employment report for the contxact to the agency
that awarded the contract, the Deparm~ant of Civil Service and the
State Comptroller.
24. PROCUREMENT LOBBYING. To the extent this
agreement is a ~procurement contract" as defined by
State Finance Law Sections 139-j and 139-k, by signing this
agreement thc contractor certifies and affirms that all disclosures
made in accordance with State Finance Law Sections 139-j and
139-k are complete, truc and accurate. In the event such
certification is found to be intentionally false or intentionally
incomplete, the State may terminate the agreement by providing
written notification to the Contractor in accordance with the terms
of the agreement.
25. CERTIFICATION OF REGISTRATION TO COLLECT
SALES AND COMPENSATING USE TAX BY CERTAIN
STATE CONTRACTORS, AFFILIATES AND
SUBCONTRACTORS.
To the extent this agreement is a contract as defined by Tax Law
Section 5-a, if the contractor fails to make the certification required
by Tax Law Section 5-a or if during the term of the contract, the
Department of Taxation and Finance or the covered agency, as
defined by Tax Law 5-a, discovers that the certification, made
under penalty of perjury, is false, then such failure to file or false
certification shall be a material breach of this contract and this
contract may be terminated, by providing written notification to thc
Contractor in accordance with the terms of the agreement, if the
covered agency determines that such action is in the best interest of
the State.
Revised June 2011
APPENDIX A1
AGENCY-SPECIFIC CLAUSES
I. This Agreement has been entered into pursuant to the following understandings:
II.
A. Title 11 of the Environmental Protection Fund Act provides for State assistance to municipalities for the State
share of the cost of approved local waterfront revitalization projects as defined in the Act.
B. The Department of State (Department) is authorized by such Act to evaluate and determine eligibility of
applications for funding of projects.
Based upon information, representations and certifications contained in Contractor's application for funding,
including the Program Work Plan as set forth in Appendix D, the Department has made a determination of
eligibility of funding for Contractor's project under such Act.
State funds (Funding Amount set forth on the Face Page) for this Project (Appendix D Program Work Plan) are
provided pursuant to a reappropriation o f funds originally made by Title 11 of the Environmental Protection Fund
Act.
E. The Contractor has demonstrated its ability to finance its share of the Project and has agreed to fund its portion
of the cost of the Project.
F. The 2009 "Request for Applications" required the Applicant to budget for costs associated with training for
projects.
Where Contractor is required to attend training session(s) in Appendix D, Pmgram Work Plan, the Contractor
agrees to participate in the designated training session(s). The Department will notify the Contractor when
training session(s) will be held. The Contractor agrees to submit payment for the required registration fee(s) in
accordance with the notification letter from the Department.
Failure of the Contractor to transmit the registration fees or attend the training session(s) will result in the
withholding of payments in the amount of the registration fee(s) and could result in this contract being
terminated. In no case should the funds allocated for training be used for any other purpose without prior
approval of the Department.
General
For the purposes of this Agreement, the terms "State" and "Department" are interchangeable, unless the context
requires otherwise. In addition, the terms "Agreement" and "Contract" are interchangeable, unless the context
requires otherwise.
B. The contract period as set forth on the Face Page is the inclusive period within which the provisions of this
Agreement shall be performed.
C~ No liabilities incurred prior to the contract period will be eligible under this Agreement.
No liabilities are to be incurred beyond the contract period and no costs will be reimbursed for such liabilities
unless: 1) funds have been mappropriated for the Project in the subsequent State fiscal year, 2) the Department
determines that it is in the best interest of the Department and the State to provide additional time to complete
the Project and 3) an extension agreement is approved in accordance with Section IA. of the Agreement.
E. Subject to the availability of funds, determination by the Department that it is in the best interest of the State,
and upon mutual written consent of the parties, the Initial Contract Period of this Agreement may be extended
III.
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by up to two contract periods not to exceed twelve months each. The parties shall revise or complete the
appropriate appendix form(s), which may be subject to approval of the Office of the State Comptroller.
F. To modify any terms of this Agreement within an existing period, the parties shall revise or complete the
appropriate appendix foml(s), which may be subject to approval of the Office of the State Comptroller.
The Department shall not be liable for expenses of any kind incurred in excess of the State Funds as set forth on
the Face Page, and shall not be responsible for seeking additional appropriations or other sources of funds for
the Project.
The Contractor shall perform all services to the satisfaction of the Department. The Contractor shall provide all
services and meet the program objectives described in Appendix D in accordance with: provisions of this
Agreement; relevant State, federal and local laws, rules and regulations, administrative and fiscal guidelines;
where applicable, operating certificates for facilities or licenses for an activity or program, and conditions of
applicable permits, administrative orders and judicial orders.
1. The Contractor shall submit with its request for final payment a Final Project Summary Report in the format
described in Appendix Al, Attachment.
The Contractor agrees to proceed expeditiously with the Project and to complete the Project in accordance with
the timetable set forth in the Work Plan (Appendix D) as well as with the conditions of any applicable permits,
administrative orders, or judicial orders and this Agreement.
The Contractor shall submit a Quarterly Contractor Report (Appendix Al, Attachment 2) pursuant to the
Department's Minority and Women-owned Business Enterprises Program. In the event Contractor utilizes
Minority and Women-owned Business Enterprises as discussed in Section XVI in Appendix A 1, such report shall
be provided to the Department at the address on the Quarterly Contractor Report.
The Contractor shall submit a "Project Status Report" (Appendix Al, Attachment 3) on a six month basis for
the periods ending June 30 and December 31. Reports are due no later than 30 days following the end of each
reporting period.
Additional Requirements for Construction Proiects
Project design, including preparation of final plans and specifications, and supervision of construction shall be
undertaken by a qualified architect and/or engineer licensed to practice in the State of New York. The Contractor
shall submit final plans and specifications to the Department for its acceptance before initiating construction
work or, if the Contractor intends to subcontract for construction work, before the work is advertised for bidding.
No change to project plans may be made without the prior written approval of the Department. The Contractor
shall also be responsible for erecting a project sign satisfactory to the Department identifying the Project. The
project sign shall remain in place for the useful life of the improvements undertaken pursuant to this Agreement.
Upon completion of the Project, the Contractor shall submit to the Department a proper certification from a
licensed architect or engineer.
The State shall make periodic inspections of the project both during its implementation and after its completion
to assure compliance with this Agreement. The Contractor shall allow the State unrestricted access to work
during the preparation and progress of the work, and provide for such access and inspection by the State in all
construction contracts relating to the project.
The Contractor shall be responsible for assuring that the project is designed and constructed in conformance with
the Uniform Federal Accessibility Standards (UFAS - Appendix A to 41 CRF part 101 - 19.6), the Americans with
Disabilities Act Accessibility Guidelines (ADAAG - Appendix A of Title 9 NYCRR). Where there are
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discrepancies among the sets of standards with regard to a particular design/construction requirement, the one
providing for the greatest degree of accommodation for the disabled shall apply.
D. It is the Contractor's responsibility, pursuant to Section 57 of the Workers' Compensation Law, to maintain for
State audit and review either proof that they have Workers' Compensation coverage for any employees, or a
waiver statement from the New York State Department of Labor. The Contractor must also obtain from uny
contractor or sub-contractor hired to provide a service pursuant to this Agreement, similar proof or waiver from
the contractor or subcontractor, and must maintain such documentation on file for audit.
IV. Reports~ Documents and Maps
The Contractor shall, where appropriate, identify documents, reports, and maps produced in whole or in part under
this Agreement by endorsing on said documents, reports, and maps the following:
"This (document, report, map, etc.) was prepared for the New York State Department of State with funds
provided under Title 11 of the Environmental Protection Fund Act."
License to use and reproduce documents and other works:
By acceptance of this Agreement, Contractor transfers to the Department a nonexclusive license to use, reproduce
in any medimn, and distribute any work prepared for or in connection with the Project, including but not limited to
reports, maps, designs, plans, analysis, and documents regardless of the medium in which they are originally
produced. Contractor warrants to the Department that it has sufficient title or interest in such works to license
pursuant to this Agreement. Such warrunty shall survive the termination of this agreement. Contractor agrees to
provide the original of each such work, or a copy thereof which is acceptable to the Department, to the Department
before payments shall be made under this Agreement.
VI. Contractors Insurance Requirements
Prior to the commencement of the work, the Contractor shall file with the Department of State, Certificates of
Insurance evidencing compliance with all requirements contained in this Agreement. Such certificate shall be
of form und substance acceptable to the Department.
B. Acceptance and/or approval by the Department does not and shall not be construed to relieve Contractor of any
obligations, responsibilities or liabilities under the Agreement.
All insurunce required by the Agreement shall be obtained at the sole cost and expense of the Contractor; shall
be maintained with insurance carriers licensed to do business in New York State; shall be primary und non-
contributing to any insurance or self insurance maintained by the Department; shall be endorsed to provide
written notice be given to the Department, at least thirty (30) days prior to the cuncellation, non-renewal, or
material alteration of such policies, which notice, evidenced by return receipt of United States Certified Marl
which shall be sent to New York State Department of State, One Commerce Plaza, 99 Washington Avenue,
Albany, New York 122314)001; and shall name the People ofthe State of New York and their directors officers,
agents, and employees as additional insured thereunder.
D. The Contractor shall be solely responsible for the paymant of all deductibles to which such policies are subject.
Each insurance carrier must be rated at least "A" Class "VII" in the most recently published Besfs Insurance
Report. If, during the term of the policy, a carrier's rating falls below "A Class "VII", the insurance must be
mptaced no later than the renewal date of the policy with un insurer acceptable to the Department and rated at
least "A" Class "VII" in the most recently published Best's Insurance Report.
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F. The Contractor shall cause all insurance to be in full fome and effect as of the date of this Agreement and to
remain in full fome and effect throughout the term of this Agreement and as further required by this Agreement.
The Contractor shall not take any action, or omit to take any action that would suspend or invalidate any of the
required coverages during the period of time such coverages are required to be in effect.
G. Not less than thirty (30) days prior to the expiration date or renewal date, the Contractor shall supply the
Depat~maent updated replacement Certificates of Insurance, and amendatory endorsements.
H. Unless the Contractor is self-insured, Contractor shall, throughout the term of the Agreement or as otherwise
required by this Agreement, obtain and maintain in full force and effect the following insurance with limits not
less than those described below and as required by the terms of this Agreement, or as required by law, whichever
is greater (limits may be provided through a combination of primary and umbrella/excess policies). Where
Contractor is self-insured, the Contractor shall provide suitable evidence of such to the Department relating to
the risks and coverage amounts as provided hereunder.
Comprehensive Liability Insurance with a limit of not less than $l,000,000 each occurrence. Such liability
shall be written on the Insurance Service Office~s (ISO) occurrence form CG 00 01, or a substitute form
providing equivalent coverages and shall cover liability arising from premises operations, independent
contractors, products-completed operations, broad form property damage, personal & advertising injury,
owners & contractors protective, cross liability coverage, liability assumed in a contract (including the tort
liability of another assumed in a contract) and explosion, collapse & underground coverage.
a. ffsuch insurance contains an aggregate limit, it shall apply separately to this location.
b. Products and Completed Operations coverage shall include a provision that coverage will extend for a
period of at least twelve (12) months from the date of final completion and acceptance by the owner of
all of contractors work.
2. Where the Pr~ject described in Appendix D inc~udes the c~nstructi~n ~f any structuse ~r bui~ding~ a Bui~der~ s
Risk Policy until the Project is completed and accepted in the amount of the total project cost.
Workers Compensation, Employers Liability, and Disability Benefits as required by New York State.
Workers Compensation Policy shall include the U.S. Longshore & Harbor Workers~ Compensation Act
endorsement.
Comprehensive Automobile Liability Insurance with a limit of not less than $1,000,000 each accident. Such
insurance shall cover liability arising out of any automobile including owned, leased, hired and non owned
automobiles.
Commercial Property Insurance covering at a minimum, the perils insured under the ISO Special Clauses of
Loss Form (CPl 0 30), or a substitute form providing equivalent coverages, for loss or damage to any owned,
borrowed, leased or rented capital equipment, tools, including tools of tbeir agents and employees, staging
towers and forms, and property oftbe Department held in their care, custody and/or control.
6. An Owner's Protective Liability Policy with limits no less than $1,000,000 in the name of the Contractor.
I. Professional consultants retained by the Contractor in connection with the Project shall show evidence of
professional liability insurance with limits no less than $1 million.
VII.
Property
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Pursuant to the provisions set forth in Section V, Page 3 of this Agreement, the ownership of all property
described therein shall reside with the Contractor unless otherwise specified in writing by the Department at any
time during the term of this Agreement and up to thirty (30) days following the issuance of the final payment.
Contractor warrants that it has fee simple or such other estate or interest in the site of the Project, where the
Project is undertaken at a site, including easements and/or rights-of-way sufficient to assure undisturbed use and
possession for the purposes of construction and operation for the estimated life of the Project. Contractor further
acknowledges that where such project is undertaken on or involves the use of lands for active or passive
recreational use, it is a material term of this Agreement that such lands shall be available for ?uch recreational
use by the People of the State of New York. Additionally, Contractor shall not limit access or discriminate on
the operation of the facilities against any person on the basis of place of residence, race, creed, color, national
origin, sex, age, disability or marital status.
VIII. Date/Time Warranty
IX.
Contractor warrants that product(s) furnished pursuant to this contract shall, when used in accordance with the
product documentation, be able to accurately process date/time data (including, but not limited to, calculating,
comparing, and sequencing) transitions, including leap year calculations. Where a Contractor proposes or an
acquisition requires that specific products must perform as a package or system, this warranty shall apply to the
products as a system.
Where Contractor is providing ongoing services, including but not limited to: i) consulting, integration, code
or data conversion, ii) maintenance or support services, iii) data entry or processing, or iv) contract administration
services (e.g. billing, invoicing, claim processing), Contractor warrants that services shall be provided in an
accurate and timely manner without interruption, failure or error due to the inaccuracy of Contractor's business
operations in processing date/time data (including, but not limited to, calculating; comparing, and sequencing)
various date/time transitions, including leap year calculations. Contractor shall be responsible for damages
resulting from any delays, errors or untimely performance resulting there from, including but not timJted to the
failure or untimely performance of such services.
This Date/Time Warranty shall survive beyond termination or expiration of this Contract through: a) ninety (90)
days or b) the Contractor's or Product manufacturer/developer's stated date/time warranty term, whichever is
longer. Nothing in this warranty statement shall be construed to limit any rights or remedies otherwise available
under this Contract for breach of warranty.
Fees
The Contractor may charge a reasonable fee for the use of any facility which is part of the project.
Except for the imposition of a differential fee schedule for non-residents of the municipality in which the project
is located, the establishment of any preferential user fee for any person or entity is prohibited. Fees charged to
non-residents shall not exceed twice those charged to residents.
B. ~herethereisn~chargef~rresidentsbutafeeischargedton~n~residents~n~n-residentfeescann~texceedfees
charged for residents at comparable State or local public facilities.
C. Reservation, membership or annual permit systems available to residents must also be available to non-residents
and the period of availability must be the same for both residents and non-residents.
D. This provision does not apply to non-msidunts' fishing and hunting license fees.
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Alienation
Where the project is undertaken on or involves parklands or public waterfront land, the following additional
provisions apply:
The Contractor shall not at any time sell or convey any facility or any portion of the project acquired or
developed pursuant to this Agreement or convert such facility or any portion of the project to other than public
park or public waterfront purposes without the express authority of an act of the Legislature, which shall provide
for the substitution of other lands of equal fair market value and reasonably equivalent usefulness and location
to those to be discontinued, sold or disposed of, and such other requirements as shall be approved by State.
The Contractor agrees to own a property interest sufficient to maintain and operate the project in perpetuity.
The Contractor shall not authorize the operation of the project, or any portion thereof, by any other person, entity,
or organization pursuant to any management agreement, lease or other arrangement without first obtaining the
written approval of the State.
XL Subcontracting Requirements
A. The Contractor may subcontract for all or any portion of the activities covered by this Agreement as provided
for in Appendix D, subject to prior written approval by the Department of any subcontractor and the terms of any
subcontract. Subcontractors shall comply with all applicable requirements of the Agreement between the
Contractor and the State.
XIL Compliance with Procurement Requirements
All contracts by municipalities for service, labor, and construction involving not more than $35,000 and goods
and equipment involving not mom than $10,000 are subject to the requirements of General Municipal Law § 104-
b, which requires such contracts to comply with the procurement policies and procedures of the municipality
involved. All such contracts shall be awarded after and in accordance with such municipal procedures, subject
to any additional requirements imposed by the State as set forth in Appendix D hereof.
The municipal attorney, chief legal officer or financial administrator of the Contractor shall certify to the
Department of State that applicable public bidding procedures of General Municipal Law § 103 were followed
for all service, labor, and construction contracts involving more than $35,000 and all goods and equipment
contracts involving more than $10,000. In the case of contracts by municipalities for service, labor, and
construction involving not more than $35,000 and goods and equipment contracts involving not more than
$10,000, the municipal attorney, chief legal officer or financial administrator shall certify that the procedures of
the municipality established pursuant to General Municipal Law § 104-b were fully complied with.
All contracts by non-municipal entities such as a community-based organization, shall have its chief legal officer
or financial administrator certify to the State that alternative proposals and quotations for professional services
were secured by use of written requests for proposals through a publicly advertised process to ensure the prudent
and economical use of public funds for professional services of maximum quality at reasonable cost.
XIII. Requirements for Contract GIS Products (2/04)
GENERAL MAP PRODUCT P, EQUIREMENTS -- The following general cartographic requirements must be
adhered to by the Contractor:
1. Map Products -- The Department requires delivery of digital map products, unless otherwise specified in the
Request for Proposal (RFP), that meet the specifications outlined in this GENERAL MAP PRODUCT
REQUIREMENTS section and the ADDITIONAL DIGITAL CARTOGRAPHIC FILE REQUIREMENTS
section. If analog map products are required by the RFP, they must meet specifications outlined in this
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GENERAL MAP PRODUCT REQUIREMENTS section and the ADDITIONAL DIGITAL-READY MAP
PRODUCT REQUIREMENTS section.
Deliverable Format -- All digital map and attribute table files must be provided in Maplnfo Tab file format
on Recordable CD or DVD, 3.5" floppy diskette media, external hard drive, via e-mail attachment
(preferably in a WinZIP file) or downloadable from an tip site on the Interact. Altematively, the digital
products may be provided in Arclnfo/GIS export format (.e00) or ArcView shape file format on the same
media types upon approval of the Department. All other digital formats require prior approval of the
Department. Coordination with the Department prior to submission of digital media is required to ensure
compatibility of the delivered materials.
Documentation -- A data dictionary must be included along with the map files describing file contents and
file names, as well as metadata for each file including map projection, horizontal and vertical datums used,
coordinate system, RMS accuracy and log sheet, information sources and dates, the map maker and date of
preparation, and creation methodology. Data provided under federal funds must be provided in a manner
which meets Digital Geospatial Federal Geographic Data Committee Metadata Standard as executed by
Executive Order 12906, April 11, 1994, "Coordinating Geographic Data Acquisition and Access: the
National Spatial Data Infrastructure".
4. Map Accuracy -- Unless otherwise stated in the RFP, all deliverable map products must conform m National
Map Accuracy Standards for horizontal and vertical accuracy as established by the United States Bureau of
the Budget, June 10, 1941, revised June 17, 1947. For example, for maps at 1:20,000 or smaller, not mom
than 10% of the well-defined map points tested must be more than 1/50 inch (0.508 mm) out of correct
position. At 1:24,000, this tolerance translates to a required horizontal accuracy of 40 feet. If by prior
agreement with the Department the map product does not conform to National Map Accuracy Standards, then
a statement of actual map accuracy should be included in the Documentation above. Furthermore,
hydrographic surveys and maps should conform to recommended accuracy standard proposed in the joim
USGS, NOS, Coastal Mapping Handbook, 1978, Melvin Ellis editor, U.S. Government Printing Office,
Appendix 6.
5. Datums -- Unless otherwise specified in the RFP, all map products should be referenced to the North
American Horizontal Datum of 1983 (NAD83) and the National Geodetic Vertical Datum of 1988
(NGVD88).
B. ADDITIONAL DIGITAL CARTOGRAPHIC FILE REQUIREMENTS -- The following cartographic
construction requirements must be adhered to by the Contractor:
1. Edge-matching -- All map sheets must be both visually and coordinate edge-matched with adjacent map
sheets. No edge-match tolerance will be allowed. Attributes for splitable features must also be identical.
2. Common Boundaries -- All features that share a common boundary, regardless of rnap layer, must have
exactly the same coordinate position of that feature in all common layers.
3. Point Duplication -- No duplication of points that occur within a data string is permitted.
4. Connectivity -- Where graphic elements visually meet, they must also digitally meet. All confluences of line
and polygon data must be exact; "overshoots", "undershoots", "slivers", or "offshoots" are NOT permitted.
Line Quality -- A high quality cartographic appearance must be achieved. Transitions from straight lines to
curvilinear elements must be smooth, with angular inflections at the point of intersection. The digital
representation must not contain extraneous data at a non visible level. There should be no jags, hooks, or
zero length segments. Any lines that are straight, or should be straight, should be digitized using only two
points that represent the beginning and ending points of the line.
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Polygon Closure -- For area features being digitized, the last coordinate pair must be exactly
(mathematically) equal to the first coordinate pair. No line or polygon must cross itself except to join at an
actual confluence. All digitized features across map boundaries must be edited to effect smooth and
continuous lines.
7. Graphic Precision -- Positional coordinates for all digital graphic elements should not be reported to a level
of precision greater than one thousandth (.001 ) of a foot,
8. Digitizer Accuracy -- The required RMS error for digitizer accuracy must be 0.003 or better for digital map
registration.
ADDITIONAL DIGITAL-READY MAP PRODUCT REQUIREMENTS ~ The following requirements for
large scale, non-digital map products must be followed to facilitate the future conversion of the maps to digital
map products. All large format, non~digital map products must be provided on stable base material at a scale
stipulated in the RFP. The map products must include an index map to all map sheets and thorough descriptions
of all the cartographic elements portrayed on the maps.
1. Base Map Media -- All maps must be created on mylar or other stable base material.
2. Map Scale -- All maps of a similar series should be created using the same base scale. Unless otherwise
stated by the Department, all maps should be compiled at 1:24,000. If other map scales are approved by the
Department, where possible they will conform to standard map scales such as 1:9600; 1:50,000; 1:75,000;
or 1: 100,000.
3. Map Registration -- The maps must provide a minimum of four (4) comer and four (4) interior ticks tied to
USGS/NYSDOT quadrangle Lat/Lung or NYTM coordinates. The maps must be geometrically correct and
should register when overlaid on the appropriate USGS/NYSDOT quadrangle control ticks.
Map Title and Legend -- The maps must provide a title and legend block describing the information
contained on the maps, and including the Documentation and Datums information requested in the
GENERAL MAP PRODUCT REQUIREMENTS above and the map scale.
Cartographic Quality -- The quality of all map line work and symbolization must conform to items 1 - 6 in
the map criteria set forth in the ADDITIONAL DIGITAL CARTOGRAPHIC FILE REQUIREMENTS
section outlined above.
D. CONTRACT DATABASE STANDA~S
Delivery Media -- All database and tabular files must be provided on digital media as specified above in
Deliverable Format.
2. Software Format - Database and tabular files can be provided in Coral Quattro, Microsoft Excel or Microsoft
Access format. Other formats that are convertible to one of the aforementioned formats may be used with
prior approval of the Department.
3. Geographic Attributes -- Database and tabular files that contain elements with a geographic reference must
provide a corresponding data field and a geographic coordinate pair for each feature location.
XIV. Payment and Records Retention
A. Payments shall be made as set forth in Appendix C.
B. The Contractor shall maintain, at its principal place of business, detailed books and accounting records supported
by original documentation relating to the incurring of all expenditures, as well as payments made pursuant to this
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Agreement. The Contractor shall make such records available for review by the Department upon request at any
time. The Department shall have the right to conduct progress assessments and review books and records as
necessary. The Department shall have the right to conduct an on-site review of the Project and/or books and
records of the Contractor prior to, and for a reasonable time following, issuance of the final payment. The
Department shall be entitled to disallow any cost or expense, and/or terminate or suspend this Agreement, if the
Contractor has misrepresented any expenditures or Project activities in its application to the Department, or in
this Agreement, or in any progress reports or payment requests made pursuant hereto. The Contractor shall
maintain such books and accounting records in a manner so that reports can be produced therefrom in accordance
with generally accepted accounting principles. The Contractor shall maintain separate fiscal books and records
for all funds received through the Department pursuant to this Agreement.
During the term of this Agreement and for a period of six years a~er its termination, the Contractor shall make
all such books and records available to the Department and the Office of the State Comptroller, or their
designated representatives, for inspection and audit.
XV. Equal Employment Opportunity
The Contractor hereby assures that it is, and shall be for the duration of this Agreement, in compliance with the
Federal Equal Employment Opportunity Act of 1972 (Public Law 92-261), as amended.
XVI. Article 15-A of The New York State Executive Law
The Department of State administers a Minority and Women-owned Business Enterprises (MWBE) Program as
mandated by Article 15-A of the New York State Executive Law. This law supersedes any other provision in state
law authorizing or requiring an equal employment opportunity program or a program for securing participation by
minority and women-owned business enterprises. Under this law, all state agencies must, subject to certain
exceptions, establish goals for minority and women-owned business participation in certain state contracts and grants.
Where MWBE goals are required, even in circumstances where this goal is zero, a Quarterly Contractor Report is
required to be submitted to the Minority and Women-owned Business Program of the Department on forms provided
by the Department, as set forth in Appendix Al, Attachment 2.
Article 15-A requires that roles and regulations be established for contracts entered into by the Department. In
accordance with Article 15-A, goals must be set for contracts entered into by the Department in excess of $25,000
for labor, services, supplies, equipment, and materials, or any combination of the foregoing, and for contracts entered
into by the Department in excess of $100,000 for acquisition, construction, demolition, replacement, major repair,
renovation or improvement of real property. In applying these roles and regulations, the Department must consider
the availability of certified minority and women-owned businesses in the region in which the state contract will be
performed, the total dollar value of the contract, the scope of work to be performed, and the project size and term.
The contractor will, when required as a part of the bid or proposal, submit a Staffing Plan on the form provided by
the Department. This Plan will detail the work force anticipated in the performance of the state contract, reported
by ethnic background, gender, and Federal Occupational Categories.
After a bid opening and prior to the award of a state contract, the contractor will submit an Equal Employment
Opportunity (EEO) Policy Statement to the Department within the time frame established by the Department. The
law requires that, as a precondition to entering into a valid and binding state contract, the contractor will agree to the
following stipulations and will include them in the EEO Policy Statement:
The contractor will not discriminate against any employee or applicant for employment because of race,
creed, color, national origin, sex, age, disability or marital status.
The contractor will undertake or continue existing programs of affirmative action to ensure that minority
group members and women are afforded equal employment opportunities without discrimination because
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of race, creed, color, national origin, sex, age, disability or marital status. For these purposes, affirmative
action applies in areas of recruitment, employment, job assignment, promotion, upgrading, demotion,
transfer, layoff, or termination and rates of pay or other forms of compensation.
The contractor will make active and conscientious efforts to employ and to utilize minority group members
and women at all levels and in all segments of its work fome on state contracts, and the contractor will
document these efforts.
The contractor will state in all solicitations and advertisements for emPloyees that, in the performance of the
state contract, all qualified applicants will be afforded equal employment opportunities without
discrimination because of race, creed, color, national origin, sex, age, disability or marital status.
The contractor will, at the request of the Department, request each employment agency, labor union, or
authorized representative of workers with which it has a collective bargaining or other agreement or
understanding, to furnish a written statement that such employment agency, labor union, or representative
will not discriminate because of race, creed, color, national origin, sex, age, disability or marital status, and
that such union or representative will affirmatively cooperate in the implementation of the contractor's
obligations herein.
The contractor will include the provisions regarding the EEO Policy Statement and the Staffing Plan
enumerated above in each and every subcontract ora state contract in such a manner that the subcontractor
is bound by these requirements.
Failure to provide an EEO Policy Statement and a Staffing Plan without reasonable written justification or
commitment to provide these requirements by a specified date will result in rejection of the contractor's bid
or proposal.
After the award of a state contract, the contractor will submit to the Department a Workforce Employment
Utilization Rel~ort, on the form supplied by the Department, detailing the work force actually utilized on the
state contract, by ethnic background, gender and Federal Occupational Categories, as specified on the form.
This Report will be submitted to the Department on a quarterly basis throughout the life of the contract.
The contractor, and any of its subcontractors, may be required to submit compliance reports relating to their
operations and implementation of their affirmative action or equal employmem opportunity program in effect
as of the date the state contract is executed.
Questions regarding this program should be directed to the Department's Minority and Women-owned Business
Program by calling (518) 474-5741. Potential contractom can access the NYS Directory of Certified Minority and
Women-owned Business Enterprises on-line through the Empire State Development website at:
http://www, empire.state.ny.us and click on NY q7 BIZ. From the list on the top lefi of the page, click on Small and
Growing Business and, from that drop~down menu, click on: Minority and Women-Owned Business. On the top of
the page click on the heading "MWBE Directory."
The Department makes no representation with respect to the availability or capability of any business listed in the
Directory.
XVII. Notice of Public Proceedings
The Contractor agrees to provide the Department with prompt and timely written notice at least two weeks in advance
of all public proceedings, including, but not limited to; public meetings or hearings, relating to the Project.
XVIII. Submission of all correspondence and documentation
Al-11
A. Unless otherwise shated in Appendix D, the Contractor agrees to provide the Department with the required
products in the following formats. All products and shall include the NYS Comptroller's # as indicated on the
Face Page of this Agreement and where applicable, reflect the Task # it relates to in the Appendix D.
1. Draft products: two paper copies of each product must be submitted.
2. Final products: two paper copies of each product must be submitted. In addition all final products
(including reports, designs, maps, drawings, and plans) must be submitted as an electronic copy (in Adobe®
Aerobat® Portable Document Format - PDF), created using 300 dpi scanning resolution, and be submitted
on a labeled CD-R type CD. The CD must be labeled with the contractor name, contract #, and project title.
3. Pictures and photographs must be dated and captioned with the location and a briefdescription ofthe activity
being documented.
B. Contractor agrees to provide the Department with original and one copy of payment request documentation as
described in Appendix C.
XIX. Environmental Review
A. Contractor agrees to provide the Department, in a timely manner, with all documentation, including but not
limited to, permit applications, environmental assessments, designs, plans, studies, environmental impact
statements, findings, and determinations, relating to the Project.
B. Contractor acknowledges that compliance with the State Environmental Quality Review Act is a material term
and condition of this Agreement. In no event shall any payments be made ander this Agreement until Contractor
has provided Department with appropriate documentation that contractor has met any requirements imposed on
Contractor by the State Environmental Quality Review Act.
XX. Default and Termination
A. The Department may terminate the Agreement in accordance with the terms and conditions in Section 11I of the
Agreement.
In addition to whatever other reserved rights it has to terminate the Agreement, the Department may terminate
the Agreement when it is in the best interests of the State or (l) for cause, (2) for convenience, or (3) due to
unavailability of funds.
If the Department determines the Contractor has breached a term of the Agreement and if the Department
determines the defect can be remedied, it may issue a written notice providing the Contractor with a minimum
of 30 days to correct the defect and the notice may include a prospective termination date, If the Contractor fails
to correct the defect or fails to makea good faith effort to do so as determined by the Department to the
Department's satisfaction, the Department may terminate the Agreement for cause.
Thc Department shall also have the right to postpone or suspend the Agreement or deem it abandoned without
this action being a breach of the Agreement. The Department shall provide written notice to the Contractor
indicating the Agreement has been postponed, suspended or abandoned. During any postponement, suspension
or abandonment the Contractor agrees not to do any work under the Agreement without prior written approval
of the Department.
In the event the Agreement is postponed, suspended, abandoned or terminated, the Department shall make a
settlement with the Contractor upon an equitable basis in good faith and under the general compensation
principles and rates established in the Agreement by the Department. This settlement shall fix the value of the
work which was performed by the Contractor to the Department's satisfaction prior to the postponement,
suspension, abandonment or termination of the Agreement.
F. Any funds paid to the Contractor by the Department which are not expended under the terms of the Agreement
shall be repaid to the Department.
XXI. Fully-Executed Agreement or Amendment Thereto
Al- 12
If this Agreement, or amendments thereto, allocates funds totaling $50,000 or less, it shall be deemed to be fully
executed when approved and signed by the Contractor and the Department.
B. If this Agreemem, or amendments thereto, allocates funds totaling more than $50,000, it shall be deemed to be
fully executed when approved by the Office of the State Comptroller.
A1 - Attachment I
FINAL PROJECT SUMMARY REPORT
Final payment of the grant is dependent upon the satisfactory completion and acceptance by the Department of State, Office of Coastal,
Local Government and Community Sustainabilitv of thls FINAL PROJECT SUMMARY REPORT along with the requisite documentation. In
addition to the other requirements of the contract, the grant recipient is responsible to relay the importance, the significance and the
value of the completed project to the community, the region and the state through the completion of the report.
The following outline should be used to complete the FINAL PROJECT SUMMARY REPORI:
1. Project Title:
2. Name of Municipality:
Actual Project Costs:
a. State funds expended (identify source, eg. EPF, Clean Water/Clean Air
Bond Act, etc.):
b. Local funds expended:
c. Other funds expended;
Project Manager: Name:
Title:
Mailing address:
TeL number:
Fax number:
E-mail address:
5, Federal Tax Identification Number:
6. Project Background (briefly explain in a short paragraph why this project was necessary, what its value is and/or its importance to the
community):
7, Project Work (briefly describe the work that was done to complete the project):
Project Descriptions (use the following guidelines to describe the project and please be concise in the description):
a. For a Planning Project describe the findings or recommended strategies.
b. For a Design Project describe what is to be built.
c. For a Construction Project describe what was built.
9. Project Measurable Results: To be completed on forms attached.
1 O. Project Documentation: The Department of State, OJflce of Coastal, Local Government and Community' Sustainability requires a visual
documentation of the Environmental Protection Fund projects. Project products should be visually documented using a 35mm camera
or a digital camera. The 35mm color slides and/or digital camera disc should be labeled and dated when submitted along with the
completed FINAL PROJECT SUMMARY REPORT.
Visuals should illustrate the final project product and, as appropriate, activities undertaken to complete the project. For example, some
projects would call for visuals that include photographs of volunteers participating in a wetland restoration project (planting Spartina);
photographs of historical signs markers, kiosks, etc. being placed; or photographs of an artist's rendering ora waterfront design.
Design, planning, and construction projects call for different visual documentation. Therefore, the following guidelines are suggested:
· For design projects, visuals of renderings and/or graphics that depict the final product.
[] For planning projects, visuals of any graphics, where appropriate, that illustrate the final product.
· For construction projects, visuals of work in progress and the finished project.
In addition to the 35mm color slides/digital camera disc, a video (vhs format) of the project wi~h a verbal description is desirable but not
mandatory. The video may be used in a future documentary.
NYS Department of State · Minority and Women-owned Business Enterprises Program
99 Washington Avenue Albany NY 12231-0001 · (518) 474-574l
A1 - Attachment 2
Minority and Women-owned Business Enterprises (MWBE) Program
Quarterly Contractor Report
~NSTRUCTIONS:
I. Please prepare reports based on calendar quarters, or prepare one annual report,
2. Use a separate Report sheet for each contract or program area
3. Record the amount paid for each service/product for the time period identified below.
4. Send completed reports to the Minority and Women-owned Business Enterprises Program at the above address.
REPORT PERIOD
Report should cover a calendar quarter OR the program year. FROM: TO:
Enter the inclusive dates of the quarter or for the program year. ~ ~ ~
CONTRACTOR NAME PROGRAM DOS CONTRACT NUMBER
CONTRACTOR ADDRESS Service Area of Contract Work
( )
NAME and TITLE qf CONTACT PERSON (Please Print) TELEPHONE NUMBER
TYPE of DESCRIPTION of AMOUNT PAID
VENDOR NAME and ADDRESS VENDOR SERVICE/PRODUCT THIS PERIOD COMMENTS
13 MBE $
D WBE
rn MBE
[3 WBE
rn MBE
[] WBE
[] MBE
[] WBE
D MBE
t3 WBE
[] MBE
[] WBE
[] MBE
D WBE
~3 MBE
[] WBE
[] MBE
[] WBE
PAGE I of
Project Status Form
RECIPIENT
PROJECT TITLE
CONTRACT #
A 1 - Attachment 3
Status Report Date:
Task Brief Task Date of Percent of
# Description A/T Completion Completion
Task Accomplishments
Product
Submitted
to DOS
ADJUSTMENTS - Please indicate proposed adjustment(s) to work program/schedule, reason(s) for the proposed
adjustment(s), and any other problems encountered during this reporting period:
Person to contact if we have questions about the information provided on this form:
Name: Email Address:
Title: Affiliation:
Phone: Fax:
Attachment 4
Certification to New York State Department of State that all State and Local and Private Procurement
Requirements Have Been Met
(Check the paragraph that applies)
I hereby certify that I am the municipal attorney, chief legal officer or financial administrator for the
and that the contracffprocurement with
....... appended hereto pursuant in whole or in part to NYS
Department of State Contract No. , was awarded in accordance all requirements of law and the following provisions:
1. For Municipal Entities (except NYC or with Borough):
_____ Applicable public bidding procedures of General Municipal Law § 103 relating to the procurement for service, labor,
and/or construction involving more than $35,000 or goods and equipment involving more than $20,000.
Procedures established by this municipality pursuant to the General Municipal Law § 104-b relating to the
procurement for service, labor, and/or construction involving not more than $35,000 or goods and equipment
involving not more than $20,000.
_____ Procedures established pursuant to General Municipal Law Section 104-b relating to the procurement for
professional services.
2. For New York City or Borough:
_____ Applicable public bidding procedures of General Municipal Law §103 and regulations of the Procurement Policy
Board relating to the procurement for service, labor, and/or construction involving more than $35,000 or goods and
equipment involving more than $20,000.
.... Procedures established by the municipality pursuant to the General Municipal Law § 104-b and regulations of the
Procurement Policy Board relating to the procurement for service, labor, and/or construction involving not more than
$35,000 or goods and equipment involving not more than $20,000.
.... Procedures established pursuant to General Municipal Law Section 104-b relating to the procurement for
professional services.
3. Not-for-Profit Organization or other entities not listed above are first subject to all requirements of law, including the NYS
Not-for-Profit Corporation Law, the organization's bylaws, and:
.... a formal competitive process to secure professional services involving not more than $35,000 was used to solicit
price quotes from no less than three qualified vendors to ensure the prudent and economical use of public funds to
obtain maximum quality at reasonable cost; or
.... a formal competitive process to secure professional services involving more than $35,000 was used to solicit price
proposals and quotations, through use of written request(s) for proposals through a publicly advertised process, to
ensure the prudent and economical use ofpubli~ funds to obtain maximum quality at reasonable cost; or
.... a method of procurement that was t~reviously reviewed and approved by the Department of State, which furthers the
purpose of this contract.
By:
Title:
Date:
Attached - Executed Contract between Contractor and Subcontractor
APPENDIX B
BUDGET SUMMARY
A. Salaries & Wages (including Fringe Benefits)
B. Travel
C. Supplies/Materials
D. Equipment
E. Contractual Services
F. Other
$221,536.03
$500.00
$239,776.88
$0.00
$5,000.00
$215,187.09
TOTAL PROJECT COST
$682,000.00
Total State Funds $341,000.00
Total Local Share $341,000.00
B-2
Appendix B (Budget Detail Sheet)
A. SALARIES & WAGES
TITLE ANNUAL AMOUNT
SALARY CHARGED TO THIS
PROJECT
LWRP Coordinator~lanner $89,180.00 $26,987.24
GIS Manager $98,098.00 $26,987.24'
Engineer $82,118.00 $50,000.00
Environmental Technician $ 83,5~45.00 $15,000.00
Plannin~ Director $123,050.00 $10,000.00
Community Development Director $124,912.00 $12,000.00
Crew Leader (l) $33.64/hr $18,225.80
Heavy Equipment Operator (3) $30.02/hr $37,369.08
Auto Equipment Operator (2) $24.32/hr $22,966.67
Secretary Assistant $64,795.00 $2,000.00
SUBTOTAL $221,536.03 -
B. TRAVEL
Travel to NYS Community Seminar Series training sessions
SUBTOTAL
l
$500.00
C. SUPPLIES/MATERIALS
Supplies and materials needed for construction and installation of BMP's:
Surface materials, such as filter cloth, asphalt, rip rap, concrete, cements, sand,
cap block, brick, gravel, stone blend, topsoil, geotextiles .......................... $167,616.87
Stormwater infrastructure materials, such as catch basin, drainage ring, concrete
traffic bearing slab, cast iron inlet grate & frame, drainage pipe ...................... $72,160.01
SUBTOTAL $239,776.88
D, EQUIPMENT
Appendix B (Budget Detail Sheet Continued)
SUBTOTAL
B-3
I
$0.00
E. CONTRACTUAL SERVICES
Professional surveying services
SUBTOTAL
I
$5,000.00
F, OTHER
Registration for NYS Community Seminar Series training sessions
(Registration fee $125 per person per session) ...................................... $500.00
Disposal fees for waste materials such as brush, limbs, and stumps, asphalt, construction
and demolition material associated with site preparation and best management practices
construction ............................................................... $7,250.01
Use of Town equipment for the construction of best management practices to capture
and treat stormwater runoff. ................................................. $207,437.08
Note: Equipment usage rates should be reasonable and valued at the established rates of the
grantee, NYS DOT or FEMA.
SUBTOTAL $215,187.09
L
APPENDIX C
PAYMENT AND REPORTING SCHEDULE
Payment Schedule
The Department shall make interim payments for eligible costs incurred up to an amount not to exceed 90% of
the State Share Funding Amount. The final payment will be made upon satisfactory completion of the Project.
Not more frequently than once every 30 days, a properly executed payment request, on forms as prescribed by the
Department documenting total project costs incurred to date, may be submitted.
Payment provided above shall be made to the Contractor upon the submission by the Contractor of
properly executed payment request. Such request shall contain the following: (1) "Summary Sheet
Documentation Forms" as provided by the Department, for reimbursement of actual and eligible
expenditures, (2) the required work products, and (3) a properly executed State Voucher.
Payment requests will be reviewed in accordance with the terms and conditions of this Agreement to
determine total allowable project costs incurred and the number and percentage of allowable project
tasks completed to date. For the purpose of determining the level of reimbursement, otherwise allowable
project costs may be reduced if the percentage of task completion is deemed insufficient.
Total allowable project costs, adjusted pursuant to 2. above, will be prorated between State Share and
Local Share costs in the same proportions as Total State Share is to Total Local Share as set forth on the
Face Page.
Interim payments will be issued in amounts equal to the State Funds calculated in 3. above.
The final payment will be issued upon receipt and approval 0fa payment request marked "FINAL"
documenting all project costs incurred and tasks completed and submission of the Final Project Summary
Report. Such final payment request shall be submitted within 60 days following the ending date of this
Agreement.
Reporting
Payment requests as described in I.B. above shall be certified by a duly authorized representative of the
Contractor as accurately representing such accomplishments and expenses as recorded in the Contractor's
accounting records, including, where goods or services are provided by third parties not party to this Agreement,
a certification that any payment obligations arising from the provision of such goods or services have been paid
by the Contractor and do not duplicate reimbursement or costs and services received from other sources.
Notwithstanding the above requirements, upon written notification by the Department, the Contractor may be
required to submit source documentation and additional verification of allowable expenditures.
Payment requests shall be submitted to:
New York State Department of State
Office of Coastal, Local Government & Community Sustainability
One Commerce Plaza - Suite 1010
Albany, New York, 12231~0001
Claimed expenditures must be in accordance with the project budget in Appendix B. Any changes to the cost
categories contained in the Budget, Appendix B, in excess of 10% will require prior approval of the
Department. If the total Contract amount is in excess of $50,000, approval will also be required by the Office of
the State Comptroller. No expenditures shall be allowed for items not set forth in the project budget.
III.
A.
C-2
Other
Notwithstanding the submission of timely and properly executed payment requests, the Department shall be
under no obligation to make payment for expenditures incurred without the prior Department approvals and/or
amendments required under this Agreement and, further, shall have the right to withhold any such payment
pending the execution of such approval and/or amendment.
Interest income earned on funds received pursuant to this Agreement shall be used to further the purpose of this
Project or shall be deducted from total eligible cost to determine the net eligible costs to be reimbursed by the
Department.
The Department shall have the right to conduct on-site progress assessments and reviews of the Project and
Contractor's books and records during the life of this Agreement and for a reasonable time following issuance of
the final payment. The Contractor shall furnish proper facilities, where necessary or useful, for such access and
inspection.
The Department shall be entitled to disallow any cost or expense, or terminate or suspend this Agreement, if
found that the Contractor has misrepresented any expenditures or project activities in this Agmemant, or in any
progress reports or payment requests made pursuant hereto.
The Contractor shall maintain separate fiscal books and records for all funds received through the Department
and project activities conducted pursuant to this Agreement, and shall make all such books and records available
to the Department, the Office of the State Comptroller, or their designated representatives for inspection and
audit for a period of six years following termination of this Agreement.
APPENDIX D
PROGRAM WORK PLAN
Contractor:
Contract Number:
Program Contact Person:
Phone:
Fax:
Town of Southold
C006880
Mark Terry
613-765-1938
613-765-6145
Hashamomuck Pond Watershed Management Plan Implementation
1. Project Description:
The NYS Department of Environmental Conservation ~YS DEC) Priority Waterbody List identifies
stormwater runoff as the primary source of pathogens entering Hashamomuck Pund. Stormwater
remediation is necessary to address water quality impairments, closed shellfishing waters, and threats to
Hashamomuck Pond, a designated NYS significant Coastal Fish and Wildlife Habitat located in the
Town of Southold, Suffolk County, Long Island.
The Town of Southold (Contractor) will implement specific stormwater remediation projects identified
as priorities in the "Hashamomuck Pond Watershed Management Plan" to reduce impacts for the
purposes of improving water quality, re-opening the shell fishery, and improving recreation opportunities.
Best management practices will be constructed: at Laurel Avenue, a grass channel, bioretention system,
dry swale, oil/grit separator; at Long Creek Drive, a grass channel, bioretention system and; at Bayview
Avenue, a grass channel, sediment forebay, pond restoration, and Iow-flow orfice outlet; at Bayview
Avenue, adjacent to the boat ramp at the east shoreline of the pond, stormwater capture and filtration to
prevent polluted stormwater from entering the pond.
These best management practices will be designed and constructed to treat 90% of average annual
stormwater runoff volume,"and treat constituent pollutants such as fecal coliform, total nitrogen, total
phosphorus, total suspended solids, metals and hydrocarbons.
2. Project Attribution and Number of Copies
The Contractor must ensure that all materials printed, constructed, and/or produced acknowledge the
contributions of the Department to the project. The materials must include the following
acknowledgment:
"This (document, report, map, etc.) was prepared for the New York State Department of State
with funds provided under Title 11 of the Environmental Protection Fund."
D-2
The Contractor must submit to the Department all required products, clearly labeled with the NYS
Comptroller's Contract # as indicated on the Face Page of this Agreement and where applicable, the
related Task it from this Work Plan. The Contractor shall submit:
Draft products: two paper copies of each product.
Final products: two paper copies of each product. In addition, all final products (including
reports, designs, maps, drawings, and plans) must be submitted as an electronic copy (in
Adobe® Acrobat® Portable Document Format - PDF), created using 300 dpi scanning
resolution, and be submitted on a labeled CD-R type CD. The CD must be labeled with the
contractor name, contract #, and project title.
Pictures and photographs must be dated and captioned with the location and a brief description of
the activity being documented.
The contributions of the Department must also be acknowledged in community press releases issued for
the project. Project press releases shall be submitted to the Department for review and approval prior tO
release to ensure appropriate attribution.
3. Compliance with Procurement Requirements
The municipal attorney, chief legal officer or financial administrator of the municipality shall certify in
writing to the Department that applicable provisions of General Municipal Law were fully complied with
(Appendix AI-XXI).
4. Training
A required component of the Title 11 Environmental Protection Fund program is Contractor participation
in a training session or sessions focused on developing and implementing revitalization strategies
(Appendix Al -I). The purpose of these training sessions is to build knowledge and provide support to
community leaders to advance revitalization efforts and advance grant priorities. The specific training
session(s) to be attended will be determined during the initial project scoping meeting.
5. Project Components
Task 1:
Initial Project Scoping Meeting
The Contractor, the Depanmen~, project panners and any other appropriate entities shall hold an
initial meeting to review the project scope, project requirements, roles and responsibilities of
project partners, the selection process for procuring consultants, State Environmental Quality
Review Act (SEQRA) compliance requirements, the number of public meetings and techniques
for public involvement proposed for the project, attendance at NYS Community Seminar Series
training sessions, and any other information which would assist in project completion. In
addition, the composition of a project advisory committee shall be discussed during initial
project scoping meeting. The Contractor, ora designated project partner, shall prepare and
distribute to all project partners a brief meeting summary clearly indicating the
agreements/understandings reached at the meeting.
D-3
Work on subsequent tasks shall not proceed prior to Department approval of the proposed
approach as outlined in the meeting summary.
Products:
Scoping meeting with appropriate parties. Written meeting summary outlining
agreements/understandings reached.
Task 2:
Community Training
The Contractor will participate in the Community Training Program as stated in Section 4 above.
Product:
Copy of transmittal letter submitting payment for registration fees. Participation
in training session(s).
Task 3:
Project Advisory Committee
The Contractor shall establish a project advisory committee to oversee all aspects of the project
in cooperation with manicipal officials and the project consultant(s), if applicable. The
committee shall be representative of project stakeholders, including representatives of State and
municipal agencies with jurisdiction over project activities or the project area, and non-
governmental and community based organizations. A draft list of proposed members shall be
circulated to the Department for review and approval prior to establishment of the committee.
Products:
Draft and final list of proposed members of projeet advisory committee. Project
advisory committee established.
Task 4:
Request for Proposals
The Contractor shall draft a Request for Pmposals (RFP) including a complete project
description with site conditions, expected final results, a schedule for completion, and criteria for
selecting a preferred proposal. The Contractor shall submit the RFP to the Department for
review and approval prior to release for solicitation of proposals.
Products:
Approved RFP released through advisement in local papers, the New York State
Contract Reporter, and other appropriate means.
Task 5:
Consultant Selection and Compliance with Procurement Requirements
In consultation with the Department, the Contractor and an appropriate review committee shall
review all proposals received as a result of the RFP. At a minimum, the following criteria are
suggested for use in evaluating consultant responses:
Quality and completeness of the response.
Understanding of the proposed scope of work.
Applicability of proposed alternatives or enhancements to information requested.
Cost-effectiveness of the proposal.
Qualifications and relevant experience with respect to the tasks to be perfornled.
Reputation among previous clients.
Ability to complete all project tasks within the allotted time and budget.
D--4
Incomplete proposals that do not address all of the requested components should not be accepted
for review and consideration.
For preparation/certification of final designs and construction documents, and for supervision of
construction, a licensed professional engineer or licensed architect/landscape architect is
required.
The municipal attorney, chief legal officer or financial administrator of the municipality shall
certify in writing to the Department that applicable provisions of General Municipal Law were
fully complied with.
The Contractor's procurement record and consultant selection is subject to approval by the
Department.
Products:
Consultant(s) selected and approved by the Department. Written certification of
procurement procedures.
Task 6:
Subcontract Preparation and Execution
The Contractor shall prepare a draft subcontract or subcontracts to conduct project work with the
consultant(s) selected. The subcontract(s) shall contain a detailed work plan with adequate
opportunity for review at appropriate stages of project completion, a payment schedule
(payments should be tied to receipt of products), and a project cost. The subcontract(s) shall
specify the composition of the entire consultant team, including firm name and area of
responsibility/expertise, and those professionals from the consultant team or consulting firm that
will be directly involved in specific project tasks. The Contractor shall submit the draft
subcontract(s) to the Department for review and approval, and shall incorporate the Department's
comments in the final subcontract(s). A copy of the final, executed subcontract(s) shall be
submitted to the Department.
Products: Draft and final, executed consultant subcontracts.
Task 7:
Second Project Scoping Meeting
In consultation with the Department, the Contractor shall hold a second project scoping meeting
with the consultant(s), and other project partners as appropriate, to review project requirements,
site conditions, and roles and responsibilities; identify new information needs and next steps; and
transfer any information to the consultant(s) which would assist in completion of the project.
The consultant(s) shall prepare and distribute a brief meeting summary clearly indicating the
agreements/understandings reached at the meeting. Work on subsequent tasks shall not proceed
prior to Department approval of the proposed approach as outlined in the meeting summary.
Products:
Scoping meeting with appropriate parties. Written meeting summary outlining
agreements/understandings reached.
Task 8:
D-5
Site Reconnaissance and Schematic Designs for BMPs at site H5, Laurel Avenue; H7,
Long Creek Drive; Hg, Bayview Avenue; H14, and HI8 Bayview Avenue boat ramp
BMPs.
Site Reconnaissance
The Contractor or its consultant(s) shall conduct site-specific reconnaissance, in
preparation for design. Work shall include, at a minimum, identification and mapping of
the following:
Site survey showing extent of project boundary
Ownership/grant/lease status of all lands to be incorporated into the design
Manmade structures, buildings, or facilities on or adjacent to the site
Above and below ground infrastructure
Transportation/circulation systems (track, car, bus, ferry, train, pedestrian,
bicycle, etc.) that serve or are located near the site
Adjacent land and water uses
Historic and archeological resources
Soil and, as appropriate, core sampling to determine site stability
Topography and hydrology
Natural resources, including location of mature trees
View corridors
Zoning and other applicable designations
Analysis of site constraints, needs and opportunities
Products:
Map(s) and written summary describing the above information and any
other appropriate information identified during project scoping.
Schematic Designs
The Contractor or its consultant(s) shall prepare schematic designs of the facility or
facilities, considering and including a summary of the following:
Best management practices to be employed to avoid or reduce water quality
impairments from upland runoff or in-water activities, and
Impacts, if any, to State designated Significant Coastal Fish and Wildlife Habitat
areas, Scenic Areas of Statewide Significance, other Coastal Management
Program special management areas, or other sensitive resources, and how those
impacts should be avoided or mitigated.
Products: Schematic designs submitted to the Department for review and approval.
D-6
Task 9: Public Meeting
In consultation with the Department, a public information meeting shall be conducted to solicit
public input on the schematic designs. A written summary of public input obtained at this
meeting shall be prepared and provided to the Department for review and comment.
Products:
Public information meeting held. Minutes/Summary of meeting prepared and
submitted to the Department.
Task 10: Construction Requirement Analysis
The Contractor or its consultant(s) shall prepare an analysis of all federal, state and local
requirements for the design, including necessary permits and approvals, and a description of how
these requirements will be satisfied by the design. This analysis shall be submitted to
appropriate project partners and the Department for review. A pre-permitting meeting with the
Department and the identified federal, state and local entities may be required to discuss any
revisions needed to satisfy regulatory requirements. Work on final design shall not proceed prior
to Department approval of the construction requirement analysis and the pre-permitting meeting,
if necessary.
ProducU:
Written construction requirement analysis. Pre-per~tting meeting with
identified entities.
Task 11: Environmental Quality Review
The Contractor or its consultant(s) shall prepare all documents necessary to comply with the
State Environmental Quality Review Act (SEQRA) through determination of significance. Ifa
positive declaration is made, a Draft Environmental Impact Statement shall be prepared.
Products: SEQRA documents and, if necessary, a Draft Environmental Impact Statement.
Task 12: Draft Final Designs
The Contractor or its consultant(s) shall prepare draft final designs. The draft final designs shall
include all required maps, tables, data, written discussions, and other information identified in
the contract and subcontract work plans and during project scoping. The draft final design shall
be provided to the Department and the project advisory committee for review at least two weeks
prior to the due date for comments. Department comments must be addressed to the satisfaction
of the Department in subsequent revisions of the products and the final design.
Products: Draft final design and supporting materials.
Task 13: Final Design and Construction Documents
The Contractor or its consultant(s) shall prepare the final design and construction drawings,
plans, specifications, and cost estimates. The final design and construction documents shall be
provided to the Department and the project advisory committee for review at least two weeks
prior to the due date for comments.
D-7
Final design and construction documents are subject to approval by the Department. These
documents must be certified by a licensed professional engineer, architect, or landscape architect
and the appropriate seal must be affixed to these documents.
Products:
Final design and construction documents, certified by a licensed professional
engineer, amhitect or landscape architect.
Task 14: Permits
After the final design and construction documents have been approved by the Department, the
Contractor or its consultant(s) shall prepare the necessary permit or other approval applications
and obtain the required permits or approvals. A pre-application meeting with the Department
and the appropriate federal, state and local regulatory authorities may be required to discuss the
necessary permit or other approval applications. Prior to filing, the Contractor or its
consultant(s) shall submit all applications to the Department for review and comment.
Potential permitting and approval agencies include but are not limited to:
federal agencies such as the United States Army Corps of Engineers;
the Department, pursuant to the consistency provisions of the federal Coastal Zone
Management Act;
other New York State agencies such as the Department of Environmental Conservation;
the Office of General Services pursuant to the Public Lands Law, or similar authorization
from the Power Authority (in certain areas of the St. Lawrence Seaway) or Canal
Authority (in the State Canal System), in order to use or occupy certain State-owned
lands or watem overlying those lands; and the Office of Parks, Recreation, and Historic
Preservation or the State Historic Preservation Officer; and
agencies of a county, city, town, village, or special purpose district, including but not
limited to: town boards, boards of trustees, or city councils; planning commissions,
boards or departments; and/or building or health officials.
Prior to construction the Contractor or its consultant(s) shall also demonstrate that the project is
in compliance with 6 NYCRR Part 502, "Floodplain Management Criteria For State Projects" by
obtaining a floodplain development permit, if local regulations establish such requirements, or by
submitting a signed certification, by an official authorized to enforce local floodplain
management regulations, that the project complies with the requirements of the statute.
Copies of all required perm/ts and approvals shall be submitted to Department upon receipt.
Products:
All required permits and approvals received. Written certification of compliance
with floodplain management regulations, if applicable.
Task 16:
Construction of BMPs at sites H-5, Laurel Avenue (grass channel, bioretention system,
dry swale, oil/grit separator); H-7, Long Creek Drive (grass channel, bioretention
system); H9, Bayview Avenue (grass channel, sediment forebay, pond restoration, low-
flow orfice outlet); and H 18 Bayview Avenue boat rump BMPs.
D-8
After receipt of all necessary permits, the Contractor may begin construction work according to
the final design and construction documents. The Contractor shall notify the Department
monthly (or more frequently) in writing of work progress, including any delays which have
occurred. The Contractor or its consultant(s) shall submit periodic payment requests to the
Department tied to project milestones identified in contract and subcontract work plans or during
project scoping. After 70% of the work is completed, the progress notification will include a
punch list of any incomplete items and an estimated schedule for project completion.
Products:
Written work progress reports. Punch list and construction completion
estimates.
Task 17: Site Inspections
The Contractor, its consultant(s), and/or the Department shall verify pmgress and completion of
the work through periodic site inspections and photo documentation. The Contractor or its
consultant(s) shall submit to the Department written summaries of progress and identification of
problems to be addressed based on periodic site inspections.
Products:
Periodic site visits. Written summary of progress with photo-documentation and
identification of any problems that need to be addressed.
Task 18: Project Completion
Following satisfaction of punch list items, the Contractor or its consultant(s) shall submit a
statement that the work has been completed in accordance with the contract and subcontract(s),
the final design and construction specifications, and all permit requirements. The completion
statement must be prepared and/or certified by a licensed professional engineer, architect or
landscape architect. Unless otherwise specified during project scoping, the Contractor or its
consultant(s) shall submit three sets of as-built plans, certified by a licensed professional
engineer, architect or landscape architect. When the Contractor is satisfied work is complete, it
shall submit a final project report to the Department, including a copy of the completion
statement and a copy of the certified as-built plans and photo-documentation in the form of
digital images of the site prior to, during and upon completion of work. The Contractor shall not
pay its consultant(s) or subcontractor(s) in full, and shall not submit a final payment request to
the Department, until the Department concurs that the work is complete.
ProducB:
Statement of completion, certified as-built plans, and final project report
including photo-documentation.
Task 19: Semi-annual Reporting
The Contractor or its consultant(s) shall submit to the Department semi-annual reports (every six
months) on the form provided, including a description oftbe work accomplished, any problems
encountered, and any assistance needed.
Products: Semi-annnal reports during the life of the contract.
D-9
Task 20: Final Project Summary Report and Measurable Results forms
The Contractor or its consultant(s) shall work with the Department project manager to complete
the Final Project Summary Report and Measurable Results forms. Final payment shall not be
authorized until these forms have been completed and filed with project deliverables.
Products: Completed Final Project Summary Report and Measurable Results forms.
6. Project Management Responsibilities
The Contractor shall administer the grant, execute a contract with Department, and ensure the completion
of work in accordance with the approved Work Plan. Unless otherwise specified in the Project
Description or under Project Components, the Contractor and/or its approved consultant(s) or
subcontractor(s) shall conduct all work as described in the component tasks.
The Contractor:
will be responsible for conducting all project work in conformance with the Work Plan included
in the executed contract with the Department.
will be responsible for all project activities including drafting request for proposals and
managing subcontracts with consultants and subconsultants,
will certify to the Department that the procurement record for project consultants and
subcontractors complies with the applicable provisions of General Municipal Law.
will receive approval from the Department for any and all consultant subcontracts before
beginning project work.
will be responsible for submission of all products and payment requests.
will be responsible for coordinating participation and soliciting comments from local government
personnel, project volunteers, and the public.
will keep the Department informed of all important meetings for the duration of this contract.
will receive approval from the Department before purchase of any equipment.
will secure all necessary permits and perform all required environmental reviews.
will ensure that all materials printed, constructed, and/or produced mfiect the Division of Coastal
Resources logo, feature the Secretary of State and the Governor, and acknowledge the
contributions of the Department to the project.
will ensure that all products prepared as a part of this agreement shall include the NYS
Comptroller's Contract # as indicated on the Face Page of this Agreement.
will ensure the project objectives are being achieved.
will ensure that comments received from the Department and the project advisory committee, or
other advisory group, are satisfactorily responded to and reflected in subsequent work.
will recognize that payments made to consultants or subcontractors covering work carried out or
products produced prior to receiving approval from the Department will not be reimbursed unless
and until the Department finds the work or products to be acceptable.
will participate, if requested by the Department, in a training session or sessions focused on
developing and implementing revitalization strategies. The purpose of the training session(s) is
to build knowledge and provide support to community leaders to advance revitalization efforts
and complete priority projects,
D-10
The Department:
will review and approve or disapprove of subcontracts between the Contractor and consultant(s)
and any other subcontractor(s),
will participate in initial project scoping and attend meetings that are important to the project.
will review all draft and final products and provide comments as necessary to meet the
objectives.
must approve any and all design, site plan, and preconstruction documents before construction
may begin,
APPENDIX F
NOTICES
All notices permitted or required hereunder shall be in writing and shall be transmitted either:
(a)
(b)
(c)
(d)
(e)
via certified or registered United States mail, retum receipt requested;
by facsimile transmission;
by personal delivery;
by expedited delivery service; or
by e-mail,
Such notices shall be addressed as follows or to such different addresses as the parties may from time-to-time
designate:
State of New York Department of State
Name:
Title:
Address:
Telephone Number:
Facsimile Number:
E-Mail Address:
Laurissa Parent
Secretaxy 1
99 Washington Avenue, Suite 1010
Albany, NY 12231
518486-9540
518473-2464
laurissa.parent@dos .state .ny.us
Town of Southold
Name:
Title:
Address:
Telephone Number:
Facsimile Number:
E-Mail Address:
Scott A. Russell
Supervisor
53095 Main Road
PO Box 1179
Southold, NY 11971
631-765-1889
631-765-1823
scott.russell~town.southold.ny.us
Any such notice shall be deemed to have been given either at the time of personal delivery or, in the case of
expedited delivery service or certified or registered United States mail, as of the date of first attempted delivery at
the address and in the manner provided herein, or in the case of facsimile transmission or email, upon receipt.
The parties may, from time to time, specify any new or different address in the United States as their address for
purpose of receiving notice under this Agreement by giving fifteen (15) days written notice to the other party sent
in accordance herewith. The parties agree to mutually designate individuals as their respective representatives
for the purposes of receiving notices under this Agreement. Additional individuals may be designated in writing
by the parties for purposes of implementation and administration/billing, resolving issues and problems and/or
for dispute resolution.
APPENDIX G
ELECTRONIC PAYMENTS
Contractor shall provide complete and accurate billing invoices to the Agency in order to receive payment. Billing
invoices submitted to the Agency must contain all information and supporting documentation required by the Contract,
the Agency and the State Comptroller. Payment for invoices submitted by the Contractor shall only be rendered
electronically unless payment by paper check is expressly authorized by the Commissioner, in thc Commissioner's sole
discretion, due to extenuating circumstances. Such electronic payment shall be made in accordance with ordinary State
procedures and practices. The Contractor shall comply with the State Comptroller's procedures to authorize electronic
payments. Authorization forms are available at the State Comptroller's website at www.osc.state.ny,us/epay/index.htm,
by email at epunit~osc.state.ny.us, or by telephone at 518-474-4032. Contractor acknowledges that it will not receive
payment on any invoices submitted under this Contract if it does not comply with State Comptroller's electronic payment
procedures, except where the Commissioner has expressly authorized payment by paper check as set forth above.
APPENDIX X
MODIFICATION AGREEMENT FORM
Agency Code: 19000
Contract Period:
Contract No.: C006880
Funding for Period: $341,000.00
This is an AGREEMENT between THE STATE OF NEW YORK, acting by and through the New York State
Department of State, having its principal office at 99 Washington Avenue, Albany, New York, 12231 (hereinafter
referred to as the STATE), and Town of Southold (hereinafter referred to as the CONTRACTOR), for modification of
Contract Number C006880, as amended above and in attached Appendice(s)
Terms and conditions of this amendment are subject to continued availability of funds for this contract.
All other provisions of said AGREEMENT shall remain in full fome and effect.
1N WITNESS WHEREOF, the parties hereto have executed this AGREEMENT as of the dates appearing under their
signatures.
CONTRACTOR SIGNATURE
NYS DEPARTMENT OF STATE
By: By:
(print name) (print name)
Title: Title:
Date: Date:
ACKNOWLEDGMENT
State of New York
County of
On this _ day of
)
, in the year 20 , before me personally appeared
, to me known, who being by me duly sworn, did depose and say that he/she is the
of , the organization described in and which
executed the above instrument; and that he/she has the authority to sign on behalf of said organization; and that he/she
executed the ibregoing agreement for and on behalf of said organization.
NOTARY PUBLIC
Approved:
Thomas P. DiNapoli
State Comptroller
By:
Date:
NEW YORK STATE DEPARTMENT OF STATE
OFFICE OF COASTAL, LOCAL GOVERNMENT
AND COMMUNITY SUSTAINABILITY
PAYMENT GUIDELINES AND REQUEST FORMS
General Accounting Requirements
Adequate financial accounts and records must be established and consistently maintained in accordance with
generally accepted accounting principles and practices during the term of the Agreement. The Recipient must
also keep a cost ledger for costs incurred for work performed under the Agreement.
The accounting and control responsibilities must be segregated from the project operations. The Recipient is
ultimately responsible for the accounting and control responsibilities.
The minimum requirements for an acceptable accounting system are:
The system must include a cost ledger (general ledger) and appropriate subsidiary ledgers in which
all financial transactions related to the Agreement must be recorded (i.e., disbursements, revenues).
A separate cost ledger and subsidiary ledgers are required for each Agreement. The accounts and
records must clearly identify all costs incurred by approved budget categories.
Disbursements (costs) and revenues (advances, reimbursements) must be recorded in subsidiary
ledgers established for each approved budget category as they are received or incurred and
summarized in the cost ledger monthly.
Each entry in the accounting records must be supported by appropriate documentation. The
documentation can be generated from outside the Recipient's organization (i.e., invoices), and/or it
can be intemally generated (i.e., payroll registers). The files of supporting documentation must be
coded and cross-referenced in such a way that transactions can be traced from any document dealing
with the transaction back to the initiation of that transaction and forward to the entry or entries in the
accounting system.
The financial accounts, records and cost ledger may be audited by appropriate State agencies based upon
applicable federal and State regulations and contractual provisions in effect during the term of the Agreement.
The financial accounts, records and cost ledger, including supporting documentation, must be kept intact and be
readily available for the period indicated in the Agreement.
General Payment Request Requirements
This guide and accompanying forms are to be used to prepare and submit payment requests for reimbursement of
costs incurred under Agreements with the Department of State, Office of Coastal, Local Government and
Community Sustainability (the Department). If payment requests are not prepared and submitted in accordance
with this guide and accompanying forms, or if they contain errors or are illegible, it may cause processing delays,
payment deduction or a rejection of the request. In the event that a payment request is denied or partially paid,
the Department will provide written notice of the reasons for partial payment or denial to the Recipient.
A payment request consists of Summary Sheet Documentation Forms and a Standard Voucher. All invoices,
receipts, timesheets and other financial backup information are required to be kept in the Recipient's project file.
This information should not be submitted with the payment request forms, however, the Department may request
to receive copies during the review of the payment request.
Payment requests will be reviewed in accordance with the terms and conditions of the Agreement to determine
total eligible project costs incurred and the number and percentage of project tasks completed to date. If the
percentage of task completion is deemed insufficient, or if products have not yet been approved by the
Department, the amount to be reimbursed may be reduced. The Department shall make interim payments for
eligible costs incurred up to an amount not to exceed 90% of the State Share Funding Amount.
The final payment request must be submitted within 60 days of the expiration date of the Agreement or the
completion of the scope of work in the Agreement, whichever occurs first. The final payment request will not be
processed until all work products have been received and approved by the Department.
When preparing payment requests, please note the following:
Costs documented must be consistent with the approved budget in Appendix B of the Agreement,
and must be shown in the same budget categories.
Costs documented must be based on actual costs incurred - no estimated or rounded costs are
allowed.
The dates and amounts shown on the Standard Voucher, the Summary Sheet, and Attachments A-G
must be consistent.
When completing Attachments A-G, only submit those that are necessary to document costs. Please
do not submit blank attachments.
When completing Attachments A-G, additional copies should be made to be used as continuation
forms, if necessary.
Care should be taken to ensure all forms are accurate, legible and complete.
The use of Other, Etcetera or Miscellaneous is not allowable in documenting expenditures.
Forms with white out or strikeouts will not be accepted.
Requests for payment will not be accepted more frequently than monthly.
Status Reports
An updated status report (project status form) no longer needs to be submitted with payment requests, unless
requested by the Department. Note that status reports still need to be submitted every six months and if your
agency is behind on submitting these reports, an updated report will be required to be submitted before any
payment requests will be processed. In addition, a final status report will be required at the end of the project, to
show the final status of all tasks.
NYS Standard Voucher
The Recipient should complete only the highlighted sections on the Standard Voucher.
Payee ID:
Payee Name & Address:
Ref./Inv. No. & Date:
Description of Materials/Service:
Total:
Payee Certification:
Recipient's Federal Tax ID number.
Recipient's name and address as it appears on the Contract Face Page.
The information entered in this box will be printed as a reference on the
OSC issued payment.
In the first and second boxes enter the period indicated on Form 2
Summary Sheet. In the third box enter the Agreement number. Do not
enter anything else in this section.
Total amount documented (from Form 2 Summary Sheet,
Expenditures Documented this Report) in the "Total" box.
This section must have an original signature by the Recipient's
responsible authorized representative. Make sure the title, date, and
name of company (Recipient) sections are completed.
Your original payment request plus one complete copy of the payment request should be mailed to:
New York State Department of State
Office of Coastal, Local Government
and Community Sustainability
ATTN: [Insert contact person listed below]
One Commerce Plaza
99 Washington Avenue - Suite 1010
Albany, New York 12231-0001
If you have questions, would like to receive electronic copies of these forms or would like to submit a draft
payment request for review, please contact the following:
For contracts funded by the Environmental Protection Fund (EPF), including the Local Waterfront
Revitalization Program, Smart Growth and Eco-Docks:
Laurissa Parent
laurissa.parent~dos.state.n¥.us
Phone: (518) 486-9540
Fax: (518) 473-2464
For contracts funded by the Clean Water/Clean Air Bond Act (CWCA/BA):
Laurissa Parent Phone: (518) 486-9540
laurissa.parent~dos.state.n¥.us Fax: (518) 473-2464
For contracts funded by the Local Government Efficiency (LGE) grant program, formally known as Shared
Municipal Services Initiative (SMSI):
John Fatato
j ohn.fatato~dos.state.n¥.us
Phone: (518) 473-2488
Fax: (518) 474-6572
For contracts funded by the New York City Watershed grant program:
Joann Ryan Phone: (518) 486-6485
joann.rvan~dos.state.n¥.us Fax: (518) 474-6572
For contracts funded by the Brownfield Opportunity Areas (BOA) grant program:
Vincent Sculco Phone: (518) 473-2466
vince.sculco~dos.state.n¥.us Fax: (518) 473-2464
For other types of DOS administered contracts:
Vincent Sculco
vince.sculco~dos.state.n¥.us
Phone: (518) 473-2466
Fax: (518) 473-2464
...................................................... -Last Updatedl/5/lO .....................................................
Summary Sheet Documentation Forms: Form 1 - Payment Request Cover Sheet
Recipient: Contract #
Project Title:
Payment Request #
Grant Program:
Type of Request: [] Interim [] Final If Final, attach:
[] Final Status Report Form
[] Final Project Summary Report Form
[] Measurable Results Form
Costs documented on this payment request were incurred during the time period of
and
By signing this form, I certify that:
1. I am the responsible representative authorized to certify this payment request;
2. The payment request as detailed on the attached forms is just, true and correct, the amount claimed accurately represents the
expenses as recorded in our accounting records and the documented expenditures were made solely for the purpose of the project
funded under the Agreement;
3. The attached project narrative accurately represents the activities undertaken during the period covered by the claim;
4. We are in compliance with all applicable provisions of the above-referenced Agreement; and,
5. Persons not parties to the above-referenced Agreement who performed work under the Agreement have been compensated or will
be compensated.
Signature: Contact Person:
Printed Name:
Title of Contact:
Title:
Affiliation of Contact:
Affiliation:
Phone of Contact:
Date: Email of Contact:
Summary Sheet Documentation Forms: Form 2 - Summary Sheet
RBCPIBNT
CONTRACT #
Approved Expenditures Cumulative Available
Budget Amount Documented Documented Balance to
this Report Expenditures Document
(1) (2) (3) (4)
S_aj a_rie_s _&_ _V~_'a_ g_e_s ......... i_S_ ................ i_S_ ...................................................
Travel ',$ ',$
S_u_p_p 1 i_e sI _&_ _M_a_t e_r i_a_l s_ ...... [$_ ................ [$_ ................ [$ ................. [$ ................
Equipment ',$ ',$ ',$ ',$
............................................................................................
Contractual Services ',$ ',$ ',$ ',$
..................... r ................. r ................. ~- ................. ~- ................
Other [$_ [$_
......................................................................................
Capital Costs/Improvements ',$ ',$ ',$ ',$
..................... i .................. i .................. i .................. i .................
TOTAL ',$ ',$ ',$ ',$
Column (1)
Column (2)
Column (3)
Column (4)
Insert the budget amounts from the approved budget of the Agreement.
Represents the expenditures being documented on Attachments A-G of this payment request.
Represents the cumulative expenditures documented to date (this payment request plus previous payment requests).
If this is the first payment request, Columns (2) and (3) will be the same.
Calculate by subtracting the Column (3) from Column (1). If this results in a negative amount for any category, the
negative amount must be shown for that category and be factored into the total.
NOTES:
Make sure to fill in the total for each column.
Note that the budget in Appendix B of your Agreement may not include all of the categories shown above. When
completing the payment request, only fill in the categories which are applicable to your Agreement.
Claimed expenditures must be in accordance with the project budget in Appendix B of your Agreement. Any changes to
the cost categories contained in the project budget in Appendix B, in excess of 10% will require prior approval of the
Department. If the total Agreement amount is in excess of $50,000, approval will also be required by the Office of the
State Comptroller. No expenditures will be allowed for items not set forth in the project budget.
Summary Sheet Documentation Forms: Form 3 - Planning/Design/Construction Breakdown
RBCPIBNT CONTRACT #
Breakdown costs for each category by the type of cost: Planning, Design, Construction, or Other. The "Total Amount" column must
match column 2 on Form 2 - Summary Sheet.
Planning:
Design:
Construction:
Other:
Costs related to the preparation of a long-term management strategy.
Costs for activities related to the development of schematic or final construction plans.
Costs for activities relating to the physical construction at a site.
Costs for administrative/project management activities and activities which do not fall under the other categories.
Planning Costs Design Costs Construction Other Costs Total Amount
Costs
Salaries & Wages 45_ j$_' j$_' j$_' '$
Travel ',$ ',$ ',$ ',$ ',$
Supplies & Materials :$ :$ :$ :$ :$
Equipment i$_ iS_' ]$_' ]$_' '$
..................................................................... i ...............
Contractual Services ',$ ',$ ',$ ',$ ',$
Other ',$ ',$ ',$ ',$ ',$
Capital Costs/Improvements ,'$_ ,'$_' ,'$_' ,'$_' _,$_' _
.................................................................................
TOTAL ',$ ',$ ',$ ',$ ',$
Summary Sheet Documentation Forms: Form 4 - Payment Narrative
RBCPIBNT
CONTRACT #
Please provide a detailed narrative describing the activities undertaken and accomplishments made during the period covered by this
payment request only.
Attachments A-G
Attachment A - Salaries & Wages
Attachment B - Travel
Attachment C - Supplies & Materials
Attachment D - Equipment (for purchase only)
Attachment E - Contractual Services
Attachment F - Other
Attachment G - Capital Costs/Improvements
When completing these attachments, only submit those that are
necessary to document costs that are shown on Form 2 of this
payment request. Please do not submit blank attachments.
Additional copies of the attachments should be made to be used as
continuation forms, if necessary.
Note that the Standard Voucher, which is the last page of this
packet, must be submitted with every payment request.
Summary Sheet Documentation Forms: Attachment A - Salaries & Wages (including Fringe Benefits)
RBCPIBNT CONTRACT #
This category is for salary costs incurred by the Recipient only. Salary costs incurred by subcontractors (whether by subcontract,
retainer, or Intermunicipal Agreement) should be listed on Attachment E - Contractual Services. The value of volunteer services or
donated professional services should be listed on Attachment F - Other.
Note that if more than one individual with the same title performs work on this project, the title should be listed only once, with
combined date and amount information. Also, the specific names of individuals should not be shown.
The Recipient's project file must include supporting documentation such as time sheets and other related documents which indicate
days and hours worked by individuals.
Title Start Date End Date Amount
$
$
$
$
$
$
$
$
$
$
Total Salaries & Wages
Summary Sheet Documentation Forms: Attachment B - Travel
RBCPIBNT CONTRACT #
This category is for travel costs incurred by the Recipient only. Rates used should be in compliance with your organization's rates, but
cannot exceed approved State rates. The Recipient's project file must include travel cost documentation forms, as well as receipts for
lodging, meals, transportation, etc. for each traveler.
Details of Trip Summary of Costs
Title of Traveler: Mileage**: $
Origin and Destination: Lodging: $
Date(s) of Trip: Car Rental/Train/Air (Specify): $
Purpose of Trip: Meals: $
Other (Specify): $
Total for Trip: $
**If claiming mileage, indicate number of miles and rate: Miles: I Rate: I
Details of Trip Summary of Costs
Title of Traveler: Mileage**: $
Origin and Destination: Lodging: $
Date(s) of Trip: Car Rental/Train/Air (Specify): $
Purpose of Trip: Meals: $
Other (Specify): $
Total for Trip: $
**If claiming mileage, indicate number of miles and rate: Miles: I Rate: I
Details of Trip Summary of Costs
Title of Traveler: Mileage**: $
Origin and Destination: Lodging: $
Date(s) of Trip: Car Rental/Train/Air (Specify): $
Purpose of Trip: Meals: $
Other (Specify): $
Total for Trip: $
**If claiming mileage, indicate number of miles and rate: Miles: I Rate: I
Total Travel
Summary Sheet Documentation Forms: Attachment C - Supplies & Materials
RBCPIBNT CONTRACT #
This category is for costs incurred by the Recipient only for the purchase of supplies. The Recipient's project file must include copies
of receipts.
Type of Supplies & Materials Date of Purchase Amount
$
$
$
$
$
$
$
$
$
$
Total Supplies&Materials
Summary Sheet Documentation Forms: Attachment D - Equipment
RECPIBNT
CONTRACT #
This category is for costs incurred by the Recipient only for the purchase of equipment. The Recipient's project file must include
copies of receipts.
Description of Equipment Date of Purchase Amount
(including Make, Year, Model, etc)
$
$
$
$
$
$
$
$
$
$
Total Equipment
Summary Sheet Documentation Forms: Attachment E - Contractual Services
RBCPIBNT CONTRACT #
This category is for costs incurred through a subcontract, retainer agreement, intermunicipal agreement, etc. Only subcontractors who
contract directly with the Recipient should be listed. Each subcontractor should be listed only once on this form, with combined date
and amount information. The start and end dates must reflect the dates that costs were actually incurred, not an invoice date.
The Recipient must have procured the subcontractor in accordance with the Agreement requirements and all applicable statutes, rules,
and regulations. Before reimbursement for Contractual Services will be made, the procurement certification and the executed
subcontract must be submitted to DOS.
The Recipient's project file must include copies of invoices. Invoices should be detailed and related directly to work program tasks.
The Recipient's project file should also include a copy of the procurement record and the executed subcontract for each subcontractor.
Name of Subcontractor Service Provided Start Date End Date Amount
$
$
$
$
$
$
$
$
$
$
Total Contractual Services
Summary Sheet Documentation Forms: Attachment F - Other
RECIPIENT
CONTRACT #
This category is for costs which do not fit in the categories above, such as registration fees, printing, advertising and to document the
value of volunteer services, donated professional services, and equipment usage.
For actual costs incurred, enter the type of cost, purpose, start and end dates, and total cost.
For Volunteer Services, for Type enter (for example) "Volunteer Services by Steering Committee". Indicate the activities
undertaken in the Purpose box, the start and end date, total hours, rate, and total value.
For Donated Professional Services, each title should be listed separately. For Type enter (for example) "Donated
Professional Services - Attorney". Indicate the activities undertaken in the Purpose box, the start and end date, total
hours, rate, and total value.
For equipment usage, each piece of equipment should be listed separately. For Type enter (for example) "Equipment
Usage - Backhoe". Indicate the start and end date, total hours, rate, and total value.
For actual costs incurred, the Recipient's project file should include copies of invoices. For the value of volunteer services, donated
professional services and equipment usage, the Recipient's project file must include appropriate backup documentation, such as
timesheets/timelogs which document the dates, hours and rates for each value claimed.
Type of Cost: Start Date:
Purpose: End Date:
Total Hours:
Rate: $
Total Cost or Value: $
Type of Cost: Start Date:
Purpose: End Date:
Total Hours:
Rate: $
Total Cost or Value: $
Type of Cost: Start Date:
Purpose: End Date:
Total Hours:
Rate: $
Total Cost or Value: $
Total Other
Summary Sheet Documentation Forms: Attachment G - Capital Costs/Improvements
RBCPIBNT CONTRACT #
This category is for costs related to making changes to improve capital assets, increase their useful life, or add to the value of these
assets. The Recipient's project file must include copies of invoices.
Description of Capital Costs/improvements Start Date End Date Amount
$
$
$
$
$
$
$
$
$
$
Total Capital Costs/improvements
State of AC92
Ne v¥ork STANDARD VOUCHER Rev6/94)
(Limit to 30 spaces) NYS Department of State ^g.,cy Code 19000
(mamD/¥'0
(roareD/Y-0
Pmchase Description of Materlal/Service
Orde~ No. If items me too nume~ ous to be incoiporated h~to tbe block below, Qum~flty u~it Price Amom~t
Date use Foim AC 93 m~d carry total foI~vm d.
Expenditures documented
during the period of
I Itol I
For Agreement #
I
Payee C er tilic ation
! cerldy tbat tbe above bill is just, line m~d conect; tbat no part tbe~ eof has bee~ paid except as stated m~d
tbat tbe balm~ce is actaally due m~d o~vh~g, m~d tbat taxes fiom wlfich tbe State is exempt me excluded. Total
Payee's Signalm e h~ Iak Tire Dis¢omlt
Net
Name of Company Date
FOR AGENCY USE ONLY STATE COMPTROLLER'S PRE AUDIT
Me~ chm~dise Recd I cedLfy tbat tl~is vouche~ is conect m~d just, m~d p ayme~t is approved, m~d tbe goods or
(as Requh ed)
Project Status Form
RECIPIENT
PROJECT TITLE
CONTRACT#
Status Report Date:
* ~ See guidelines on reverse side for completing this form ~ ~
Task Brief Task Percent of Date of Product Submitted
# Description Completion A/T Completion Task Accomplishments to DOS
NOTE: Enter information into the boxes above. Pushing tab to move from box to box will insert additional rows.
ADJUSTMENTS - Please indicate proposed adjustment(s) to work program/schedule, reason(s) for the proposed
adjustment(s), and any other problems encountered during this reporting period:
Person to contact if we have questions about the information provided on this form:
Name: Email Address:
Title: Affiliation:
Phone: Fax:
Status Form 060310.doc
Guidelines for completing the Proiect Status Form
Contract Information Section:
Recipient:
Contract #:
Project Title:
Status Report Date:
The entity that entered into the Agreement with DOS.
NYS Comptroller number listed on the Face Page of the Agreement.
The official title of the project (can be found on most correspondence from DOS).
The date that the report is being completed. Please do not submit backdated reports.
In the Task List section:
Task#:
Every task and every subtask listed in Appendix D of the Agreement must be listed on each report submitted.
Brief Task Description:
Enter a couple words to describe the task (for example, "RFP", "Final Designs", "Permits").
Percent of Completion:
The percentage of completion of this task as of the Status Report Date.
A/T:
If the task is 100% complete, enter "A" (to indicate that the date in the Date of Completion column is the Actual date
of completion of the task). If the task is less than 100% complete, enter "T" (to indicate that the date in the Date of
Completion column is the Target date for completion of the task).
Date of Completion:
If the task is 100% complete, indicate the date that the task was completed this date must be a past date. If the task is
less than 100% complete, indicate the date that the task is expected to be completed this date must be a future date.
NOTE: If the target completion dates for any project tasks go beyond the current end date of the Agreement, an
extension should be requested in the Adjustments section of this form.
Task Accomplishments:
Should be brief, but describe specific accomplishments made for each task as of the Status Report Date. Status
reports submitted with generic accomplishment entries will take longer to review by DOS and may not be accepted
(*see below for tips on improving Task Accomplishments entries). If a task is 0% complete, no accomplishments
would have yet been made, so the accomplishment column should be left blank for this task.
Product Submitted:
Indicate the task-related products which to date, have been submitted to DOS for review and approval.
*Here are some tips on how to improve Task Accomplishments entries:
Generic accomplishment entry:
Advisory commi~ee established.
RFP issued.
Consultant Selected.
Final designs.
Specific accomplishment entry:
8 person advisory committee was established and has met (6) times to date.
RFP was released through local papers and NYS Contract Reporter.
5 responses were received and ABC Construction Company, Inc. was selected
Final Design & Construction Drawings (incorporating DOS comments of 11/5/05)
were approved by DOS.
Status Guidelines 060310.doc
Training Task:
If training is a task in the Agreement, the training is required to be attended if it is offered by DOS/SUNY during the
life of the Agreement. At the time of the status report, if all training sessions have listed in the Agreement have been
attended, the task should be shown as 100% complete with the completion date being the date that the last session was
attended. If all training sessions listed in the Agreement have not been completed, the percentage should reflect the
sessions attended and the target completion date should match the date that the project is expected to be complete.
Example: Your status report indicates that the final project task has a target completion date of December 31, 2012 and
so far, 3 of 5 training sessions have been attended. The percentage for the training task would be 60% and the target
completion date for the training task would be December 31, 2012.
Status Report Task:
Status reports are required for the life of the Agreement, with the final status report being due within 60 days following
completion of the project. The status report task should not be shown as 100% complete until the entire project is
completed and the final status report is completed and submitted. The target completion date for the status report task
should be within 60 days after the project is expected to be complete.
Example: Your status report indicates that the final project task has a target completion date of December 31, 2012.
Four status reports have been submitted to date and one more is due during the course of the project, in addition to the
final status report. The percentage for the status report task would be 66% and the target completion date would be
March 1, 2013.
Final Project Summary Report and Measurable Results Forms Task (FPSR/MR):
Final Project Summary Report and Measurable Results Forms are required to be submitted within 60 days following
completion of the project. This task should be shown as 0% complete until the entire project is completed and the Final
Project Summary Report and Measurable Results forms are completed and submitted.
Example: Your status report indicates that the final project task has a target completion date of December 31, 2012.
The percentage for the FPSR/MR task would be 0% and the target completion date would be March 1, 2013.
Adjustments section:
Indicate proposed adjustments to the budget, work program, or project schedule, and the reason why the adjustment is
necessary. If any problems have been encountered during this reporting period, they should also be indicated here.
The information listed in this section should refer to this reporting period only.
If an extension is requested on this form, the reasons provided should be detailed and specific. For example, requesting
an extension to "complete the project" or "allow time to finish tasks" is not acceptable. The reasons provided in this
section should be specific and explain why tasks were delayed and/or problems were experienced.
The extension requested must also be supported by the target completion dates in the task list. For example, if the task
list indicates that the final project task has a target completion date of December 31, 2012, you cannot request an
extension to June 30, 2013.
Contact Information section:
Provide the Name, Title, Affiliation, Email Address, Phone Number, and Fax Number of the person that DOS should
contact directly, if we have questions on the information provided on this form.
Submitting the status report:
Please 5ax the completed status report to Laurissa Parent at (518) 473-2464 or email to laurissa.parent(c~dos.state.n¥.us.
Please do not forward the original by mail - we only need to receive one copy of the report.
If you have any questions, please contact Laurissa at (518) 486-9540 or your DOS project manager at (518) 474-6000.
Status Guidelines 060310.doc