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HomeMy WebLinkAboutElizabeth Field Airport RESOLUTION 2012-902 ~o-e ADOPTED DOC ID: 8355 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2012-902 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON DECEMBER 18,2012: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Scott A. Russell to execute the Aviation Capital Project Agreement between the Town of Southold and the New York State Department of Transportation for the 5-year Capital Improvement Project No. 0913.19 at Elizabeth Field Airport, Fishers Island, New York, subject to the approval of the Town Attorney. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: William Roland, Councilman SECONDER: Albert Krupski Jr., Councilman AYES: Ruland, Talbot, Doherty, Krupski Jr., Evans, Russell NYS PIN 0913.19 State Environmental Quality Review In accordance with the rules, regulations, and procedures adopted by Town of Southold (or 6NYCRR Part 617 where the Municipal Corporationhas not adopted such rules, regulations, and procedures) pursuant to the intent of the State Environmental Quality Review Act, the project described below is classified as a: CHECK ONE ? Type I Action - with possible significant effect (NEPA or SEQR DEIS, FEIS, and SEQR Record of Decision have been prepared). ?Type I Action - with no significant effect (Environmental Assessment Form or Environmental Assessment and Negative Declaration have been prepared and filed). ? Unlisted Action - with possible significant effect (NEPA or SEAR DEIS, FEIS, and SEQR Record of Decision have been prepared). ? Unlisted Action - with no significant effect (Environmental Assessment Form or Environmental Assessment and Negative Declaration have been prepared and filed). XType II Action ? Ministerial Act ? Exempt Act PROJECT DESCRIPTION Conduct an Environmental Study for 5 Year ACIP Projects Au rized Signature Title 17. cc 2hnloe~ l"ly Z~j 'Z Date STATE OF NEW YORK DEPARTMENT OF TRANSPORTATION ALBANY, N.Y. 12232 www.dot.ny.gov JOAN MCDONALD ANDREW M. CUOMO COMMISSIONER GOVERNOR January 28, 2013 Mr. Scott A. Russell JAN 3 0 2013 Town Supervisor 53095 Main Street P.O. Box 1179 Southold, NY 11971 Re: Elizabeth Field Airport PIN 0913.19 - T034427 Executed Grant Dear Mr. Russell: Please find enclosed one fully executed grant agreement for the above referenced grants. Please note that, on this signature page, there will be no approval by either the NYS Attorney General or the NY State Comptroller, as in the past. This grant was assigned a °T" contract number (as opposed to a "K") and therefore only requires NYS Department of Transportation approval. If you should have any questions regarding this grant, please contact me at 518-457-8438 or email dgeraldi@dot.state.ny.us. Sincerely, Denise E. Geraldi Aviation Bureau Enclosure ToWN ATI DRNEw•3 OFFICE TOWN OF SOUTHOLD cc: M. Geiger, Region 10 ORIGINAL C.:.~..y AVIATION CAPITAL PROJECT AGREEMENT ELIZABETH FIELD AIRPORT PROJECT NO. 0913.19 CONTRACT NO. TC34( ~"1 THIS AGREEMENT made this 17`h day of September, 2012 by and between the People of the State of New York (hereinafter referred to as "State") acting by and through the Commissioner of Transportation (hereinafter referred to as "Commissioner" and "Department" respectively) with offices at 50 Wolf Rd, Albany, New York 12232, and Town of Southold (hereinafter referred to as "Grantee") with offices at Southold, New York. WHEREAS, Article 2 of the Transportation Law authorizes the Commissioner to provide for the accomplishment of airport or aviation projects, and to provide funding to private owners, municipalities and authorities in connection therewith; and WHEREAS, the Grantee is the sponsor of an airport known as Elizabeth Field Airport in Suffolk County (hereinafter referred to as the "Airport"); and WHEREAS, the Grantee has made and will make application to the Commissioner for State aid for the accomplishment of airport or aviation projects at the Airport; and WHEREAS, the Grantee has applied for and will secure available Federal Assistance for the Projects from the Federal Aviation Administration, (hereinafter called "FAA Grant Agreements"); and WHEREAS, the Projects will be approved by the Commissioner as consistent with sound transportation development policy and planning concepts and eligible for State participation; and WHEREAS, the Grantee is authorized to enter into this Agreement by resolution, a copy of which is attached hereto and made a part hereof; and WHEREAS, State funding for said airport or aviation projects has been and will be provided by budget bills duly enacted into law. NOW THEREFORE, in consideration of the mutual covenants hereinafter set forth, the State and the Grantee agree as follows: Article 1. Purpose of Agreement. The purpose of this Agreement is to provide for the undertaking of airport or aviation projects (each project hereinafter referred to as the "Project"), the details of which are more fully described in Schedule A-1 attached hereto, with State financial assistance to the Grantee in the form of a grant, and to state the terms, conditions, requirements, and restrictions upon which such State assistance will be provided and the mutual understandings and agreements of the parties as to the manner in which the Project will be undertaken and completed, and the Project facilities and equipment will be used. This grant is established with the Grantee for a period of ten years commencing on the date first above written after this Agreement is approved by the State Comptroller, and terminating ten years therefrom, and shall not be dependent on the official duty continuity of the signatories or their successors. The Agreement may be concluded at any time upon written agreement between the Commissioner and the official representative(s) of the Grantee subject to the written approval of the State Comptroller. Article 2. Documents Forming the Agreement. Schedule A, containing individual project information including project description, cost, funding allocation and schedule, is attached hereto and is hereby made a part of this agreement as if set forth fully herein. Appendix A, standard clauses for all New York State contracts, is attached hereto and is hereby made a part of this agreement as if set forth fully herein. Appendix A-1, Supplemental Title VI Provisions (Civil Rights Act) Appendix B, containing State bidding requirements, is attached hereto and is hereby made a part of this agreement as if set forth fully herein. Appendix 2, Iran Divestment Act. Resolution of the Grantee (if applicable) affirming the terms of this Agreement and authorizing the Agreement to be executed. ,krticle 3. The Project. The Grantee agrees to complete and provide for the use of project facilities and equipment in accordance with Federal law, rules and the FAA Grant Agreements, and the terms and conditions of this Agreement. The Grantee shall commence and continue operation of the Project upon its completion and shall not discontinue operation or dispose of the Project without the approval of the Commissioner. The Grantee shall also provide for the payment of its share of the cost of the Project. Article 4. The Grant. The State share of project costs is fifty percent of the non-Federal costs to complete the Project approved by the Commissioner and procured in part through Federal funding. The maximum amount of the State's share of funding is as set forth in Schedule A. The Grantee agrees to apply for additional Federal assistance which may become available for the Project, subject to such conditions as the Commissioner may require, in order to maximize the amounts of Federal assistance received or to be received for all projects in the State. Article 5. Use of Project Facilities and Equipment. a. On completion of the Project, the Grantee shall commence and continue operation and maintenance of the Project as its own cost and shall not discontinue operation, or dispose of the Project, without the approval of the Commissioner, for the period of time corresponding to the period of useful life for the Project as determined by references to Section 61 of the State Finance Law. b. No part of any Project or Project facility shall be sold, rendered unusable, or otherwise relinquished without obtaining prior written approval of the Commissioner and State Comptroller. If any Project parts or facilities are so sold, other than for their 2 replacement in such service with like facilities or equipment, the State share of the proceeds of such a sale will be returned to the State Comptroller for deposit in the General Fund. C. The Grantee will operate and maintain the Airport in full compliance with the terms of the FAA Grant Agreement and all the covenants made by the Grantee to the FAA are deemed made to the State by this Agreement as if fully set forth herein. d. All facilities of the Airport developed with State aid and all those usable for the landing and taking off of aircraft, will be available to State Aircraft at all times, without charge, e. The Grantee shall submit to the Commissioner, at such time as he may require, such financial statements, operating information and other data as may be deemed necessary by the Commissioner to assure compliance with this Agreement and to prepare his annual report on the scope and results of the Project. The Airport and all Airport records and documents affecting the Airport, including deeds, leases, operation and use agreements, and other instruments, will be made available for inspection by any duly authorized representative of the Commissioner upon reasonable request. The Grantee will furnish to the Commissioner upon request, a true copy of any such document. Article 6. Accomplishment of the Project. a. Pursuant to Federal, State and Local Law. In the event that any election, referendum, approval, permit, notice or other proceedings or authorization is requisite under applicable law to enable the Grantee to enter into this Agreement or to undertake the Project hereunder, or to observe, assume, or carry out any of the provisions of this Agreement, the Grantee will initiate and consummate, as provided by law, all actions necessary with respect to any such matters so requisite. b. Funds of the Grantee. The Grantee shall initiate and prosecute to completion all proceedings necessary to enable the Grantee to provide its share of actual total cost of the Project, as provided in Schedule A of this Agreement, on or prior to the time that such funds are needed to meet the Project costs. C. Submission of Proceedings, Contracts and other Documents. The Grantee shall submit to the Commissioner and the state comptroller such data, reports, records, contract and other documents relating to the Project as the Commissioner and the State Comptroller may require. Article 7. The Project Budget. Costs for any new Project approved by the FAA and the Commissioner, and costs incurred for any change that increases the State share set forth in Schedule A or any amendment thereto, will be eligible for state reimbursement under this Agreement only after an amendment is made to the Agreement in writing and approved by the State Comptroller. 3 Article 8. Accounting Records. a. Establishment and Maintenance of Accounting Records. The Grantee shall establish and maintain for the Project, in accordance with requirements established by the Commissioner, and approved by the State Comptroller, separate accounts within its existing accounting system or set up independently, to be known as the project account. The Grantee shall segregate and group project costs so that it can furnish on due notice, cost information in the following cost classifications: i. Purchase price or value of land ii. Incidental costs of land acquisition iii. Costs of contract construction iv. Costs of force account construction v. Engineering costs of plans and designs vi. Engineering costs of supervision and inspection vii. Other administrative costs viii. Costs of equipment acquisition ix. Miscellaneous costa not otherwise included b. Funds Received or Made Available for the Project. The Grantee shall record in the project account, as they are received, all grant payments received from the Federal Government on account of the Project. The Grantee shall also record in the project account such funds as it may allocate for payment of its share of the actual cost of the Project. The Grantee shall advise the Commissioner monthly in writing of the amounts recorded in the project account or at such times as the Commissioner may prescribe. The Commissioner or the State Comptroller may audit the project account at such times as the Commissioner or the State Comptroller may require. C. costs Incurred for the Project. The Grantee shall charge to the project account all eligible costs of the Project. costs in excess of the latest approved budget or attributable to actions which have not received the required approval of the Commissioner shall not be considered eligible costs. In specific cases, where it is impractical to determine precise costs of certain indirect or service functions, eligible costs will include such allowances for these costs as may be approved by the Commissioner and the state. Comptroller. Such approval will be based upon an audit determination that the amounts reimbursed will not exceed actual cost. d. Eligible Costs. Eligible Project costs consist of any costs involved in accomplishing a project including those of: (1) Making field surveys; (2) Preparing plans and specifications; (3) Accomplishing or procuring the accomplishing of the work; 4 (4) supervising and inspecting construction work; (5) Acquiring land or an interest therein, or any easement through or other interest in airspace; and (6) Administrative and other incidental costs incurred specifically in connection with accomplishing project, and that would not have otherwise been incurred. e. The costs described in this section, including the value of land, labor, materials and equipment donated or loaned to the Grantee and appropriated to the Project by the Grantee, are eligible for consideration as to their allowability, except for: (1) That part of the cost of acquiring an existing private airport that represents the cost of acquiring passenger automobile parking facilities and buildings to be used as hangars; (2) The cost of materials and supplies owned by the Grantee or furnished from a source of supply owned by the Grantee if: (i) Those materials and supplies were used for airport development before the effective date of the grant; or (ii) Those costs are not supported by proper evidence of quantity and value. (3) The cost of nonexpendable machinery, tools, or equipment owned by the Grantee and used under a project by the Grantee's force account, except to the extent of the fair rental value of that machinery, tools, or equipment for the period it is used on the project; (4) The value of any land, including improvements, donated to the sponsor by another public agency; and (5) Any costs incurred in connection with raising funds by the Grantee, including interest and premium charges and administrative expenses involved in conducting bond elections and in the sale of bonds. f. To be an eligible project cost, for the purposes of computing the amount of a grant, an item that is paid or incurred must, in the opinion of the Commissioner: (1) Have been necessary to accomplish airport development in conformity with the approved plans and specifications for an approved project and with the terms of the grant agreement for the project; (2) Be reasonable in amount; (3) Have been incurred after the effective date of the Grant Agreement, except for those costs incurred to apply for Federal funds; prepare project engineering reports, plans and specifications; to identify, describe and determine value of land acquisition required for the project such as surveys, title searches and abstracts, appraisals and legal fees and to acquire real property; and 5 (4) Be supported by satisfactory evidence. g. Documentation of Project Costs. All costs charged to the project account, including any approved services contributed by the Grantee or others, shall be supported by properly executed payrolls, time records, invoices, contracts, or vouchers evidencing in proper detail the nature and propriety of the charges, in accordance with the rules and regulations of the commissioner as approved by the State Comptroller. h. checks, Orders, and Vouchers. Any check or order drawn by the Grantee with respect to any item which is or will be chargeable against the project account will be drawn only in accordance with a properly signed voucher then on file in the office of the Grantee stating in proper detail the purpose for which such check or order is drawn. All checks, payrolls, invoices, contracts, vouchers, orders, or other accounting documents pertaining in whole or in part to the Project shall be clearly identified, readily accessible, and to the extent feasible, kept separate and apart from all other such documents. i. Reports. The Grantee shall prepare an interim report at the end of its fiscal year accounting for the expenditures of the funds of the State, the Grantee, any Federal agency, and any other source with respect to the Project. Article 9. Payments. a. Payments shall be made to the Grantee upon request to the Commissioner under the following conditions: i. Such request for reimbursement of the State's share of authorized project expenditures shall be made on a regular periodic basis, a approved by the Commissioner. Cumulative payment requests e :hall in no event exceed the total cumulative amount of State funding approved by the commissioner. U. Such request shall be in a form established by the Commissioner, and shall include a certification that Federal reimbursement has been received therefor. The documents supporting such expenditures by the Grantee shall be maintained in a secure manner by the Grantee at its headquarters or at such other place as shall be readily accessible to the commissioner and the State comptroller for purposes of auditing project costs and expenditures. All such accounting records shall be retained by the Grantee until six (6) years after final payment is made hereunder. iii. Subject to the other provisions hereof, applications for payment will be honored by the commissioner except that the State may elect by notice in writing to withhold any payment if: (1) Misrepresentation. The Grantee shall have made any misrepresentation of a material nature in its application for funds hereunder, or any supplement thereto or amendment thereof, or in or with respect to any document or data furnished to the Commissioner or other State official in connection with a Project under this Agreement; 6 (2) Litigation. There is then pending litigation with respect to the performance by the Grantee of any of its duties or obligations which may jeopardize or adversely effect the Project, this Agreement, or payments to the Project; (3) Concurrence by State. The Grantee shall have taken any action pertaining to the Project which under the established procedures require the prior approval of the commissioner or shall have made related expenditures or incurred related obligations without the approval of the Commissioner; (4) Conflict of Interest. There has been in connection with the Project any violation of the conflict of interest rule, regulation, ordinance or statute applicable to the Grantee, its officers, members, or employees; or (5) Default. The Grantee shall be in default under any of the provisions of this Agreement. b. In no event shall the making by the State of any payment pursuant to this Agreement constitute or be construed as a waiver by the State of any breach of covenant or any default which may then exist, on the part of the Grantee, and the making of any such payment by the State while any such breach or default shall exist shall in no way impair or prejudice any right or remedy available to the state in respect of such breach or default. Article 10. Termination of Suspension of State's Obligation. a. Termination or Suspension Generally. If the Grantee abandons or, before completion, finally discontinues the Project; or if, by reason of any of the events or conditions set forth in paragraphs (1) to (5), inclusive, of Article 9 a.iii. hereof, or for any other reason, the commencement, prosecution, or timely completion of the Project by the Grantee is rendered improbable, infeasible, impossible or illegal, the Commissioner may, by written notice to the Grantee, suspend any or all of its obligations under this Agreement until such time as the event or condition resulting in such suspension has ceased or been corrected, or the Commissioner may terminate any or all of its obligations under this Agreement. b. Action Subsequent to Notice of Termination or Suspension. Upon receipt of any final termination notice under this Section, the Grantee shall proceed promptly to carry out the actions required therein which may include any or all of the following: i. Necessary action to terminate or suspend, as the case may be, Project activities and contracts and such other actions as may be required or desirable to keep to a minimum State costs. ii. Furnish a statement of the status of the Project activities and of the project account as well as a proposed schedule, plan and budget for terminating or suspending the closing out project activities and contracts, and other undertakings the cost of which are otherwise includable as project costs; and iii. Provide to the Commissioner an estimate of the State's share of the costs arising from the termination, 7 suspension, or closing out of such activities, shall contra bectscarr, and undertakins. The with theslatestt schedule, and budget approved by the commissioner upon the basis of terms and conditions imposed by the commissioner upon the failure of the Grantee to furnish the schedule, plan and budget within a reasonable time. The acceptance of a remittance by the State of any or all Project Funds previously received by the Grantee or the closing out of State financial participation in the Project shall not constitute a waiver of any claim which the State may otherwise have arising out of this Agreement. Article 11. Audit Disallowances. Costs claimed or previously reimbursed that cannot be supported as outlined herein are subject to audit disallowance by the Commissioner, the State Comptroller, the FAA, and\or the Officer of the Inspector General of the U. S. Department of Transportation. Amounts paid to the Grantee that are subsequently disallowed are subject to recovery by the Commissioner, or at the option of the State, will be offset or reduced against current or future reimbursement claims on the same or other projects. Article 12. Audit and Inspection. The Grantee shall permit, and shall require its contractors to permit the Commissioner's and the State Comptroller's authorized representatives to inspect all work, materials, payrolls, records of personnel, invoices of materials and other relevant construction, accounent, data and Granteerecords; inidntoauiit the books, records and the the Project. 4 t he Grant and the development of Article 13. Manner of Performing Work. The work constituting the Project may be performed by the employment of the forces and the use of the equipment of the Grantee as authorized by the Commissioner or by contract let pursuant to bidding procedures, more particularly referred to in Appendix B hereof. Article 14. Executory Clause. The Grantee agrees that this Agreement shall be deemed executory only to the extent of the monies available, and no liability shall be incurred by the State beyond the monies available for the purpose. 8 Article 15. E-Mail Provision Notice. 1. All notices permitted or required hereunder shall be in writing and shall be transmitted either: (a) via certified or registered United States mail, return receipt requested; (b) by facsimile transmission; (c) by personal delivery; (d) by expedited delivery service; or (e) 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 Transportation Name: Jackie Van Heusen Title: Assistant Aviation Grants Coordinator Address: NYSDOT Aviation Bureau 50 Wolf Road P.O.D. 5-4 Albany, NY 12232 Telephone Number: 518-485-7691 Facsimile Number: 518-457-9779 E-Mail Address: Jackie.Vanheusen@dot.ny.gov !Contractor Name] Name: Mr. Scott A. Russell Title: Town Supervisor Address: 53095 Main Road, PO Box 1179, Southold, NY 11971 Telephone Number: (631) 765-1889 Facsimile Number: (631) 765-1823 E-Mail Address: scott.russellatownsouthold.ny.us 2. 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. 3. 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. 9 Article 16. Contract 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 the 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.a.us/et)av/index/htm by e-mail at eounitia,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 the State Comptroller's electronic payment procedures, except where the Commissioner has expressly authorized payment by paper check as set forth above. 10 RESOLUTION 2012-902 Mlv ADOPTED DOC ID: 8355 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2012-902 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON DECEMBER 18,2012: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Scott A. Russell to execute the Aviation Capital Project Agreement between the Town of Southold and the New York State Department of Transportation for the 5-year Capital Improvement Project No. 0913.19 at Elizabeth Field Airport, Fishers Island, New York, subject to the approval of the Town Attorney. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: William Ruland, Councilman SECONDER: Albert Krupski Jr., Councilman AYES: Ruland, Talbot, Doherty, Krupski Jr., Evans, Russell IN WITNESS WHEREOF, the parties hereto have caused this Supplemental Agreement to be axecuted by their duly authorized officers as of the date herein above set forth. Department of Transportation Certification "In addition to the acceptance of this contract, I also certify that original copies of this signature page will be attached to all other exact copies of this contract." NEW YORK STATE DEPARTMENT GRANTEE ~pcJot ©4-\ --50 64 r!`+ O RANSPORTATION r Commi sioner of Transportation By: ~r DATE: JAN 18 2013 J~~ ~s o uSs DATE: 11 /2. APPROVED AS TO FORM: STATE OF NEW YORK APPROVED: ATTORNEY GENERAL BY: For the New York State Assistant Attorney General Comptroller pursuant to Section 112 of the State Finance Law DATE: DATE: Sponsor ACKNOWLEDGMENT _ STATE OF NEW YORK j COUNTY OF ) On this da of bugmwo-r 201.., before me personally came S , to me know and known to me to be the of the the same person described in and ho executed the foregoing instrument; that skerhe is a thorized to execute the foregoing instrument on behalf of the TOcda2 pF S.~u F ursuant to and as provided by statute. Q U l! /l !Y1 446 AoUA h otary Public LAUR Saa -)i ii NOtaty P;rr r C`: !?4N York QuaW iu 3! i?C unt Commission Exl o bs April 9.2t)t S Contract: TQ3Uya'1 Grantee: Town of Southold Facility: ELIZABETH FIELD Schedule A-1 PIN Project Description Estimated Total Cost Federal Share Local Share State Share 0913.19 Conduct an Environmental Study for 5 $156,000.00 $140,400.00 $7,800.00 $7,800.00 Year ACIP Projects Maximum State Share Payable` $8,970.00 " The State share payable under this Agreement is 50% of the non-federal share of eligible costs. In accordance with the separate federal grant referenced herein, the federal share shown above may be increased administratively, upon request of the grantee based on increases in eligible costs, to a maximum of 15%. If and when the federal share increases, the State share shall be increased proportionately, without further amendment to this Agreement, up to the maximum amount shown above. APPENDIX A STANDARD CLAUSES FOR NEW YORK STATE CONTRACTS December, 2011 STUMICLUMNI1MraCIr1UM A"fl A TABLE OF CONTENTS Page 1. Executory Clause 3 2. Non-Assignment Clause 3 3. Comptroller's Approval 3 4. Workers' Compensation Benefits 3 5. Non-Discrimination Requirements 3 6. Wage and Hours Provisions 3 7. Non-Collusive Bidding Certification 4 8. International Boycott Prohibition 4 9. Set-Off Rights 4 10. Records 4 11. Identifying Information and Privacy Notification 4 12. Equal Employment Opportunities For Minorities and Women 4-5 13. Conflicting Terms 5 14. Governing Law 5 15. Late Payment 5 16. No Arbitration 5 17. Service of Process 5 18. Prohibition on Purchase of Tropical Hardwoods 5-6 19. MacBride Fair Employment Principles 6 20. Omnibus Procurement Act of 1992 6 21. Reciprocity and Sanctions Provisions 6 22. Compliance with New York State Information Security Breach and Notification Act 6 23. Compliance with Consultant Disclosure Law 6 24. Procurement Lobbying 7 25. Certification of Registration to Collect Sales and Compensating Use Tax by Certain 7 State Contractors, Affiliates and Subcontractors Page 2 December, 2011 STUMMILA= NIMTECIRMOTE fIP1 fi STANDARD CLAUSES FOR NYS CONTRACTS required to be covered by the provisions of the Workers' Compensation Law. The parties to the attached contract, license, lease, amendment or other agreement of any kind (hereinafter, "the contract" or 5. NON-DISCRIMINATION REQUIREMENTS. To the "this contract") agree to be bound by the following clauses extent required by Article 15 of the Executive Law (also which are hereby made a part of the contract (the word known as the Human Rights Law) and all other State and "Contractor" herein refers to any party other than the State, Federal statutory and constitutional non-discrimination whether a contractor, licenser, licensee, lessor, lessee or any provisions, the Contractor will not discriminate against any other party): employee or applicant for employment because of race, creed, color, sex, national origin, sexual orientation, age, disability, L EXECUTORY CLAUSE. In accordance with Section 41 genetic predisposition or carrier status, or marital status. of the State Finance Law, the State shall have no liability Furthermore, in accordance with Section 220-e of the Labor under this contract to the Contractor or to anyone else beyond Law, if this is a contract for the construction, alteration or funds appropriated and available for this contract. repair of any public building or public work or for the manufacture, sale or distribution of materials, equipment or 2. NON-ASSIGNMENT CLAUSE. In accordance with supplies, and to the extent that this contract shall be performed Section 138 of the State Finance Law, this contract may not be within the State of New York, Contractor agrees that neither it assigned by the Contractor or its right, title or interest therein nor its subcontractors shall, by reason of race, creed, color, assigned, transferred, conveyed, sublet or otherwise disposed disability, sex, or national origin: (a) discriminate in hiring of without the State's previous written consent, and attempts against any New York State citizen who is qualified and to do so are null and void. Notwithstanding the foregoing, available to perform the work; or (b) discriminate against or such prior written consent of an assignment of a contract let intimidate any employee hired for the performance of work pursuant to Article XI of the State Finance Law may be under this contract. If this is a building service contract as waived at the discretion of the contracting agency and with the defined in Section 230 of the Labor Law, then, in accordance concurrence of the State Comptroller where the original with Section 239 thereof, Contractor agrees that neither it nor contract was subject to the State Comptroller's approval, its subcontractors shall by reason of race, creed, color, where the assignment is due to a reorganization, merger or national origin, age, sex or disability: (a) discriminate in consolidation of the Contractor's business entity or enterprise. hiring against any New York State citizen who is qualified and The State retains its right to approve an assignment and to available to perform the work; or (b) discriminate against or require that any Contractor demonstrate its responsibility to do intimidate any employee hired for the performance of work business with the State. The Contractor may, however, assign under this contract. Contractor is subject to tines of $50.00 its right to receive payments without the State's prior written per person per day for any violation of Section 220-e or consent unless this contract concerns Certificates of Section 239 as well as possible termination of this contract Participation pursuant to Article 5-A of the State Finance Law. and forfeiture of all moneys due hereunder for a second or subsequent violation. 3. COMPTROLLER'S APPROVAL. In accordance with Section 112 of the State Finance Law (or, if this contract is 6. WAGE AND HOURS PROVISIONS. If this is a public with the State University or City University of New York, work contract covered by Article 8 of the Labor Law or a Section 355 or Section 6218 of the Education Law), if this building service contract covered by Article 9 thereof, neither contract exceeds $50,000 (or the minimum thresholds agreed Contractor's employees nor the employees of its to by the Office of the State Comptroller for certain S.U.N.Y. subcontractors may be required or permitted to work more and C.U.N.Y. contracts), or if this is an amendment for any than the number of hours or days stated in said statutes, except amount to a contract which, as so amended, exceeds said as otherwise provided in the Labor Law and as set forth in statutory amount, or if, by this contract, the State agrees to prevailing wage and supplement schedules issued by the State give something other than money when the value or Labor Department. Furthermore, Contractor and its reasonably estimated value of such consideration exceeds subcontractors must pay at least the prevailing wage rate and $10,000, it shall not be valid, effective or binding upon the pay or provide the prevailing supplements, including the State until it has been approved by the State Comptroller and premium rates for overtime pay, as determined by the State tiled in his office. Comptroller's approval of contracts let by Labor Department in accordance with the Labor Law. the Office of General Services is required when such contracts Additionally, effective April 28, 2008, if this is a public work exceed 585,000 (State Finance Law Section 163.6.a). contract covered by Article 8 of the Labor Law, the Contractor understands and agrees that the tiling of payrolls in a manner 4. WORKERS' COMPENSATION BENEFITS. In consistent with Subdivision 3-a of Section 220 of the Labor accordance with Section 142 of the State Finance Law, this Law shall be a condition precedent to payment by the State of contract shall be void and of no force and effect unless the any State approved sums due and owing for work done upon Contractor shall provide and maintain coverage during the life the project. of this contract for the benefit of such employees as are Page 3 December, 2011 Si11MWNCWSEEF1~N75GNiMCIS ARFrd~ " 7. NON-COLLUSIVE BIDDING CERTIFICATION. In agreeable and reasonable venue within the State, for the term accordance with Section 139-d of the State Finance Law, if specified above for the purposes of inspection, auditing and this contract was awarded based upon the submission of bids, copying. The State shall take reasonable steps to protect from Contractor affirms, under penalty of perjury, that its bid was public disclosure any of the Records which are exempt from arrived at independently and without collusion aimed at disclosure under Section 87 of the Public Officers Law (the restricting competition. Contractor further affirms that, at the "Statute") provided that: (i) the Contractor shall timely inform time Contractor submitted its bid, an authorized and an appropriate State official, in writing, that said records responsible person executed and delivered to the State a non- should not be disclosed; and (ii) said records shall be collusive bidding certification on Contractor's behalf. sufficiently identified; and (iii) designation of said records as exempt under the Statute is reasonable. Nothing contained 8. INTERNATIONAL BOYCOTT PROHIBITION. In herein shall diminish, or in any way adversely affect, the accordance with Section 220-f of the Labor Law and Section State's right to discovery in any pending or future litigation. 139-h of the State Finance Law, if this contract exceeds $5,000, the Contractor agrees, as a material condition of the 11. IDENTIFYING INFORMATION AND PRIVACY contract, that neither the Contractor nor any substantially NOTIFICATION. (a) Identification Number(s). Every owned or affiliated person, firm, partnership or corporation invoice or New York State Claim for Payment submitted to a has participated, is participating, or shall participate in an New York State agency by a payee, for payment for the sale of international boycott in violation of the federal Export goods or services or for transactions (e.g., leases, easements, Administration Act of 1979 (50 USC App. Sections 2401 et licenses, etc.) related to real or personal property must include seq.) or regulations thereunder. If such Contractor, or any of the payee's identification number. The number is any or all of the aforesaid affiliates of Contractor, is convicted or is the following: (i) the payee's Federal employer identification otherwise found to have violated said laws or regulations upon number, (ii) the payee's Federal social security number, and/or the final determination of the United States Commerce (iii) the payee's Vendor Identification Number assigned by the Department or any other appropriate agency of the United Statewide Financial System. Failure to include such number States subsequent to the contract's execution, such contract, or numbers may delay payment. Where the payee does not amendment or modification thereto shall be rendered forfeit have such number or numbers, the payee, on its invoice or and void. The Contractor shall so notify the State Comptroller Claim for Payment, must give the reason or reasons why the within five (5) business days of such conviction, determination payee does not have such number or numbers. or disposition of appeal (2NYCRR 105.4). (b) Privacy Notification. (1) The authority to request the 9. SET-OFF RIGHTS. The State shall have all of its above personal information from a seller of goods or services common law, equitable and statutory rights of set-off. These or a lessor of real or personal property, and the authority to rights shall include, but not be limited to, the State's option to maintain such information, is found in Section 5 of the State withhold for the purposes of set-off any moneys due to the Tax Law. Disclosure of this information by the seller or lessor Contractor under this contract up to any amounts due and to the State is mandatory. The principal purpose for which the owing to the State with regard to this contract, any other information is collected is to enable the State to identify contract with any State department or agency, including any individuals, businesses and others who have been delinquent contract for a term commencing prior to the term of this in filing tax returns or may have understated their tax contract, plus any amounts due and owing to the State for any liabilities and to generally identity persons affected by the other reason including, without limitation, tax delinquencies, taxes administered by the Commissioner of Taxation and fee delinquencies or monetary penalties relative thereto. The Finance. The information will be used for tax administration State shall exercise its set-off rights in accordance with normal purposes and for any other purpose authorized by law. (2) The State practices including, in cases of set-off pursuant to an personal information is requested by the purchasing unit of the audit, the finalization of such audit by the State agency, its agency contracting to purchase the goods or services or lease representatives, or the State Comptroller. the real or personal property covered by this contract or lease. The information is maintained in the Statewide Financial 10. RECORDS. The Contractor shall establish and maintain System by the Vendor Management Unit within the Bureau of complete and accurate books, records, documents, accounts State Expenditures, Office of the State Comptroller, 110 State and other evidence directly pertinent to performance under Street, Albany, New York 12236. this contract (hereinafter, collectively, "the Records"). The Records must be kept for the balance of the calendar year in 12. EQUAL EMPLOYMENT OPPORTUNITIES FOR which they were made and for six (6) additional years MINORITIES AND WOMEN. In accordance with Section thereafter. The State Comptroller, the Attorney General and 312 of the Executive Law and 5 NYCRR 143, if this contract any other person or entity authorized to conduct an is: (i) a written agreement or purchase order instrument, examination, as well as the agency or agencies involved in this providing for a total expenditure in excess of $25,000.00, contract, shall have access to the Records during normal whereby a contracting agency is committed to expend or does business hours at an office of the Contractor within the State expend funds in return for labor, services, supplies, of New York or, if no such office is available, at a mutually equipment, materials- or any combination of the foregoing, to Page 4 December, 2011 STAMMAgCU N8MTEC1MT=U ARElrM1A he performed for, or rendered or famished to the contracting with any such federal law and if such duplication or conflict agency; or (ii) a written agreement in excess of $100.000.00 exists, the contracting agency shall waive the applicability of o hereby a contracting agency is committed to expend or does Section 312 to the extent of such duplication or conflict. expend funds for the acquisition, construction, demolition, Contractor will comply with all duly promulgated and lawful replacement, major repair or renovation of real property and rules and regulations of the Department of Economic improvements thereon; or (iii) a written agreement in excess Development's Division of Minority and Women's Business of $100,000.00 whereby the owner of a State assisted housing Development pertaining hereto. project is committed to expend or does expend funds for the acquisition, construction, demolition, replacement, major 13. CONFLICTING TERMS. In the event of a conflict repair or renovation of real property and improvements between the terms of the contract (including any and all thereon for such project, then the following shall apply and by attachments thereto and amendments thereof) and the terms of eigning this agreement the Contractor certifies and affirms that this Appendix A, the terms of this Appendix A shall control. it is Contractor's equal employment opportunity policy that: 14. GOVERNING LAW. This contract shall be governed by (a) The Contractor will not discriminate against employees or the laws of the State of New York except where the Federal applicants for employment because of race, creed, color, supremacy clause requires otherwise. national origin, sex, age, disability or marital status, shall make and document its conscientious and active efforts to 15. LATE PAYMENT. Timeliness of payment and any employ and utilize minority group members and women in its interest to be paid to Contractor for late payment shall be work force on State contracts and will undertake or continue governed by Article I I-A of the State Finance Law to the existing programs of affirmative action to ensure that minority extent required by law. group members and women are afforded equal employment opportunities without discrimination. Affirmative action shall 16. NO ARBITRATION. Disputes involving this contract, mean recruitment, employment, job assignment, promotion, including the breach or alleged breach thereof, may not be upgradings, demotion, transfer, layoff, or termination and rates submitted to binding arbitration (except where statutorily of pay or other forms of compensation; authorized), but must, instead, be heard in a court of competent jurisdiction of the State of New York. (b) at the request of the contracting agency, the Contractor shall request each employment agency, labor union, or 17. SERVICE OF PROCESS. In addition to the methods of authorized representative of workers with which it has a service allowed by the State Civil Practice Law & Rules collective bargaining or other agreement or understanding, to ("CPLR"), Contractor hereby consents to service of process furnish a written statement that such employment agency, upon it by registered or certified mail, return receipt requested. labor union or representative will not discriminate on the basis Service hereunder shall be complete upon Contractor's actual of race, creed, color, national origin, sex, age, disability or receipt of process or upon the State's receipt of the return marital status and that such union or representative will thereof by the United States Postal Service as refused or affirmatively cooperate in the implementation of the undeliverable. Contractor must promptly notify the State, in Contractor's obligations herein; and writing, of each and every change of address to which service of process can be made. Service by the State to the last known (c) the Contractor shall state, in all solicitations or address shall be sufficient. Contractor will have thirty (30) advertisements for employees, that, in the performance of the calendar days after service hereunder is complete in which to State contract, all qualified applicants will be afforded equal respond. employment opportunities without discrimination because of race, creed, color, national origin, sex, age, disability or 18. PROHIBITION ON PURCHASE OF TROPICAL marital status. HARDWOODS. The Contractor certifies and warrants that all wood products to be used under this contract award will be Contractor will include the provisions of "a", "b", and "c" in accordance with, but not limited to, the specifications and above, in every subcontract over $25,000.00 for the provisions of Section 165 of the State Finance Law, (Use of construction, demolition, replacement, major repair, Tropical Hardwoods) which prohibits purchase and use of renovation, planning or design of real property and tropical hardwoods, unless specifically exempted, by the State improvements thereon (the "Work") except where the Work is or any governmental agency or political subdivision or public for the beneficial use of the Contractor. Section 312 does not benefit corporation. Qualification for an exemption under this apply to: (i) work, goods or services unrelated to this contract; law will be the responsibility of the contractor to establish to or 00 employment outside New York State. The State shall meet with the approval of the State. consider compliance by a contractor or subcontractor with the requirements of any federal law concerning equal employment In addition, when any portion of this contract involving the opportunity which effectuates the purpose of this section. The use of woods, whether supply or installation, is to be contracting agency shall determine whether the imposition of performed by any subcontractor, the prime Contractor will the requirements of the provisions hereof duplicate or conflict indicate and certify in the submitted bid proposal that the Page 5 December, 2011 STAIIIII/ CIIIIIFI FIN NU CINIII0II ARENIpI subcontractor has been informed and is in compliance with retained the documentation of these efforts to be provided specifications and provisions regarding use of tropical upon request to the State; hardwoods as detailed in §165 State Finance Law. Any such use must meet with the approval of the State; otherwise, the (b) The Contractor has complied with the Federal Equal bid may not be considered responsive. Under bidder Opportunity Act of 1972 (P.L. 92-261), as amended; certifications, proof of qualification for exemption will be the responsibility of the Contractor to meet with the approval of (c) The Contractor agrees to make reasonable efforts to the State. provide notification to New York State residents of employment opportunities on this project through listing any 19. MACBRIDE FAIR EMPLOYMENT PRINCIPLES. such positions with the Job Service Division of the New York In accordance with the MacBride Fair Employment Principles State Department of Labor, or providing such notification in (Chapter 807 of the Laws of 1992), the Contractor hereby such manner as is consistent with existing collective stipulates that the Contractor either (a) has no business bargaining contracts or agreements. The Contractor agrees to operations in Northern Ireland, or (b) shall take lawful steps in document these efforts and to provide said documentation to good faith to conduct any business operations in Northern the State upon request; and Ireland in accordance with the MacBride Fair Employment Principles (as described in Section 165 of the New York State (d) The Contractor acknowledges notice that the State may Finance Law), and shall permit independent monitoring of seek to obtain offset credits from foreign countries as a result compliance with such principles. of this contract and agrees to cooperate with the State in these efforts. 20. OMNIBUS PROCUREMENT ACT OF 1992. It is the policy of New York State to maximize opportunities for the 21. RECIPROCITY AND SANCTIONS PROVISIONS. participation of New York State business enterprises, Bidders are hereby notified that if their principal place of including minority and women-owned business enterprises as business is located in a country, nation, province, state or bidders, subcontractors and suppliers on its procurement political subdivision that penalizes New York State vendors, contracts, and if the goods or services they offer will be substantially produced or performed outside New York State, the Omnibus Information on the availability of New York State Procurement Act 1994 and 2000 amendments (Chapter 684 subcontractors and suppliers is available from: and Chapter 383, respectively) require that they be denied contracts which they would otherwise obtain. NOTE: As of NYS Department of Economic Development May 15, 2002, the list of discriminatory jurisdictions subject Division for Small Business to this provision includes the states of South Carolina, Alaska, '0 South Pearl St 7"' Floor West Virginia, Wyoming, Louisiana and Hawaii. Contact Albany, New York 12245 NYS Department of Economic Development for a current list Telephone: 518.292-5220 of jurisdictions subject to this provision. Fax: 518-292-5884 http://www.empire.state.ny.us 22. COMPLIANCE WITH NEW YORK STATE INFORMATION SECURITY BREACH AND A directory of certified minority and women-owned business NOTIFICATION ACT. Contractor shall comply with the enterprises is available from: provisions of the New York State Information Security Breach and Notification Act (General Business Law Section 899-aa; NYS Department of Economic Development State Technology Law Section 208). Division of Minority and Women's Business Development 30 South Pearl St 2nd Floor 23. COMPLIANCE WITH CONSULTANT Albany, New York 12245 DISCLOSURE LAW. If this is a contract for consulting Telephone: 518-292-5250 services, defined for purposes of this requirement to include Fax: 518-292-5803 analysis, evaluation, research, training, data processing, http://www.empire.state.ny.us computer programming, engineering, environmental, health, and mental health services, accounting, auditing, paralegal, The Omnibus Procurement Act of 1992 requires that by legal or similar services, then, in accordance with Section 163 signing this bid proposal or contract, as applicable, (4-g) of the State Finance Law (as amended by Chapter 10 of Contractors certify that whenever the total bid amount is the Laws of 2006), the Contractor shall timely, accurately and ,greater than $I million: properly comply with the requirement to submit an annual employment report for the contract to the agency that awarded (a) The Contractor has made reasonable etTorts to encourage the contract, the Department of Civil Service and the State the participation of New York State Business Enterprises as Comptroller. suppliers and subcontractors, including certified minority and women-owned business enterprises, on this project, and has Page 6 December, 2011 STIINNNSS CWSTS RC NTS CSNTWO 11MFrp1 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 the contractor certifies and affirms that all disclosures made in accordance with State Finance Law Sections 139-j and 139-k are complete, true 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 the 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. Page 7 December, 2011 APPENDIX A-1 SUPPLEMENTAL TITLE VI PROVISIONS (CIVIL RIGHTS ACT) (To be included in all contracts) During the performance of this contract, the contractor, for itself, its assignees and successors in interest (hereinafter referred to as the "contractor") agrees as follows: (1) Compliance with Regulations: The contractor shall comply with the Regulation relative to nondiscrimination in Federally assisted programs of the Department of Transportation of the United States, Title 49, Code of Federal Regulations, Part 21, and the Federal Highway Administration (hereinafter "FHWA") Title 23, Code of Federal Regulations, Part 200 as they may be amended from time to time, (hereinafter referred to as the Regulations), which are herein incorporated by reference and made a part of this contract. (2) Nondiscrimination: The Contractor, with regard to the work performed by it during the contract, shall not discriminate on the grounds of race, religion, age, color, sex or national origin, sex, age, and disability/handicap in the selection and retention of subcontractors, including procurements of materials and leases of equipment. The contractor shall not participate either directly or indirectly in the discrimination prohibited by 49 CFR, section 21.5 of the Regulations, including employment practices when the contract covers a program set forth in Appendix B of the Regulations. (3) Solicitations for Subcontractors. Including Procurements of Materials and Eguioment: In all solicitations either by competitive bidding or negotiation made by the contractor for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the contractor of the contractor's obligations under this contract and the Regulations relative to nondiscrimination on the grounds of race, color, or national origin, sex, age, and disability/handicap. (4) Information and Reports: The contractor shall provide all information and reports required by the Regulations or directives issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its facilities as may be determined by NYSDOT or the FHWA to be pertinent to ascertain compliance with such Regulations, orders and instructions. Where any information required of a contractor is in the exclusive possession of another who fails or refuses to furnish this information the contractor shall so certify to NYSDOT's Office of Civil Rights or FHWA, as appropriate, and shall set forth what efforts it has made to obtain the information. (5) Sanctions for Noncompliance: In the event of the contractor's noncompliance with the nondiscrimination provisions of this contract, NYSDOT shall impose such contract sanctions as it or the FHWA may determine to be appropriate, including, but not limited to: a) Withholding of payments to the contractor under the contract until the contractor complies; and/or b) Cancellation, termination or suspension of the contract, in whole or in part. (6) Incorporation of Provisions: The contractor shall include the provisions of paragraphs (1) through (6) in every subcontract, including procurements of materials and leases of equipment, unless exempt by the Regulations, or directives issued pursuant thereto. The contractor shall take such action with respect to any subcontractor procurement as NYSDOT or the FHWA may direct as a means of enforcing such provisions including sanctions for non-compliance: Provided, however, that in the event a contractor becomes involved in, or is threatened with, litigation with a subcontractor or supplier as a result of such direction, the contractor may request NYSDOT to enter into such litigation to protect the interests of NYSDOT, and, in addition, the contractor may request the United States to enter into such litigation to protect the interests of the United States. APPENDIX B REQUIREMENTS FOR FEDERALLY AIDED TRANSPORTATION PROJECTS (January 2009) There is a substantial body of requirements attached to the use of Federal highway or transportation aid. These requirements create or overlay processes, procedures, documentation requirements, authorizations, approvals and certifications that may be substantially greater or different from those that are not funded with Federal-aid and proceed under applicable State and local laws, customs and practices. Under Title 23 of the United States Code, NYSDOT is responsible for the administration of transportation projects in New York State to which NYSDOT provides Federal highway or transportation-related aid. Through this Agreement, which provides or is associated with such funding, NYSDOT delegates various elements of project and funding administration as described elsewhere in this Agreement. In undertaking a Federally aided project, the Municipality/Sponsor, Authority or Project Manager designated under this Agreement with Federal-aid funding or project administration agrees to proceed in compliance with all the applicable Federal-aid requirements. NYSDOT, in cooperation with FHWA, has assembled the body of Federal-aid requirements, procedures and practices in its "Procedures for Locally Administered Federal-Aid Projects" (available through NYSDOT's web site at: www.dot.ny.oov/Dlafao). In addition, the Municipality/Sponsor, Authority or Project Manager designated under this Agreement for Federal-aid funding or project administration that enters into Federally aided project construction contracts is required to physically incorporate into all its Federally aided construction contracts and subcontracts there under the provisions that are contained in Form FHWA-1273 (available from NYSDOT or electronically at: www.fhwa.dot.gov/programadmin/contracts/1273 htm). In addition to the referenced requirements, the attention of Municipality/Sponsor hereunder is directed to the following requirements and information: NON DISCRIMINATION/EEO/DBE REQUIREMENTS The Municipality/Sponsor and its contractors agree to comply with Executive Order 11246, entitled "Equal Employment Opportunity" and Department of Transportation regulations (49 CFR Parts 21, 23, 25, 26 and 27) and the following: 1. NON DISCRIMINATION. No person shall, on the ground of race, color, creed, national origin, sex, age or handicap, be excluded from participation in, or denied the benefits of, or be subject to, discrimination under the Project funded through this Agreement. 2. EQUAL EMPLOYMENT OPPORTUNITY. In connection with the execution of this Agreement, the Municipality/Sponsor's contractors or subcontractors shall not discriminate against any employee or applicant for employment because of race, religion, age, color, sex or national origin. Such contractors shall take affirmative actions to ensure that applicants are employed, and that employees are treated during their employment, without regard to their race, religion, color, sex, national origin or age. Such actions shall include, but not be limited to, the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. 3. DISADVANTAGED BUSINESS ENTERPRISES. In connection with the performance of this Agreement, the Municipality/Sponsor shall cause its contractors to cooperate with the State in meeting its commitments and goals with regard to the utilization of Disadvantaged Business Enterprises (DBEs) and will use its best efforts to ensure that DBEs will have opportunity to compete for subcontract work under this Agreement. Also, in this connection the Municipality or Municipality/Sponsor shall cause its contractors to undertake such actions as may be necessary to comply with 49CFR Part 26. FEDERAL SINGLE AUDIT REQUIREMENTS Non-Federal entities that expend $500,000 or more in a year in Federal awards from all sources are required to comply with the Federal Single Audit Act provisions contained in U.S. Office of Management and Budget (OMB) Circular No. A-133, "Audits of States, Local Governments, and Non-Profit Organizations". Non-Federal entities that expend Federal awards from a single source may provide a program specific audit, as defined in the Circular. Non-Federal entities that expend less than $500,000 in a year in Federal awards from all sources are exempt from Federal audit requirements for that year, except as noted in Sec. 215 (a) of OMB Circular A-133 Subpart B--Audits, records must be available for review or audit by appropriate officials of the cognizant Federal agency' the New York State Department of Transportation, the New York State Comptroller's Office and the U.S. Governmental Accountability Office (GAO). Non-Federal entities are required to submit a copy of all audits, as described above, within 30 days of issuance of audit report, but no later than 9 months after the end of the entity's fiscal year, to the New York State Department of Transportation, Contract Audit Bureau, 50 Wolf Road, Albany, NY 12232. Unless a time extension has been granted by the cognizant Federal Agency and has been filed with the New York State Department of Transportation's Contract Audit Bureau, failure to comply with the requirements of OMB Circular A-133 may result in suspension or termination of Federal award payments. THE CATALOG OF FEDERAL DOMESTIC ASSITANCE The Catalog of Federal Domestic Assistance (CFDA2), is an on-line database of all Federally- aided programs available to State and local governments (including the District of Columbia); Federally recognized Indian tribal governments; Territories (and possessions) of the United States; domestic public, quasi-public, and private profit and nonprofit organizations and institutions; specialized groups; and individuals. THE CFDA IDENTIFICATION NUMBER OMB Circular A-133 requires all Federal-aid recipients to identify and account for awards and expenditures by CFDA Number. The Municipality/Sponsor is required to identify in its accounts all Federal awards received and expended, and the Federal programs under which they were received. Federal program and award identification shall include, as applicable, the CFDA title and number, award number and year, name of the Federal agency, and name of the pass-through entity. The most commonly used CFDA number for the Federal Aid Highway Planning and Construction program is 20.205. ' The designated cognizant agency for audit shall be the federal awarding agency that provides the predominant amount of direct funding to a recipient unless OMB changes it. 2 ,niww.cfda.aov/ Additional CFDA numbers for other transportation and non-transportation related programs are: 20.215 Highway Training and Education 20.219 Recreational Trails Program 20.XXX Highway Planning and Construction - Highways for LIFE; 20.XXX Surface Transportation Research and Development; 20.500 Federal Transit-Capital Investment Grants 20.505 Federal Transit-Metropolitan Planning Grants 20.507 Federal Transit-Formula Grants 20.509 Formula Grants for Other Than Urbanized Areas 20.600 State and Community Highway Safety 23.003 Appalachian Development Highway System 23.008 Appalachian Local Access Roads PROMPT PAYMENT MECHANISMS (a) You must establish, as part of your DBE program, a contract clause to require prime contractors to pay subcontractors for satisfactory performance of their contracts no later than 7 calendar days from receipt of each payment you make to the prime contractor. (b) You must ensure prompt and full payment of retainage from the prime contractor to the subcontractor within 7 calendar days after the subcontractor's work is satisfactorily completed. You must use one of the following methods to comply with this requirement: (1) You may decline to hold retainage from prime contractors and prohibit prime contractors from holding retainage from subcontractors. (2) You may decline to hold retainage from prime contractors and require a contract clause obligating prime contractors to make prompt and full payment of any retainage kept by prime contractor to the subcontractor within 7 calendar days after the subcontractor's work is satisfactorily completed. (3) You may hold retainage from prime contractors and provide for prompt and regular incremental acceptances of portions of the prime contract, pay retainage to prime contractors based on these acceptances, and require a contract clause obligating the prime contractor to pay all retainage owed to the subcontractor for satisfactory completion of the accepted work within 7 calendar days after your payment to the prime contractor. (c) For purposes of this section, a subcontractor's work is satisfactorily completed when all the tasks called for in the subcontract have been accomplished and documented as required by the recipient. When a recipient has made an incremental acceptance of a portion of a prime contract, the work of a subcontractor covered by that acceptance is deemed to be satisfactorily completed. (d) Your DBE program must provide appropriate means to enforce the requirements of this section. These means may include appropriate penalties for failure to comply, the terms and conditions of which you set. Your program may also provide that any delay or postponement of payment among the parties may take place only for good cause, with your prior written approval. (e) You may also establish, as part of your DBE program, any of the following additional mechanisms to ensure prompt payment: (1) A contract clause that requires prime contractors to include in their subcontracts language providing that prime contractors and subcontractors will use appropriate alternative dispute resolution mechanisms to resolve payment disputes. You may specify the nature of such mechanisms. (2) A contract clause providing that the prime contractor will not be reimbursed for work performed by subcontractors unless and until the prime contractor ensures that the subcontractors are promptly paid for the work they have performed. (3) Other mechanisms, consistent with this part and applicable state and local law, to ensure that DBEs and other contractors are fully and promptly paid. ' • APPENDIX 2 IRAN DIVESTMENT ACT As a result of the Iran Divestment Act of 2012 (Act), Chapter l of the 2012 Laws of New York, a new provision has been added to the State Finance Law (SFL), § 165-a, effective April 12, 2012. Under the Act, the Commissioner of the Office of General Services (OGS) will be developing a list (prohibited entities list) of "persons" who are engaged in "investment activities in Iran" (both are defined terms in the law). Pursuant to SFL § 165-a(3)(b), the initial list is expected to be issued no later than 120 days after the Act's effective date, at which time it will be posted on the OGS website. By entering into this Contract, Contractor (or any assignee) certifies that once the prohibited entities list is posted on the OGS website, it will not utilize on such Contract any subcontractor that is identified on the prohibited entities list. Additionally, Contractor agrees that after the list is posted on the OGS website, should it seek to renew or extend the Contract, it will be required to certify at the time the Contract is renewed or extended that it is not included on the prohibited entities list. Contractor also agrees that any proposed Assignee of the Contract will be required to certify that it is not on the prohibited entities list before the New York State Department of Transportation (NYSDOT) may approve a request for Assignment of Contract During the term of the Contract, should NYSDOT receive information that a person is in violation of the above- referenced certification, NYSDOT will offer the person an opportunity to respond. If the person fails to demonstrate that it has ceased its engagement in the investment which is in violation of the Act within 90 days after the determination of such violation, then NYSDOT shall take such action as may be appropriate including, but not limited to, imposing sanctions, seeking compliance, recovering damages, or declaring the Contractor in default. NYSDOT reserves the right to reject any request for assignment for an entity that appears on the prohibited entities list prior to the award of a contract, and to pursue a responsibility review with respect to any entity that is awarded a contract and appears on the prohibited entities list after contract award. OUTLAY REPORT AND REQUEST FOR Approved by Office of Management REIMBURSEMENT FOR CONSTRUCTION PROGRAMS 1n TYPE Budget OF REQUEST: PAGE 1 OF 1 PAGES ' 2. BASIS OF REQUEST: X~ PARTIAL X? CASH FINAL ACCRUAL 3. FEDERAL SPONSORING AGENCY AND ORGANIZATIONAL ELEMENT 4. FEDERAL GRANTOR OTHER IDENTIFYING 5. PARTIAL PAYMENT REQUEST NO. TO WHICH THIS REPORT IS SUBMITTED: NUMBER ASSIGNED BY FEDERAL AGENCY: Federal Aviation Administration - NY Do THREE 3-36-0029-19-12 6. EMPLOYER IDENTIFICATION NO.: rOTHEC'I'DENTIFYINOGUNUMBER: EENT ACT OR 8. PERIOD COVERED BY THIS REPORT FF (Month, day, year) TO: (Month, da 11-6003307 NSA y~ Year) 9. RECIPIENT ORGANIZATION: 04/11/13 06/05/13 PAYEE: (Where check should be sent if different than n item item 9) Name: Town of Southold Name: Town Hall Address P.O. Box 1179 Address: Southold, NY 11971 11 STATUS OF FUNDS PROGRAMS - FUNCTIONS - ACTIVITIES (a) Q) (c) CLASSIFICATION Environmental Assessment for 5 Year CIP TOTAL a. Administrative expense $0.00 $0.00 $0.00 $0.00 b. Preliminary expense $0.00 $0.00 $0.00 $0.00 C. Land, structures, right-of-way $0.00 $0.00 $0.00 $0.00 d. Architectural engineering basic fees $0.00 $0.00 $0.00 $0.00 e. Other architectural engineering fees $17,934.40 $0.00 $0.00 $17,934.40 f. Project inspection fees $0.00 $0.00 $0.00 9. Land development $0.00 $0.00 $0.00 $0.00 $0.00 h. Relocation expense $0.00 $0.00 $0.00 $0.00 L Relocation payments to individuals and businesses $0.00 $0.00 $0.00 $0.00 j. Demolition and removal $0.00 $0.00 $0.00 $0.00 k. Construction and project improvement cost $0.00 $0.00 $0.00 $0.00 1. Equipment $0.00 $0.00 $0.00 $0.00 m. Miscellaneous cost $1,500.00 $0.00 $0.00 $1,500.00 n. Total cumulative to dale (sum of lines a thru m) $19,434.40 $0.00 $0.00 $19,434.40 0. Deductions for program income $0.00 $0.00 $0.00 $0.00 Q. Net cumulative to date (Line n minus line o) $19,434.40 $0.00 $0.00 q. Federal share to data $19,434.40 $17,490.96 $0.00 $0.00 $17,490.96 r. Rehabilitation grants (100% reimbursement) $0.00 $0.00 $0.00 $0.00 s. Total Federal share (sum of lines q and r) $17,490.96 $0.00 $0.00 $17,490.96 t. Federal payments previously. requested $8,353.00 $0.00 $0.00 $8,353.00 u. Amount requested for reimbursement $9,137.96 $0.00 $0.00 $9,137.96 v. Percent of physical completion of project 12.46% 0.00% ° 0.00 /0 12.46% SIGNAT E OF AUTHORIZED CERTIFYIN DATE REPORT SUBMITTED: 12. CERTIFICATION: (p cy I certify that to the best of my knowledge a. RECIPIENT l 1 ~I 3 and belief the billed costs or disburse- PED OR PRINTED NAME AND TITLE: TELEPHONE NO. ments are in accordance with the terms SCOTT A. RUSSELL of the project and that the reimbursement TOWN SUPERVISOR represents the Federal share due which (631) 765-1889 has not been previously requested and SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL: DATE REPORT SUBMITTED: that an inspection has been performed and all work is in accordance with the b. Representative /f terms of the award. certifying to line 11v. TYPED OR PRINTED NAME AND TITLE: TELEPHONE NO.: KELLI R. WALTERS GRANTS ADMINISTRATOR (315) 455-2000 C&S ENGINEERS, INC. 271-102 STANDARD FROM 271 (7-76) PreacriGed by Olfira W MarupemeM and Budget Cir. A-110 FIN 190-4b (MO1) STATE OF NEW YORK Comptroller's Number Ac 5033 DEPARTMENT OF TRANSPORTATION T034427 Approved State MUNICIPAL CORPORATION APPLICATION FOR PAYMENT Certificate Number Comptroller ONE PAYEE (Name,Address and Zip Code): FINANCIAL STATEMENT Town of Southold COST OF WORK PERFORMED TO DATE: 615/13 Town Hall P.O. Box 1179 1. Total Expended $19,434.40 Southold, NY 11971 2. Less non-participating $0.00 3. Eligible Cost $19,434.40 4. Less Federal Share $17,490.96 Payee-Employer Identification No. Vendor ID 5. Project Cost $1,943.44 470379000 000 1000000876 6. State Share at 50% $971.72 GRANT AGREEMENT 7. Total prior requests $0.00 State No. 0913.19 Max. State Amt. $7,800 8. Amount requested $971.72 Federal No. 3-36-0029-19-12 Max. Fed. Amt. $140,400 In accordance with the provisions of the Grant Agreement, the Municipal Corporation applies for payment as follows: A B C D E F ELIGIBLE FEDERAL PROJECT PRIOR CURRENT STATE FUNDS DESCRIPTION COST SHARE COST PROJECT PROJECT REQUESTED INCURRED (A-B) COSTS COSTS (C-D) (50% OF E)' EQUIPMENT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 LAND $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 CONSTRUCTION $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ENGINEERING $17,934.40 $16,140.96 $1,793.44 $0.00 $1,793.44 $896.72 OTHER $1,500.00 $1,350.00 $150.00 $0.00 $150.00 $75.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ADMINISTRATION $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTALS $19,434.40 $17,490.96 $1,943.44 $0.00 $1,943.44 $971.72 As the sponsor's Authorized Representative, I hereby certify that the above information is true and that the funding requested is for a project approved by the New York State Department of Transportation. The project for which funding is being requested satisfies all requirements and the terms and conditions of the above listed State Grant Agreement. Additionally, I certify that according to my knowledge and belief, all items and amounts shown on this application are correct, all work has been preformed and / or all materials supplied and federal reimbursement has been received. (See Attached) Dater Signature: Title: TOWN SUPERVISOR NEW YORK STATE USE Approved Amount: $ ACCEPTED BY - NEW YORK STATE DEPT. OF TRANSPORTATION APPROVED AS TO FUNDS AVAILABLE AUDITS & ACCOUNTS BUREAU - DEPT. OF TRANSPORTATION Date: By: Date By: PROJECT NUMBER REQUEST PAYMENT Dept. of Transp. State Number Interim Voucher Number Federal Date Semi-final Final Fir+,1.ka20(10171) STATE OF NEW YORK Comptroller's Number AC 5033 DEPARTMENT OF TRANSPORTATION T034427 Approved State MUNICIPAL CORPORATION APPLICATION FOR PAYMENT Certificate Number Comptroller ONE PAYEE (Name,Address and Zip Code): FINANCIAL STATEMENT Town of Southold COST OF WORK PERFORMED TO DATE: 615/13 Town Hall P.O. Box 1179 1. Total Expended $19,434.40 Southold, NY 11971 2. Less non-participating $0.00 3. Eligible Cost $19,434.40 4. Less Federal Share $17,490.96 Payee-Employer Identification No. Vendor ID 5. Project Cost $1,943.44 470379000 000 1000000876 6. State Share at 50% $971.72 GRANT AGREEMENT 7. Total prior requests $0.00 State No. 0913.19 Max. State Amt. $7,800 8. Amount requested $971.72 Federal No. 3-36-0029-19-12 Max. Fed. Amt. $140,400 In accordance with the provisions of the Grant Agreement, the Municipal Corporation applies for payment as follows: A B C 0 E F ELIGIBLE FEDERAL PROJECT PRIOR CURRENT STATE FUNDS DESCRIPTION COST SHARE COST PROJECT PROJECT REQUESTED INCURRED (A-B) COSTS COSTS (C-D) (50% OF E)' EQUIPMENT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 LAND $0.00 $0.00 $0.00 $0.00 $0.00 MOO CONSTRUCTION $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ENGINEERING $17,934.40 $16,140.96 $1,79144 $0.00 $1,793.44 $896.72 OTHER $1,500.00 $1,350.00 $150.00 $0.00 $150.00 $75.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ADMINISTRATION $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTALS $19,434.40 $17,490.96 $1,943.44 $0.00 $1,943.44 $971.72 As the sponsor's Authorized Representative, I hereby certify that the above information is true and that the funding requested is for a project approved by the New York State Department of Transportation. The project for which funding is being requested satisfies all requirements and the terms and conditions of the above listed State Grant Agreement. Additionally, I certify that according to my knowledge and belief, all items and amounts shown on this application are correct, all work has been preformed and I or all materials supplied and federal reimbursement has been received. (See Attached) Date:A /t a Signature: 4tin /M~ Title: TOWN SUPERVISOR NEW YORK STATE USE Approved Amount: $ ACCEPTED BY - NEW YORK STATE DEPT. OF TRANSPORTATION APPROVED AS TO FUNDS AVAILABLE AUDITS & ACCOUNTS BUREAU - DEPT. OF TRANSPORTATION Date: By: Date By: PROJECT NUMBER REQUEST PAYMENT Dept. of Transp. State Number Interim Voucher Number Federal Dale Semi-final Final FEDERAL FINANCIAL REPORT (Follow form instructions) 1. Federal Agency and Organizational Element to 2. Federal Grantor Other Identifying Number Assigned by Federal Agency (To Which Report is Submitted report multiple grants, use FFR Attachment) Federal Aviation Admimstratton Airports Division- Page of NY ADO AIP Grant # 3-36-0029-19-12 1 1 3. Recipient Organization (Name and complete address including Zip code) pages Town of Southold Town Hall PO Box 1179 Southold, NY 11971 4a. DUNS Number 41b. EIN 5. Recipient Account Number or Identifying 197736387 6. Report Type 7. Basis of Accounting 11-6003307 Number (TO report multiple grants, use FFR Attachment) ?Quanerly ? Cash 3-36-0029-19-12 ?Semi-Annual ?Acomal ?Annual ? Final 8. Project /Grant (Month, Day, Year) 9. Reporting Period End Date (Month, Day, Year) From: 9119 9/19/2012 To: 9/19/2016 10. Transactions 9130/2013 (Use lines a-c for single or combined multiple grant reporting) Cumulative Federal Cash To re Ort multiple rants separately, also use FFR Attachment : a. Cash Receipts b. Cash Disbursements $0.00 c. Cash on Hand (line a minus b) $0.00 $0 (Use lines do for single grant re )rt/ng) Federal Expenditures and Unobli ated Balance: It. Total Federal funds authorized $140,400.00 I. Federal share of expenditures f. Federal share of unliquidated obligations $0.00 g. Total Federal share (sum of lines a and 0 $0 In. Unobli ated balance of Federal funds line d minus ) $0.00 Red lent Share: $140,400.00 i. Total recipient share required $7,800.00 j. Recipient share of expenditures $0.00 k. Remaining recipient share to be provided (line i minus) $73800.00 Pro ram Income: I. Total Federal share of ro ram income earned m. Pro ram income expended in accordance with the deduction alternative n. Program income expended in accordance with the addition alternative o. Unexpended program income (line I minus line in or line n) 11. a. Type b. Rate c. Period Period To d. Base e. Amount Charged f. Federal Share Indirect From Expense . Totals: 0 p 0 12. Remarks Attach any explanations deemed necessary or information required by Federal spmsonng agency in compliance with governing legislation: I 13. Certification: By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, and accurate, and the expenditures, disbursements and cash receipts are for the purposes and intent It forth in the award documents. I am aware that any false, fictitious, or fraudulent information may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 18, Section 1001) a. Typed or Printed N me and Title of Authorized Certifying Official c. Telephone (Area code, number, and extension) ScottA. Russell n Supervisor (631) 765-1889 j 113 b. Signature of Authorized Cedi in Official f Y 9 (sign here) I. Date Report Submitted (Month, Day, Year) I f. Standard Form 425 - Revised lull 1 /2 01 1 OMB Approval Number: 0348-0061 Expiration Date: 2/28/2015 Paperwork Burden Statement According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a va=per mber. The valid OMB control number for this information collection is 0348-0061. Public reporting burden for this collection of information is estimated to avresponse, including lime for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewf information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burdeanagement and Budget, Paperwork Reduction Project (0348-0061), Washington, DC 20503. I I