Loading...
HomeMy WebLinkAboutOperation Shield 11 0 RESOLUTION 2014-248 *®tr ADOPTED DOC ID: 9612 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2014-248 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON MARCH 11, 2014: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Scott A. Russell to execute the Consultant/Personal Services Contract between the Town of Southold and the County of Suffolk, acting through its duly constituted Sheriffs Office, in connection with the NYS Office of Homeland Security Grant Program regarding pass-through grant funds in the sum of $40,000.00 for Operation Shield administered by the Suffolk County Sheriffs Office in partnership with the East End Marine Task Force, for the term commencing on March 1, 2014 and ending on July 11, 2014, at a cost not to exceed $2,243.00, subject to the approval of the Town Attorney. 4Q? Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: William P. Ruland, Councilman SECONDER: Jill Doherty, Councilwoman AYES: Ghosio, Dinizio Jr, Ruland, Doherty, Evans, Russell 1046%) RESOLUTION 2014-248 $4,Fe ADOPTED DOC ID: 9612 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO.2014-248 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON MARCH 11,2014: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Scott A. Russell to execute the Consultant/Personal Services Contract between the Town of Southold and the County of Suffolk, acting through its duly constituted Sheriff's Office, in connection with the NYS Office of Homeland Security Grant Program regarding pass-through grant funds in the sum of$40,000.00 for Operation Shield administered by the Suffolk County Sheriff's Office in partnership with the East End Marine Task Force, for the term commencing on March 1, 2014 and ending on July 11, 2014, at a cost not to exceed$2,243.00, subject to the approval of the Town Attorney. ajedde, , 4/-#;140, Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: William P. Ruland, Councilman SECONDER:Jill Doherty, Councilwoman AYES: Ghosio, Dinizio Jr,Ruland, Doherty, Evans,Russell COUNTY OF SUFFOLK ER;" p q. G�1 -11 SHERIFF'S OFFICE � 44r i VINCENT F.DEMARCO `� SHERIFF May 12, 2014 [1E C E I V E MAY 1 5 2014 2/ Town of Southold ATT: Scott Russell, Supervisor P O Box 1179 SUPERVISOR'S OFFICE TOWN OF SOUTHOLD Southold, New York 11971 RE: "OPERATION SHIELD FY2014" Contract with the County of Suffolk Contract amount: $2,243.00 Dear Supervisor Scott Russell: Attached please find a copy of the contract between the Town and the County of Suffolk for services provided for maritime law enforcement focusing on foreign flagged vessels. When the detail of 6/28-6/30/14 is complete we will be able to reimburse you. Please forward invoices ASAP as grant expires 8/31/14. In order to process payment for these services, it will be necessary for you to sign the enclosed voucher. The area is highlighted for your convenience. We also need an original invoice along with all detailed supporting documentation showing names, dates and hours worked, payroll rate, etc. Please return the signed voucher to: Suffolk County Chief Deputy Sheriff's Office Attn: Jackie Brown 100 Center Drive Riverhead, NY 11901-3389 If you have any questions, please do not hesitate to call me at 631-852-2211. Thank you for your attention in this matter. Very truly yours, -Famg.03-^ RECEIVED ackie Brown MAY 16 2014 100 Center Drive Town Attorney's Office Riverhead,New York 11901 631-852-2200 SUFFOLK COUNTY PAYMENT VOUCHER Dept.: Contact: Payment Voucher# Responsible Agcy Modify Dept.Address SHF Document Total(Include Cents) Vendor Code(10-1) Address 59035 Main Road 116001939 Southold,NY 11971 Ln Reference Document Corn Invoice Fnd Agy Orgn Sub Actv Obj Sub Rept Capital (02) Ln# (3) (3) (4) Org (4) (4) Obj Cat Project# Cd(2)Number(11)Ln(2) (3) Number(12)Ln(3) (2) (2) (4) (8) Rev(4) BS Acct(4) Description(17) Amount(Include Cents) I/D P/F 01 S e*6 3 g O 001 SHF 3112 4980 Federal OP SHIELD FY2014 REIMB 02 03 04 05 Additional Comments OPERATION SHIELD FY2014 RESO.#175-2014 EXPIRES 8/31/14 DEPARTMENT CERTIFICATION: I hereby certify that the materials above PAYEE CERTIFICATION: I certify that the above bill is just,true and specified have been received by me in good condition without substitution.The correct;that no part thereof has been paid except as stated;that the balance is service properly performed and that the quantities thereof have been verified actually due and owing;that taxes from which the County is exempt are with the exceptions of discrepancies noted and payment is approved. excluded and that I have read and am familiar with the provisions of Local Law 32-1980 as detailed in the payee instruction section of this voucher. SIGNED DATE TITLE PAYEE'S SIGNATURE TITLE NAME OF COMPANY Form PV Original: Audit&Control Yellow Copy: Department Accounting 56-0105 3102 • SCE 63gv Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services Consultant/Personal Services Contract This Contract("the Contract") is between the County of Suffolk("the County"), a municipal corporation of the State of New York, acting through its duly constituted S.C. Sheriff's Office ("the Office"), located at 100 Center Drive, Riverhead,New York 11901; and The Town of Southold ("the Contractor"),having an address at 59035 Main Road, Southold,New York 11971. The Contractor has been designated to receive funds from the County for Operation Shield Maritime Law Enforcement Services ("the Services") as set forth in Article I, entitled"Description of Services." Term of the Contract: March 1, 2014 to July 11, 2014. Total Cost of the Contract: Shall not exceed $2,243.00, as set forth in Article II, attached. Terms and Conditions: Shall be as set forth in Articles I and II and Exhibits 1 and 2, attached hereto and made a part hereof. In Witness Whereof, the parties hereto have executed the Contract as of the latest date written below. Town of So old COU Y OF SUFFOLK By: 7r Scott A.Russell By: Supervisor Dennis M. Cohen Fed. Tax ID#11 600 1939 Chief Deputy County Executive Date: /✓'/�/ `f c'ef.fhereby certifies under penalties of perjury that I am an officer of�u!/1 C.4 f�-, Q t that I have read and am familiar with Section A5-7q(Article 5 //Approved: of the Suffolk County Code,and that41!1 C* -5 u.`' o f� Suffolk County Sheriff's Office meets all requirements to qualify for exemption thereunder. B By: V By: Vincent F. DeMarco Date: 3 1811 y Sheriff /11 Date: o'//o3 Approved as to Form: Dennis M. Brown County Attorne By: 1/4n � — Name 1 Assistan ounty Attorney Date: Y 25 i 4 lANA !'Ii Page 1 of 7 0025906 Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services List of Articles & Exhibits Article I Description of Services Article II Financial Terms and Conditions 1. Conflicting Provisions 2. General Payment Terms 3. Agreement Subject to Appropriation of Funds 4. Accounting Procedures 5. Audit 6. Comptroller's Rules and Regulations for Consultant's Agreements 7. Specific Payment Terms and Conditions Exhibit 1 County Terms and Conditions 1. Elements of Interpretation 2. Meanings of Terms 3. Contractor Responsibilities 4. Qualifications, Licenses, and Professional Standards 5. Notifications 6. Documentation of Professional Standards 7. Credentialing 8. Engineering Certificate 9. Termination 10. Indemnification and Defense 11. Insurance 12. Independent Contractor 13. Severability 14. Merger;No Oral Changes 15. Set-Off Rights 16. Non-Discrimination in Services 17. Nonsectarian Declaration 18. Governing Law 19.No Waiver 20. Conflicts of Interest 21. Cooperation on Claims 22. Confidentiality 23. Assignment and Subcontracting 24. Changes to Contractor 25. No Intended Third Party Beneficiaries 26. Certification as to Relationships 27. Publications 28. Copyrights and Patents 29. Arrears to County Page 2 of 7 Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services 30. Lawful Hiring of Employees Law in Connection with Contracts for Construction or Future Construction 31. Record Retention 32. Certification Regarding Lobbying 33.Notice Exhibit 2 Suffolk County Legislative Requirements 1. Contractor's/Vendor's Public Disclosure Statement 2. Living Wage Law 3. Use of County Resources to Interfere with Collective Bargaining Activities 4. Lawful Hiring of Employees Law 5. Gratuities 6. Prohibition Against Contracting with Corporations that Reincorporate Overseas 7. Child Sexual Abuse Reporting Policy 8. Non Responsible Bidder 9. Use of Funds in Prosecution of Civil Actions Prohibited 10. Youth Sports 11. Work Experience Participation 12. Safeguarding Personal Information of Minors 13. Suffolk County Local Laws Website Address Page 3 of 7 Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services Article I Description of Services Whereas,the County has received federal pass-through grants funds from the New York State Office of Homeland Security for an"Operation Shield"; and ,,/ Whereas, the County has accepted and appropriated said funds via Resolution No. I1� -14; and Whereas, the Contractor will provide personnel to assist the County in the "Operation Shield"exercises as set forth herein; Now Therefore,in consideration of the mutual provisions and covenants hereafter set forth,the parties hereto agree as follows: 1. Conflicting Provisions In the event of any conflict between this Article I and any other provision to this Contract, such other provision shall prevail unless it is expressly stated that this Article I shall prevail. 2. The Contractor will assist the County in carrying out New York State funded"Operation Shield" exercises by providing personnel for maritime enforcement. End of Text for Article I Page 4 of 7 Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services Article II Financial Terms and Conditions 1. Conflicting Provisions In the event of any conflict between any provision in this Article II and an exhibit to this Contract,the exhibit shall prevail unless it is expressly stated in the conflicting provision in this Article II, that it shall prevail over the exhibit. 2. General Payment Terms a. Presentation of Suffolk County Payment Voucher In order for payment to be made by the County to the Contractor for the Services, the Contractor shall prepare and present a Suffolk County Payment Voucher(Voucher), which shall be documented by sufficient, competent and evidential matter. Each Suffolk County Payment Voucher submitted for payment is subject to Audit at any time during the Term or any extension thereof. This provision shall survive expiration or termination of this Contract for a period of not less than seven(7) years, and access to records shall be as set forth in paragraph 31 of Exhibit 1, and paragraph 4(b) of Article II. b. Voucher Documentation The Suffolk County Payment Voucher shall list all information regarding the Services and other items for which expenditures have been or will be made in accordance with the Contract. Either upon execution of the Contract(for the Services already rendered and expenditures already made), or not more than thirty(30) days after the expenditures were made, and in no event after the 31St day of January following the end of each year of the Contract,the Contractor shall furnish the County with detailed documentation in support of the payment for the Services or expenditures under the Contract, e.g., dates of the Service, worksite locations, activities, hours worked, pay rates for all Services. The Suffolk County Payment Voucher shall include time records, certified by the Contractor as true and accurate, of all personnel for whom expenditures are claimed during the period. All Suffolk County Payment Vouchers must bear a signature as that term is defined pursuant to New York State General Construction Law §46 by duly authorized persons. Disbursements made by the Contractor in accordance with the Contract and submitted for reimbursement must be documented and must comply with accounting procedures as set forth by the Suffolk County Department of Audit and Control. c. Payment by County Payment by the County shall be made within thirty(30) days after approval of the Voucher by the Comptroller. d. Final Voucher The acceptance by the Contractor of payment of all billings made on an approved voucher shall operate as and shall be a release of the County from all claims by the Contractor through the date Page 5 of 8 Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services of the Voucher. 3. Subject to Appropriation of Funds a. The Contract is subject to the amount of funds appropriated each fiscal year and any subsequent modifications thereof by the County Legislature, and no liability shall be incurred by the County beyond the amount of funds appropriated each fiscal year by the County Legislature for the Services. b. If the County fails to receive Federal or State funds originally intended to pay for the Services, or to reimburse the County, in whole or in part, for payments made for the Services,the County shall have the sole and exclusive right to: i.) determine how to pay for the Services; ii.) determine future payments to the Contractor; and iii.) determine what amounts, if any, are reimbursable to the County by the Contractor and the terms and conditions under which such reimbursement shall be paid. 4. Accounting Procedures a. The Contractor shall maintain accounts, books, records, documents, other evidence, and accounting procedures and practices which sufficiently and properly reflect all direct and indirect costs of any nature expended in the performance of the Contract, in accordance with generally accepted accounting principles and with rules, regulations and financial directives, as may be promulgated by the Suffolk County Department of Audit and Control and the Department. The Contractor shall permit inspection and audit of such accounts, books, records, documents and other evidence by the Department and the Suffolk County Comptroller, or their representatives, as often as, in their judgment, such inspection is deemed necessary. Such right of inspection and audit as set forth in subparagraph(b)below shall exist during the Term and for a period of seven (7)years after expiration or termination of the Contract. b. The Contractor shall retain all accounts, books, records, and other documents relevant to the Contract for seven(7)years after final payment is made by the County. Federal, State, and/or County auditors and any persons duly authorized by the County shall have full access and the right to examine any of said materials during said period. Such access is granted notwithstanding any exemption from disclosure that may be claimed for those records which are subject to nondisclosure agreements, trade secrets and commercial information or financial information that is privileged or confidential. 5. Audit a. All payments made under the Contract are subject to audit by the Comptroller pursuant to Article V of the Suffolk County Charter. The Contractor further agrees that the Comptroller and the Department shall have access to and the right to examine, audit, excerpt, copy or transcribe any Page 6 of 8 Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services pertinent transactions or other records relating to Services under the Contract. If such an audit discloses overpayments by the County to the Contractor, within thirty(30) days after the issuance of an official audit report by the Comptroller or his duly designated representatives,the Contractor shall repay the amount of such overpayment by check to the order of the Suffolk County Treasurer or shall submit a proposed plan of repayment to the Comptroller. If there is no response, or if satisfactory repayments are not made, the County may recoup overpayments from any amounts due or becoming due to the Contractor from the County under the Contract or any other Fund Source. b. The provisions of this paragraph shall survive the expiration or termination of the Contract for a period of seven(7)years, and access to records shall be as set forth in paragraph 31 of Exhibit 1, and paragraph 4(b) of Article II. 6. Comptroller's Rules and Regulations for Consultant's Agreements The Contractor shall comply with the "Comptroller's Rules and Regulations for Consultant's Agreements"as promulgated by the Department of Audit and Control of Suffolk County and any amendments thereto during the Term of the Contract. The "Comptroller's Rules and Regulations for Consultant's Agreements" may be viewed online at the County's website, SuffolkCountyny.gov; go to "Government,"then"Comptroller,"then"Consultant's Agreements." 7. Specific Payment Terms and Conditions a. Payments Contingent upon State/Federal Funding Payment under the contract may be subject to and contingent upon continued funding by State and/or Federal agencies. In such event, no payment shall be made until the Contractor submits documentation in the manner and form as shall be required by State and/or Federal agency. If late submission of claims precludes the County from claiming State or Federal reimbursement, such late claims shall not be honored. If, for any reason,the full amount of such funding is not made available to the county, the Contract may be terminated in whole or in part, or the amount payable to the contractor may be reduced at the discretion of the County,provided that any such termination or reduction shall not apply to allowable costs incurred by the Contractor prior to such termination or reduction, and provided that money has been appropriated for payment of such costs. b. Denial of Aid If a State or Federal government agency is funding the Contract and fails to approve aid in reimbursement to the County for payments made hereunder by the County to the Contractor for expenditures made during the term because of any act, omission or negligence on the part of the contractor,then the County may deduct and withhold from any payment due to the Contractor an amount equal to the reimbursement denied by the state or federal government agency, and the County's obligation to the contractor shall be reduced by any such amounts. In such an event, if there should be a balance due to the County after it has made a final payment to the Contractor Page 7 of 8 Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services under the contract, on demand by the County, the Contractor shall reimburse the County for the amount of the balance due the County, payable to the Suffolk County Treasurer. The provisions of this subparagraph shall survive the expiration or termination of the Contract. c. Budget The Contractor expressly represents and agrees that the budget below, to the extent applicable, lists all personnel and/or all other costs of the Services. RANK #ASSIGNED SALARY TOTAL Sr. Bay Constable 1 $54.60 $1,083.00 Bay Constable 1 $46.80 $1,160.00 d. Salaries The Contractor shall not be eligible to receive any salary reimbursement until proof of deposit or payment of all withholding and payroll taxes to the Federal/State governments has been provide to the County. e. No salary, wage or other compensation for the Services shall be increased over the amount stated in the Budget with the prior written approval of the County. End of Text for Article II Page 8 of 8 Consulfant/Personal Services Exhibit 1 Rev.12/17/13 Exhibit 1 agent for service of process;or County Terms and Conditions d. The Contractor's failure to comply with any 1. Elements of Interpretation Federal,State or local law,rule,or regulation,and County policies or directives;or As used throughout the Contract: e. The Contractor's bankruptcy or insolvency;or a. Words of the masculine gender shall mean and f. The Contractor's failure to cooperate in an Audit; include correlative words of the feminine and neuter genders and words importing the singular number shall or mean and include the plural number and vice versa. Words The Contractor's falsification of records or importing persons shall include firms,associations, g. partnerships(including limited partnerships),trusts, reports,misuse of funds,or malfeasance or nonfeasance in corporations and other legal entities,including public financial record keeping arising out of,or in connection bodies,as well as natural persons,and shall include with,any contract with the County;or successors and assigns. h. The Contractor's failure to submit,or failure to b. Capitalized terms used,but not otherwise defined timely submit,documentation to obtain Federal or State herein,shall have the meanings assigned to them in the funds;or Contract. i. The inability of the County or the Contractor to obtain Federal or State funds due to any act or omission of 2. Meanings of Terms the Contractor;or As used in the Contract: j. Any condition the County determines,in its sole discretion,that is dangerous. "Comptroller"means the Comptroller of the County of Suffolk. "Federal"means the United States government,its departments and "Contract"means all terms and conditions herein forming all rights agencies. and obligations of the Contractor and the County. "Fund Source"means any direct or indirect sum payable to the "Contractor"means the signatory person,partnership,corporation, Contractor by the County pursuant to any lawful obligation. association or other entity,its officers,officials,employees,agents, servants,sub-contractors and any successor or assign of any one or "Legislature"means the Legislature of the County of Suffolk. more of the foregoing performing the Services. "Services"means all that which the Contractor must do,and any part "County"means the County of Suffolk,its departments,and thereof arising out of,or in connection with,the Contract as agencies. described in Article I"Description of Services." "County Attorney"means the County Attorney of the County of "State"means the State of New York. Suffolk. "Suffolk County Payment Voucher"means the document "Department"means the signatory department approving the authorized and required by the Comptroller for release of payment. Contract. "Term"means the time period set forth on page one of the Contract "Engineering Services"means the definition of the practice of and,if exercised by the County,the option period. engineering and the definition of practice of land surveying,as the case may be,under Section 7201 and Section 7203 of the State Education Law,respectively. 3. Contractor Responsibilities "Event of Default"means a. It shall be the duty of the Contractor to discharge, or cause to be discharged,all of its responsibilities,and to a. the Contractor's failure to perform any duty administer funds received in the interest of the County in required of it under paragraphs 4 through 7 of this Exhibit accordance with the provisions of the Contract. 1 of the Contract;or b. The Contractor shall promptly take all action as b. the Contractor's failure to maintain the amount may be necessary to render the Services. and types of insurance with an authorized insurer as required by the Contract;or c. The Contractor shall not take any action that is inconsistent with the provisions of the Contract. c. the Contractor's failure to maintain insurance required by the Contract with an insurer that has designated d. Services provided under this Contract shall be the New York Superintendent of Insurance as its lawful open to all residents of the County. 1 of 7 pages Exhibit 1 • Consulfant/Personal Services Exhibit 1 Rev.12/17/13 Contractor to contact the Department,or division thereof, as the case may be,in writing,no later than three(3)days 4. Qualifications,Licenses,and Professional Standards after such restriction,suspension,or revocation. a. The Contractor represents and warrants that it b. The Contractor shall forward to the Department, has,and shall continuously possess,during the Term,the or division thereof,as the case may be,on or before July 1 required licensing,education,knowledge,experience,and of each year during the Term,a complete list of the names character necessary to qualify it to render the Services. and addresses of all persons providing the Services,as well as their respective areas of certification,credentialing, b. The Contractor shall continuously have during registration,and licensing. the Term all required authorizations,certificates, certifications,registrations,licenses,permits,and other 8. Engineering Certificate approvals required by Federal,State,County,or local authorities necessary to qualify it to render the Services. In the event that the Contract requires any Engineering Services,the Contractor shall submit to the County,no 5. Notifications later than the due date for submission for approval of any engineering work product,the Certificate of Authorization a. The Contractor shall immediately notify the ("Certificate"),issued pursuant to§7210 of the New York County,in writing,of any disciplinary proceedings, Education Law,of every person performing any commenced or pending,with any authority relating to a Engineering Services. The failure to file,submit or license held by any person necessary to qualify him or the maintain the Certificate shall be grounds for rejection of Contractor to perform the Services. any engineering work product submitted for approval. b. In the event that a person is no longer licensed to 9. Termination perform the Services,the Contractor must immediately notify the County,but in no event shall such notification be a. Thirty Days Termination later than five(5)days after a license holder has lost the license required to qualify the license holder or the The County shall have the right to terminate the Contractor to perform the Services. Contract without cause,for any reason,at any time,upon c. In the event that the Contractor is not able to such terms and conditions it deems appropriate,provided, however,that no such termination shall be effective unless perform the Services due to a loss of license,the Contractor the Contractor is given at least thirty(30)days notice. shall not be reimbursed for the Services rendered after the effective date of termination of such license. Without b. Event of Default;Termination on Notice limiting the generality of the foregoing,if any part of the Contract remains to be performed,and the termination of i.) The County may immediately terminate the license does not affect the Contractor's ability to render the Contract,for cause,upon such terms and the Services,every other term and provision of the Contract conditions it deems appropriate,in the Event of shall be valid and enforceable to the fullest extent permitted Default. by law. ii.) If the Contractor defaults under any 6. Documentation of Professional Standards other provision of the Contract,the County may terminate the Contract,on not less than five(5) The Contractor shall maintain on file,in one location in days notice,upon such terms and conditions it Suffolk County,all records that demonstrate that it has deems appropriate. complied with paragraphs 4 and 5 above. The address of the location of the aforesaid records and documents shall c. Termination Notice be provided to the County no later than the date of execution of the Contract. Such documentation shall be Any notice providing for termination shall be kept,maintained,and available for inspection by the delivered as provided for in paragraph 33 of this Exhibit 1. County upon twenty-four(24)hours notice. d. Duties upon Termination 7. Credentialing i.) The Contractor shall discontinue the a. In the event that the Department,or any division Services as directed in the termination notice. thereof,maintains a credentialing process to qualify the Contractor to render the Services,the Contractor shall ii.) Subject to any defenses available to it, complete the required credentialing process. In the event the County shall pay the Contractor for the that any State credential,registration,certification,or Services rendered through the date of license,Drug Enforcement Agency registration,or termination. Medicare or Medicaid certification is restricted,suspended, or temporarily or permanently revoked,it is the duty of the 2 of 7 pages Exhibit 1 Consulfant/Personal Services Exhibit 1 Rev.12/17/13 iii.) The County shall be released from any i.) Commercial General Liability and all liability under the Contract,effective as of insurance,including contractual liability the date of the termination notice. coverage,in an amount not less than Two Million Dollars($2,000,000.00)per occurrence for iv.) Upon termination,the Contractor shall bodily injury and Two Million Dollars reimburse the County the balance of any funds ($2,000,000.00)per occurrence for property advanced to the Contractor by the County no damage. The County shall be named an later than thirty(30)days after termination of the additional insured. Contract. The provisions of this subparagraph shall survive the expiration or termination of the ii.) Automobile Liability insurance(if any Contract. non-owned or owned vehicles are used by the Contractor in the performance of the Contract)in v.) Nothing contained in this paragraph an amount not less than Five Hundred Thousand shall be construed as a limitation on the County's Dollars($500,000.00)per person,per accident, rights set forth in paragraphs 5(c)and 15 of this for bodily injury and not less than One Hundred Exhibit 1. Thousand Dollars($100,000.00)for property damage per occurrence. 10. Indemnification and Defense iii.) Workers'Compensation and a. The Contractor shall protect,indemnify,and hold Employer's Liability insurance in compliance harmless the County,its agents,servants,officials,and with all applicable New York State laws and employees from and against all liabilities,fines,penalties, regulations and Disability Benefits insurance,if actions,damages,claims,demands,judgments,losses,suits required by law. The Contractor shall furnish to or actions,costs,and expenses caused by the negligence or the County,prior to its execution of the Contract, any acts or omissions of the Contractor,including the documentation required by the State of New reimbursement of the cost of reasonable attorneys'fees York Workers'Compensation Board of coverage incurred by the County,its agents,servants,officials,and or exemption from coverage pursuant to§§57 employees in any action or proceeding arising out of or in and 220 of the Workers'Compensation Law. In connection with the Contract. accordance with General Municipal Law§108, the Contract shall be void and of no effect unless b. The Contractor hereby represents and warrants the Contractor shall provide and maintain that it will not infringe upon any copyright in performing coverage during the Term for the benefit of such the Services. The Contractor agrees that it shall protect, employees as are required to be covered by the indemnify,and hold harmless the County,its agents, provisions of the Workers'Compensation Law. servants,officials,and employees from and against all liabilities,fines,penalties,actions,damages,claims, iv.) Professional Liability insurance in an demands,judgments,losses,suits or actions,costs,and amount not less than Two Million Dollars expenses arising out of any claim asserted for infringement ($2,000,000.00)on either a per-occurrence or of copyright,including reimbursement of the cost of claims-made coverage basis. reasonable attorneys'fees incurred by the County,its agents,servants,officials,and employees in any action or b. The County may mandate an increase in the proceeding arising out of or in connection with any claim liability limits set forth in the immediately preceding asserted for infringement of copyright. paragraphs(11)(a)(i),(ii),and(iv). c. The Contractor shall defend the County,its c. All policies providing such coverage shall be agents,servants,officials,and employees in any proceeding issued by insurance companies authorized to do business in or action,including appeals,arising out of,or in New York with an A.M.Best rating of A-or better. connection with,the Contract,and any copyright infringement proceeding or action. Alternatively,at the d. The Contractor shall furnish to the County,prior County's option,the County may defend any such to the execution of the Contract,declaration pages for each proceeding or action and require the Contractor to pay policy of insurance and certificates,other than a policy for reasonable attorneys'fees or salary costs of County commercial general liability insurance,and upon demand,a employees of the Department of Law for the defense of any true and certified original copy of each such policy such suit. evidencing compliance with the aforesaid insurance requirements. 11. Insurance e. In the case of commercial general liability insurance,and business use automobile insurance,the a. The Contractor shall continuously maintain, Contractor shall furnish to the County,prior to the during the Term of the Contract,insurance in amounts and execution of the Contract,a declaration page or insuring types as follows: agreement and endorsement page evidencing the County's 3 of 7 pages Exhibit 1 'Consultant/Personal Services Exhibit 1 Rev.12/17/13 status as an additional insured on said policy,and upon 16. Non-Discrimination in Services demand,a true and certified original copy of such policy evidencing compliance with the aforesaid insurance a. The Contractor shall not,on the grounds of race, requirements. creed,color,national origin,sex,age,disability,sexual orientation,military status,or marital status: f. All evidence of insurance shall provide for the County to be notified in writing thirty(30)days prior to i.) deny any individual the Services any cancellation,nonrenewal,or material change in the provided pursuant to the Contract;or policy to which such evidence relates. It shall be the duty ii.) provide the Services to an individual of the Contractor to notify the County immediately of any cancellation,nonrenewal,or material change in any that is different,or provided in a different manner,from those provided to others pursuant insurance policy. to the Contract;or g. In the event the Contractor shall fail to provide iii.) subject an individual to segregation or evidence of insurance,the County may provide the separate treatment in any matter related to the insurance required in such manner as the County deems individual's receipt of the Services provided appropriate and deduct the cost thereof from a Fund pursuant to the Contract;or Source. iv.) restrict an individual in any way from 12. Independent Contractor any advantage or privilege enjoyed by others receiving the Services provided pursuant to the The Contractor is not,and shall never be,considered an Contract;or employee of the County for any purpose. Notwithstanding v.) treat an individual differently from anything herein,the Contract shall not be construed as others in determining whether or not the creating a principal-agent relationship between the County individual satisfies any eligibility or other and the Contractor or the Contractor and the County,as the requirements or conditions which individuals case may be. must meet in order to receive the Services provided pursuant to the Contract. 13. Severability b. The Contractor shall not utilize criteria or It is expressly agreed that if any term or provision of the methods of administration which have the effect of Contract,or the application thereof to any person or subjecting individuals to discrimination because of their circumstance,shall be held invalid or unenforceable to any race,creed,color,national origin,sex,age,disability, extent,the remainder of the Contract,or the application of sexual orientation,military status,or marital status,or have such term or provision to persons or circumstances other the effect of substantially impairing the Contract with than those as to which it is held invalid or unenforceable, respect to individuals of a particular race,creed,color, shall not be affected thereby,and every other term and national origin,sex,age,disability,sexual orientation, provision of the Contract shall be valid and shall be military status,or marital status,in determining: enforced to the fullest extent permitted by law. i.) the Services to be provided,or ii.) the class of individuals to whom,or the 14. Merger;No Oral Changes situations in which,the Services will be provided;or It is expressly agreed that the Contract represents the entire agreement of the parties and that all previous iii.) the class of individuals to be afforded understandings are herein merged in the Contract. No an opportunity to receive the Services. modification of the Contract shall be valid unless in written form and executed by both parties. 17. Nonsectarian Declaration 15. Set-Off Rights The Services performed under the Contract are secular in nature. No funds received pursuant to the Contract shall be The County shall have all of its common law,equitable, used for sectarian purposes or to further the advancement and statutory rights of set-off.These rights shall include, of any religion. The Services will be available to all but not be limited to,the County's option to withhold from eligible individuals regardless of religious belief or a Fund Source an amount no greater than any moneys due affiliation. and owing to the County for any reason. The County shall exercise its set-off rights subject to approval by the County 18. Governing Law Attorney. In cases of set-off pursuant to a Comptroller's audit,the County shall only exercise such right after the The Contract shall be governed by and construed in finalization thereof,and only after consultation with the accordance with the laws of the State of New York,without County Attorney. regard to conflict of laws. Venue shall be designated in the 4 of 7 pages Exhibit 1 Consultant/Personal Services Exhibit 1 Rev.12/17/13 Supreme Court,Suffolk County,the United States District provisions of the Contract and to any other condition the Court for the Eastern District of New York,or,if County requires. No approval of any Assignment shall be appropriate,a court of inferior jurisdiction in Suffolk construed as enlarging any obligation of the County under County. the terms and provisions of the Contract. No Assignment of the Contract or assumption by any person of any duty of 19. No Waiver the Contractor under the Contract shall provide for,or otherwise be construed as,releasing the Contractor from It shall not be construed that any failure or forbearance of any term or provision of the Contract. the County to enforce any provision of the Contract in any particular instance or instances is a waiver of that 24. Changes to Contractor provision. Such provision shall otherwise remain in full force and effect,notwithstanding any such failure or a. The Contractor may,from time to time,with the forbearance. County's consent,enter into a Permitted Transfer. For purposes of the Contract,a Permitted Transfer means: 20. Conflicts of Interest i.) if the Contractor is a partnership,the withdrawal or change,voluntary,involuntary or The Contractor shall not,during the Term,pursue a course by operation of law,of the partners,or transfer of of conduct which would cause a reasonable person to partnership interests(other than the purchase of believe that he or she is likely to be engaged in acts that partnership interests by existing partners,by the create a substantial conflict between its obligations under partnership itself or the immediate family the Contract and its private interests. The Contractor is members by reason of gift,sale or devise),or the charged with the duty to disclose to the County the dissolution of the partnership without immediate existence of any such adverse interests,whether existing or reconstitution thereof,and potential. This duty shall continue as long as the Term. The determination as to whether or when a conflict may ii.) if the Contractor is a closely held potentially exist shall ultimately be made by the County corporation(i.e.whose stock is not publicly held and Attorney after full disclosure is obtained. not traded through an exchange or over the counter), 21. Cooperation on Claims 1. the dissolution,merger, consolidation or other reorganization of The Contractor and the County shall render diligently to the Contractor, each other,without compensation,any and all cooperation that may be required to defend the other party,its 2. the sale or other transfer of employees and designated representatives against any twenty percent(20%)or more of the claim,demand or action that may be brought against the shares of the Contractor(other than to other party,its employees or designated representatives existing shareholders,the corporation arising out of,or in connection with,the Contract. itself or the immediate family members of shareholders by reason of gift,sale 22. Confidentiality or devise). Any document of the County,or any document created by b. If the Contractor is a not-for-profit corporation,a the Contractor and used in rendering the Services,shall change of twenty percent(20%)or more of its shares or remain the property of the County and shall be kept members shall be deemed a Permitted Transfer. confidential in accordance with applicable laws,rules,and regulations. c. The Contractor shall notify the County in writing, which notice(the"Transfer Notice")shall include: 23. Assignment and Subcontracting i.) the proposed effective date of the a. The Contractor shall not delegate its duties under Permitted Transfer,which shall not be less than the Contract,or assign,transfer,convey,subcontract, thirty(30)days nor more than one hundred sublet,or otherwise dispose of the Contract,or any of its eighty(180)days after the date of delivery of the right,title or interest therein,or its power to execute the Transfer Notice; Contract,or assign all or any portion of the monies that may be due or become due hereunder,(collectively referred ii.) a summary of the material terms of the to in this paragraph 23 as"Assignment"),to any other proposed Permitted Transfer, person,entity or thing without the prior written consent of the County,and any attempt to do any of the foregoing iii.) the name and address of the proposed without such consent shall be void ab initio. transferee, b. Such Assignment shall be subject to all of the iv.) such information reasonably required 5 of 7 pages Exhibit 1 'Consultant/Personal Services Exhibit 1 Rev.12/17/13 by the County,which will enable the County to determine the financial responsibility,character, 27 Publications and reputation of the proposed transferee,nature of the proposed assignee/transferee's business and experience; Any book,article,report,or other publication related to the Services provided pursuant to this Contract shall contain v.) all executed forms required pursuant to the following statement in clear and legible print: Exhibit 2 of the Contract,that are required to be "This publication is fully or partially funded by submitted by the Contractor;and the County of Suffolk." vi.) such other information as the County may reasonably require. 28. Copyrights and Patents d. The County agrees that any request for its a. Copyrights consent to a Permitted Transfer shall be granted provided that the transfer does not violate any provision of the If the work of the Contractor should result in the Contract,and the transferee has not been convicted of a production of original books,manuals,films,or other criminal offense as described under Article II of Chapter materials for which a copyright may be granted,the 189 of the Suffolk County Code. The County shall grant or Contractor may secure copyright protection. However,the deny its consent to any request of a Permitted Transfer County reserves to itself,and the Contractor hereby gives within twenty(20)days after delivery to the County of the to the County,and to any other person designated by the Transfer Notice,in accordance with the provisions of County,a royalty-free,nonexclusive license to produce, Paragraph 33 of this Exhibit 1 of the Contract. If the reproduce,publish,translate,or otherwise use any such County shall not give written notice to the Contractor materials. denying its consent to such Permitted Transfer(and setting forth the basis for such denial in reasonable detail)within b. Patents such 20-day period,then the County shall be deemed to have granted its consent to such Permitted Transfer. If the Contractor makes any discovery or invention during the Term,or as a result of work performed e. Notwithstanding the County's consent, under the Contract,the Contractor may apply for and secure for itself patent protection. However,the County i.) the terms and conditions of the reserves to itself,and the Contractor hereby gives to the Contract shall in no way be deemed to have been County,and to any other person designated by the County, waived or modified,and a royalty-free,nonexclusive license to produce or otherwise use any item so discovered or patented. ii.) such consent shall not be deemed consent to any further transfers. 29. Arrears to County 25. No Intended Third Party Beneficiaries The Contractor warrants that,except as may otherwise be The Contract is entered into solely for the benefit of the authorized by agreement,it is not in arrears to the County County and the Contractor. No third party shall be deemed upon any debt,contract,or any other lawful obligation,and a beneficiary of the Contract and no third party shall have is not in default to the County as surety. the right to make any claim or assert any right under the Contract. 30. Lawful Hiring of Employees Law in Connection with Contracts for Construction or Future 26. Certification as to Relationships Construction The Contractor certifies under penalties of perjury that, In the event that the Contract is subject to the Lawful other than through the funds provided in the Contract and Hiring of Employees Law of the County of Suffolk,Suffolk other valid agreements with the County,there is no known County Code Article II of Chapter 353,as more fully set spouse,life partner,business,commercial,economic,or forth in Exhibit 2 entitled"Suffolk County Legislative financial relationship with the County or its elected Requirements,"the Contractor shall maintain the officials. The Contractor also certifies that there is no documentation mandated to be kept by this law on the relationship within the third degree of consanguinity, construction site at all times. Employee sign-in sheets and between the Contractor,any of its partners,members, register/log books shall be kept on the construction site at directors,or shareholders owning five percent(5%)or all times and all covered employees,as defined in the law, more of the Contractor,and the County, shall be required to sign such sign-in sheets/register/log books to indicate their presence on the construction site during such working hours. 6 of 7 pages Exhibit 1 'Consultant/Personal Services Exhibit 1 Rev.12/17/13 31. Record Retention The Contractor shall retain all accounts,books,records, and other documents relevant to the Contract for seven (7)years after final payment is made by the County. Federal,State,and/or County auditors and any persons duly authorized by the County shall have full access and the right to examine any of said materials during said period. Such access is granted notwithstanding any exemption from disclosure that may be claimed for those records which are subject to nondisclosure agreements,trade secrets and commercial information or financial information that is privileged or confidential.Without limiting the generality of the foregoing,records directly related to contract expenditures shall be kept for a period of ten(10)years because the statute of limitations for the New York False Claims Act(New York False Claims Act§ 192) is ten(10)years. 32. Certification Regarding Lobbying Together with this Contract and as a condition precedent to its execution by the County,the Contractor shall have executed and delivered to the County the Certification Regarding Lobbying(if payment under this Contract may exceed$100,000)as required by Federal regulations,and shall promptly advise the County of any material change in any of the information reported on such Certification,and shall otherwise comply with,and shall assist the County in complying with,said regulations as now in effect or as amended during the term of this Contract. 33. Notice Unless otherwise expressly provided herein,all notices shall be in writing and shall be deemed sufficiently given if sent by regular first class mail and certified mail,or personally delivered during business hours as follows: 1.) to the Contractor at the address on page 1 of the Contract and 2.)to the County at the Department,or as to either of the foregoing,to such other address as the addressee shall have indicated by prior written notice to the addressor. All notices received by the Contractor relating to a legal claim shall be immediately sent to the Department and also to the County Attorney at 100 Veterans Memorial Highway,P.O. Box 6100,(Sixth Floor),Hauppauge,New York, 11788- 0099. End of Text for Exhibit 1 7 of 7 pages Exhibit 1 Consultant/Personal Services Exhibit 2 Rev.12/17/13 Exhibit 2 Contract and to seek other remedies as set forth Suffolk County Legislative Requirements therein,for violations of this Law. NOTE:THE CONTRACTOR'S COMPLETED Required Forms: LEGISLATIVE REQUIRED FORMS REFERENCED HEREIN ARE AVAILABLE ON FILE AT THE Suffolk County Living Wage Form LW-1; COUNTY ATTORNEY'S OFFICE AND THE entitled"Suffolk County Department of Labor— DEPARTMENT NAMED ON THE SIGNATURE Living Wage Unit Notice of Application for PAGE OF THIS CONTRACT. County Compensation(Contract)." 1. Contractor's/Vendor's Public Disclosure Suffolk County Living Wage Form LW-38; Statement entitled"Suffolk County Department of Labor— Living Wage Unit Living Wage It shall be the duty of the Contractor to read, Certification/Declaration—Subject To Audit." become familiar with,and comply with the requirements of section A5-7 of Article V of the 3. Use of County Resources to Interfere with Suffolk County Code. Collective Bargaining Activities Unless certified by an officer of the Contractor as It shall be the duty of the Contractor to read, being exempt from the requirements of section become familiar with,and comply with the A5-7 of Article V of the Suffolk County Code, requirements of Article I of Chapter 803 of the the Contractor represents and warrants that it has Suffolk County Code. filed with the Comptroller the verified public disclosure statement required by Suffolk County County Contractors(as defined by section 803-2) Administrative Code Article V,Section A5-7 and shall comply with all requirements of Chapter shall file an update of such statement with the 803 of the Suffolk County Code,including the Comptroller on or before the 31st day of January following prohibitions: in each year of the Contract's duration. The • Contractor acknowledges that such filing is a a. The Contractor shall not use County material,contractual and statutory duty and that funds to assist,promote,or deter union the failure to file such statement shall constitute a organizing. material breach of the Contract,for which the County shall be entitled,upon a determination b. No County funds shall be used to that such breach has occurred,to damages,in reimburse the Contractor for any costs addition to all other legal remedies,of fifteen incurred to assist,promote,or deter percent(15%)of the amount of the Contract. union organizing. Required Form: c. No employer shall use County property Suffolk County Form SCEX 22;entitled to hold a meeting with employees or "Contractor's/Vendor's Public Disclosure supervisors if the purpose of such Statement" meeting is to assist,promote,or deter union organizing. 2. Living Wage Law If the Services are performed on County property, It shall be the duty of the Contractor to read, the Contractor must adopt a reasonable access become familiar with,and comply with the agreement,a neutrality agreement,fair requirements of Chapter 575,of the Suffolk communication agreement,non-intimidation County Code. agreement,and a majority authorization card agreement. This Contract is subject to the Living Wage Law of the County of Suffolk. The law requires that, If the Services are for the provision of human unless specific exemptions apply,all employers services and are not to be performed on County (as defined)under service contracts and property,the Contractor must adopt,at the least, recipients of County financial assistance,(as a neutrality agreement. defined)shall provide payment of a minimum wage to employees as set forth in the Living Under the provisions of Chapter 803,the County Wage Law. Such rate shall be adjusted annually shall have the authority,under appropriate pursuant to the terms of the Suffolk County circumstances,to terminate the Contract and to Living Wage Law of the County of Suffolk. seek other remedies as set forth therein,for Under the provisions of the Living Wage Law, violations of this Law. the County shall have the authority,under appropriate circumstances,to terminate the Required Form: 1 of 4 pages 4 Consultant/Personal Services Exhibit 2 Rev.12/17/13 Suffolk County Labor Law Form DOL-L01; other financial compensation agreement between entitled"Suffolk County Department of Labor— the covered employer and the County;and shall Labor Mediation Unit Union Organizing be made available to the public upon request. Certification/Declaration-Subject to Audit." An updated affidavit shall be submitted by each such employer,owner,contractor and subcontractor no later than January 1 of each year 4. Lawful Hiring of Employees Law for the duration of any contract and upon the renewal or amendment of the Contract,and It shall be the duty of the Contractor to read, whenever a new contractor or subcontractor is become familiar with,and comply with the hired under the terms of the Contract. requirements of Article II of Chapter 353 of the Suffolk County Code. The Contractor acknowledges that such filings are a material,contractual and statutory duty and This Contract is subject to the Lawful Hiring of that the failure to file any such statement shall Employees Law of the County of Suffolk.It constitute a material breach of the Contract. provides that all covered employers,(as defined), and the owners thereof,as the case may be,that Under the provisions of the Lawful Hiring of are recipients of compensation from the County Employees Law,the County shall have the through any grant,loan,subsidy,funding, authority to terminate the Contract for violations appropriation,payment,tax incentive,contract, of this Law and to seek other remedies available subcontract,license agreement,lease or other under the law. financial compensation agreement issued by the County or an awarding agency,where such The documentation mandated to be kept by this compensation is one hundred percent(100%) law shall at all times be kept on site. Employee funded by the County,shall submit a completed sign-in sheets and register/log books shall be kept sworn affidavit(under penalty of perjury),the on site at all times during working hours and all form of which is attached,certifying that they covered employees,as defined in the law,shall have complied,in good faith,with the be required to sign such sign-in requirements of Title 8 of the United States Code sheets/register/log books to indicate their Section 1324a with respect to the hiring of presence on the site during such working hours. covered employees(as defined)and with respect to the alien and nationality status of the owners Required Forms: thereof. The affidavit shall be executed by an authorized representative of the covered Suffolk County Lawful Hiring of Employees Law employer or owner,as the case may be;shall be Form LHE-1;entitled"Suffolk County part of any executed contract,subcontract,license Department of Labor—Notice Of Application To agreement,lease or other financial compensation Certify Compliance With Federal Law(8 U.S.C. agreement with the County;and shall be made Section 1324a)With Respect To Lawful Hiring available to the public upon request. of Employees." All contractors and subcontractors(as defined)of Suffolk County Lawful Hiring of Employees Law covered employers,and the owners thereof,as Form LHE-2;entitled"Affidavit Of Compliance the case may be,that are assigned to perform With The Requirements Of 8 U.S.C. Section work in connection with a County contract, 1324a With Respect To Lawful Hiring Of subcontract,license agreement,lease or other Employees" financial compensation agreement issued by the County or awarding agency,where such 5. Gratuities compensation is one hundred percent(100%) funded by the County,shall submit to the covered It shall be the duty of the Contractor to read, employer a completed sworn affidavit(under become familiar with,and comply with the penalty of perjury),the form of which is attached, requirements of Chapter 664 of the Suffolk certifying that they have complied,in good faith, County Code. with the requirements of Title 8 of the United States Code Section 1324a with respect to the The Contractor represents and warrants that it has hiring of covered employees and with respect to not offered or given any gratuity to any official, the alien and nationality status of the owners employee or agent of the County or the State or thereof,as the case may be. The affidavit shall of any political party,with the purpose or intent be executed by an authorized representative of of securing an agreement or securing favorable the contractor,subcontractor,or owner,as the treatment with respect to the awarding or case may be;shall be part of any executed amending of an agreement or the making of any contract,subcontract,license agreement,lease or determinations with respect to the performance of 2 of 4 pages COUNTY OF SUFFOLK 0 0 K Ky. OFFICE OF THE SHERIFF VINCENT F. DEMARCO SHERIFF February 24, 2014 RECEIVED Scott A. Russell, Supervisor MAR 6 _ 2014 Town of Southold 59035 Main Road 7bwn Attorney's Office Southold, New York 11971 Re: Operation Shield Contracts Dear Supervisor Russell, The NYS Office of Homeland Security is appropriating pass-through grant funds in the amount of $40,000.00 for "Operation Shield". The funds will be administered by the Suffolk County Sheriff's Office. Enclosed find four (4) original contracts for the Town of Southold for "Operation Shield". Note that only one set of attachments needs to be signed this year, as the County Attorney's Office streamlined the procedure for submission of forms. Please review and sign all contracts in the designated areas. Be aware that questions #12 and #13 on the LW-1 form must be addressed. Please return all four contracts to my office by Friday, March 28, 2014. A Certificate of Insurance must be provided, as outlined in Exhibit 1. Thank you for your consideration in this matter. If you have any questions, please do not hesitate to contact my office, (631) 852-2220. ery pIl 0" v rP.Sharkey Michael Chief otaff MPS/dlh Enc. 100 CENTER DRIVE RIVERHEAD. NEW YORK 11901-3390 (691) 032-2200 STATE OF NEW YORK WORKERS' COMPENSATION BOARD CERTIFICATE OF PARTICIPATION IN WORKERS' COMPENSATION GROUP SELF-INSURANCE la Legal Name and Address of Business Participating In Group Self- 1d. Business Telephone Number of Business referenced In box Insurance (Use Street Address Only) "la" Town of Southold 631-765-4333 P.O. Box 1179 Southold, NY 11971 le. NYS Unemployment Insurance Employer Registration lb. Effective Date of Membership in the Group 01/01/2006 Number of Business referenced in box "la" le. The Proprietor, Partners or Executive Officers are if. Federal Employer Identification Number of Business reforenced in Box "la„ ? Included (only check box ti all partners/officers Included) ? all excluded or certain partners/officers excluded 3. Name and Address of Group Seif-Insurer 2. Name and Address of the Entity Requesting Proof of Coverage (Entity Being Listed as Certificate Holder) NEW YORK STATE MUNICIPAL WORKERS' COMPENSATION ALLIANCE County of Suffolk, Office of the Sheriff CLAIMS ADMINISTERED BY: 100 Center Drive WRIGHT RISK MANAGEMENT Riverhead, NY 11901 333 EARLE OVINGTON BLVD., SUITE 505 UNIONDALE,NY 11553-3524 This certifies that the business referenced above in box "Is" is complying with the mandatory coverage requirements of the New York State Workers' Compensation Law as a participating member of the Group Self-Insurer listed above in box "3" and participation in such group self-insurance is still in force. The Group Self-Insurer's Administrator will send this Certificate of Participation to the entity listed above as the certificate holder in box "2". The Group Self-Ins re's Administrator will notify the above certificate holder within 10 days IF the membership of the participant listed in box "la" is terminated. (These notices may be sent by regular mail.) Otherwise, this Certificate is valid for a maximum of are year from the date certified by the group self-insurer. Ifthis cerrificate is no longer valid according to the above guidelines and the business referenced in box "l a"continues to be named on a permit; license or contract issued by the certificate holder, the business must provide the cert(ficate holder either with a new certificate or other authorized proojthe business is complying with the mandatory coverage requirements ojthe New Pork State Workers' Compensation Law. Under penalty of perjury, I certify, that I am an authorized representative of the Group Self-Insurer referenced above and that the business referenced in box "la" has the coverage as depicted on lids form Certified by: Eric Hartcom 01/01/2014 -12/31/2014 (Print name of authorized representative of the Group Self-Insurer) Date Certified by: (Signature) Title: PROGRAM MANAGER Telephone Number 516-750-9409 GSI-105.2 WORKERS' COMPENSATION LAW Section 57 Restriction on issue of permits and the entering into contracts unless compensation is secured. 1. 1. The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, and notwithstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carver is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any compensation to any such employee if so employed. 2. 2. The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. Please Note: This Certificate is valid only through the policy dates indicated above. OR a maximum of one year after this form is approved by the authorized representatives of the Group Self-Insurer. At the expiration of those dates, if the business continues to be named on a permit or contract issued by the above government entity, the business must provide that government entity with a new Certificate. The business must also provide a new Certificate upon notice of cancellation or change in status of the policy. GSI-105.2 (2-02) Reverse STATE OF NEW YORK WORKERS'COMPENSATION BOARD CERTIFICATE OF INSURANCE COVERAGE UNDER THE NYS DISABILITY BENEFITS LAW PART 1. To be completed b Disabili Benefits Carrier or licensed Insurance Agent of that Carrier Ia. Legal Name and Address of Insured (Use sheet address only) lb. Business Telephone Number of Insured 631-7654333 TOWN OF SOUTHOLD IQ NYS UnemFloymem Insurance Employer Registration S309S ROUTE 25 Number of tamed SOUTHOLD, NY 11971 PENDING Id. Federal Employer Identification Number of Insured or Social Security Number 1/600/939 2. Name and Address orthe Entity Requesting Proof of 3a. Name of Insurance Carrier Coverage (Entity Being Listed as de Certificate Holder) HARTFORD LIFE INSURANCE CO. COUNTY OF SUFFOLK 3b. Policy Number of entity listed in box "la": OFFICE OF THE SHERIFF LNY-643531 100 CENTER DRIVE RIVERHEAD, NY 11901 3c. Policy effective period: 04/012013 to 03/312014 4. Policy avers: L ® All of the cinployces eatployca eligible wrier the New York Disability Benefits Law b. ? Only the following class or classes of t e employer's em*yas: Under penalty of perjury, I unify dot i on an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability Benefits hsnaace average as described above. +~re-Mvud- Date Signcd_l/192014 By (Sipawe ofhausanconW9 oWwrbed nionsenlmtve orNYS Lbmud kamanrce Ap aofam lousawseankr) Telephone Number (000) 454-7020 Title , Manager IMPORTANP. Ifbn •4P b dreekd, and 146 brut b damd by tae Wrnoa m..In amhorked represeobare orNYS Lkeamd imuroateAbat of tear earrler.bbce -11 ' bCOMPLETL bloaadkeslybtbeterlalaleboWer. Ifboa-4b• kNctbea,thbonim Ne6NOTCompt trE forporsous of SeHbn 320.Subd, a of the DlmbtatyDennis Low. 6noMbeowMed far Completion to the Workew' CompautW Dowd, DD rWtAeteptance Usk, 20 Pub Streat.AOaoy, New York 12707. PART L To be completed b NYS Worker' Compensation Board On if box "4b" of Part 1 has been ahedred State Of New York Worker' Compensation Board According to information aWouined by the NYS Workers' Compensation Board, the above-named employer hm cmMlkd with tie NYS Disability Beufds Law with respect to all ofbisha employses. Date Signed By (SWoomeofNYS Works' Comp anodon Baud ftonym) Telephone Number Title Please Now Only Insurance canters 0cented to write NFS disability bencilts Insurance polkles and NYS licensed Insurance agents of lase hourance arrien ars authorked to issue Form DII-120.1. Insurance brokers are NOT autbodad to Issue thisforns, DB-120.1 (5-06) Additional Instructions for Form DB-120.1 By signing this form, the insurance artier ideni ifx d in box "3" on this form is certifying that it is insuring the business referenced In box "Is" for disability berrefnts under the New York State Disability Benefits Law. The Insurance Carrier or its licensed agent will send this Certificate offien vane to the entity listed as the certificate holder in box 020. 77ik: Cembleateis mgd forrkerarllnefoaeymrglkribb joran Is approved iiytke htsaronce carder or Inikessed agent, ortke policy erpiradon date fisted /a car "3c". Please Nos: Upon on cancellation of the disability beaeas policy inns ed on this form tram busbies continues to be awned on a pemth, lien or contra issued by a ceraficale holder, dte buares mmprmide do eeataaneholder with anewCertificate ofNYS Disability aeneatsCoveragomother authorized proof dun the business is complying with the r aoduory eoverege mquiren ens orlhe New York SWe Disability BeneOs Law. DISABILITY BENEFITS LAW §220. Subd. 8 (a) The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in employment as defined in this article, and notwithstanding any general or special statute requiring or authorizing the issue ofsuch permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that the payment of disability benefits for all employees has been secured as provided by this article. Nothing herein, however, shall be construed as creating any liability on the par of such state or municipal department, board, commission or office to pay any disability benefits to any such employee if so employed. (b) The head of a slate or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in employment as defined in this article, and notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a fort satisfactory to the chair, that the payment of disability benefits for all employees has been secured as provided by this article. DB•120.1(3-06) Reverse STATE OF NEW YORK WORKERS' COWENSATION BOARD CERTIFICATE OF INSURANCE COVERAGE UNDER THE NYS DISABILITY BENEFITS LAW PART 1. To be completed b Disability Benefits Carrier or Licensed Insurance Agent of that Carrier la. Legal Name and Address of insured (Use street address only) Ib. Business Telephone Number of Insured 631-7654333 TOWN OF SOUTHOLD lo. NYS Unemployment Insurance Employer Registration 53095 ROUTE 25 Number of Insured SOUTHOLD,NY 11971 PENDING Id. Federal Employer IdemiOcation Number of insured or Social Security Number 116001939 1 Name and Address of the Emily Requesting Proof of 3a. Name of Insurance Carrier Coverage (Eatity Being Listed as the Certificate Holder) HARTFORD LIFE INSURANCE CO. COUNTY OF SUFFOLK 3b. Policy Number of entity listed in box "le: OFFICE OF THE SHERIFF LNY4A3531 100 CENTER DRIVE RIVERHEAD. NY 11901 3c. Policy effective period: 04/0112014 to 03/31/2015 4. Policy covers: L ® All of the employer's employees eligible under the New York Disability Benefits Law Is. ? Only the following class or classes of the employer's employees: Under penalty of perjury, l certify that 1 am an authorized represemmiveor licensed agent of the insurance carrier refercnxd above and dm die named insured has NYS Disability Bewfils insurance coverage as described above. Date Signed 3/19/2014 By y (Sipmws of ina¦r.oce w0ier's wehabe0 uprexrr W ire «NYS f.ioewed hnuuce Aada of ar iu«urce c¦nicr) Telephone Number-_L00 01 4 5 4-7 020 Title: Manwer 11WKWAtR: 1f 0ea •q• Y ekdkea, wan alt arc b,pd y ae twrnw e¦rrMre ¦aM¦rhd reprneewAe er NYS t.leemee nnunea Agar that arrbnibb«rwk¦ebCD&fPLere. Muamceab woe eertlnewlw kotfer Ifba•O•bdmkW.ibbeerarteswbNOTCOMPLVMforparpe ofSeetb¦270.Saboaortae DhobntyneeeabtAw.bs¦YbeaWW sereospMbs is Ike WorkeW Compea.tb¦ Dowd. DD Ptaa Acceptance Vaa.20 Fork Sired. Albany. New Yerk JIM. PART 2. To be completed b NYS Workers' Compensation Board (Only if box "4116" of Part I has hem checked State Of New York Workers' Compensation Board Auordieg to inkmmion maintained by tae NYS Wotkets' Compensation Board, the abovemmsd employer has complied with the NYS Disability Bananas Law with respect to all of hisAt« amploymes. Date Signed By, (swakaw of NYS waken' Canpawam Bare Fmpbya) Telephone Number Title PleaseNoh: Only insurance callers famed to write NYS disability benefits insurance polklesand NYSlkensed insurance agents of than bsarance carriers are au7arized to urine Fora DB-110.1. Insurance brokers are NOT eatbadized to IsstretBBform. DB-120.1(5.06) Additional Instructions for Form DB-120.1 By signing this form, the insurance carrier identified in box "3" on this form is certifying that it is insuring the business refuenced in box Ne for disability beaellls under the New York State Disability Benefits Law. 11m Inwranee Carrier or Its licensed agent will send this CerdficateofInsurance btheentity listed asthecectiftwteholder inbox"2". ThlsCerri/lMekva/Mjordtrarllerafowyearafkrlh& font k approved by the lasurance carrleror fk!lcemed ages r, orlhe poNry expbadon dale fined in box "3c". Pit= Now Upon the anallmion ofarc disability benefits policy indiearedon this Ibrm, iftlre holism continues to be named on a pemttL limm or contract anxd bya cordfiesse holder. alebusiaess mart provided atcerafieate holderwithanewCortilicale ofNYS DkidiskyBewfts Covageordher a dkdzcd proof dot the business is complyutg with the mandnwy coverage requimnenrs of the New Yak Stare Dhabithy Benefits Law. DISABILITY BENEFITS LAW §220. Subd. 8 (a) The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in employment as defined in this article, and not withstanding any general orspecial statute requiring or authorizing the issueofsuch permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that the payment of disability benefits for all employees has been secured as provided by this article. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any disability benefits to any such employee if so employed. (b) The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in employment as defined in this article, and notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that the payment of disability benefits for all employees has been secured as provided by this article. DB-120.1(5-06) Reverse CERTIFICATE OF LIABILITY INSURANCE (912014rn ACS 3/19no1a o THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT: N the ceri fOats holler Is an ADDITIONAL INSURED, the polky(les) must be endorsed. R SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder M lieu of such andomenumt(a). mcoucaR Phone: (631)298-4170D F.: (01)288,30W CONrA~ Barbara Dammers ROY H REEVE AGENCY, INC. PHONE I: 631 2983700 rA'r (631) 2983850 54 PO BOX E#WL bdammem@royreeve.wm 13400 MATTMAJ NITUCK NY 7 1ROAD952 INSURER(St AFFORDING COVERAGE NAICa ATT INSURER.: US Specialty Ins. Co. INSURED TOWN OF SOUTHOLD INSURER8 : US Specialty Ins. Co. C/O SOUTHOLD TOWN HALL INSURERC P.O. BOX 1179 INSURER D: SOUTHOLD NY 11971 INSURERE IXSURERF COVERAGES CERTIFICATE NUMBER: 52047 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS U I S. L MITS SHOWN MAY HAVE BEEN ED BY PAD CLAIMS. INSR TYPE OF INSURANCE ADO` Sn POLICY NUMBER nLX;Y EPP rMO W LIMITS MUD A X COMMERCULLGENERALLULINL CPKG80520109 01101/14 01/01115 EACH OCCURRENCE f 1,000,000 CINMSMADE EXIOCCUR PREMSES(a.m.Nra) f 1,000,000 X f50,0D0. Deducads MED. EXP (Arty one person) f 10,000 PERSONAL A ADV INJURY f 1,000,000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 5,000,000 POLICY JJEGTT LOC PRODUCTS -COMP/OPAGG f 5,000,000 PO' F~ OTHER: f AUTOMOBILE LIAeIDEY COMMMMSINGLELINT n...da.M) f ANY AUTO BODILY INJURY (Per pereon) ALL OWNED SCHEDULED BODILY INJURY (Par acdaen) f AUTOS AUTOS HIRED AUTOS NON-C NED TYOAMACE f AUTOS IPNazaanp f useRelu me X OCCUR CPKGO0520109 01101/14 01101115 EACH OCCURRENCE f 10,000,000 B acres We CLAIMS-MADE AGGREGATE S 10,000,000 ~DED X RETENTIONS 10,000 f PE o w INORKERS aOYPaIIeAswuI STAME ER AND EIlIDKRY LVWLnY YIN EL EACH ACCIDENT $ OEFICERdIEYBER EXCLUDED? El NIA E.L. DISEASE-EA EMPLOYEE f P1.PadwrM Nil) XOa.aurdM alEer E.L. DISEASE-POLICY LIMB f DESCRIPEIGn GF OPEMTgN3 Nw DESCRIPTION OF OPERATIONS I LOCATN)NS I VEHICLES (ACORD 101, AddNmal Remarks Schedule, msy be al ehiMl If awwN spay is E.eum,d) Certificate holder is listed as additional Insured With respect to general liability only as per written contract or agreement. Re : Operation Shield CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE County of Suffolk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN O 100 ffice of the Sheriff ACCORDANCE WITH THE POLICY PR~OVI_S~IIOONNSSj/~~y, Center Drive AumoRUZD REPRESrrvuTlw Riverhead, NY 77907 Riverhead, Attention: Barbara J. Dammers ACORD 25 (2014101) ®1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services Consultant/Personal Services Contract This Contract ("the Contract') is between the County of Suffolk ("the County"), a municipal corporation of the State of New York, acting through its duly constituted S.C. Sheriff's Office ("the Office"), located at 100 Center Drive, Riverhead, New York 11901; and The Town of Southold ("the Contractor"), having an address at 59035 Main Road, Southold, New York 11971. The Contractor has been designated to receive funds from the County for Operation Shield Maritime Law Enforcement Services ("the Services") as set forth in Article I, entitled "Description of Services." Term of the Contract: March 1, 2014 to July 11, 2014. Total Cost of the Contract: Shall not exceed $2,243.00, as set forth in Article II, attached. Terms and Conditions: Shall be as set forth in Articles I and 11 and Exhibits 1 and 2, attached hereto and made a part hereof. In Witness Whereof, the parties hereto have executed the Contract as of the latest date written below. Town of So old COUNTY OF SUFFOLK By:- t rtLAZ Scott A. Russel By: Supervisor Dennis M. Cohen Fed. Tax ID #11600 1939 Chief Deputy County Executive y~S Date: I ereby certifies~funder penalties / of perjury that I am an officer of7ow/7 OT lb"I'Ay G d that I have read and am familiar with Sceoon A5-7q~ Article 5 Approved: of the Suffolk County Code, and tltarrOAIA o(' '0 a' 45 t( Suffolk County Sheriffs Office meets all requirements to qualify for exemption thereunder. By: By. Vincent F. DeMarco Date: Sheriff Date: Approved as to Form: Dennis M. Brown County Attorney By: Name Assistant County Attorney Date: Page 1 of 7 Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services List of Articles & Exhibits Article I Description of Services Article II Financial Terms and Conditions 1. Conflicting Provisions 2. General Payment Terms 3. Agreement Subject to Appropriation of Funds 4. Accounting Procedures 5. Audit 6. Comptroller's Rules and Regulations for Consultant's Agreements 7. Specific Payment Terms and Conditions Exhibit 1 County Terms and Conditions 1. Elements of Interpretation 2. Meanings of Terms 3. Contractor Responsibilities 4. Qualifications, Licenses, and Professional Standards 5. Notifications 6. Documentation of Professional Standards 7. Credentialing 8. Engineering Certificate 9. Termination 10. Indemnification and Defense 11. Insurance 12. Independent Contractor 13. Severability 14. Merger; No Oral Changes 15. Set-Off Rights 16. Non-Discrimination in Services 17. Nonsectarian Declaration 18. Governing Law 19. No Waiver 20. Conflicts of Interest 21. Cooperation on Claims 22. Confidentiality 23. Assignment and Subcontracting 24. Changes to Contractor 25. No Intended Third Party Beneficiaries 26. Certification as to Relationships 27. Publications 28. Copyrights and Patents 29. Arrears to County Page 2 of 7 Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services 30. Lawful Hiring of Employees Law in Connection with Contracts for Construction or Future Construction 31. Record Retention 32. Certification Regarding Lobbying 33. Notice Exhibit 2 Suffolk County Legislative Requirements 1. Contractor's/Vendor's Public Disclosure Statement 2. Living Wage Law 3. Use of County Resources to Interfere with Collective Bargaining Activities 4. Lawful Hiring of Employees Law 5. Gratuities 6. Prohibition Against Contracting with Corporations that Reincorporate Overseas 7. Child Sexual Abuse Reporting Policy 8. Non Responsible Bidder 9. Use of Funds in Prosecution of Civil Actions Prohibited 10. Youth Sports 11. Work Experience Participation 12. Safeguarding Personal Information of Minors 13. Suffolk County Local Laws Website Address Page 3 of 7 Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services Article I Description of Services Whereas, the County has received federal pass-through grants funds from the New York State Office of Homeland Security for an "Operation Shield"; and Whereas, the County has accepted and appropriated said funds via Resolution No. -14; and Whereas, the Contractor will provide personnel to assist the County in the "Operation Shield" exercises as set forth herein; Now Therefore, in consideration of the mutual provisions and covenants hereafter set forth, the parties hereto agree as follows: 1. Conflicting Provisions In the event of any conflict between this Article I and any other provision to this Contract, such other provision shall prevail unless it is expressly stated that this Article I shall prevail. 2. The Contractor will assist the County in carrying out New York State funded "Operation Shield" exercises by providing personnel for maritime enforcement. End of Text for Article I Page 4 of 7 Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services Article II Financial Terms and Conditions 1. Conflicting Provisions In the event of any conflict between any provision in this Article II and an exhibit to this Contract, the exhibit shall prevail unless it is expressly stated in the conflicting provision in this Article II, that it shall prevail over the exhibit. 2. General Payment Terms a. Presentation of Suffolk County Payment Voucher In order for payment to be made by the County to the Contractor for the Services, the Contractor shall prepare and present a Suffolk County Payment Voucher (Voucher), which shall be documented by sufficient, competent and evidential matter. Each Suffolk County Payment Voucher submitted for payment is subject to Audit at any time during the Term or any extension thereof. This provision shall survive expiration or termination of this Contract for a period of not less than seven (7) years, and access to records shall be as set forth in paragraph 31 of Exhibit 1, and paragraph 4(b) of Article II. b. Voucher Documentation The Suffolk County Payment Voucher shall list all information regarding the Services and other items for which expenditures have been or will be made in accordance with the Contract. Either upon execution of the Contract (for the Services already rendered and expenditures already made), or not more than thirty (30) days after the expenditures were made, and in no event after the 31" day of January following the end of each year of the Contract, the Contractor shall furnish the County with detailed documentation in support of the payment for the Services or expenditures under the Contract, e.g., dates of the Service, worksite locations, activities, hours worked, pay rates for all Services. The Suffolk County Payment Voucher shall include time records, certified by the Contractor as true and accurate, of all personnel for whom expenditures are claimed during the period. All Suffolk County Payment Vouchers must bear a signature as that term is defined pursuant to New York State General Construction Law §46 by duly authorized persons. Disbursements made by the Contractor in accordance with the Contract and submitted for reimbursement must be documented and must comply with accounting procedures as set forth by the Suffolk County Department of Audit and Control. C. Payment by County Payment by the County shall be made within thirty (30) days after approval of the Voucher by the Comptroller. d. Final Voucher The acceptance by the Contractor of payment of all billings made on an approved voucher shall operate as and shall be a release of the County from all claims by the Contractor through the date Page 6 of 8 Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services of the Voucher. 3. Subject to Appropriation of Funds a. The Contract is subject to the amount of funds appropriated each fiscal year and any subsequent modifications thereof by the County Legislature, and no liability shall be incurred by the County beyond the amount of funds appropriated each fiscal year by the County Legislature for the Services. b. If the County fails to receive Federal or State funds originally intended to pay for the Services, or to reimburse the County, in whole or in part, for payments made for the Services, the County shall have the sole and exclusive right to: i.) determine how to pay for the Services; ii.) determine future payments to the Contractor; and iii.) determine what amounts, if any, are reimbursable to the County by the Contractor and the terms and conditions under which such reimbursement shall be paid. 4. Accounting Procedures a. The Contractor shall maintain accounts, books, records, documents, other evidence, and accounting procedures and practices which sufficiently and properly reflect all direct and indirect costs of any nature expended in the performance of the Contract, in accordance with generally accepted accounting principles and with rules, regulations and financial directives, as may be promulgated by the Suffolk County Department of Audit and Control and the Department. The Contractor shall permit inspection and audit of such accounts, books, records, documents and other evidence by the Department and the Suffolk County Comptroller, or their representatives, as often as, in their judgment, such inspection is deemed necessary. Such right of inspection and audit as set forth in subparagraph (b) below shall exist during the Term and for a period of seven (7) years after expiration or termination of the Contract. b. The Contractor shall retain all accounts, books, records, and other documents relevant to the Contract for seven (7) years after final payment is made by the County. Federal, State, and/or County auditors and any persons duly authorized by the County shall have full access and the right to examine any of said materials during said period. Such access is granted notwithstanding any exemption from disclosure that may be claimed for those records which are subject to nondisclosure agreements, trade secrets and commercial information or financial information that is privileged or confidential. 5. Audit a. All payments made under the Contract are subject to audit by the Comptroller pursuant to Article V of the Suffolk County Charter. The Contractor further agrees that the Comptroller and the Department shall have access to and the right to examine, audit, excerpt, copy or transcribe any Page 6 of 8 Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services pertinent transactions or other records relating to Services under the Contract. If such an audit discloses overpayments by the County to the Contractor, within thirty (30) days after the issuance of an official audit report by the Comptroller or his duly designated representatives, the Contractor shall repay the amount of such overpayment by check to the order of the Suffolk County Treasurer or shall submit a proposed plan of repayment to the Comptroller. If there is no response, or if satisfactory repayments are not made, the County may recoup overpayments from any amounts due or becoming due to the Contractor from the County under the Contract or any other Fund Source. b. The provisions of this paragraph shall survive the expiration or termination of the Contract for a period of seven (7) years, and access to records shall be as set forth in paragraph 31 of Exhibit 1, and paragraph 4(b) of Article II. 6. Comptroller's Rules and Regulations for Consultant's Agreements The Contractor shall comply with the "Comptroller's Rules and Regulations for Consultant's Agreements" as promulgated by the Department of Audit and Control of Suffolk County and any amendments thereto during the Term of the Contract. The "Comptroller's Rules and Regulations for Consultant's Agreements" may be viewed online at the County's website, SuffolkCountyny.gov; go to "Government," then "Comptroller," then "Consultant's Agreements." 7. Specific Payment Terms and Conditions a. Payments Contingent upon State/Federal Funding Payment under the contract may be subject to and contingent upon continued funding by State and/or Federal agencies. In such event, no payment shall be made until the Contractor submits documentation in the manner and form as shall be required by State and/or Federal agency. If late submission of claims precludes the County from claiming State or Federal reimbursement, such late claims shall not be honored. If, for any reason, the full amount of such funding is not made available to the county, the Contract may be terminated in whole or in part, or the amount payable to the contractor may be reduced at the discretion of the County, provided that any such termination or reduction shall not apply to allowable costs incurred by the Contractor prior to such termination or reduction, and provided that money has been appropriated for payment of such costs. b. Denial of Aid If a State or Federal government agency is funding the Contract and fails to approve aid in reimbursement to the County for payments made hereunder by the County to the Contractor for expenditures made during the term because of any act, omission or negligence on the part of the contractor, then the County may deduct and withhold from any payment due to the Contractor an amount equal to the reimbursement denied by the state or federal government agency, and the County's obligation to the contractor shall be reduced by any such amounts. In such an event, if there should be a balance due to the County after it has made a final payment to the Contractor Page 7 of 8 Rev. 12-17-2013 Law No. 14-SH-035 Consultant/Personal Services under the contract, on demand by the County, the Contractor shall reimburse the County for the amount of the balance due the County, payable to the Suffolk County Treasurer. The provisions of this subparagraph shall survive the expiration or termination of the Contract. C. Budget The Contractor expressly represents and agrees that the budget below, to the extent applicable, lists all personnel and/or all other costs of the Services. RANK # ASSIGNED SALARY TOTAL Sr. Bay Constable 1 $54.60 $1,083.00 Bay Constable 1 $46.80 $1,160.00 d. Salaries The Contractor shall not be eligible to receive any salary reimbursement until proof of deposit or payment of all withholding and payroll taxes to the Federal/State governments has been provide to the County. e. No salary, wage or other compensation for the Services shall be increased over the amount stated in the Budget with the prior written approval of the County. End of Text for Article II Page 8 of 8 Consultant/Personal Services Exhibit 1 Rev. 12/17/13 Exhibit 1 agent for service of process; or County Terms and Conditions d. The Contractor's failure to comply with any 1.. Elements of Interpretation Federal, State or local law, rule, or regulation, and County policies or directives; or As used throughout the Contract: e. The Contractor's bankruptcy or insolvency; or a. Words of the masculine gender shall mean and f. The Contractor's failure to cooperate in an Audit; include correlative words of the feminine and neuter genders and words importing the singular number shall or mean and include the plural number and vice versa. Words importing persons shall include firms, associations, g• The Contractor's falsification of records or reports, (including limited partnerships), trusts, misuse of funds, or malfeasance or nonfeasance in corporations and other legal entities, including public financial record keeping arising out of, or in connection bodies, as well as natural persons, and shall include with, any contract with the County; or successors and assigns. h. The Contractor's failure to submit, or failure to b. Capitalized terms used, but not otherwise defined timely submit, documentation to obtain Federal or State herein, shall have the meanings assigned to them in the finds; or Contract. i. The inability of the County or the Contractor to 2. Meanings of Terms obtain Federal or State funds due to any act or omission of the Contractor; or As used in the Contract: j. Any condition the County determines, in its sole discretion, that is dangerous. "Comptroller" means the Comptroller of the County of Suffolk. "Federal" means the United States government, its departments and "Contract" means all terms and conditions herein forming all rights agencies. and obligations of the Contractor and the County. "Fund Source" means any direct or indirect sum payable to the "Contractor" means the signatory person, partnership, corporation, Contractor by the County pursuant to any lawful obligation. association or other entity, its officers, officials, employees, agents, servants, sub-contractors and any successor or assign of any one or "Legislature" means the Legislature of the County of Suffolk. more of the foregoing performing the Services. "Services" means all that which the Contractor must do, and any part "County" means the County of Suffolk, its departments, and thereof arising out of, or in connection with, the Contract as agencies. described in Article I "Description of Services." "County Attorney" means the County Attorney of the County of "State" means the State of New York. Suffolk. "Suffolk County Payment Voucher" means the document "Department" means the signatory department approving the authorized and required by the Comptroller for release of payment. Contract "Term" means the time period set forth on page one of the Contract "Engineering Services" means the definition of the practice of and, if exercised by the County, the option period. engineering and the definition of practice of land surveying, as the case may be, under Section 7201 and Section 7203 of the State Education Law, respectively. 3. Contractor Responsibilities "Event of Default" means a. It shall be the duty of the Contractor to discharge, or cause to be discharged, all of its responsibilities, and to a. the Contractor's failure to perform any duty administer funds received in the interest of the County in required of it under paragraphs 4 through 7 of this Exhibit accordance with the provisions of the Contract. I of the Contract; or b. The Contractor shall promptly take all action as b. the Contractor's failure to maintain the amount may be necessary to render the Services. and types of insurance with an authorized insurer as required by the Contract; or c. The Contractor shall not take any action that is inconsistent with the provisions of the Contract. C. the Contractor's failure to maintain insurance required by the Contract with an insurer that has designated d. Services provided under this Contract shall be the New York Superintendent of Insurance as its lawful open to all residents of the County. 1 of 7 pages Exhibit 1 Consultant/Personal Services Exhibit 1 Rev. 12/17/13 Contractor to contact the Department, or division thereof; as the case may be, in writing, no later than three (3) days 4. Qualifications, Licenses, and Professional Standards after such restriction, suspension, or revocation. a. The Contractor represents and warrants that it b. The Contractor shall forward to the Department, has, and shall continuously possess, during the Term, the or division thereof, as the case may be, on or before July I required licensing, education, knowledge, experience, and of each year during the Term, a complete list of the names character necessary to qualify it to render the Services. and addresses of all persons providing the Services, as well as their respective areas of certification, credentialing, b. The Contractor shall continuously have during registration, and licensing. the Term all required authorizations, certificates, certifications, registrations, licenses, permits, and other S. Engineering Certificate approvals required by Federal, State, County, or local authorities necessary to qualify it to render the Services. In the event that the Contract requires any Engineering Services, the Contractor shall submit to the County, no 5. Notifications later than the due date for submission for approval of any engineering work product, the Certificate of Authorization a. The Contractor shall immediately notify the ("Certificate"), issued pursuant to § 7210 of the New York County, in writing, of any disciplinary proceedings, Education Law, of every person performing any commenced or pending, with any authority relating to a Engineering Services. The failure to file, submit or license held by any person necessary to qualify him or the maintain the Certificate shall be grounds for rejection of Contractor to perform the Services. any engineering work product submitted for approval. b. In the event that a person is no longer licensed to 9. Termination perform the Services, the Contractor must immediately notify the County, but in no event shall such notification be a. Thirty Days Termination later than five (5) days after a license holder has lost the license required to qualify the license holder or the The County shall have the right to terminate the Contractor to perform the Services. Contract without cause, for any reason, at any time, upon C. In the event that the Contractor is not able to such terms and conditions it deems appropriate, provided, however, that no such termination shall be effective unless perform the Services due to a loss of license, the Contractor the Contractor is given at least thirty (30) days notice. shall not be reimbursed for the Services rendered after the effective date of termination of such license. Without b. Event of Default; Termination on Notice limiting the generality of the foregoing, if any part of the Contract remains to be performed, and the termination of i.) The County may immediately terminate the license does not affect the Contractor's ability to render the Contract, for cause, upon such terms and the Services, every other term and provision of the Contract conditions it deems appropriate, in the Event of shall be valid and enforceable to the fullest extent permitted Default. by law. ii.) If the Contractor defaults under any 6. Documentation of Professional Standards other provision of the Contract, the County may terminate the Contract, on not less than five (5) The Contractor shall maintain on file, in one location in days notice, upon such terns and conditions it Suffolk County, all records that demonstrate that it has deems appropriate. complied with paragraphs 4 and 5 above. The address of the location of the aforesaid records and documents shall c. Termination Notice be provided to the County no later than the date of execution of the Contract. Such documentation shall be Any notice providing for termination shall be kept, maintained, and available for inspection by the delivered as provided for in paragraph 33 of this Exhibit 1. County upon twenty-four (24) hours notice. it. Duties upon Termination 7. Credentialing I.) The Contractor shall discontinue the a. In the event that the Department, or any division Services as directed in the termination notice. thereof, maintains a credentialing process to qualify the Contractor to render the Services, the Contractor shall ii.) Subject to any defenses available to it, complete the required credentialing process. In the event the County shall pay the Contractor for the that any State credential, registration, certification, or Services rendered through the date of license, Drug Enforcement Agency registration, or termination. Medicare or Medicaid certification is restricted, suspended, or temporarily or permanently revoked, it is the duty of the 2 of 7 pages Exhibit 1 Consultant/Personal Services Exhibit 1 Rev. 12/17/13 III.) The County shall be released from any i.) Commercial General Liability and all liability under the Contract, effective as of insurance, including contractual liability the date of the termination notice. coverage, in an amount not less than Two Million Dollars ($2,000,000.00) per occurrence for iv.) Upon termination, the Contractor shall bodily injury and Two Million Dollars reimburse the County the balance of any funds ($2,000,000.00) per occurrence for property advanced to the Contractor by the County no damage. The County shall be named an later than thirty (30) days after termination of the additional insured. Contract. The provisions of this subparagraph shall survive the expiration or termination of the ii.) Automobile Liability insurance (if any Contract. non-owned or owned vehicles are used by the Contractor in the performance of the Contract) in V.) Nothing contained in this paragraph an amount not less than Five Hundred Thousand shall be construed as a limitation on the County's Dollars ($500,000.00) per person, per accident, rights set forth in paragraphs 5(c) and 15 of this for bodily injury and not less than One Hundred Exhibit 1. Thousand Dollars ($100,000.00) for property damage per occurrence. 10. Indemnification and Defense iii.) Workers' Compensation and a. The Contractor shall protect, indemnify, and hold Employer's Liability insurance in compliance harmless the County, its agents, servants, officials, and with all applicable New York State laws and employees from and against all liabilities, fines, penalties, regulations and Disability Benefits insurance, if actions, damages, claims, demands, judgments, tosses, suits required by law. The Contractor shall furnish to or actions, costs, and expenses caused by the negligence or the County, prior to its execution of the Contract, any acts or omissions of the Contractor, including the documentation required by the State of New reimbursement of the cost of reasonable attomeys' fees York Workers' Compensation Board of coverage incurred by the County, its agents, servants, officials, and or exemption from coverage pursuant to §§57 employees in any action or proceeding arising out of or in and 220 of the Workers' Compensation Law. In connection with the Contract. accordance with General Municipal Law § 108, the Contract shall be void and of no effect unless b. The Contractor hereby represents and warrants the Contractor shall provide and maintain that it will not infringe upon any copyright in performing coverage during the Term for the benefit of such the Services. The Contractor agrees that it shall protect, employees as are required to be covered by the indemnify, and hold harmless the County, its agents, provisions of the Workers' Compensation Law. servants, officials, and employees from and against all liabilities, fines, penalties, actions, damages, claims, iv.) Professional Liability insurance in an demands, judgments, losses, suits or actions, costs, and amount not less than Two Million Dollars expenses arising out of any claim asserted for infringement ($2,000,000.00) on either a per-occurrence or of copyright, including reimbursement of the cost of claims-made coverage basis. reasonable attorneys' fees incurred by the County, its agents, servants, officials, and employees in any action or b. The County may mandate an increase in the proceeding arising out of or in connection with any claim liability limits set forth in the immediately preceding asserted for infringement of copyright paragraphs (I1)(a)(i), (ii), and (iv). C. The Contractor shall defend the County, its c. All policies providing such coverage shall be agents, servants, officials, and employees in any proceeding issued by insurance companies authorized to do business in or action, including appeals, arising out of, or in New York with an A.M. Best rating of A- or better. connection with, the Contract, and any copyright infringement proceeding or action. Alternatively, at the d. The Contractor shall famish to the County, prior County's option, the County may defend any such to the execution of the Contract, declaration pages for each proceeding or action and require the Contractor to pay policy of insurance and certificates, other than a policy for reasonable attorneys' fees or salary costs of County commercial general liability insurance, and upon demand, a employees of the Department of Law for the defense of any true and certified original copy of each such policy such suit. evidencing compliance with the aforesaid insurance requirements. 11. Insurance e. In the case of commercial general liability insurance, and business use automobile insurance, the a. The Contractor shall continuously maintain, Contractor during the Term of the Contract, insurance in amounts and shall furnish to the County, prior to the - types as follows: execution of the Contract, a declaration page or insuring agreement and endorsement page evidencing the County's 3 of 7 pages Exhibit 1 Consultant/Personal Services Exhibit 1 Rev. 12/17/13 status as an additional insured on said policy, and upon 16. Non-Discrimination in Services demand, a true and certified original copy of such policy evidencing compliance with the aforesaid insurance a. The Contractor shall not, on the grounds of race, requirements. creed, color, national origin, sex, age, disability, sexual f. All evidence of insurance shall provide for the orientation, military status, or marital status: County to be notified in writing thirty (30) days prior to i.) deny any individual the Services any cancellation, nonrenewal, or material change in the provided pursuant to the Contract; or policy to which such evidence relates. It shall be the duty it.) provide the Services to an individual of the Contractor to notify the County immediately of any that is different, or provided in a different cancellation, nonrenewal, or material change in any manner, from those provided to others pursuant insurance policy. to the Contract; or g. In the event the Contractor shall fail to provide fit.) subject an individual to segregation or evidence of insurance, the County may provide the separate treatment in any matter related to the insurance required in such manner as the County deems individual's receipt of the Services provided appropriate and deduct the cost thereof from a Fund pursuant to the Contract; or Source. iv.) restrict an individual in any way from any advantage or privilege enjoyed by others 12. Independent Contractor receiving the Services provided pursuant to the The Contractor is not, and shall never be, considered an Contract; or employee of the County for any purpose. Notwithstanding v.) treat an individual differently from anything herein, the Contract shall not be construed as others in determining whether or not the creating a principal-agent relationship between the County individual satisfies any eligibility or other and the Contractor or the Contractor and the County, as the requirements or conditions which individuals case may be. must meet in order to receive the Services provided pursuant to the Contrita 13. Severability b. The Contractor shall not utilize criteria or methods is expressly agreed that if any term or provision of the of administration which have the effect of or subjecting individuals to discrimination because of their Contract, or the application thereof to any person race, shall be held invalid or unenforceable to any creed, color, national origin, sex, age, disability, have , the remainder of the Contract, or the application of sexual orientation, military status, or marital stems, with extent, term or provision to persons or circumstances other the effect of substantially impairing the Contract with than those as to which it is held invalid or unenforceable, national respect to individuals age, particular race, creed, color, shall not be affected thereby, and every other term and origin, sex, agq disability, sexual orientation, military slams, or marital stems, in determining: provision of the Contract shall be valid and shall be enforced to the fullest extent permitted by law. i.) the Services to be provided, or ii.) the class of individuals to whom, or the 14. Merger; No Oral Changes situations in which, the Services will be It is expressly agreed that the Contract represents the entire provided; or agreement of the parties and that all previous iii.) the class of individuals to be afforded understandings are herein merged in the Contract. No an opportunity to receive the Services. modification of the Contract shall be valid unless in written form and executed by both parties. 17. Nonsectarian Declaration 15. Set-Off Rights The Services performed under the Contract are secular in nature. No funds received pursuant to the Contract shall be The County shall have all of its common law, equitable, used for sectarian purposes or to further the advancement and statutory rights of set-off. These rights shall include, of any religion. The Services will be available to all but not be limited to, the County's option to withhold from eligible individuals regardless of religious belief or a Fund Source an amount no greater than any moneys due affiliation. and owing to the County for any reason. The County shall exercise its set-off rights subject to approval by the County Attorney. In cases of set-off pursuant to a Comptroller's 1S. Governing Law audit, the County shall only exercise such right after the The Contract shall be governed by and construed in finalization thereof, and only after consultation with the accordance with the laws of the State of New York, without County Attorney. regard to conflict of laws. Venue shall be designated in the 4 of 7 pages Exhibit 1 Consultent/Personal Services Exhibit 1 Rev. 12/17/13 Supreme Court, Suffolk County, the United States District provisions of the Contract and to any other condition the Court for the Eastern District of New York, or, if County requires. No approval of any Assignment shall be appropriate, a court of inferior jurisdiction in Suffolk construed as enlarging any obligation of the County under - County. the terms and provisions of the Contract No Assignment of the Contract or assumption by any person of any duty of 19. No Waiver the Contractor under the Contract shall provide for, or otherwise be construed as, releasing the Contractor from It shall not be construed that any failure or forbearance of any term or provision of the Contract. the County to enforce any provision of the Contract in any 24. Changes to Contractor particular instance or instances is a waiver of that provision. Such provision shall otherwise remain in full force and effect, notwithstanding any such failure or a. The Contractor may, from time to time, with the forbearance. County's consent, enter into a Permitted Transfer. For purposes of the Contract, a Permitted Transfer means: 20. Conflicts of Interest i.) if the Contractor is a partnership, the withdrawal The Contractor shall not, during the Tenn, pursue a course or change, voluntary, involuntary or of conduct which would cause a reasonable person to by operation oreslaw,ts (other thethan partners the , purchase transfer nsfer of believe that he or she is likely to be engaged in acts that partnership interests he create a substantial conflict between its obligations under partnership interests he existing partners, by the the Contract and its private interests. The Contractor is partnership itself the immediate family charged with the duty to disclose to the County the members by reason n gift, sale or devise), or the existence of any such adverse interests, whether existing or dissolution of the partnership without immediate potential. This duty shall continue as long as the Term. reconstitution thereof, and The determination as to whether or when a conflict may ii.) if the Contractor is a closely held potentially exist shall ultimately be made by the County corporation (i.e. whose stock is not publicly held and Attorney after full disclosure is obtained. not traded through an exchange or over the counter), 21. Cooperation on Claims 1. the dissolution, merger, consolidation or other reorganization of The Contractor and the County shall render diligently to the Contractor, each other, without compensation, any and all cooperation that may be required to defend the other party, its 2. the sale or other transfer of employees and designated representatives against any twenty percent (20%) or more of the claim, demand or action that may be brought against the shares of the Contractor (other than to other party, its employees or designated representatives existing shareholders, the corporation arising out of, or in connection with, the Contract. itself or the immediate family members of shareholders by reason of gift, sale 22. Confidentiality or devise). Any document of the County, or any document created by It. If the Contractor is a not-for-profit corporation, a the Contractor and used in rendering the Services, shall change of twenty percent (20%) or more of its shares or remain the property of the County and shall be kept members shall be deemed a Permitted Transfer. confidential in accordance with applicable laws, rules, and regulations. C. The Contractor shall notify the County in writing, which notice (the "Transfer Notice") shall include: 23. Assignment and Subcontracting i.) the proposed effective date of the a. The Contractor shall not delegate its duties under Permitted Transfer, which shall not be less than the Contract, or assign, transfer, convey, subcontract, thirty (30) days nor more than one hundred sublet, or otherwise dispose of the Contract, or any of its eighty (180) days after the date of delivery of the right, title or interest therein, or its power to execute the Transfer Notice; Contract, or assign all or any portion of the monies that may be due or become due hereunder, (collectively referred ii.) a summary of the material terms of the to in this paragraph 23 as "Assignment"), to any other proposed Permitted Transfer, person, entity or thing without the prior written consent of the County, and any attempt to do any of the foregoing iii.) the name and address of the proposed without such consent shall be void ab initio. transferee, b. Such Assignment shall be subject to all of the iv.) such information reasonably required 5 of 7 pages Exhibit 1 Consultant/Personal Services Exhibit 1 Rev. 12/17113 by the County, which will enable the County to determine the financial responsibility, character, 27 publications and reputation of the proposed transferee, nature of the proposed assignee/transferee's business and experience; Any book, article, report, or other publication related to the Services provided pursuant to this Contract shall contain v.) all executed fors required pursuant to the following statement in clear and legible print: Exhibit 2 of the Contract, that are required to be "This publication is fully or partially funded by submitted by the Contractor; and the County of Suffolk." vi.) such other information as the County may reasonably require. 28. Copyrights and Patents d. The County agrees that any request for its a. Copyrights consent to a Permitted Transfer shall be granted provided that the transfer does not violate any provision of the If the work of the Contractor should result in the Contract, and the transferee has not been convicted of a production of original books, manuals, films, or other criminal offense as described under Article II of Chapter materials for which a copyright may be granted, the 189 of the Suffolk County Code. The County shall grant or - Contractor may secure copyright protection. However, the deny its consent to any request of a Permitted Transfer County reserves to itself, and the Contractor hereby gives within twenty (20) days after delivery to the County of the to the County, and to any other person designated by the Transfer Notice, in accordance with the provisions of County, a royalty-free, nonexclusive license to produce, Paragraph 33 of this Exhibit 1 of the Contract. If the reproduce, publish, translate, or otherwise use any such County shall not give written notice to the Contractor materials. denying its consent to such Permitted Transfer (and setting forth the basis for such denial in reasonable detail) within b. Patents such 20-day period, then the County shall be deemed to have granted its consent to such Permitted Transfer. If the Contractor makes any discovery or invention during the Term, or as a result of work performed e. Notwithstanding the County's consent, under the Contract, the Contractor may apply for and secure for itself patent protection. However, the County 1.) the terms and conditions of the reserves to itself, and the Contractor hereb Contract shall in no way be deemed to have been County, and to any other person hereby gives waived or modified, and a lty designated bi y the . to the County, royal-free, nonexclusive license to produce or otherwise ii.) such consent shall not be deemed use any item so discovered or patented. consent to any further transfers. 29. Arrears to County 25. No Intended Third Party Beneficiaries The Contractor warrants that, except as may otherwise be The Contract is entered into solely for the benefit of the authorized by agreement, it is not in arrears to the County County and the Contractor. No third party shall be deemed upon any debt, contract, or any other lawful obligation, and a beneficiary of the Contract and no third party shall have is not in default to the County as surety. the right to make any claim or assert any right under the Contract. 30. Lawful Hiring of Employees Law in Connection with Contracts for Construction or Future 26. Certification as to Relationships Construction In the event that the Contract is subject to the Lawful The Contractor certifies under penalties of perjury that, other than through the funds provided in the Contract and Hiring of Employees Law of the County of Suffolk, Suffolk other valid agreements with the County, there is no known County Code Article II of Chapter 353, as more fully set spouse, life parer, business, commercial, economic, or forth in Exhibit 2 entitled "Suffolk County Legislative financial relationship with the County or its elected Requirements," the Contractor shall maintain the officials. The Contractor also certifies that there is no documentation mandated to be kept by this law on the relationship within the third degree of consanguinity, construction site at all times. Employee sign-in sheets and between the Contractor, any of its partners, members, register/log books shall be kept on the construction site at directors, or shareholders owning five percent (5%) or all times and all covered employees, as defined in the law, more of the Contractor, and the County. shall be required to sign such sign-in sheets/register/log books to indicate their presence on the construction site during such working hours. 6 of 7 pages Exhibit 1 Consultant/Personal Services Exhibit 1 Rev. 12/17/13 31. Record Retention The Contractor shall retain all accounts, books, records, and other documents relevant to the Contract for seven (7) years after final payment is made by the County. Federal, State, and/or County auditors and any persons duly authorized by the County shall have full access and the right to examine any of said materials during said period. Such access is granted notwithstanding any exemption from disclosure that may be claimed for those records which are subject to nondisclosure agreements, trade secrets and commercial information or financial information that is privileged or confidential. Without limiting the generality of the foregoing, records directly related to contract expenditures shall be kept for a period of ten (10) years because the statute of limitations for the New York False Claims Act (New York False Claims Act § 192) is ten (10) years. 32. Certification Regarding Lobbying Together with this Contract and as a condition precedent to its execution by the County, the Contractor shall have executed and delivered to the County the Certification Regarding Lobbying (if payment under this Contract may exceed $100,000) as required by Federal regulations, and shall promptly advise the County of any material change in any of the information reported on such Certification, and shall otherwise comply with, and shall assist the County in complying with, said regulations as now in effect or as amended during the term of this Contract. 33. Notice Unless otherwise expressly provided herein, all notices shall be in writing and shalt be deemed sufficiently given if sent by regular first class mail and certified mail, or personally delivered during business hours as follows: 1.) to the Contractor at the address on page 1 of the Contract and 2.) to the County at the Department, or as to either of the foregoing, to such other address as the addressee shall have indicated by prior written notice to the addressor. All notices received by the Contractor relating to a legal claim shall be immediately sent to the Department and also to the County Attorney at 100 Veterans Memorial Highway, P.O. Box 6100, (Sixth Floor), Hauppauge, New York, 11788- 0099. End of Text for Exhibit 1 7 of 7 pages Exhibit 1 Consultant/Personal Services Exhibit2 Rev. 12/17/13 Exhibit 2 Contract and to seek other remedies as set forth Suffolk County Legislative Requirements therein, for violations of this Law. NOTE: THE CONTRACTOR'S COMPLETED Required Forms: LEGISLATIVE REQUIRED FORMS REFERENCED HEREIN ARE AVAILABLE ON FILE AT THE Suffolk County Living Wage Form LW-1; COUNTY ATTORNEY'S OFFICE AND THE entitled "Suffolk County Department of Labor - DEPARTMENT NAMED ON THE SIGNATURE Living Wage Unit Notice of Application for PAGE OF THIS CONTRACT. County Compensation (Contract)." 1. Contractor's/Vendor's Public Disclosure Suffolk County Living Wage Form LW-38; Statement entitled "Suffolk County Department of Labor - Living Wage Unit Living Wage It shall be the duty of the Contractor to read, Certification/Declaration - Subject To Audit." become familiar with, and comply with the requirements of section A5-7 of Article V of the 3. Use of County Resources to Interfere with Suffolk County Code. Collective Bargaining Activities Unless certified by an officer of the Contractor as It shall be the duty of the Contractor to read, being exempt from the requirements of section become familiar with, and comply with the A5-7 of Article V of the Suffolk County Code, requirements of Article I of Chapter 803 of the the Contractor represents and warrants that it has Suffolk County Code. filed with the Comptroller the verified public disclosure statement required by Suffolk County Administrative Code Article V, Section A5-7 and County Contractors (as defined by section 803-2) comply with all requirements of Chapter shall file an update of such statement with the shall 803 of the Suffolk County Code, including the Comptroller on or before the 31st day January following prohibitions: in each year of the Contract's duration. . The Contractor acknowledges that such filing is a a. The Contractor shall not use County material, contractual and statutory duty and that funds to assist, promote, or deter union the failure to file such statement shall constitute a organizing. material breach of the Contract, for which the County shall be entitled, upon a determination b. No County funds shall be used to that such breach has occurred, to damages, in reimburse the Contractor for any costs addition to all other legal remedies, of fifteen incurred to assist, promote, or deter percent (15%) of the amount of the Contract. union organizing. Required Form: C. No employer shall use County property Suffolk County Form SCEX 22; entitled to hold a meeting with employees or "Contractor'sfVendor's Public Disclosure supervisors if the purpose of such Statement" meeting is to assist, promote, or deter union organizing. 2. Living Wage Law If the Services are performed on County property, It shall be the duty of the Contractor to read, the Contractor must adopt a reasonable access become familiar with, and comply with the agreement, a neutrality agreement, fair requirements of Chapter 575, of the Suffolk communication agreement, non-intimidation County Code. agreement, and a majority authorization card agreement. This Contract is subject to the Living Wage Law of the County of Suffolk. The law requires that, If the Services are for the provision of human unless specific exemptions apply, all employers services and are not to be performed on County (as defined) under service contracts and property, the Contractor must adopt, at the least, recipients of County financial assistance, (as a neutrality agreement. defined) shall provide payment of a minimum wage to employees as set forth in the Living Under the provisions of Chapter 803, the County Wage Law. Such rate shall be adjusted annually shall have the authority, under appropriate pursuant to the terms of the Suffolk County circumstances, to terminate the Contract and to Living Wage Law of the County of Suffolk. seek other remedies as set forth therein, for Under the provisions of the Living Wage Law, violations of this Law. the County shall have the authority, under appropriate circumstances, to terminate the Required Form: 1 of 4 pages Consultant/Personal Services Exhibit 2 Rev. 12/17/13 Suffolk County Labor Law Form DOL-LO I; other financial compensation agreement between entitled "Suffolk County Department of Labor - the covered employer and the County; and shall Labor Mediation Unit Union Organizing be made available to the public upon request. Certification/Declaration - Subject to Audit." An updated affidavit shall be submitted by each such employer, owner, contractor and subcontractor no later than January 1 of each year 4. Lawful Hiring of Employees Law for the duration of any contract and upon the renewal or amendment of the Contract, and It shall be the duty of the Contractor to read, whenever a new contractor or subcontractor is become familiar with, and comply with the hired under the terms of the Contract. requirements of Article If of Chapter 353 of the Suffolk County Code. The Contractor acknowledges that such filings are a material, contractual and statutory duty and This Contract is subject to the Lawful Hiring of that the failure to file any such statement shall Employees Law of the County of Suffolk. It constitute a material breach of the Contract. provides that all covered employers, (as defined), and the owners thereof, as the case may be, that Under the provisions of the Lawful Hiring of are recipients of compensation from the County Employees Law, the County shall have the through any grant, loan, subsidy, funding, authority to terminate the Contract for violations appropriation, payment, tax incentive, contract, of this Law and to seek other remedies available subcontract, license agreement, lease or other under the law. financial compensation agreement issued by the County or an awarding agency, where such The documentation mandated to be kept by this compensation is one hundred percent (100%) law shall at all times be kept on site. Employee funded by the County, shall submit a completed sign-in sheets and register/log books shall be kept sworn affidavit (under penalty of perjury), the on site at all times during working hours and all form of which is attached, certifying that they covered employees, as defined in the law, shall have complied, in good faith, with the be required to sign such sign-in requirements of Title 8 of the United States Code sheets/register/log books to indicate their Section 1324a with respect to the hiring of presence on the site during such working hours. covered employees (as defined) and with respect to the alien and nationality status of the owners Required Forms: thereof. The affidavit shall be executed by an authorized representative of the covered Suffolk County Lawful Hiring of Employees Law employer or owner, as the case may be; shall be Form LHE-1; entitled"Suffolk County part of any executed contract, subcontract, license Department of Labor -Notice Of Application To agreement, lease or other financial compensation Certify Compliance With Federal Law (8 U.S.C. agreement with the County; and shall be made Section 1324a) With Respect To Lawful Hiring available to the public upon request. of Employees." All contractors and subcontractors (as defined) of Suffolk County Lawful Hiring of Employees Law covered employers, and the owners thereof as Form LHE-2; entitled "Affidavit Of Compliance the case may be, that are assigned to perform With The Requirements Of 8 U.S.C. Section work in connection with a County contract, 1324a With Respect To Lawful Hiring Of subcontract, license agreement, lease or other Employees" financial compensation agreement issued by the County or awarding agency, where such 5. Gratuities compensation is one hundred percent (100%) funded by the County, shall submit to the covered It shall be the duty of the Contractor to read, employer a completed sworn affidavit (under become familiar with, and comply with the penalty of perjury), the form of which is attached, requirements of Chapter 664 of the Suffolk certifying that they have complied, in good faith, County Code. with the requirements of Title 8 of the United States Code Section 1324a with respect to the The Contractor represents and warrants that it has hiring of covered employees and with respect to not offered or given any gratuity to any official, the alien and nationality status of the owners employee or agent of the County or the State or thereof, as the case may be. The affidavit shall of any political party, with the purpose or intent be executed by an authorized representative of of securing an agreement or securing favorable the contractor, subcontractor, or owner, as the treatment with respect to the awarding or case may be; shall be part of any executed amending of an agreement or the making of any contract, subcontract, license agreement, lease or determinations with respect to the performance of 2 of 4 pages Consultant/Personal Services Exhibit2 Rev. 12/17/13 an agreement any judicial or administrative forum. 6. Prohibition Against Contracting with 10. Youth Sports Corporations that Reincorporate Overseas It shall be the duty of the Contractor to read, It shalt be the duty of the Contractor to read, become familiar with, and comply with Article become familiar with, and comply with the III of Chapter 730 of the Suffolk County Code. requirements of sections A4-13 and A4-14 of Article IV of the Suffolk County Code. All contract agencies that conduct youth sports progress are required to develop and maintain a The Contractor represents that it is in compliance written plan or policy addressing incidents of with sections A4-13 and A4-14 of Article IV of possible or actual concussion or other head the Suffolk County Code. Such law provides that injuries among sports program participants. Such no contract for consulting services or goods and plan or policy must be submitted prior to the services shall be awarded by the County to a award of a County contract, grant or funding. business previously incorporated within the Receipt of such plan or policy by the County U.S.A. that has reincorporated outside the U.S.A. does not represent approval or endorsement of any such plan or policy, nor shall the County be 7. Child Sexual Abuse Reporting Policy subject to any liability in connection with any such plan or policy. It shall be the duty of the Contractor to read, become familiar with, and comply with the 11. Work Experience Participation requirements of Article II of Chapter 880 of the Suffolk County Code. If the Contractor is a not-for-profit or governmental agency or institution, each of the The Contractor shall comply with Article II of Contractor's locations in the County at which the Chapter 880, of the Suffolk County Code, Services are provided shall be a work site for entitled "Child Sexual Abuse Reporting Policy," public-assistance clients of Suffolk County as now in effect or amended hereafter or of any pursuant to Chapter 281 of the Suffolk County other Suffolk County Local Law that may Code at all times during the Term of the Contract. become applicable during the term of the If no Memorandum of Understanding ("MOU") Contract with regard to child sexual abuse with the Suffolk County Department of Labor for reporting policy. work experience is in effect at the beginning of the Term of the Contract, the Contractor, if it is a 8. Non Responsible Bidder not-for-profit or governmental agency or institution, shall enter into such MOU as soon as It shall be the duty of the Contractor to read, possible after the execution of the Contract and become familiar with, and comply with the failure to enter into or to perform in accordance requirements of Article II of Chapter 189 of the with such MOU shall be deemed to be a failure to Suffolk County Code. perform in accordance with the Contract, for which the County may withhold payment, Upon signing the Contract, the Contractor terminate the Contract or exercise such other certifies that it has not been convicted of a remedies as may be appropriate in the criminal offense within the last ten (10) years. circumstances. The term "conviction" shall mean a finding of guilty after a trial or a plea of guilty to an offense 12. Safeguarding Personal Information of covered under section 189-5 of the Suffolk Minors County Code under "Nonresponsible Bidder." It shall be the duty of the Contractor to read, 9. Use of Funds in Prosecution of Civil Actions become familiar with, and comply with the Prohibited requirements of Suffolk County Local Law No. 20-2013, a Local Law to Safeguard the Personal It shall be the duty of the Contractor to read, Information of Minors in Suffolk County. become familiar with, and comply with the All contract agencies that provide services to requirements of Article III of Chapter 893 of the minors are required to protect the privacy of the Suffolk County Code. minors and are strictly prohibited from selling or otherwise providing Contractor shall not use any of the moneys, to any third party, in any in part n or in whole, and either directly or manner whatsoever, the personal or identifying information of any minor participating in their indirectly, received under the Contract in connection with the prosecution of any civil programs. action against the County in any jurisdiction or 13. Suffolk County Local Laws Website Address 3 of 4 pages Consultant/Personal Services Exhibit2 Rev. 12/17/13 Suffolk County Local Laws, Rules and Regulations can be accessed on the homepage of the Suffolk County Legislature. End of Text for Exhibit 2 4 of 4 pages a Steven Bellone Suffolk County Executive Samuel Chu Co mmissioner SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING & CONSUMER AFFAIRS LIVING WAGE CERTIFICATION/DECLARATION - SUBJECT TO AUDIT If either of the following definitions of `compensation' (Living Wage Law Chapter 575 -2) applies to the contractor's/recipient's business or transaction with Suffolk County, the contractor/recipient must complete Sections 1, 3, 4 below; and Form LW-1 (Notice of Application for County Compensation). If the following definitions do not apply, the contractor/recipient must complete Sections 2, 3 and 4 below. Completed forms must be submitted to the awarding agency. "Any grant, loan, tax incentive or abatement, bond financing subsidy or other form of compensation of more than $50,000 which is realized by or provided to an employer of at least ten (10) employees by or through the authority or approval of the County of Suffolk," or "Any service contract or subcontract let to a contractor with ten (10) or more employees by the County of Suffolk for the furnishing of services to or for the County of Suffolk (except contracts where services are incidental to the delivery of products, equipment or commodities) which involve an expenditure equal to or greater than $10,000. For the purposes of this definition, the amount ofexpenditure for more than one contract for the same service shall be aggregated. A contract for the purchase or lease of goods, products, equipment, supplies or other property is not `compensation' for the proposes of this definition." E Section I Check if The Living Wage Law applies to this contract. ]/we hereby agree to comply with all the provisions of Suffolk County applicable Local Law No. 12-2001, the Suffolk County Living Wage Law (the Law) and, as such, will provide to all full, part-time or temporary employed persons who perform work or render services on or for a project, matter, contract or subcontract where this company has received compensation, from the County of Suffolk as defined in the Law (compensation) a wage rate of no less than $11.74 ($9.25 for child care providers) per hour worked with health benefits, as described in the Law, or otherwise $13.37 ($10.50 for child care providers) per hour or the rates as may be adjusted annually in accordance with the Law. (Chapter 575-3 B) I/we further agree that any tenant or leaseholder of this company that employs at least ten (10) persons and occupies property or uses equipment or property that is improved or developed as a result of compensation or any contractor or subcontractor ofthis company that employs at least ten (10) persons in producing or providing goods or services to this company that are used in the project or matter for which this company has received compensation shall comply with all the provisions of the Law, including those specified above. (Chapter 575-2) I/we further agree to permit access to work sites and relevant payroll records by authorized County representatives forthe purpose of monitoring compliance with regulations under this Chapter of the Suffolk County Code, investigating employee complaints of noncompliance and evaluating the operation and effects of this Chapter, including the production for inspection & copying of payroll records for any or all employees for the term of the contract or for five (5) years, whichever period of compliance is longer. All payroll and benefit records required by the County wilt be maintained for inspection for a similar period oftime. (Chapter 575-7 D) The Suffolk County Department of Labor, Licensing & Consumer Affairs shall review the records of any Covered Employer at least once every three years to verify compliance with the provisions of the Law. (Chapter 575-4 C) Section 11 The Living Wage Law does not apply to this contract for the following reason(s): _ beck if _ )plicable Section 111 Contractor Name: Town of Southold Federal Employer ID#: 1 1 600 1939 Contractor Address: 59035 Main Road _ Amount ofcompensation:$2,243.00 Southold, New York 11971 Vendor N: ContractorPhone# (631) 765-1889 Description of projector service: Maritime law enforcement focused on foreign flaezed vessels. Section IV I declare under penalD~oq perjury under the Laws of the State of New York that the undersigned is authorized to provide this certification, and th t above is tru nd connect. 3/i81)y Authorized Si ture Date Scott A. Russell, Supervisor Print Name and Title of Authorized Representative noIrI.W36 (revised 3/13) Steven Mlone Samuel Chu Suffolk County Executive Commissioner SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING & CONSUMER AFFAIRS NOTICE OF APPLICATION FOR COUNTY COMPENSATION (Contract) Living Wage Law, Suffolk County Code, Chapter 575 (2001) To Be Completed By Applicant/Employer/Contractor 1) NAME: Town of Southold 2) VENDOR 3) CONTRACT ID (If known) (If known) 4) CONTACT: Chief Flatley 5)TELEPHONE#: (631) 765-3115 6 ADDRESS: 59035 Main Road, Southold New York 11971 7) TERM OF CONTRACT (DATES): 3/1 - 7/ I 1 14 8) PROJECTNAME: (IFDIFFERENTFROM #1) Operation Shield 9) AMOUNT: $2,243.00 10) AWARDING AGENCY: Homeland Security, 11) BRIEF DESCRIPTION OF PROJECT OR SERVICE: - Maritime law enforcement focused on foreign lagged iresselc 12) PROJECTED EMPLOYMENT NEEDS: Attach a statement listing, by job classification, the total workforce dedicated to performing this contract or service, including calculation of estimated net increase or decrease in jobs as a result of funding). 13) PROJECTED WAGE LEVELS: Attach a statement listing projected wage levels, compensated days off and medical benefits for total workforce dedicated to fulfilling the terms of this contract, broken down annually for each year of the term of the contract). DOL: LW-1 (revised 4/13) Steven Belione Samuel Chu Suffolk County Executive Commissioner SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING & CONSUMER AFFAIRS P.O. Box 6100, Hauppauge, NY 11788-0099 (631) 853-4600 FAX(631)853-4825 UNION ORGANIZING CERTIFICATION/DECLARATION - SUBJECT TO AUDIT If the following definition of "County Contractor" (Union Organizing Law Chapter 803) applies to the contractor's/beneficiary's business or transaction with Suffolk County, the contractor/beneficiary must complete Sections I, III, and IV below. If the following definitions do not apply, the contractor/beneficiary must complete Sections II, III and IV below. Completed forms must be submitted to the awarding agency. County Contractor: "Any employer that receives more than $50,000 in County funds for supplying goods or services pursuant to a written contract with the County of Suffolk or any of its agencies; pursuant to a Suffolk County grant; pursuant to a Suffolk County program; pursuant to a Suffolk County reimbursement for services provided in any calendar year; or pursuant to a subcontract with any of the above." Section I ? The Union Organizing Law applies to this contract. Uwe hereby agree to comply with all the provisions of Suffolk County Local Law No. 26-2003, the Suffolk County Union Organizing Law (the law) and, as to the goods and/or services that are the subject of the contract with the County of Suffolk shall not use County funds to assist, promote, or deter union Check if organizing (Chanter 803-3), nor seek reimbursement from the County for costs incurred to assist, promote, or deter union Applicable organizing. I/we further agree to take all action necessary to ensure that County funds are not used to assist, promote, or deter union organizing. Uwe further agree that Uwe will not use County property to hold meetings to assist, promote, or deter union organizing. I/we further agree that if any expenditures or costs incurred to assist, promote, or deter union organizing are made, I/we shall maintain records sufficient to show that no County funds were used for those expenditures and, as applicable, that no reimbursement from County funds has been sought for such costs. Uwe agree that such records shall be made available to the pertinent County agency or authority, the County Comptroller, or the County Department of Law upon request. Uwe further affirm to the following as to the goods and/or services that are the subject of the contract with the County of Suffolk: • I/we will not express to employees any false or misleading information that is intended to influence the determination of employee preferences regarding union representation; • I/we will not coerce or intimidate employees, explicitly or implicitly, in selecting or not selecting a bargaining representative; • Uwe will not require an employee, individually or in a group, to attend a meeting or an event that is intended to influence his or her decision in selecting or not selecting a bargaining representative; • I/we understand my/our obligation to limit disruptions caused by pre-recognition labor disputes through the adoption of non-confrontational procedures for the resolution of pre-recognition labor disputes with employees engaged in the production of goods or the rendering of services for the County; and • Uwe have or will adopt any or all of the above-referenced procedures, or their functional equivalent, to ensure the efficient, timely, and quality provision of goods and services to the County. Uwe shall include a list of said procedures in such certification. Section II a The Union Organizing Law does not apply to this contract for the following reason(s): Will not receive more than $50,000 in County funds Check if Applicable Section III Contractor Name: Town of Southold Federal Employer ID#: 11 600 1939 Contractor Address: 59035 Main Road, Southold, NY 11971 Amount of Assistance: $2,243.00 Vendor Contractor Phone (631) 765-1889 Description of project or service: Maritime law enforcement focused on foreign flagged vessels. Section IV In the event any part of the Union Organizing Law, Chapter 466 of the Laws of Suffolk County, is found by a court of competent jurisdiction to be preempted by federal and/or state law, this certification/declaration shall be void ab initio. Section V I declare under penalty o erjury under the Laws of the State of New York that the undersigned is authorized to provide this certification, and that the above is and correct ~ 31 i 811Y Authorized Si a re Date Scott A. Russell, Supervisor Print Name and Title of Authorized Representative DOL-L01 3113 Steven Bellone Samuel Chu Suffolk County Executive Commissioner SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING, & CONSUMER AFFAIRS NOTICE OF APPLICATION TO CERTIFY COMPLIANCE WITH FEDERAL LAW (8 U.S.C. SECTION 1324A) WITH RESPECT TO LAWFUL HIRING OF EMPLOYEES Suffolk County Code, Chapter 353 (2006) To Be Completed By Applicant/Covered Employer/Owner EMPLOYER/CORP/ BUSINESS/COMPANY NAME: Town of Southold ADDRESS: 59035 Main Road, Southold, New York 11971 NOT-FOR-PROFIT: YES x NO (Submit Proof of IRS Not-for-Profit Status) VENDOR # (If known): CONTRACT ID (If known): CONTACT: Chief Flatley TELEPHONE#: (631) 765-3115 TERM OF CONTRACTOR EXTENSION (PROVIDE DATES): 3/1-7/11/14 BRIEF DESCRIPTION OF COMPENSATION, PROJECT OR SERVICE Maritime law enforcement focused on foreign flagged vessels. SUBCONTRACTOR: ADDRESS: VENDOR#: TELEPHONE CONTACT: DESCRIPTION OF COMPENSATION, PROJECT OR SERVICE: EVIDENCE OF COMPLIANCE: Copies of the following must be maintained by covered employers or the owners thereof for each employee for the time periods set forth in Suffolk County Code, Section 353-14 (A): A. United States passport; or B. Resident alien card or alien registration card; or C. Birth certificate indicating that person was born in the United States; or D. (1) A driver's license, if it contains a photograph of the individual; and (2) A social security account number card (other than such a card which specifies on its face that the issuance of the card does not authorize employment in the United States); or E. Employment authorization documents such as an H-1B visa, H-2B visa, and L-1 visa, or other work visa as may be authorized by the United States Government at the time the County contract is awarded for all covered employees. DOL: LHE-1 (revised 4/13) Steven Bellone " Samuel Chu Suffolk County Executive Commissioner SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING & CONSUMER AFFAIRS AFFIDAVIT OF COMPLIANCE WITH THE REQUIREMENTS OF 8 U.S.C. SECTION 1324a WITH RESPECT TO LAWFUL HERING OF EMPLOYEES State of New York ) ss: Countyof Suffolk Scott A. Russell being duly sworn, deposed and says: (Print Name of Deponent) 1. I am owner/authorized representative of Town of Southold (Circle one) (Name of Corp., Business, Company) 2. I certify that I have complied, in good faith, with the requirements of Title 8 of the United States Code (U.S.C.) section 1324a (Aliens and Nationality) with respect to the hiring of covered employees and with respect to the alien and nationality status of the owners thereof, as set forth in Suffolk County Code Chapter 353 (2006). ( ature of eponent) Sworn to before me this jg day of (Y atCh 20 I _ otary Public) ~iM/PYbMR OAMW in S d%ft thuma, DOL: LHfr2 (`evised 4/13)