HomeMy WebLinkAboutDASNY - Town Community Center Bldg improvements RESOLUTION 2018-149
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ADOPTED DOC ID: 13795
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THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO.2018-149 WAS
ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON
FEBRUARY 6, 2018:
RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs
Supervisor Scott A. Russell to execute a Grant Distribution Agreement with the Dormitory
Authority of the State of New York("DASNY") in connection with a State and Municipal
Facilities Program("SAM") grant to be utilized for improvements to the Southold Town
Community Center in the amount of$50,000.00 for which funds will be advanced from the
General Fund until Grant reimbursements are received.
Elizabeth A.Neville
Southold Town Clerk
RESULT: ADOPTED [UNANIMOUS]
MOVER: William P. Ruland, Councilman
SECONDER:Louisa P. Evans, Justice
AYES: Dinizio Jr, Ruland, Doherty, Ghosio, Evans, Russell
ORIGINAL
RECEIVED
NOV - 5 2018
Office of the Town Attorney Southold Town Clerk
Town of Southold
Town Hall Annex, 54375 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone : 631-765-1939
Facsimile: 631-765-6639
MEMORANDUM
To: Ms. Elizabeth A. Neville, Town Clerk
From: Mary Silleck
Secretary to the Town Attorney
Date: November 2, 2018
Subject: Agreement between the Town of Southold and DASNY
Improvements to the Town Community Center Building
With respect to the above-referenced matter, I am enclosing the original
Agreement together with the Resolution.
If you have any questions regarding the enclosed, please do not hesitate to call
me. Thank you.
/ms
Enclosures
cc: Accounting
This GRANT DISBURSEMENT AGREEMENT includes
all exhibits and attachments hereto and is made on the terms and by the parties listed below
and relates to the Project described below:
DORMITORY AUTHORITY OF THE STATE OF 515 Broadway
NEW YORK("DASNY"): Albany, New York 12207
Contact: Sara Richards, Esq.
Phone: (518) 257-3177
Fax: (518) 257-3475
E-mail: grants@dasny.org
THE GRANTEE: Town of Southold
P.O. Box 1179
53095 Main Rd
Southold, NY 11971
Contact: Mr. Dennis Noncarrow
Phone: (631) 765-5806
Fax: (631) 765-1823
THE PROJECT: Improvements to the Exterior of the Town
Community Center Building
PROJECT LOCATION: Town of Southold Community CenteF
GRANT AMOUNT: $50,000
j FUNDING SOURCE: State and Municipal Facilities Program
("SAM")
For Office Use Only:
PRELIMINARY APPLICATION OR PROJECT
INFORMATION SHEET DATE: 02/15/18
DATE GDA SENT TO GRANTEE: 10/15/18
DATE AGREEMENT SIGNED BY GRANTEE:
DATE AGREEMENT SIGNED BY DASNY: !�
EXPIRATION DATE OF THIS AGREEMENT:
PROJECT ID #: 11670
FMS#: 143044
GranteelD: 3210
'GrantlD: 12749
Updated 7-28-14 1
TERMS AND CONDITIONS
1. The Project
The Project description, including tasks and a timeline with respect thereto, is set forth in
Exhibit A. The Grantee will perform the tasks,on the schedule and as described in Exhibit A to
this Agreement.
2. Proiect Budget and Use of Funds
a) The Grantee will undertake the Project in accordance with the overall Project budget,
which includes the Grant funds, as set forth in Exhibit A to this Agreement. The
Grant will be applied only to Eligible Expenses, which are separately identified, as
described in the Preliminary Application or Project Information Sheet and in Exhibit A
hereto.
b) Grantee agrees and covenants to apply the Grant proceeds only to capital works or
purposes, which shall consist of the following:
(i) the acquisition, construction, demolition, or replacement of a fixed asset or
assets;
(ii) the major repair or renovation of a fixed asset, or assets, which materially
extends its useful life or materially improves or increases its capacity; or
(iii) the planning or design of the acquisition, construction, demolition,
replacement, major repair or renovation of a fixed asset or assets, including
the preparation and review of plans and specifications including engineering
and other services, field surveys and sub-surface investigations incidental
thereto.
c) Grantee agrees and covenants that the Grant proceeds shall not be used for costs
that are not capital in nature, which include, but shall not be limited to working
capital, rent, utilities, salaries, supplies, administrative expenses, or to pay down debt
incurred to undertake the Project.
3. Books and Records
r
The Grantee will maintain-accurate books and records concerning the Project for six(6)
years from the date the Project is completed and will make those books and records available to
DASNY, its agents, officers and employees during Grantee's business hours upon reasonable
request. In the event of earlier termination of this Agreement, such documentation shall be
made available to DASNY, its agents, officers and employees for six (6) years following the date
of such early termination.
4. Conditions Precedent to Disbursement of the Grant
No Grant funds shall be disbursed until the following conditions have been satisfied:
Updated 7-28-14 2
(a) DASNY has received a description of the Project, budget and timeline in the form
of Exhibit A, and an opinion of Grantee's counsel, in substantially the form
appended to this Agreement as Exhibit B; and
(b) The requirements of the SAM Program have been met; and
(c) The monies required to fund the Grant have been received by DASNY; and
(d) In the event of disbursement pursuant to paragraph 5(b) below, the Grantee has
provided DASNY with documentation evidencing that a segregated account has
been established by the Grantee into which Grant funds will be deposited (the
"Segregated Account"). Eligible Expenses incurred in connection with the Project
to be financed with Grant proceeds that are to be paid on invoice shall be paid
out of the Segregated Account. The funds in such account shall not be used for
any other purpose.
(e) The Grantee certifies that it is in compliance with the provisions of the SAM and
this Agreement and that the Grant will only be used for the Project set forth in the
Preliminary Application or Project Information Sheet and in Exhibit A hereto.
(f) Not-for-profit organizations are required to register and prequalify on the New
York State Grants Gateway (www.4rantsreform.ny.4ov) in order to receive Grant
funds. The Grantee's Document Vault must be in prequalification status prior to
any disbursements of the grant funds.
5. Disbursement
Subject to the terms and conditions contained in this Agreement, DASNY shall disburse
the Grant to the Grantee, in the manner set forth in Exhibit D, as follows:
(a) Reimbursement: DASNY shall make payment directly to the Grantee in the
amount of Eligible Expenses actually incurred and paid for by the Grantee, upon
presentation to DASNY of (i)the Payment Requisition Forms attached to this
Agreement as Exhibit E and its attachments; (ii) copies of invoices for Eligible
Expenses from the Grantee's contractor and/or vendor and proof of payment
from the Grantee to the contractor and/or vendor in a form acceptable to DASNY;
and (iii) such additional supporting documentation as DASNY may require in
order to clearly demonstrate that Eligible Expenses were incurred and paid by"
the Grantee in connection with the Project described herein; or
(b) Payment on Invoice:
(1) DASNY may make payment directly to the Grantee in the amount of
Eligible Expenses actually incurred by the Grantee, upon presentation to DASNY
of(i)the Payment Requisition Forms attached to this Agreement as Exhibit E and
its attachments; (ii) copies of invoices for Eligible Expenses from the Grantee's
contractor and/or vendor in a form acceptable to-DASNY evidencing the
completion of work; and (iii) such additional supporting documentation as DASNY
may require in order to clearly demonstrate that Eligible Expenses were incurred
by the Grantee in connection with the Project described herein.
Updated 7-28-14 3
(2) The Grantee must deposit all Grant proceeds paid on invoice pursuant to
this paragraph (b) into the Segregated Account established pursuant to
Paragraph 4(d). All Eligible Expenses incurred in connection with the Project to
be financed with Grant funds that are to be paid on invoice must be paid out of
this account. The account shall not be used for any other purpose.
(3) The Grantee must provide proof of disbursement of Grant funds to the
respective contractor and/or vendor in a form acceptable to DASNY, within sixty
(60) days of the date that Grant funds are disbursed to the Grantee to pay for
such costs. DASNY will not make any additional disbursements from Grant
funds until such time as proof of payment is provided.
(4) Utilizing the Grant funds paid to the Grantee pursuant to this section for
any purpose other than paying the contractors and/or vendors identified in the
requisition documentation in the amounts set forth in the requisition shall
constitute a default under this Agreement and shall, at a minimum, result in the
denial of payment on invoice for subsequent requisitions.
(5) DASNY may deny payment on invoice at its sole and absolute discretion,
thereby restricting the method of payment pursuant to this contract to
reimbursement subject to the terms of Section 5(a).
(c) Electronic Payments Program: DASNY reserves the right to implement an
electronic payment program ("Electronic Payment Program")for all payments to
be made to the Grantee thereunder. Prior to implementing an Electronic
Payment Program, DASNY shall provide the Grantee written notice one hundred
twenty days prior to the effective date of such Electronic Payment Program
("Electronic Payment Effective Date"). Commencing on or after the Electronic
Payment Effective Date, all payments due hereunder by the Grantee shall only
be rendered electronically, unless payment by paper check is expressly
authorized by DASNY. Commencing on or after the Electronic Payment Effective
Date the Grantee further acknowledges and agrees that DASNY may withhold
any request for payment hereunder, if the Grantee has not complied with
DASNY's Policies and Procedures relating to its Electronic Payment Program in
effect at such time, unless payment by paper check is expressly authorized by
DASNY.
,(d) In no event will DASNY make any payment which would cause DASNY's
aggregate disbursements to exceed the Grant amount. ,
(e) The Grant, or a portion thereof, may be subject to recapture by DASNY as
provided in Section 9(c) hereof.
6. Non Discrimination and Affirmative Action
The Grantee shall make its best effort to comply with DASNY's Non-Discrimination and
Affirmative Action policies set forth in Exhibit F to this Agreement.
Updated 7-28-14 4
7. No Liability of DASNY or the State
DASNY shall not in any event whatsoever be liable for any injury or damage, cost or
expense of any nature whatsoever that occurs as a result of or in any way in connection with the
Project and the Grantee hereby agrees to indemnify and hold harmless DASNY, the State and
their respective agents, officers, employees and directors (collectively, the "Indemnitees")from
and against any and all such liability and any other liability for injury or damage, cost or expense
resulting from the payment of the Grant by DASNY to the Grantee or use of the Project in any
manner, including in a manner which, if the bonds are issued on a tax-exempt basis, (i) results
in the interest on the bonds issued by DASNY the proceeds of which were used to fund the
Grant (the"Bonds")to be includable in gross income for federal income tax purposes or(ii)
gives rise to an allegation against DASNY by a governmental agency or authority, which
DASNY defends that the interest on the Bonds is includable in gross income for federal income
tax purposes, other than that caused by the gross negligence or the willful misconduct of the
Indemnitees.
8. Warranties and Covenants
The Grantee warrants and covenants that:
(a) The Grant shall be used solely for Eligible Expenses in accordance with the
terms and conditions of this Agreement.
(b) No materials, if any, purchased with the Grant will be used for any purpose other
than the eligible Project costs as identified in Exhibit A.
(c) The Grantee agrees to utilize all funds disbursed in accordance with this
Agreement in accordance with the terms of the SAM Program.
(d) The Grantee is solely responsible for all Project costs in excess of the Grant.
The Grantee will incur and pay Project costs and submit requisitions for
reimbursement in connection with such costs.
(e) The Grantee has sufficient, secured funding for all Project costs in excess of the
Grant, and will complete the Project as described in the Preliminary Application
or Project Information Sheet and in this Agreement.
(f) The Grantee agrees to use its best efforts to utilize the Project for substantially
the same purpose set forth in this Agreement until such time as the Grantee
determines that the Project is no longer reasonably necessary or useful in
furthering the public purpose for which the grant was made.
(g) There has been no material adverse change in the financial condition of the
Grantee since the date of submission of the Preliminary Application or Project
Information Sheet to DASNY.
(h) No part of the Grant will be applied to any expenses paid or payable from any
other external funding source, including State or Federal grants, or grants from
any other public or private source.
Updated 7-28-14 5
(i) The Grantee owns, leases, or otherwise has control over the site where the
Project will be located. If the Project includes.removable equipment or
furnishings including but not limited to, computer hardware and software, air
conditioning units, lab equipment, office furniture and telephone systems,
Grantee will develop, implement and maintain an inventory system for tracking
such removable equipment and furnishings.
0) The Project to be funded by the Grant will be located in the State of New York. If
the Grant will fund all or a portion of the purchase of any type of vehicle, such
vehicle will be registered in the State of New York and a copy of the New York
State Vehicle Registration documents will be provided to DASNY's Accounts
Payable Department at the time of requisition.
(k) Grantee is in compliance with, and shall continue to comply in all material
respects, with all applicable laws, rules, regulations and orders affecting the
Grantee and the Project including but not limited to maintaining the Grantee's
document vault on the New York State Grants Reform Gateway
(www.grantsreform.ny.4ov).
(1) The Grantee has obtained all necessary consents.and approvals from the
property owner in connection with any work to be undertaken in connection with
the Project.
(m) All contractors and vendors retained to perform services in connection with the
Project shall be authorized to do business in the State of New York and/or filed
such documentation, certifications, or other information with the State or County
as required in order to lawfully provide such services in the State of New York. In
addition, said contractor/venodrs shall possess and maintain all professional
licenses and/or certifications required to perform the tasks undertaken in
connection with the Project.
(n) Neither the Grantee nor any of the members of its Board of Directors or other
governing body or its employees have given or will give anything of value to
anyone to procure the Grant or to influence any official act or the judgment of any
person in the performance of any of the terms of this Agreement.
(o) The Grant shall not be used in any manner for any of the following purposes:
(i) political activities of any kind or nature, including, but not limited to,
furthering the election or defeat of any candidate for public, political or
party office, or for providing a forum for such candidate activity to promote
the passage, defeat, or repeal of any proposed or enacted legislation;
(ii) religious worship, instruction or proselytizing as part of, or in connection
with, the performance of this Agreement;
(iii) payments to any firm, company, association, corporation or organization
in which a member of the Grantee's Board of Directors or other governing
body, or any officer or employee of the Grantee, or a member of the
immediate family of any member of the Grantee's Board of Directors or
other governing body, officer, or employee of the Grantee has any
Updated 7-28-14 6
ownership, control or financial interest, including but-not limited to an
officer or employee directly or indirectly responsible for the preparation or
the determination of the terms of the contract or other arrangement
pursuant to which the proceeds of the Grant are to be disbursed. For
purposes of this paragraph, "ownership" means ownership, directly or
indirectly, of more than five percent (5%) of the assets, stock, bonds or
other dividend or interest bearing securities; and "control" means serving
as a member of the board of directors or other governing body, or as an
officer in any of the above; and
(iv) payment to any member of Grantee's Board of Directors or other
governing body of any fee, salary or stipend for employment or services,
except as may be expressly provided for in this Agreement.
(p) The relationship of the Grantee (including, for purposes of this paragraph, its
officers, employees, agents and representatives) to DASNY arising out of this
Agreement shall be that of an independent contractor. The Grantee covenants
and agrees that it will conduct itself in a manner consistent with such status, that
it will neither hold itself out as, nor claim to be, an officer, employee, agent or
representative of DASNY or the State by reason hereof, and that it will not by
reason thereof, make any claim, demand or application for any right or privilege
applicable to an officer, employee, agent or representative of DASNY or the
State, including without limitation, worker's compensation coverage,
unemployment insurance benefits, social security coverage or retirement
membership or credit.
(q) The information contained in the Preliminary Application or Project Information
Sheet submitted by the Grantee in connection with the Project and the Grant, as
such may have been amended or supplemented and any supplemental
documentation requested by the State or DASNY in connection with the Grant, is
incorporated herein by reference in its entirety. In the event of an inconsistency
between the descriptions, conditions, and terms of this Agreement and those
contained in the Preliminary Application or Project Information Sheet, the
provisions of this Agreement shall govern. The Grantee hereby acknowledges
that DASNY has relied on the statements and representations made by the
Grantee in the Preliminary Application or Project Information Sheet and any
supplemental information in making the Grant. The Grantee hereby represents
and warrants that it has made no material misstatement or omission of fact in the
Preliminary Application or Project Information Sheet, supplemental information,
or otherwise in connection with the Grant and that the information contained in
the Preliminary Application or Project Information Sheet and,supplemental
information continues on the date hereof to be materially correct and complete.
(r) The Grantee hereby represents and warrants that it has made no material
misstatement or omission of fact in the Grantee Questionnaire ("GQ"), attached
hereto as Exhibit C,or the Grantee's document vault in the New York State's
Grants Reform Gateway completed by the Grantee in connection with the Project
and the Grant, and that the responses in the GQ and the document vault
continue on the date hereof to be materially correct and complete. The Grantee
hereby acknowledges that DASNY has relied on the statements and
representations made by the Grantee in the GQ in making the Grant, and that the
Updated 7-28-14 7
Grantee will be required to reaffirm the information therein each time a requisition
for grant funds is presented to DASNY.
(s) The Grantee is duly organized, validly existing and in good standing under the
laws of the State of New York, or is duly organized and validly existing under the
laws of another jurisdiction and is authorized to do business and is in good
standing in the State of New York and shall maintain its corporate existence in
good standing in each such jurisdiction for the term of this Agreement, and has
full power and authority to execute and deliver the Agreement and to perform its
obligations thereunder;
(t) The Grantee agrees to provide such documentation to DASNY as may be
requested by DASNY in its sole and absolute discretion to support a requisition
for payment, to determine compliance by the Grantee with the terms of this
Agreement or otherwise reasonably requested by DASNY in connection with the
Grant, and further acknowledges that if documentation requested in connection
with a requisition for payment does not, in the sole and absolute discretion of
DASNY, provide adequate support for the costs requested, that such requisition
request shall be denied and payment shall not be made to the Grantee.
(u) The Agreement was duly authorized, executed and delivered by the Grantee and
is binding on and enforceable against the Grantee in accordance with its terms.
9. Default and Remedies
(a) Each of the following shall constitute a default by the Grantee under this Agreement:
(i) Failure to perform or observe any obligation, warranty or covenant of the
Grantee contained herein, or the failure by the Grantee to perform the
requirements herein to the reasonable satisfaction of DASNY and within
the time frames established therefor under this Agreement.
(ii) Failure to comply with any request for information reasonably made by
DASNY to determine compliance by the Grantee with the terms of this
Agreement or otherwise reasonably requested by DASNY in connection
with the Grant.
(iii) The making by the Grantee of any false statement or the omission by the
Grantee to state any material fact in or in connection with this Agreement
or the Grant, including information provided in the Preliminary Application
or Project Information Sheet or in any supplemental information that may
be requested by the State or DASNY.
(iv) The Grantee shall (A) be generally not paying its debts as they become
due, (B)file, or consent by answer or otherwise to the filing against it of, a
petition under the United States Bankruptcy Code or under any other
bankruptcy or insolvency law of any jurisdiction, (C) make a general
assignment for the benefit of its general creditors, (D) consent to the
appointment of a custodian, receiver, trustee or other officer with similar
powers of itself or of any substantial part of its property, (E) be
Updated 7-28-14 1 8
adjudicated insolvent or be liquidated or (F)take corporate action for the
purpose of any of the foregoing.
(v) An order of a court having jurisdiction shall be made directing the sale,
disposition or distribution of all or substantially all of the property
belonging to the Grantee, which order shall remain undismissed or
unstayed for an aggregate of thirty (30) days.
(vi) The Grantee abandons the Project prior to its completion.
(vii) The Grantee is found to have falsified or modified any documents
submitted in connection with this grant, including but not limited to
invoice, contract or payment documents submitted in connection with a
Grantee's request for payment/reimbursement.
(viii) Utilizing the Grant funds paid to the Grantee pursuant to Section 5(b)for
any purpose other than paying the contractors and/or vendors identified in
the requisition documentation in the amounts set forth in the requisition.
(b) Upon the occurrence of a default by the Grantee and written notice by DASNY
indicating the nature of the default, DASNY shall have the right to terminate this
Agreement.
(c) Upon any such termination, DASNY may withhold any Grant proceeds not yet
disbursed and may require repayment of Grant proceeds already disbursed. If
DASNY determines that any Grant proceeds had previously been released
based upon fraudulent representations or other willful misconduct, DASNY may
require repayment of those funds and may refer the matter to the appropriate
authorities for prosecution. DASNY shall-be entitled to exercise any other rights
and seek any other remedies provided by law.
10. Term of Agreement
Notwithstanding the provisions of Section 9 hereof, this Agreement shall terminate three
(3) years after the latest date set forth on the front page hereof without any further notice to the
Grantee. DASNY, in its sole discretion, may extend the term of this Agreement upon a showing
by the Grantee that the Project is under construction and is expected to be completed within the
succeeding twelve (12) months. All requisitions must be submitted to DASNY in proper form
prior to the termination date in order to be reimbursed.
11. Proiect Audit
DASNY shall, upon reasonable notice, have the right to conduct, or cause to be
conducted, one or more audits, including field inspections, of the Grantee to assure that the
Grantee is in compliance with this Agreement. This right to audit shall continue for six (6) years
following the completion of the Project or earlier termination of this Agreement.
12. Survival of Provisions
The provisions of Sections 3, 7, 8(n),'8(o) and 11 shall survive the expiration or earlier
termination of this Agreement.
Updated 7-28-14 9
13. Notices
Each notice, demand, request or other communication required or otherwise permitted
hereunder shall be in writing and shall be effective upon receipt if personally delivered or sent
by any overnight service or three (3) days after dispatch by certified mail, return receipt
requested, to the addresses set forth on this document's cover page.
14. Assignment
The Grantee may not assign or transfer this Agreement or any of its rights hereunder.
15. Modification
This Agreement may be modified only by a written instrument executed by the party
against whom enforcement of such modification is sought.
16. Governinq Law
This Agreement shall be governed by and construed in accordance with the laws of the
State of New York. This Agreement shall be construed without the aid of any presumption or
other rule of law regarding construction against the party drafting this Agreement or any part of
it. In case any one or more of the provisions of this Agreement shall for any reason be held to
be invalid, illegal or unenforceable in any respect, such invalidity, illegality or unenforceability
shall not affect any other provision hereof and this Agreement shall be construed as if such
provision(s) had never been contained herein.
17. Confidentiality of Information
Any information contained in reports made to DASNY or obtained by DASNY as a result
of any audit or examination of Grantee's documents or relating to trade secrets, operations and
commercial or financial information, including but not limited to the nature, amount or source of
income, profits, losses, financial condition, marketing plans, manufacturing processes,
production costs, productivity rates, or customer lists, provided that such information is clearly
marked "confidential" by the Grantee that concerns or relates to trade secrets, operations and
commercial or financial information, including but not limited to the nature, amount or source of
income, profits, losses or expenditures, financial condition, marketing plans, manufacturing
processes, production costs, productivity rates, or customer lists, which is determined by
DASNY to be exempt from public disclosure under the Freedom of Information Law, shall be
considered business confidential and is not to be released to anyone, except DASNY and staff
directly involved in assisting the Grantee, without prior written authorization from the Grantee,
as applicable. Notwithstanding the foregoing, DASNY will not be liable for any information
disclosed, in DASNY's sole discretion, pursuant to the Freedom of Information Law, or which
DASNY is required to disclose pursuant to legal process.
18. Executory Clause
This Agreement shall be deemed executory to the extent of monies available for the
SAM Program to DASNY.
f
Updated 7-28-14 10
This agreement is entered into as of the latest date written below:
DORMITORY AUTHORITY OF THE STATE OF NEW YORK
Authorized Officer
(Printed Name)
Date:
GRANTEE: TOWN OF SOUTHOLD
(Signature)
SC k 17 USS
(Printed name and title)
Date: l c ( 19
Updated 7-28-14 11
GRANT DISBURSEMENT AGREEMENT
EXHIBITS
EXHIBIT A Project Budget
EXHIBIT B Opinion of Counsel
EXHIBIT C Grantee Questionnaire
EXHIBIT D Disbursement Terms
EXHIBIT E Payment Requisition Form and Dual Certification
EXHIBIT E-1 Payment Requisition Cover Letter
EXHIBIT E-2 Payment Requisition Back-up Summary
EXHIBIT F Non-Discrimination and Affirmative Action Policy
Updated 7-28-14 12
EXHIBIT A: Project Budget
Town of Southold
Improvements to the Exterior of the Town Community Center Building
Project ID 11670
USE OF FUNDS TIMELINE SOURCES TOTAL
DASNY
Anticipated Dates Share In-Kind/Equity/Sponsor Other Sources
TASKS* Start End Amount Source Amount Entity Name Amount
Name
Improvements to the 2/2019 12/2019 $50,000 Town of $156 $50,156
exterior of the town Southold
community center
building
Total Project Cost $50,000 $156 $50,156
Please note that the tasks set forth in this column must be those for which reimbursement or payment on invoice will be sought. Please
ensure that the task list is complete and includes all the tasks for which you will be submitting requisitions. The failure to do so may
delay payment.
Updated 7-28-14 13
WILLIAM McQUAID DUFFY SCOTT A.RUSSELL
TOWN ATTORNEY O�*QF SU(/r�ol Supervisor
bill.duffy@ town.Southold.ny.us
DAMON A. RAGAN Town Hall Annex, 54375 Route 25
ASSISTANT TOWN ATTORNEY P.O.Box 1179
damonh@southoldtownny.gov G Q Southold,New York 11971-0959
Telephone(631) 765-1939
CQUNT` 1 Facsimile(631) 765-6639
OFFICE OF THE TOWN ATTORNEY
TOWN OF SOUTHOLD
October 19, 2018
DASNY
515 Broadway
Albany, NY 12207
ATTN: Michael E. Cusack, General Counsel
RE: State and Municipal Facilities Program ("SAM") Grant
Improvements to the Exterior of the Town Community Center Building
Project ID 11670
Ladies and Gentlemen:
I have acted as counsel to the Town of Southold (the"Grantee") in connection with the Project
referenced above. In so acting, I have reviewed a certain Grant Disbursement Agreement
between you and the Grantee, executed by the Grantee on October 19, 2018,(the"Agreement")
and such other documents as I consider necessary to render the opinion expressed hereby.
Based on the foregoing, I am of the opinion that:
1. The Grantee is duly organized, validly existing and in good standing under the laws of
-the State of New York, and has full power and authority to execute and deliver the
Agreement and to perform its obligations thereunder; and
2. The Agreement was duly authorized, executed and delivered by the Grantee and is
binding on and enforceable against the Grantee in accordance with its terms.
Ve Truly Yours,
1 '
William M. DU f sq.
Southold Town At orney
14
EXHIBIT C: Grantee (questionnaire
Updated 7-28-14 15
U) 1b
N�INYORK
'ST
DASNY
-
• 4PPORTIINITY_ -
'Gra'ntee Qlesfionnaire
llilS,QUESTIONNAIRE MUST BE COMPETED INFULL BEFORE DASNY V1ILT,
MOiCESS YOITRGRANT.APPLICATION
if you have previously submittcd a Grantee Questionnaire m the past six (6)months and ibere are no
changes since your last Submission,please attach a signed and notarizAd Affidavit of No Chang*a Form
along with your most recent copy of the previously siibmidad'Grantee Question airc_The Form js attached
to the back ofthis document.
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' if yes,'prgMda the name(s� FEW(s) and d/h/a(s) and the address for each such entity on a
separate piece of-paper and attach to this questionnaire: }
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CONFIDI;Ivl AND SHOULDBBMM4pTFROMDISCIASIJIlEUNDLRTHEIItEEDOA2OFD*oRhWnODTLAW:
1:1 YES ZZ40
ZFYOU CHECM"YES"'YOU MUST IAENTiFY UE INFORMATION YOUFHSL IS CONFIDEI-MAL BY
PLAC 4G-M4MT'bRTSKIN FRONT OF THE APPROPRIATE QUESTIONNUMBla(S)AlIDD YOU ARE
REQUESTED TO ATrACHAN ADDITTONALSHII(S)UPON WHIM'nMBASIS FORSUCH'CLA-D"(S)IS
='L'ABIHD.
YoUMAX AiS.o REQUEST TTiAT THE'cat,TIDENTTAT.DOCOME NrATSON BE REYIBWED Arm REUJR.N5D
I'o YOU AND NOT RBTAINID,I3Y THRATMORI'iX_PLEASE BT A13VISEVE(t,fTIAZTT�
AuTSopm, I+iUST COMPLY LN ALI.RFSPECTS vlrR,=.FREEDOM OF INFORMATION LAW.
1'agcZ.of R
12J4I2D13 '
SECTION II: GRANTEE CERTIFICATION AS TO MLIC PURPOSE
A. DEB'IIQITIONS
AS USED HEREjN IN THIS Gw7PROGRaff GRANTEE QUESTIONNAIRE:
I. "AFFII A.TE"MEANS ANY PERSON OR ENTITY THAT DIRECTLY OR INDIRECTLY CONTROLS OR IS CONTROLLED
BY ORIS UNDER COMMON CONTROL OR OWNERSHIP WITH THE GRANTEE.
2. "GRANTEE" MEANS THE PARTY OR PARTIES RECEIVING FUNDS PURSUANT TO THE TERMS OF A GRANT
DISBURSE=AGRITMENT("GDA")TO BE R=ED INTO BETWEEN THE GRANTEE AMID DASNY OR
THEIR.EMPLOYEES AND AFFILIATES.
3. "GRANT-FUNDED PROJECT"MEANS THE WORK THAT WILL BE FULLY OR PARTIALLY PAID FOR WITH THE
PROCEEDS OF THE GRANT, As DESCRIBED IN TEE PRELIMINARY APPLICATION, PROJECT INFORMATION
SHEET AND THE GDA,AND INCLUDES,BUT IS NOT T IN91E.T)TO,ARCHITECTURAL,ENGINEERING AND-OTHER
PRELZa,IARY PLANNING COSTS,CONSTRUCTION,FURNISHINGS AND EQUIPMENT.
4. "RELATED PARTY"MEANS:(I)THE PARTY'S SPOUSE,(II)NATURAL OR ADOPTED DESCENDANTS OR STEP-
CHILDREN OF=PARTY OR OF THE SPOUSE,(III)ANY NATURAL OR ADOPTED PARENT OR STEP PARENT OR
ANY NATURAL,ADOPTED,OR STEP-SIBLING OF THE PARTY OR OF THE SPOUSE,(IV)THE SON-IN-LAW,
DAUGHTER IN--LAW,BROTHER-IN-LAW,SISTER-IN-LAW,FATHER-IN LAW OR MOTHER-IN-LAW OF TEE PARTY
OR OF THE SPOUSE,(V)ANY PERSON SHARING TEE ROME OF ANY OF THE PARTY OR OF TEE SPOUSE,(VI)ANY
PERSON WHO HAS BM4 A STAFF MEMBER,EMPLOYEE,DIRECTOR,OFFICER OR AGENT OF THE PARTY WITHIN
TWO(2)YEARS OF THE DATE OF THIS GRANTEE QUESTIONNAIRE, AND(VII)AFFILIATES OR
SUBCONTRACTORS OF THE PARTY.
5. "SPONSORING MEMBER(S)" MEANS THE ASSEMBLY MEMBER OR STATE SENATOR WHO SPONSORED,
ARRANGED FOR AND/OR PROCURED THE GRANT.IN ADDITION,"SPONSORING MEMBER(S)"SHALL INCLUDE*
THE GOVERNOR WHEN APPROPRIATE AS LTSTED BEP EIN.
$. GRANT AWARD
I. HAS TEE GRANTEE OR ANY OF THE GRANTEE'S RELATED PARTIES PAID ANY THIRD PARTY OR AGENT,ERTiER
DIRECTLY OR I�IDIRECTLY,TO AID IN THE SECURING OF THIS GRANT? ❑YES PI NO
IF ANSWER IS-YES",PLEASE EXPLAIN:
2. HAS THE GRANTEE OR ANY OF THE GRANTEE'S RELATED PARTIES AGREED TO SELECT SPECIFIC
CONSULTANTS, CONTRACTORS, SUPPLIERS OR VENDORS TO PROVIDE GOODS OR SERVICES IN CONNE TION
W=TEE GRANT FUNDED PROJECT AS A CONDITION OF RECEIVING THE GRANT. ❑YF-s EW
IF ANSWER IS"YES",PI EASE EXPLAIN:
3. WILL ALL CONSULTANTS, CONTRACTORS, SUPPLIERS AND VENDORS SELECTED TO PROVIDE GOODS OR
SERVICES IN CONNECTION WITH THE GRANT FUNDED PROJECT BE CHOSEN IN ACCORDANCE WITH TEE
GRANTEE'S CONFLICT OF INTERESTS POLICY,OR IF CONSULTANTS,SUPPLIERS AND VENDORS RETAINED IN
CONNECTION WITS TEE GRANT FUNDED PROJECT HAVE ALREADY BEEN SELECTED, WAS THE SELECTION
UATDERTAKEN IN ACCORDANCE WITH THE GRANTEES CONFLICT OF UTIEREST POLICY? LP1YES EINO
IF GRANTEE'S GOVERNINCT BOARD HAS NOT ADOPTED A CONFLICT OF INTERESTS POLICY,PLEASE
STATE NONE.
IF ANSWER IS"NO",PLEASE EXPLAIN:
Page 3 of 8
12J4/2012
i
4; DOES .9I'ON$ORLN_GAfEI IBER(S) OR ANY RELATED PARTIES TO SPONSORING MEMBES(S)HAVE,ANY
FINANCIAL INTEREST,DIRECT OR INDIRECT,IN THE GRANTEE OR INT ANY OF TRE GRANTEWS EQ=OWNERS,,OR
WILL TBE SPONSORING MEMBERS OR ANY RELATED PARTIES TO SPONSORING MEMBERS RECEIVE ANY
FfiANCIAL SENECTI,,k iLR IaIRI ]L Y OR INDIRECTLY,FROM THE PROJECT FUNDEP IN WHOLE OR LN•PARXWim I
GRANTPROCEEDS? DYES NO
IFTFMAN$WER4"YES",?LEASE PROVIDE DBTAILSWSEPARATE APPP.I� Dl ATTACBED TO TIM
G�RTIFTCATION. .
SECTION-III: DTIR DmaGENa QTJESTIONS'
I. DOES TEE GRANTEE POSSESS ALL CERTIFICATIONS, LICENSES, PERI Im, ,4FPRl3VAlz, OR ,OTT3ER
A=CIRIZA7ION5 ISSUED BY ANY LOCAL,STATE,OR FEDERAL GOVERNMENTAL.ENTITY IN CONNECTI0N VmB
TATE PROTECT,GRANTI:E'S.SERYICES,OPPRATIONS,BMIPESS,OR ABILTIY'TocomUCT ITS AMWITIES7 PLEASE
fiI0 TICS DOES.NOT INCLUDE CONSTRUCTION X'I A= ACTNTTIFS SUCH AS BUILDING P.FtMITS AND I
`
C.EVITF7CATES OF OCCOPANCY.
YBs ONO
IF THE ANSWER 15"No",-PLEASE SET FORTH ON A SEPARATE DOCtAN-1tNT ATTACI3ED HERETO THE
CERTIDCATIONS, LICENSES, PERMITS, APPROVALS, OR OTHER. AUTEORIZ&TiONS THAT ARI;
REQU1RhD AND TIM-DATE(S) THAT SUCH CERTIFICATIONS, LICENSES, PERIv1TTS, &..FpItovw, OR
OTHER AU MORIZATION IS FJ;PECTED,
EbN A SIrPARATE DOCUMENT A-TTACSMD$EBE'T0,LIST ALL CONTRACTS-THE GRANTEE HAS ENTERED INTO WITH
ANY.NEW YORK STAT$AGENCY,PUBLIC AUTEOATIY,OR OTHER QUASI-STATE EK=,INTO PAST FIVE (5) ,
YEARS, PLEASE LIST'THENAME,ADDR�CS AND CONTACT PERSON FOR TTS CONIRAC77NG ENTITY,AS WELL_AS {
'TIL£CONTRACTrRsCTTVE'D,k=-& ALSOPROVIDESTATECONTRACT1iM4=ICATTONNU'vMLR;U-'C Oo N. N/A
ON A:sEPARATS DOCUMENT^ATTACHED F11iRIiTO,LIST ALL GRAN C9 RECL'IVED ROld FEDERAL;;STAI7,AND
IACALZ IJITI7Fs T{I FUND ALL ORA PORTION OE ANY CGAIPONENI OP THE PROJECT WTfIDN TPAST 5 YEARS.- NIA
4. 'Wft' ,.THE PAST FIVE(5)YEARS,HAS THE GRANTEE,ANY PRINCIPAL,OWNER,DIRECTOR OFFiCEIL,MAJOR
�TDC]cHOLDER(100/a ORMORE OF TAE VOTING SHARES FORPUBLICL-Y TRADED COMPANIES,25p/4 OR.MORE OF TM
SHARES FOR ALL OTHER COMPANIES),RELATED COMPANY OR AFFILIATE BEEN-THE SUBJECT OF ANY OF THE
Fb OWING:
(a} A=GI EN 1,OR CONVIC77oN FOR ANY BUSINESS RELATED CONDUCT CONSTITUTING A RJ
UNDERFEDERAL,STATE ORLOCAL GOVERNMENT LAW.? [IYECNQ
(b) BMK SUSpEKDED,DEBARRED ORTFRMWATED BY A LOCAL,STATE ORFEDIERARALAUTFIORTTY
CONNECTION WTIH A-COIJMCT OR CONTRACTING PROCESS? 0 YES. IJ No
(C) BEENDENISD AN AWARD OF A LOCAL,STATE ORFEDERAL QOVEIWMENT CONTRACT,HAD A
CQNZRACT SUSPENDEb ORHAD A CONTRACT TERMINATED FORNON-RWPONSIBILI7,Y2
Q YES WNo
(d) HAD A LOCAI-,.STATB,ORFEDER1iLMVE16DAENT CONtRACTSb5PE1IDLD OF'IMMINA7LD F( t
CAUSE PRIOR TO TFM COMPLETION OF TBE TERM OF THE CONTT�ACT? O YFS NO
(e) A CMENAL INVESTIGATION OR INDICl?,flRTr MO ,W BUSINESS RELATED CONDUCT CONSTT! TIRG
A CRIME UNDER FEDERAL,STATE OR LOCAL GOVtnWOMyls HO
( AN DWE.STIGATIONFOR A CiVII{VIOLATION FOR ANY BUSINESS RELATED CONDUCT BY ANY—J
PIDERAL,STATE ORLOCAL AGENCY? ❑Ws NO
Page 4 of 8
12/412012
(g) AN UNSATISFIED JUDGMENT,INJUNCTION OR LIFT FOR ANY BUSINESS RELATED CONDUCT
OBTAINED BY ANY FEDERAL STATE OR LOCAL GOVT AGENCY INCLUDING,BUT NOT
L IM[TED TO,JUDGMENTS BASED ON TAXES OWED AND FINES AND PENALTIES ASSESSED BY ANY
FEDERAL,STATE ORLOCAL GOVERI�IIv1EriT AGENCY? ❑YES ANY.
(h) A GRANT OF IMMUNITY FOR ANY BUSINESS-RELATED CONDUCT CONSTITUTING A CRIME UNDER
FEDERAL,STATE OR LOCAL LAW INCLUDING,BUT NOT LIMITED TO ANY CRIME RELATED TO -
TRUTHFULNPSS AND/ORBUSINFSS CONDUCT? D YES C<NO
(i) AN ADMINISTRATIVE PROCEEDING OR CIVIL ACTION SEEKING SPECIFIC PERFORMANCE OR
RESTITUTION IN CONNECTION WITH ANY FEDERAL,STATE OR LOCAL CONTRACT OR LEASE?
D YES �No
(j) TEE WITHDRAWAL,TERMIIZATION OR SUSPENSION OF ANY GRANT OR OTH Et FINANCIAL SUPPORT
BY ANY FEDERAL,STATE,OR LOCAL AGENCY,ORGANIZATION OR FOUNDATION?
❑YES HrNo
(k) A SUSPENSION ORREVOCAUGN OF ANY BUSINESS ORPROFESSIONAL LICENSE HELD BY THE
GRANTEE,A C[JRRENT OR FORMER PRINCIPAL,DIRECTOR,OR OFFICER OF THE GRANTEE,OLANY
MEMBER OF THE ANY CURRENT OR FORMER STAFF OF TEE GRANTEE? D YES H NO
(I) A SANCTION IMPOSED AS A RESULT OF JUDICIAL OR ADMINISTRATIVE PROCEEDINGS REIA TO
ANY BUSINESS OR PROFESSIONAL LICENSE? D YES mNO
(m) A CONSENT ORDER WITH TBE NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL
CoNsEiRVATION,OR A FEDERAL,STATE OR LOCAL GOVERNI,=ENFORCEMENT DATION
INVOLVING A VIOLATION OF FEDERAL,STATE OR LOCAL LAWS? D YES eNo
(n) A CITATION,NOTICE,VIOLATION ORDER,PENDING ADMINISTRATIVE HEARING OR PROCEEDING OR
DEERM[XATION FOR VIOLATIONS OF-
- FEDERAL,STATE OR LOCAL HEALTH LAWS,RUMS OR REGULATIONS ❑YES 9'NO
-UNEMPLOYMENT INSURANCE OR WORKERS'COMPENSATION DYES 4�PNO
- COVER-AGE OR CLAIM REQUIREMENTS ❑YES--f�'No
- ERISA(EMPLOYEE RETIREMENT INCOME SECURITY ACT) D YES ETN o
- FEDERAL,STATE OR LOCAL HUMAN RIGHTS LAWS D YES `MNO
- FEDERAL INS(IMMIGRATION AND NATURALIZATION SERVICE)AND
ALIENAGE LAWS,SHERMAN ACT OR On-IER FEDERAL ANTI-TRUST LAWS D YES 6NO
-A FEDERAL,STATE,OR LOCAL DEIERIvENATJON OF A WILLFUL VIOLATION
OF ANY PUBLIC WORKS OR LABOR LAW OR REGULATION? D YES 60
- AN OCCUPATIONAL SAFETY AND HEALTH ACT CITATION AND
NOTIFICATION OF PENALTY CONTAINING A VIOLATION CLASSIFIED
AS SERIOUS ORWIL=? ❑YES KNo
FOR EACH YES ANSVM TO QUESTIONS 4 A-N, PROVIDE DETAILS ON ADDITIONAL SHEETS REGARDING THE
FINDING,INCLUDING BUT NOT LIMITED TO CAUSE,CURRENT STATUS,RESOLUTION,ETC.
Page 5 of 8
12/42012
5. DURING TEE PAST THREE(a)YEARS,HAS TEE GRANTEE FAILED TO:
(a-1) FILE ANY RETURNS,INCLUDING,IF APPLICABLE,FEDERAL FORM 990,WITH ANY FEDERAL,STATE O
LOCAL GOVERNMENT ENTITY? El YES NO
IF YES,IDENTIFY THE RETURN THAT WAS NOT FILED,TAE TYPE OF FORM,TEE YEAR(S)IN WHICH THE REQUIRED
RETURN WAS NOT I=,AND THE REASON WHY TAE RETURN WAS NOT FILED:
(a-2) PAY ANY APPLICABLE FEDERAL,STATE,OR LOCAL GovERm IENT TAXES? ❑YES U NO
IF YES,IDENTIFY THE TAXING JURISDICTION,TYPE OF TAX,LIABILITY YEAR(S)AND TAX IJABIT ITY AMOUNT
TEE GRANTEE FAILED TO PAY AND TEE CURRENT STATUS OF THE LIABILITY:
(b) FILE RETURNS OR PAY NEW YORK STATE UNENTPLOYMENT INSURANCE? ❑YES tNO
IF YES, INDICATE THE YEARS TEE GRANTEE FAILED TO FILE/PAY THE INSURANCE AND TEE CURRENT
STATUS OF THE LIABILITY:
(c) FILE DOCUMENTATION REQUESTED BY ANY REGULATING ENTITY SET FORTH IN SECTION III,QUESTION I
ABOVE,WITH TEE ATTORNEY GENERAL OF TEE STATE OF NEW YORK,OR WITH ANY OTHER LOCAL
STATE,OR FEDERAL ENTITY THAT HAS MADE A FORMAL REQUEST FOR INFORMATION? ❑YES kNO
IF YES, INDICATE THE YEARS TEE GRANTEE FAILED TO FILE TIS REQUESTED INFORMATION AND THE
CURRENT STATUS OF THE MATTER:
6. HAVE ANY BANKRUPTCY PROCEEDINGS BEEN INITIATED BY OR AGAINST THE GRANTEE, RELATED
ORGANIZATIONS, ENT= OR ITS AFFILIATES WITHIN THE PAST SEVEN (7) YEARS (WHETHER OR NOT
CLOSED) OR IS ANY BANKRUPTCY PROCEEDING PENDING BY OR AGAINST TEE GRANTEE, TED
ORGANIZATIONS,ENTITIES OR ITS AFFILIATES,REGARDLESS OF TEE DATE OF FILING? ❑YESNNo
IF YES,INDICATE IF THIS IS APPLICABLE TO THE SUBMITTING GRANTEE OR ONE OF ITS AFFILIATES:
IF IT IS AN AFFILIATE, RELATED ORGANIZATION OR ENTiTY, INCLUDE THE AFFILIATE'S NAME AND
FEIN:
PROVIDE THE COURT NAME,ADDRESS AND DOCKETNUMBER:
INDICATE IF THE PROCEEDINGS HAVE BEEN INITIATED, REMAIN PENDING OR HAVE BEEN
CLOSED:
IF CLOSED,PROVIDE TEE DATE CLOSED:
7. DOES GRANTEE HAVE THE FINANCIAL RESOURCES (IN EXCESS OF THE GRANT) TO FULFff-L THE
REQUIREMIENT�OF THE PROJECT DESCRIBED IN THE PRaIMRZARY APPLICATION OR PROJECT IIIFORMATION
SHEET? YES • ❑No ❑ N/A,PROJECT IS FULLY FUNDED BY GRANT.
IF YES, PLEASE SET FORTH ON A SEPARATE DOCUMENT ATTACHED HERETO TEE SOURCE(S) OF TTS
ADDITIONAL FUNDS NECESSARY TO COMPLETE THE PROJECT, TEE TIIYIING OF TEE AVAILABILITY OF THE
FUNDING,'AND A CONTACT PERSON FOR EACH SOURCE. PLEASE BE ADVISED THAT DASNYMAY
CONTACT ONE OR MORE OF TEE LISTED SOURCES TO VERIFY FUNDING AVAILABILITY.
IF NO,INDICATE HOW THE GRANTEE WILL FULFILL THE REQUIREIv=OF THE PROJECT DESCRIBED IN THE
pR7 LlIvEtNARY APPLICATION OR PROJECT INFORMATION SHEET AND THE TERMS OF TEE GRANT
DISBURSEMENT AGREEMENT.
Page 6of8
12/4/2012
CERTIFICATION
THE GRANTEE CERTIFIES THAT ALL FUNDS THAT WILL BE EXPENDED PURSUANT TO THE TERMS OF THE
GDA TO BE ENTERED INTO BETWEEN DASNYAND THE GRANTEE ARE TO BE USED SOLELY AND DIRECTLY
FOR THE PUBLIC PURPOSE ORPUBLIC PURPOSES DESCRIBED IN THE PRELIMINARY APPLICATION,PROTECT
INFORMATION SHEET AND GDA_THE GRANTEE FURTHER CERTIFIES THAT ALL SUCH FUNDS WELL BE USED
SOLELY IN THE MANNER DESCRIBE)IN THE PRELIMINARY APPLICATION,PROJECT INFORMATION SHEET,
AND GDA. THE GRANTEE FURTHER CERTIFIES THAT IT WILL UTILIZE THE REAL PROPERTY,
EQUIPMENT, FURNISHINGS, AND OTHER CAPITAL COSTS PAID FOR WITH GRANT PROCEEDS UNTIL SUCH
UMS AS TEE GRANTEE REASONABLY DETERMINES THAT SUCH REAL PROPERTY, EQUIPMENT,
FURNISHINGS AND OTHER CAPITAL COSTS ARE NO LONGER REASONABLY NECESSARY OR USEFUL TO
FURTHER THE PUBLIC PURPOSE FOR WHICH TEE GRANT WAS MADE.
THE UNDERSIGNED RECOGNMES THAT THIS QUESTIONNAIRE IS SUBMITTED FOR TEE EXPRESS PURPOSE OF
INDUCING DASNY TO MAIM PAYMENT TO TEE GRANTEE FOR SERVICES RENDERED BY THE UNDERSIGNED
AND THAT DASNY MAY IN ITS DISCRETION,BY MEANS WHICH IT MAY CHOOSE,DETERMINE THE TRUTH
AND ACCURACY OF ALL STATIIVIENTS MADE HEREIN. THE UNDERSIGNED FLIRT HER ACKL`TOWLEDGES
THAT INTENTIONAL SUBMISSION OF FALSE OR MISLEADING INFORMATION MAY CONSTITUTE A FELONY
UNDER PENAL LAW SECTION 210.40 OR A MISDEMEANOR UNDER PENAL LAW SECTION 21035 OR
SECTION 210.45,AND MAY ALSO BE PUNISHABLE BY A FINE OF UP TO 510,000 OR D&RISONMENT OF UP TO
FIVE YEARS UNDER 18 U.S.C.SECTION 1001;AND STATES THAT TEE INFORMATION SUBMITTED IN THIS
QUESTIONNAIRE AND ANY ATTACHED PAGES IS TRUE,ACCUkATE AND COMPLETE.
THE-UNDERSIGNED ALSO CERTIFIES THAT S/HE HAS NOT ALTERED THE CONTENT OF THE QUESTIONS IN
THE QUESTIONNAIRE IN ANY MANNER,HAS READ AND UNDERSTANDS ALL OF THE ITEMS CONTAINED IN
THE QUESTIONNAIRE AND ANY ATTACHED PAGES; HAS SUPPLIED FULL AND COMPLETE RESPONSES TO
EACH ITEM THEREIN TO THE- BEST OF HIS/HER KNOWLEDGE, 'INFORMATION AND BELIEF; IS
KNOWLEDGEABLE ABOUT THE SUBMITTING GRANTEE'S BUSINESS AND OPERATIONS;UNDERSTANDS THAT
DASNY WILL RELY ON THE INFORMATION SUPPLIED IN THIS QUESTIONNAIRE WHEN ENTERING INTO A
CONTRACT WITH THE GRANTEE;AND IS UNDER DUTY TO NOTIFY DASNYOF ANY MATERIAL CHANGES
To THE GRANTEE'S RESPONSES HEREIN UNTIL SUCH TIME AS THE GRANT PROCEEDS HAVE BEEN FULLY
PAID OUT T R-ANTEE. 9 -
Si2xiature of Authorized Officer Signature of Chair of the Board f Grantee
(or other Authorized Officer)
� i lliu.rn P- _R ylc�r�d�
Printed Name of Authorized Officer Print Name of Chair of the Board of Grantee
(or other Authorized Officer)
Title of Authorized Officer
SwQm to before me this/J day Sino to before me �S day
of V:4—'O N=j ,20120,
201
F���'f�-�.1 `711 � -�•1'•�-�2� �l X �--� ��'? .��,'.�1�
Notary Public Notary Public
LAUREN M.STANDISH LAUREN M.STANDISH Pap T of 8
1?J4/2012 Notary Public,State of New York Notary Public,State of New York
No.01 ST6164008 No.01 ST6164008
Qualified in Suffolk County Qualified in Suffolk County '
Commission Expires April 9,2019 Commission Expires April 9,2019
EXHIBIT D: Disbursement Terms
Town of Southold
Improvements to the Exterior of the Town Community Center Building
Project ID 11670
Subject to the terms and conditions contained in this Agreement, DASNY shall disburse the
Grant to the Grantee as follows:
Standard Reimbursement
DASNY shall make payment to the Grantee, no more frequently than monthly, based
upon Eligible Expenses (as set forth and in accordance with the budget in Exhibit A) actually
incurred by the Grantee, in compliance with Exhibit A and upon presentation to DASNY of the
Payment Requisition Forms attached to this Agreement as Exhibit E and its attachments,
together with such supporting documentation as DASNY may require in order to clearly
demonstrate that Eligible Expenses were actually incurred by the Grantee in connection with
the Project described herein. Payment shall be made by reimbursement, subject to the terms
and conditions of Sections 4 and 5(a) of this Agreement or by payment on invoice subject to
the terms and conditions of Sections 4 and 5(b) of this Agreement.
Supporting documentation acceptable to DASNY'must be provided prior to payment,
including invoices and proof of payment in a form acceptable to DASNY. If the fronts and backs
of canceled checks cannot be obtained from the Grantee's financial institution, a copy of the
front of the check must be provided, along with a copy of a bank statement clearly showing that
payment was made by the Grantee to the contractor. DASNY reserves the right to request
additional supporting documentation in connection with requests for payment, including the
backs of canceled checks, certifications from contractors or vendors, or other documentation to
verify that grant funds are properly expended. Please note that quotes, proposals, estimates,
purchase orders, and other such documentation do NOT qualify as invoices.
The Grantee agrees to provide such documentation to DASNY as may be requested by
DASNY in its sole and absolute discretion to support a requisition for payment, to,determine
compliance by the Grantee with the terms of this Agreement or otherwise reasonably
requested by DASNY in connection with the Grant, and further acknowledges that if
documentation requested in connection with a requisition for payment does not, in the sole and
absolute discretion of DASNY, provide adequate support for the costs requested, that such
requisition request shall be-denied and payment shall not be made to the Grantee.
All expenses submitted for reimbursement or payment on invoice must be for work
completed at the approved project location(s) and/or items received at the approved project
location(s) prior to the date of the request for reimbursement/payment. In addition, if funds are
requisitioned for the purchase of a vehicle, the New York State Vehicle Registration Documents
and title must be submitted along with the requisition forms.
Updated 7-28-14 16
EXHIBIT E: Payment Requisition Form and Dual Certification
Town of Southold
Improvements to the Exterior of the Town Community Center Building
Project ID 11670
For Office Use Only:
FMS#: 143044 GranteeED: 3210 GrantID: 12749
Payment Request#
For work completed between -/ - '- / and
THIS REQUEST:
A. B: DASNY SHARE' D:TOTAL E: B-C-D
TASK C:THIS REQUEST REQUESTED PRIOR BALANCE
#'
TO THIS REQUEST
TOTAL-
Please note that the task numbers and DASNY Share amounts set forth in columns A and
B respectively must correspond to the tasks and DASNY Share amounts set forth in Exhibit
A. When submitting a requisition for payment, please remember that DASNY can
reimburse you for capital expenditures made by and invoiced to the Grantee set forth on
the cover page of this Agreement only. Capital expenditures include the costs of
acquisition, design, construction, reconstruction, rehabilitation, preservation, development,
improvement, modernization and equipping of a State and Municipal Facilities Program
facility.
DASNY may not reimburse Grantees or make payments on invoice for costs including, but
not limited to, the following: working capital, rent, utilities, salaries, supplies and other
administrative expenses.
Updated 7-28-14 17
EXHIBIT E: Payment Requisition Form and Dual Certification
DUAL CERTIFICATION
This certification must be signed by two Authorized Officers of the Town of Southold, for Project# 11670.
We hereby warrant and represent to DASNY that:
1. To the best of our knowledge, information and belief, the expenditures described in Payment
Requisition Request# ' � attached hereto in the amount of$ :for which Town of
Southold, is seeking payment and/or reimbursement comply with the requirements of the Agreement
between DASNY and Town of Southold (the "Agreement"), are Eligible Expenses, and that the
payment and/or reimbursement of expenditures for which it is seeking payment and/or reimbursement
from DASNY does not duplicate reimbursement or disbursement of costs and/or expenses from any
other source.
2. The warranties and covenants contained in Section 8 of the Agreement are true and correct as if made
on the date hereof
3. The Eligible Expenses for which reimbursement is sought in connection with this requisition were
actually incurred by the Grantee named on the cover page of this Agreement, and/or will be paid by
the Grantee solely from the Segregated Account established pursuant to paragraph 4(d) of the Grant
Disbursement Agreement to the contractor named on the invoices submitted in connection with this
requisition and shall not be used for any other purpose.
4. All Project costs described in any contractor/vendor invoice submitted pursuant the payment
requisition form have been completely and fully performed prior to the date hereof.
5. Proof of disposition of funds from the Segregated Account to the contractor and/or vendors that are
being paid on invoice, if any, will be provided to DASNY within sixty(60) days of the date that Grant
funds are disbursed to the Grantee to pay for such costs. We understand that in the event that
acceptable proof of payment is not provided, DASNY will not make any additional disbursements from
Grant funds until such time as such proof of payment is provided.
6. We have the authority to submit this requisition on behalf of Town of Southold. The tasks have been
completed in the manner outlined in the Agreement.
7. The following documents are hereby attached for DASNY approval, in support of this requisition, and
are accurate images of the original documents (Please check off all that apply):
❑ Readable copies of both front and back of canceled checks.
❑ Readable copies of the front of the checks and copies of bank statements showing that the checks
have cleared.
❑ Copy of New York State Vehicle Registration and Title documents for all vehicles purchased with
Grant funds.
❑ Invoices/receipts for eligible goods/services that have been received/performed at the approved
project location(s) and a completed Exhibit E-2: Payment Requisition Back-up Summary.
❑ Other:
Authorized Officer Signature: Date:
Print Name:
Title:
Authorized Officer Signature: Date
Print Name:
Title:
Updated 7-28-14 18
r
EXHIBIT E-I: Payment Requisition Cover Letter
ON GRANTEE'S LETTERHEAD
Date
Attention:,Accounts Payable - Grants
DASNY
515 Broadway
Albany, New York 12207
Re: State and Municipal Facilities Program ("SAM') Grant
Improvements to the Exterior of the Town Community Center Building
Project No. 11670
To Whom it May Concern:
Enclosed please find our request for payment/reimbursement. The package includes completed
Exhibits E and E-2, including a Dual Certification with original signatures from two authorized
officers. I have also included supporting documentation and invoices, as summarized in Exhibit
E-2.
Below I have checked off the relevant payment option and completed the required payment
information. This information is complete and accurate as of the date of this letter:
1) ❑ We would like to be paid by reimbursement pursuant to section 5(a) of the grant
disbursement agreement. Proof of payment is enclosed for all invoices submitted in this
request. Please remit payment by check.
OR
2) ❑ We would like to be paid by reimbursement pursuant to section 5(a)of the grant
disbursement agreement. Proof of payment is enclosed for all invoices submitted in this
request. Please remit payment by wire. The wire instructions for our account are as
follows:
BANK NAME: ACCOUNT#:
ACCOUNT NAME: ABA#:
OR
3) ❑ We would like to be paid on invoice pursuant to Section 5(6) of the grant disbursement
agreement.We have not paid the invoice(s) included in this request.We have established
a segregated account to be used solely for accepting and disbursing funds from
DASNY for this grant and for no other purpose. The wire instructions for this account
are as follows:
BANK NAME: ACCOUNT#:
ACCOUNT NAME: ABA#:
If any further information is needed, please contact me at )
Signature:
Print Name: Title:
Updated 7-28-14 19
EXHIBIT E-2: Payment Requisition Back-up Summary
Please list below all invoice amounts totaling the amount for which you are seeking reimbursement in this request.
Invoices should be organized and subtotaled by task#. Please use additional sheets if necessary.
Task#: Task Description:
VENDOR/ INVOICE/ AMOUNT REQUESTED COMMENT
CONTRACTOR NAME APPLICATION# FROM GRANT FUNDS
TOTAL Requested for Task: (Transfer to Exhibit E)
Task#: Task Description:
VENDOR/ INVOICE/ AMOUNT REQUESTED COMMENT
CONTRACTOR NAME APPLICATION # FROM GRANT FUNDS
TOTAL Requested for task: (Transfer to Exhibit E) .
Task#: .Task Description:
VENDOR/ INVOICE/ AMOUNT REQUESTED COMMENT
CONTRACTOR NAME APPLICATION# FROM GRANT FUNDS
TOTAL Requested for task: (Transfer to Exhibit E)
Updated 7-28-14 20
EXHIBIT F
NON-DISCRIMINATION AND AFFIRMATIVE ACTION POLICY FOR THE PROJECT
It is the policy of the State of New York and DASNY, to comply with all federal, State and local
law, policy, orders, rules and regulations which prohibit unlawful discrimination because of race,
creed, color, national origin, sex, sexual orientation, age, disability or marital status, and to take
affirmative action to ensure that Minority and Women-owned Business Enterprises (M/WBEs),
Minorities Group Members and women share in the economic opportunities generated by
DASNY's participation in projects or initiatives, and/or the use of DASNY funds.
1 ) The recipient of State funds represents that its equal employment opportunity policy
statement incorporates, at a minimum, the policies and practices set forth below:
a) Grantee shall (i) not unlawfully discriminate against employees or applicants for
employment because of race, creed, color, national origin,lsex, sexual orientation, age,
disability or marital status, (ii) undertake or continue existing programs of affirmative
action to ensure that Minority Group Members and women are afforded equal
employment opportunities, and (iii) make and document its conscientious and active
efforts to employ and utilize M/WBEs, Minority Group Members and women in its
workforce on contracts. Such action shall be taken with reference to, but not limited to,
solicitations or advertisements for employment, recruitment,job assignment, promotion,
upgrading, demotion, transfer, layoff or termination, rates of pay or other forms of
compensation, and selection for training or retraining, including apprenticeship and on-
the-job training.
b) At the request of the AAO, the Grantee shall request each employment agency, labor
union, or authorized representative of workers with whom it has a collective bargaining
or other agreement or understanding, to furnish a written statement that such
employment agency, labor union, or representative does not unlawfully discriminate, and
that such union or representative will affirmatively cooperate in the implementation of the
Grantee's obligations herein.
2) The Grantee is encouraged to include minorities and women in any job opportunities
created by the Project; and to solicit and utilize M/WBE firms fo_r any contractual
opportunities generated in connection with the Project.
3) Grantee represents and warrants that, for the duration of the Agreement, it shall furnish all
information and reports required by the AAO and shall permit access to its books and
records by DASNY, or its designee, for the purpose of ascertaining compliance with
provisions hereof.
4) Grantee shall include or cause to be included, paragraphs (1)through (3) herein, in every
contract, subcontract or purchase order with a Contracting Party executed in connection
with the Project, in such a manner that said provisions shall be binding upon each
Contracting Party as to its obligations incurred in connection with the Project.
NON-DISCRIMINATION AND AFFIRMATIVE ACTION DEFINITIONS
Affirmative Action
Shall mean the actions to be undertaken by the Borrower, Grantee and any Contracting Party in
connection with any project or initiative to ensure non-discrimination and Minority/Women-
owned Business Enterprise and minority/female workforce participation, as set forth in
paragraph 2) herein, and developed by DASNY.
Updated 7-28-14 21
Affirmative Action Officer ("AAO")
Shall mean DASNY's Affirmative Action Officer or his/her designee, managing the affirmative
action program for DASNY.
Contracting Party
Shall mean (i) any contractor, subcontractor, consultant, subconsultant or vendor supplying
goods or services, pursuant to a contract or purchase order in excess of$1,500, in connection
with any projects or initiatives funded in whole or in part by DASNY and (ii) any borrower or
Grantee receiving funds from DASNY pursuant to a loan or Grant document.
Minority Business Enterprise ("MBE")
Shall mean a business enterprise, including a sole proprietorship, partnership or corporation
that is (i) a lease fifty-one percent (51%) owned by one or more Minority Group Members; (ii) an
enterprise in which such minority ownership is real, substantial and continuing, (iii) an enterprise
in which such minority ownership has and exercises DASNY to control and operate,
independently, the day-to-day business decisions of the enterprise; (iv) an enterprise authorized
to do business in the State of New York and is independently owned and operated; and (v) an
enterprise certified by New York State as a minority business.
Minority Group Member
Shall mean a United States citizen or permanent resident alien who is and can demonstrate
membership in one of the following groups: (i) Black persons having origins in any of the Black
African racial groups; (ii) Hispanic persons of Mexican, Puerto Rican, Dominican, Cuban,
Central or South American descent of either Indian or Hispanic origin, regardless of race; (iii)
Asian and Pacific Islander persons having origins in any of the Far East countries, South East
Asia, the Indian subcontinent or the Pacific Islands; and (iv) Native American or Alaskan native
persons having origins in any of the original peoples of North America.
Minority and Women-Owned Business Enterprise Participation
Minority and Women-owned Business Enterprise participation efforts are not limited to the
efforts suggested herein, and the role of M/WBE firms should not be restricted to that of a
subcontractor/subconsultant. Where applicable, M/WBE firms should be considered for roles as
prime contractors. Such efforts may include but not be limited to:
(a) Dividing the contract work into smaller portions in such a manner as to permit
subcontracting to the extent that it is economically and technically feasible to do so;
(b) Actively and affirmatively soliciting bids from qualified M/WBEs, including circulation of
solicitations to Minority and Women's trade associations;
(c) Making plans and specifications for prospective work available to M/WBEs in sufficient
time for review;
(d) Utilizing the services and cooperating with those organizations providing technical
assistance to the Contracting Party in connection with potential M/WBE participation on
DASNY contract;
(e) Utilizing the resources of DASNY Affirmative Action Unit to identify New York State
certified M/WBE firms for the purpose of soliciting bids and subcontracts;
(f) Encouraging the formation of join ventures, associations, partnerships, or other similar
entities with M/WBE firms, where appropriate, and
(g) The Contracting Party shall remit payment in a timely fashion.
Updated 7-28-14 22
Women-owned Business Enterprise ("WBE")
Shall mean a business enterprise, including a sole proprietorship, partnership or corporation
that is: (i) at least fifty-one percent (51%) owned by one or more citizens or permanent resident
aliens who are women; (ii) an enterprise in which the ownership interest of such women is real,
substantial and continuing, (iii) an enterprise in which such women ownership has and exercises
DASNY to control and operate, independently, the day-to-day business decisions of the
enterprise; (iv) an enterprise authorized to do business in the State of New York and is
independently owned and operated; and (v) an enterprise certified by New York State as
woman-owned.
Updated 7-28-14 23
NEW YORK DASNY
STATE OF
OPPORTUNITY_
Grant Programs
Frequently Asked Questions
This list is designed to answer many of the questions that you, the Grantee, may have about the Grant
Programs administered by DASNY. If, after reviewing this list, you have additional questions, please
call us at(518) 257-3177.,
1. Process Questions
A. Questions regarding DASNY's Role in the Grant Administration Process
Q.A1: What is DASNY's role in the Grant administration process?
A.A1: DASNY undertakes a review of each project to be funded by a Grant to be certain that
the Grant may be financed with the proceeds of DASNY bonds; the Project may be
funded under the Grant Program; and the Grantee is otherwise eligible to receive Grant
funds. Once the Grant has been approved by the necessary parties for processing and
funds have been made available, DASNY will enter into a Grant Disbursement
Agreement with each Grantee. Once the Grant Disbursement Agreement is fully
executed, DASNY will process requisitions for eligible costs upon submission of certified
requisitions by the Grantee. (Please note that for the HECap Program, the GDA is
executed by the HECap Board and payments are made by the Office of the State
Comptroller).
In addition, DASNY issues bonds and uses the proceeds of the bonds to finance the
Grants. In some instances, the bond proceeds are used to reimburse the State of New
York for funds previously transferred to DASNY for the purpose of financing the Grants.
B. Grant Processing Prior to Final Approval
Q.131: What happens now that DASNY has received the Grant Preliminary Application or
Project Information Sheet for our Project?
A.131: General Review:
DASNY' reviews each Preliminary Application or Project Information Sheet for
compliance with the enabling legislation for the Grant Programs and applicable tax laws.
DASNY will also review documentation evidencing site control, corporate authority,
evidence of committed funding to pay for the entire Project as described, and other
matters. In addition, a review as required by the State Environmental Quality Review Act
FAA's 8-10-15 Page 1
will be undertaken. During the course of the review process, you will be asked to
complete certain forms and return them to DASNY. Please do so promptly, as delays in
returning these forms will delay the process and, ultimately, the disbursement of Grant
funds to you.
Prequalification:
Effective August 1, 2013, not-for-profit organizations, are required to register and
prequalify on the New York State Grants Gateway (www grantsreform.ny.gov) in order to
receive Grant funds. State entities will post upcoming and available funding
opportunities on this website. The Grants Gateway will also provide grantees a secure
online repository to store and share commonly requested documents
Incorporation Documentation:
Please note that in order to verify that we enter into a Grant Disbursement Agreement
with the appropriate Grantee, we will need to review the incorporation papers or the
charter for the Grantee organization and verify that the Grantee is authorized to do
business in the State of New York. If the Grantee has a D/B/A, we will need the
paperwork establishing the D/B/A as well.
Site Control:
In addition, we will need documentation to establish that the Grantee has appropriate
site control at the premises where the Grant funded Project will occur and where Grant
proceeds will be spent. If the Grantee will use Grant proceeds to purchase a facility, we
will need to see the contract of sale before we will be able to complete our review, along
with other documentation as may be requested by DASNY If the Grantee owns the
facility, we will need to see the deed. If the Grantee leases the facility, we will need to
review the lease, and the term of the lease must be for at least five (5) years and extend
a reasonable period of time after the capital improvements to the facility are scheduled
to be completed.
In some circumstances, a lease term of less than five (5) years is acceptable where the
Grant will be utilized to purchase moveable equipment or furnishings.
Financial Review:
For most programs, DASNY must verify the existence of committed funding resources
sufficient to complete the Project as described. For these programs, acceptable proof of
such funding commitments may include the following: commitment letters from a bank or
other lending institution, evidence of other Grant awards, a board resolution committing
funds to complete the Project accompanied by recent audited financial statements; or
other documentation acceptable to DASNY that confirms that funding exists to complete
the Project as proposed.
FAA's 8-10-15 Page 2
Bond Counsel Review/Governmental Approvals:
Once all information has been returned to DASNY, we will review it in consultation with
our bond counsel and may call you to discuss further. Once we have determined that
your Project complies with relevant statutory provisions and all paperwork is in order,
DASNY will arrange for final governmental approvals as set forth by the particular Grant
Program. The timing of the final governmental approval varies depending upon the
particular Grant Program and other factors, and can take several weeks to several
months.
When DASNY is notified that the requisite governmental approvals have been obtained,
two copies of the Grant Disbursement Agreement will be forwarded to the Grantee for
execution.
Q.B2: Why must we complete a letter certifying that the Grant funds will not be used for
programs that might have some religious components?
A.B2:. It could be a violation of federal law to use public funds,to finance religious programs or
programs that may favor one religion over another. As the issuer of the bonds, DASNY
must take great care to ensure that it is in compliance with all applicable Federal and
State laws, including tax laws and regulations promulgated by the Securities and
Exchange Commission.
Q.B3: Is there a deadline for when the Grantee Certification, due diligence documents, or
other materials must be returned DASNY?
A.133: There is�no deadline per se, but please be advised that your Preliminary Application or
Project Information Sheet will not be processed without these documents.
Q.B4: My financial institution and/or other entity providing funds for the Project has
requested a letter from DASNY confirming that the grant funds are available for
the approved Project. Can DASNY provide such a letter?
A.134: No. Since DASNY does not award the grants, DASNY cannot guarantee that any
particular grant will ultimately receive final legislative approval, three way approval, or
funding approval. In addition, the Grant Disbursement Agreements are contingent upon
DASNY receiving the funds necessary to make payment on the grant. To the extent that
such funds are not available to DASNY from the State or from the proceeds of a bond
issuance, payment will not be made.
FAQ's 8-10-15 Page 3
C. Processing of the Grant Disbursement Agreement.
Q.C1: When will I receive a Grant'Disbursement Agreement from DASNY?,
A.C1: The Grant Disbursement Agreement is the contract between DASNY and the Grantee
setting forth the terms pursuant to which the Grant funds will be disbursed. When
DASNY is notified that-the requisite final governmental approvals have been obtained,
two copies of the Grant Disbursement Agreement will be forwarded to the Grantee for
execution.
Q.C2: What parts of the Grant Disbursement Agreement must be returned to DASNY?
AM: The Grantee must complete both Grant Disbursement Agreements and include the
following: Project Description (enter task, an anticipated time frame and the estimated
Project completion date); the Project Budget (enter the sources of all the funding that will
be used to finance the Project); an Opinion of Counsel in the form set forth in the Grant
Disbursement Agreements; execute and date all of the Grant Disbursement Agreements
provided (the signatures should be original on all Grant Disbursement Agreements), and
return all copies to' DASNY to complete the process. Please note that if the Project
described in the Grant Disbursement Agreement differs from the Project as described in
the Preliminary Application or the Project Information Sheet, or if your attorney is unable
to provide the opinion in the form provided in the Grant Disbursement Agreement, the
processing of the Grant may be delayed.
Once the Grant Disbursement Agreement is fully executed and costs have been incurred
in connection with the Project, you may begin to submit requests for reimbursement
utilizing the forms included with the Grant Disbursement Agreement.
QM: When do I receive my money?
AM: The Grant Programs administered by DASNY are reimbursement programs; that is, you
must actually incur Project costs and have paid those expenses or have been invoiced
by your contractor for work actually completed before receiving reimbursement from
Grant proceeds. Once expenses have been incurred and/or paid, you will submit one or
more requisitions to DASNY, using the forms included with your Grant Disbursement
Agreement (the contract between DASNY and the Grantee) along with such supporting
documentation as may be required by DASNY. Please note that in cases where
payment on invoice is requested, the Grantee must establish a segregated bank account
into which Grant funds will be deposited and from which Grant funded Project costs will
be paid. See section below regarding the requisition process for more information.
FAA's 8-10-15 Page 4
ll. Reimbursable Costs
A. Deposits, Retainers, Professional Service Fees, and Storage of Materials
Q.A1: Can I use the Grant money for a down payment`or a deposit to a contractor or
vendor or for a retainer fee to a professional such as an architect or an engineer?
A.A1: No. Grant funds may only be used to pay for work actually undertaken and completed
upon the approved Project and for materials received at the Project site. However, you
will be able to submit for reimbursement of a down payment or deposit once you have
received documentation from your contractor that the payment has been applied to the
value of the work completed to date and is no longer being held as a deposit, or once
the job has been completed and the contractor bills you for the balance of the job.
Q.A2: Can I use the Grant money to make a payment to my attorney for work related to
my Project?
A.A2: Generally, no. Attorney's fees do not qualify as a capital work pursuant to Federal and
State laws. If the fees were incurred•in connection with the closing of real property
acquired with Grant proceeds, however, these costs may be reimbursable.
Q.A3: Can I use the Grant money to make a down payment or make option payments for
real property?
A.A3: No. However, you will be able to submit for reimbursement of these costs once the real
property is acquired. For more information regarding the acquisition of real property,
please see the section below entitled "Acquisition of Real Property."
Q.A4: Can I use the Grant money for payment of the materials stored off-site that my
contractor has billed me for?
A.A4: You may not submit for reimbursement of materials stored off-site. All materials are
required to be received at the approved-project location(s) prior to submission for
reimbursement.
B. Payment for Internal Labor
Q.131: In order to save money, we used internal labor to undertake the Project described
in the Grant Preliminary Application. Is this acceptable?
A.131: ; Generally, costs associated with internal labor are not reimbursable with Grant
proceeds. Therefore, costs incurred by the Grantee for custodial services; maintenance
of equipment; salaries of facilities management personnel; security personnel; director or
other,high level Project oversight, or other similar expenditures may not be reimbursed
with Grant funds.
FAA's 8-10-15 Page 5
Q.132: We would like to use the Grant funds to pay the salary of the person who will be
administering the Grant for our organization. Is this allowable?
A.132: No. As explained above, internal costs may be reimbursed only in certain circumstances.
-Salaries of administrative personnel do not qualify.
C. Payments on a Lease, Mortgage, or to Pay Existing Debt
Q.C1: May Grant funds be used to make lease payments on equipment?
A.C1: No. Grant funds may only be used to purchase equipment and may not be used to make
lease payments or pay down existing debt -incurred to finance the purchase of
equipment.
Q.C2: May we use Grant- funds to make mortgage payments, pay off an existing
mortgage, or make other debt service payments?
A.C2: No. As explained above, this would be considered working capital, as opposed to a
capital- cost. While Grant funds may be used to purchase property from a seller, they
may not be used to make mortgage payments or pay off an existing mortgage.
D. Acquisition of Real Property
Q.D1: Can I use the Grant money to make a down payment or make option payments for
real property?
A.D1: No. However, you will be able to submit for reimbursement of these costs once the real
property is acquired.
Q.132: Our Project involves the purchase of real property and it is our intention to utilize
the Grant proceeds to pay for all or a portion of the purchase price. What
documentation must be provided to DASNY in order for us to pay or be
reimbursed for the purchase price?
A.132: Prior to disbursing public funds for the acquisition of real property, DASNY will need an
appraisal confirming the value of the property to be acquired, 'as well as other
documentation supporting the costs paid to the seller in connection with the transaction.
As part of DASNY's review process, the,Granteemust provide a summary appraisal for
the property to be acquired. The appraisal must have been completed by an
independent appraiser, and must comply in all respects with the requirements of the
Uniform Standards of Professional Appraisal Practice ("USPAP"). DASNY requires all
Grantees purchasing real property with grant funds to speak with an analyst in DASNY's
Office of Real Property as early in th6oprocess as possible so that the proper appraisal
documentation can be obtained and reviewed.
FAA's 8-10-15 Page 6
Prior to disbursement of grant funds for a real property purchase, DASNY will also need
to review the contract of sale; a closing statement; a title insurance policy, and a copy of
all checks drawn on grant funds. DASNY may also need to review,other documentation,
as deemed necessary by DASNY.
Q. D3: Can we purchase the property prior to our receipt of the Grant proceeds or do we
need to wait?
AM: A Grantee may acquire real property prior to their receipt of their Grant proceeds
provided such acquisition occurs on or after the date the Preliminary Application was
signed and/or the effective date of the enabling statute. The purchase price for real
property acquired by a Grantee prior to the date the Preliminary Application was signed
or prior to the effective date of the enabling legislation is not eligible for reimbursement.
The Grant proceeds may be used to pay-off a bridge loan or a mortgage in its entirety, if
clear documentation is provided to show that the Grantee intended at the time of
purchase to pay off such bridge loan or mortgage with the Grant proceeds. It is strongly
recommended that when acquiring real property that the Grantee contact DASNY as
soon as possible to discuss the use of the Grant proceeds for real property acquisition.
In order to reimburse the Grantee for a property acquisition, regardless of whether the
acquisition occurs before or after the execution of a Grant Disbursement Agreement, a
summary appraisal meeting the requirements set forth in A.D2, above, must be provided
to DASNY for review. If the appraisal does not meet USPAP requirements, DASNY will
be unable,to reimburse for the property acquisition without a new appraisal being
undertaken.
In addition, the other documentation described in A.D2, above, must also be provided to
DASNY prior to disbursement of grant funds. . I .
Q.D4: Is there a way to obtain the Grant funds prior to the closing on real property to
avoid taking out interim financing?
A.D4:, For real property acquisitions ONLY, DASNY has the ability to wire funds one day prior
to the scheduled closing to a designated escrow agent (usually the Grantee's attorney)
pursuant to an escrow agreement. The escrow agent would be authorized to release the
Grant funds at the closing only upon submission of certain documentation to DASNY
including the executed, deed, title insurance policy, and copies of all ,checks drawn
against the Grant funds and paid at closing. If you are using the Grant funds for a real
property purchase, please note that you will need to notify DASNY as soon as possible,
as it will take some time to work out the process for such a,transfer.
FAA's 8-10-15 Page 7
E. Costs Constituting Working Capital
Q.E1: Our organization runs on a very tight budget and we believe the Grant money
should be used to assist us in making our rent,payments or in paying the utility
bills at our site. Is this an allowable use of Grant funds?
A.E1: No. Such costs would be considered working capital, or operating costs, as opposed to a
capital cost. Federal and State laws mandate that Grant funds be spent on capital work
only.
Q.E2: May we use Grant funds to pay for certain maintenance or repair costs?
A.E2: No. As explained above, this would be considered working capital, as opposed to a
capital cost. Please note that maintenance and repair costs are not reimbursable even if
the Grant was awarded for the purpose of upgrading and/or replacing a particular
system. For example, suppose a Grant was awarded for the purpose of replacing a
boiler. In addition to replacing the boiler, the contractor also tests the entire heating
system, makes necessary repairs, and replaces worn parts. While the costs for replacing
the boiler would be reimbursable, the cost of testing and repairing the heating system
would not be.
Q.E3: May we use Grant funds to purchase office supplies such as paper, pens,
postage, and similar items if they would be used in connection with the Project?
A.E3: No: Such costs would be considered working capital, or operating costs, as opposed to a -
capital cost. As explained above, Grant funds may only be spent on capital costs.
Q.E4: May we use Grant funds to purchase a maintenance plan, service agreement or
extended warranty for our Project?
A.E4: No. Such costs would be considered working capital, or operating costs, as opposed to a
capital cost. As explained above, Grant funds may only be spent on capital costs. Grant
funds may not be used to pay for service agreements or extended warranties unless
they were required by the terms of the contract.with the vendor to be purchased at the
time of equipment purchase and are reflected as such on the equipment invoice.
Q.E5: May we use Grant funds to pay for training costs for equipment acquired with
Grant proceeds?
A.E5: Grant funds may only be used to pay for training costs incurred to "train the trainer' on
specialized equipment or software applications. That is, the Grant funds may be used to
pay the costs incurred to train one person within the Grantee organization who will be
responsible to train the other users. If training expenses are incurred to train groups of
users, or to train users on general use software, then these costs are operational in
nature and may not be reimbursed with Grant proceeds.
FAA's 8-10-15 Page 8
F. New Yorkers Must Benefit
Q.F1: Our organization has offices in another,State as well as in New York. May Grant
funds be used to improve our facilities in the other State?
A.F1: No. Grant funds must be used for Projects that will be located in the State of New York
and benefit New Yorkers.
lll. The Requisition Process
A. Timinq Questions Y
Q.A1: We started work on the Project before we submitted our Preliminary Application
or Project Information Sheet. May we submit a requisition for work undertaken
before the Preliminary Application date?
A.A1: Yes, so long as 1) the Project to be financed in part utilizing Grant proceeds was not
completed as of the date the Preliminary Application was signed; 2) the costs were
incurred after the effective date the Grant Program was enacted; and 3) such costs are
directly related to the approved Project. However, DASNY reserves the right to reject
requisitions for costs that appear to have been incurred far in advance of the actual
construction of the Project or far in advance of the Preliminary Application date. We will
consider such costs on a case-by-case basis. Generally, however, we do not reimburse
for costs incurred more than two (2) years prior to the date of the Grant Disbursement
Agreement.
Q.A2: How often may I submit a requisition for payment?
A.A2: There is no limit on the number or frequency of submissions. DASNY has two payment
dates per month, and Grantees may receive payment once per month.
Q.A3: Is there a time limit as to when I can submit a requisition?
A.A3: Yes. The Grant Disbursement Agreement terminates three (3) years from the date
DASNY executes. the Grant Disbursement Agreement. All requisitions must be
submitted,,in form satisfactory to DASNY, prior to the termination date in order to be
reimbursed. In addition, we would not expect to reimburse for costs incurred more than
two (2) years prior to the date the Grant Disbursement Agreement was executed.
You may submit your first requisition once the Grant Disbursement Agreement is fully
executed. Please do not submit a requisition before the fully executed Grant
Disbursement Agreement is returned to you.
FAA's 8-10-15 Page 9
Q.A4: How long will it take to receive payment after I submit a requisition?
A.A4: DASNY attempts to pay all requisitions submitted with the proper supporting
documentation within six (6) weeks from the date the requisition is submitted. Please
note that in the event that insufficient documentation is provided, or if DASNY requires
additional documentation to support a requisition, it could take longer. In addition, for
many programs DASNY must voucher the funds from the State in order to make
payment on a requisition. While typically such funds are received such that payment can
be made within six (6) weeks of submittal, please be advised that DASNY will be unable
to make payment on the requisitions until funds from the State are received.
B. Submission of Requisitions
Q.131: What backup documentation must I submit with my requisition?
A.B1: Certain exhibits to the Grant Disbursement Agreement must be returned to DASNY in
connection with each requisition for reimbursement. Please note that two (2) Authorized
Officers of the Grantee must sign the Dual Certification in support of each requisition. In
addition, copies of invoices provided by the contractor must be provided. Quotes,
proposals, estimates, purchase orders, and other such documentation do NOT qualify
as invoices.
In addition, readable copies of both the front and back of canceled checks or other
satisfactory proof of payment MUST be included with the request for reimbursement
Please see A.B2, below, for more information.
All checks must be drawn on an account of the Grantee and not an affiliate, subsidiary,
or parent organization. If a check is drawn on an account with a name that is different
from the Grantee, it will delay the reimbursement process. Please note that for payment
on invoice, checks must be drawn on the segregated account as discussed in Section
IIIC.
If funds are requisitioned for the purchase of a vehicle, the New York State Vehicle
Registration Documents and title must be submitted along with the requisition forms.
Before DASNY can reimburse you, we will also need a W-9 form from the Grantee,
along with wire instructions if a wire transfer of funds is requested. Current wire
instructions must be provided with every requisition.
Q.132: My bank does not provide copies of canceled checks, so I can't provide them.
Does this pose any problems?
A.132: If you cannot get copies of canceled checks, you may instead provide a copy of the front
of the check, along with a copy of a bank statement clearly showing that payment was
made by the Grantee to the contractor. In addition, DASNY requires the Grantee to
certify that the documents submitted in connection with the requisition are accurate
FAQ's 8-10-15 Page 10
copies of the original documents as presented to, and cashed by, the contractor or
vendor.
Q.133: What backup documentation must be provided when payment is made by credit
card?
A.133: If the card was a corporate credit card, we need a copy of the statement showing the
charge, the invoice for the materials purchased, and a copy of the canceled check
paying the statement in full. We do not recommend using a personal credit card to pay
for Grant Project related costs. This may require additional processing time and could
delay payment. If, however, payments have been made using a personal credit card, we
will need to,see the individual's credit card statement, the invoice for the materials
purchased, and a copy of the canceled check showing the Grantee reimbursed the
individual for the Grant Project related items.
Please note that Project expenses that have been incurred by a Grantee using a credit
card are NOT eligible for payment on invoice.
Q.134: I paid my contractor in cash for work related to my Project. Does this pose any
problems?
A.134: Yes: DASNY must receive adequate proof of payment prior to releasing Grant funds and
we will not reimburse the Grantee for costs paid in cash. The preferred method of
payment is by check as evidenced by a ,copy of a Grantee's canceled check made
payable directly to the contractor or vendor.
Q.136: My contractor did not give me an invoice, so I cannot provide one with the
requisition. Is this a problem?
A.BS: Yes. You will need to provide an invoice from the contractor along with proof of payment
in order to be reimbursed for Project expenditures. Please ask each contractor for an
invoice when work is undertaken in connection with the Project.
Q.136: My contractor requested that we make the check payable to him personally, and
not to the corporate entity. Is this acceptable?
A.136: No. Payment should be made to the corporate entity that performed the work and
provided the invoice. For example, if an invoice is received from "Jack's Contracting,
Inc.,"the,check should be payable to "Jack's Contracting, Inc." and not to "Jack Smith."
Q.137: Another entity has actually paid for the construction costs relating to my Project
and is looking to us for reimbursement. Does this pose any problems?
A.67: Yes. DASNY may only utilize Grant proceeds to reimburse a Grantee for costs related to
their Project that were actually incurred by the Grantee and not another entity. The
Grantee is the entity that should be incurring Project costs, paying those costs from their
FAA's 8-10-15 Page 11
G
own bank or checking account, and then requesting reimbursement. If another entity
paid for the Project costs and the Grantee is seeking reimbursement for those costs,
there will likely be a delay in processing the requisition. Please contact DASNY for more
information if you have a specific question regarding Project payments made by another
entity.
Q.BB: What if I do not submit the proper information with my requisition?
A.BB: If the proper information is not included with your requisition request, DASNY will not
make payment. You will be informed, in writing, of the portions of the requisition for
which we are unable to make payment and the reason(s) why payment was denied.
Please note that it is the Grantee's responsibility to submit requisitions that are properly
assembled and clearly delineate allowable costs to be paid for with Grant proceeds; it is
not the responsibility of DASNY staff to make sense of a disorganized submission. If the
requisition is not readily understandable, the entire requisition package will be returned
to the Grantee for resubmission prior to payment.
Q.139: Is there someone available to assist my organization with assembling a
requisition? -
A.139: As indicated above, it is the Grantee's responsibility to submit requisitions that are
properly assembled and clearly delineate allowable costs to be paid for with Grant
proceeds. While members of our Accounts Payable, Grants Administration, and
Counsel's Office staff are available to answer specific questions about a requisition, we
cannot assume the Grantee's responsibility to locate the documentation necessary to
support costs to be paid for with Grant proceeds or evidencing proof of payment;
matching proof of payment to invoiced costs; inferring the services or materials provided
where the documentation does not clearly provide an explanation; and other such tasks.
C. Payment on Invoice
Q.C1: We are a not-for-profit organization and do not have the funds to make payment in
the first instance. Is there a way to access the Grant funds to pay the costs as
they are incurred?
A.C1,: The Grant Programs are intended to be reimbursement programs. However, we
recognize that it may be difficult for some organizations to pay for Project costs upfront.
If that is the case, pursuant to the terms of the Grant Disbursement Agreement, you will
need to provide•DASNY with documentation evidencing that a segregated account has
been established by the Grantee into which Grant funds will be deposited. Eligible
expenses incurred in connection with the Project to be financed with Grant funds must
be paid out of this account. All work being paid on invoice must be completed prior to
disbursement of Grant proceeds. The funds in the segregated account shall not be used
for any purpose other than making payments to a contractor or vendor for costs in
connection with the Grant funded Project. The Grantee must provide proof of
disbursement of Grant funds to the respective contractor and/or vendor in a form
FAQ's 8-10-15 Page 12
acceptable to DASNY, within sixty (60) days of the date that Grant funds are disbursed
to the Grantee to pay for such costs. DASNY will not make any additional.disbursements
from Grant funds until such time as proof of payment is provided.
Q.C2: When seeking payment on invoice, what must we submit to access the Grant
funds?
A.C2: You will need to submit,an invoice from your contractor/vendor for the completed work
undertaken on the,Project. All Project related work being paid on invoice must be
completed prior to the disbursement of Grant proceeds. All Grant funds paid on invoice
must be deposited into the segregated account established by the Grantee (see prior
question and answer) and all eligible expenses incurred in connection with the Project to
be financed with Grant funds must be paid out of this segregated account. The funds in
the segregated account shall not be used for any purpose other than making payments
to a contractor or vendor for costs incurred in connection with the Grant funded Project.
When you receive payment on invoice, you must show proof of disbursement of all funds
from the segregated account to the contractor,before DASNY will pay any additional
payment requests.
In certain instances, DASNY may issue a two party check payable to both the Grantee
and the contactor or make other payment arrangements acceptable to DASNY and the
Grantee.
The Grantee must provide proof of disbursement of Grant funds to the respective
contractor and/or vendor in a form acceptable to DASNY, within sixty (60) days of the
date that Grant funds are disbursed to the Grantee to pay for such costs. DASNY will not
make any additional disbursements from Grant funds until such time as proof of payment
is provided.
IV. Project Changes After the Grant Disbursement Agreement has been
Executed
01: My Project is going to take longer than we originally estimated. How can I get an
extension of time to complete the Project?
Al: By its terms, the Grant Disbursement Agreement automatically terminates without further
notice or action on the part of DASNY three (3) years from the date it is executed by
DASNY. DASNY, in its sole and absolute discretion, may consent to an extension of the
termination date. Such extension may be granted upon the DASNY's receipt in writing,
PRIOR to the date the Grant Disbursement Agreement will terminate, of: 1) an
explanation of the circumstances leading to the delay in the Project; 2) the current status
of the Project; and 3) a new Project completion date. To request an extension please
write to DASNY, Attention: Grant Administration.
FAQ's 8-10-15 Page 13
Q2: What do we do if we need to shift costs from one Project task to another after the
Grant Disbursement Agreement has been executed and the Project is underway?
A2: We understand that it is sometimes difficult to accurately predict a Project's actual cost
and that costs within a Project may change over time. Please write to DASNY, Attention:
Grant Administration, and explain the circumstances leading to the requested
reallocation. In certain circumstances, DASNY may require that you provide a copy of
the proposed revised budget and/or a revised Project description.
Q3: What if we want to use the Grant funds to pay for costs other than those
described in the Preliminary Application or Project Information Sheet?
A3: If you would like to use the Grant funds for a Project other than that set forth in the
Preliminary Application or Project Information Sheet, you must notify DASNY as soon as
possible. If the change is minor in scope, DASNY may be able to approve the change. If,
however, the change is major in the opinion of DASNY, we may need to obtain
Legislative approval. Please contact DASNY to discuss the proposed change and we will
assist you. Please note that any request for Project change may delay the process.
FAQ's 8-10-15 Page 14