HomeMy WebLinkAboutAgreement - Neighborhood Resources Connection - Neighborhood Programs and Services1316 COUNTY -CITY BUILDING
227 W.JEFFERSON BOULEVARD
SOI ITH BEND_ INDIANA 46601-1 830
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PEACE
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1865
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARDU LIC WORKS
February 26, 2019
Diana Hess
Neighborhood Resources Connection
115 N. William St.
South Bend, IN 46601
RE: Agreement — Neighborhood Programs and Services Support
Dear Ms. Hess:
PHONE 574/235-9251
FAX 574/235-9171
The Board of Public Works, at its meeting held on February 26, 2019, approved the above
referenced agreement regarding neighborhood programs and services support in the amount
not to exceed $100,000.
Enclosed please find the original of the agreement for your signature. Please sign and return
the original agreement to our office and retain a copy for your records.
If you have any further questions regarding this matter, please call this office at (574) 235-
9251.
Sincerely,
Linda M. Martin, Clerk
Enclosure
GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARAWK LAURA O'SULLIVAN THERESE J. DORAU
INTER OFF'ICE MEMORANDUM
Department of Community Investment
City of South Bend 227 W Jefferson Blvd
TO: Board of Public Works, Linda Martin
CC: Sandra Kennedy, Diana Hess
FROM: Alkeyna Aldridge
SUBJECT: 2019 Neighborhood Resources Connection (NRC) Agreement
DATE: February 18, 2019
Dear Clerk and Members of the Board,
We are submitting for review and approval at the February 261" meeting an agreement between
the City of South Bend and the Neighborhood Resources Connection to implementing programs
that build the capacity and sustainability of neighborhood associations. In the spirit of the city
values of inclusion, empowerment, and accountability we believe it is the responsibility of the
municipality to build capacity and sustainability for a robust neighborhood association system as
means to effectively communicate with and respond to residents.
The Neighborhood Resources Connection (NRC) in similar mission has been a longstanding City
partner leading neighborhood engagement and civic leadership training programming. In
collaboration with the NRC, the Department of Community Investment aims to create a mutually
beneficial relationship to meet neighborhood and resident needs, as well as, support the NRC in
a path toward sustainability. Thank you for your consideration and should feel free to contact me
directly at aal road@ c Ahb ncl ngqy should you have any questions or concerns.
Than
Director of agement' E�nomic Empowerment
AGREEMENT FOR PROGRAMS AND SERVICES WITH
NEIGHBORHOOD RESOURCES & TECHNICAL SERVICES CORPORATION,
INC.
(PROGRAMS AND SERVICES)
THIS AGREEMENT (the or this "Agreement") is made effective the 26th day of
February, 2019, by and between the CITY OF SOUTH BEND, INDIANA, a municipal
corporation organized and operating under the laws of the State of Indiana, acting by and
through its Board of Public Works (collectively the "City") and NEIGHBORHOOD
RESOURCES & TECHNICAL SERVICES CORP. d/b/a NEIGHBORHOOD
RESOURCES CONNECTION (the "Organization").
RECITALS
WHEREAS, the Organization is an Indiana non-profit corporation, with a mission
to build and foster neighborhood organization capacity in South Bend, Indiana; and
WHEREAS, the Organization has represented that it is a duly existing non-profit
corporation under Indiana law and exempt from federal income taxation under Section
501(c)(3) of the Internal Revenue Code, as evidenced by the copy of the Indiana Secretary
of State's Certificate of Existence for the Organization and the copy of its Tax -exemption
Letter issued by the Internal Revenue Service, respectively attached as Appendix radix and
Apl nc 11; and
WHEREAS, the City desires to provide for certain services and programs to be
provided to the residents of the City, which services and programs are more particularly
described at Exhibit A (collectively, the "Program"); and
WHEREAS, the Organization is duly qualified to provide for, oversee and
administer the Program; and
WHEREAS, the City has appropriated funds for the Program in the amount of One
Hundred Thousand Dollars ($100,000) (the "Contract Amount"), and fifty percent (50%)
or Fifty Thousand and 00/100 dollars ($50,000), of this amount is required to have a 1:1
match of non-federal dollars; and
WHEREAS, the City believes that the actions contemplated by this Agreement are
in the best interests of the health, safety and welfare of the City and its residents and that
such actions comply with the public purposes and applicable provisions of state and local
law.
NOW THEREFORE, for and in consideration of the mutual covenants and
promises contained herein, the City and the Organization hereby agree as follows:
1. Contract Amount and Term. The Organization shall provide the programs
and services set forth at Exhibit A (the "Program") on behalf of the City, for the Contract
Amount for the period commencing March 1, 2019 and ending December 31, 2019. The
schedule for the Program is set forth at Exhibit „ . (the "Program Schedule"). The
Organization shall submit quarterly reports to the Contract Administrator on June 30,
September 30 and December 31 showing the progress of the Program.
2. 'ro& a,nai R ciget and t,(&> �t "c4( ijrrmmgjio . The Program budget is set forth
at Exhibit. (11 hereto (the "Budget"), which exhibit is hereby incorporated herein by
reference. The Organization shall not seek from the City more than the Contract Amount
for any expenses related to the Program or otherwise. The Organization shall use the
Contract Amount to implement the Program in conformance with the Budget and for no
other purpose.
3. C'ornlicn,—Va it n hr• Pr og aq .
a. Upon both parties' execution of this Agreement, the City will pay the
Organization Fifty Thousand Dollars ($50,000.00) as the first
installment of the Contract Amount.
b. The City will pay the Organization half of the remaining portion or
Twenty-five Thousand Dollars ($25,000.00) of the Contract Amount as
reimbursement of the Organization's expenses in carrying out the
Program ("Reimbursement Amount"), provided that the Organization
has first obtained an equivalent amount of funds from a non-federal
funding source satisfactory to the City (the "Matching Funds") and that
the Organization's performance hereunder has been satisfactory as
determined in the City's sole discretion. To request a reimbursement,
the Organization will submit to the Contract Administrator (as defined
below) satisfactory documentation, including at least (i) an invoice
detailing the expenses the Organization seeks to have reimbursed, (ii)
documentation evidencing the Organization's receipt of Matching
Funds of at least the same amount, and (iii) a report summarizing
disbursements and expenditures of the Contract Amount to date by the
line items set forth in the Budget and describing the progress of the
Organization's implementation of the Program.
c. The final Twenty-five Thousand Dollars ($25,000.00) is to be utilized
as a matching incentive to leverage additional external funding at a
dollar -to -dollar match ("Leverage Amount") and is subject to the
Organization having obtained Matching Funds and continued
satisfactory performance hereunder in the City's sole discretion. To
request the outside leverage dollars, the Organization will submit to the
Contract Administrator (as defined below) satisfactory documentation,
including at least (i) an invoice detailing the expenses the Organization
seeks to have reimbursed, (ii) documentation evidencing the
Organization's receipt of Matching Funds of at least the same amount,
and (iii) a report summarizing disbursements and expenditures of the
Contract Amount to date by the line items set forth in the Budget and
describing the progress of the Organization's implementation of the
Program.
d. Wherever possible, the Organization will not submit Reimbursement
Amount or Leverage Amount requests of less than Two Thousand
Dollars ($2,000) at a time. By way of example, the Organization may
request reimbursement for $3,000 in expenses by providing an invoice
detailing those particular expenses, documentation of the
Organization's receipt of $3,000 in Matching Funds, and a progress
report showing the disbursements and expenditures of the Contract
Amount (exclusive of the $3,000 in expenses the Organization seeks to
have reimbursed).
e. The City may reject any payment requests under this Agreement in the
event the Contract Administrator determines, in her sole discretion, that
the Organization is materially failing to implement and perform the
Program in accordance with this Agreement.
4. Desi n and hp,a1�aentaati at To the extent not set forth in
Exhibit A, Exhibit B and Exhibit C, the Organization shall be solely responsible for the
design and implementation of the Program, unless specifically directed otherwise by the
City, the City's Internal Auditor (as defined herein), or the Director of Engagement &
Economic Empowerment or any person appointed by said Director or the City to administer
this Agreement (the "Contract Administrator"). The Program and this Agreement must be
performed and administered in accordance with all applicable federal, state and local laws.
The Organization shall use the Contract Amount only for activities related to the Program.
S. Termination o Agreement. If the City Controller makes a written
determination that funds are not appropriated or are otherwise unavailable to support the
continuation of this Agreement, it shall be cancelled. A determination by the City
Controller that funds are not appropriated or are otherwise unavailable to support the
continuation of performance shall be final and conclusive. Effective thirty (30) days after
delivery of a written termination notice, the City may terminate this Agreement, in whole
or in part, for any or no reason, if the City determines that such termination is in the best
interest of the City. The Organization shall be compensated for satisfactory (in the City's
sole discretion) work related to the Program performed prior to the effective date of
termination. The City will not be liable for work on the Program performed after the
effective date of termination. In no case shall total payment made to the Organization
exceed the original Contract Amount.
6. Remedies err. Breach rah f"�. nlr act, Failure to complete the Program in
accordance with this Agreement may be considered a material breach and shall entitle the
City to impose sanctions against the Organization including, but not limited to, suspension
of all payments and/or suspension of the Organization's involvement in the Program on
behalf of the City. The Organization shall repay any portion of the Contract Amount
expended for matters not within the scope of the Program or the Budget. In addition to the
3
foregoing, the City may pursue any and all remedies available to it at law or in equity.
7. A40,igtengnce c , Access to .Records. The Organization shall keep
a written record, in a form acceptable to the City, related to the use and expenditure of the
Contract Amount. Within thirty (30) days of the expiration or termination of this
Agreement, the Organization shall provide the City with a final accounting of the use and
disposition of the Contract Amount by the Organization. Unless otherwise authorized by
the City or required by law, such records shall be maintained by the Organization for a
period of four (4) years of the date of this Agreement. The Organization understands and
agrees to comply with the legal requirements of Indiana Code § 5-14-3-1 et seq.
(commonly known as Indiana's Access to Public Records Act), if applicable, with respect
to all documentation related to the Contract Amount.
8. Auditmctarngq;cqy,. The Organization agrees to make all information
available to the Indiana State Board of Accounts, the City's Internal Auditor, and the
Contract Administrator as requested to comply with any audit requested related to the
receipt and use of the Contract Amount and the Organization's performance in delivering
the Program in accordance with the provisions of this Agreement. If requested by the City
or the Contract Administrator, the Organization shall provide the City a progress report on
the Program. If requested by the City or the City's Internal Auditor, the Organization shall
arrange for a financial and compliance audit of the Contract Amount to be conducted by
an independent public or certified public accountant (or as applicable, the Indiana State
Board of Accounts) and in accordance with applicable Indiana State Board of Accounts
standards. The City's Internal Auditor shall mean the City Controller appointed pursuant
to Indiana Code § 36-4-9-6 (the "City Controller") or any person appointed or retained by
the City Controller or the City for the purpose of auditing the Organization for this
Agreement or other agreements of the City.
9. Ctare iac:.t . Q htg.m.t. The Organization hereby certifies and agrees that no
member, officer, or employee of the City, or its designees or agents, and no member of the
governing body of the City of South Bend or the Organization (and no one with whom
there is a family or business tie) who exercises any functions or responsibilities with respect
to the receipt and use of City funds during his or her tenure or for one year thereafter, shall
have any financial benefit, direct or indirect, in any contract or subcontract, or the proceeds
thereof, for work to be performed in connection with the Program. To the extent the
Program involves the awarding of a contract or grant, the Organization shall not award the
same to a person or entity that creates a conflict of interest described in Indiana Code § 5-
16-11-5.5. Additionally, any employees, contractors, or agents of the Organization who
will administer or otherwise perform any services connected to the Program shall first be
identified to the Contract Administrator to ensure that no conflict of interest exists. The
Contract Administrator may, in his or her sole discretion, seek additional information to
confirm the absence of such conflict of interest, and the Organization shall comply or cause
its employee, contractor, or agent to comply with any reasonable request made for this
purpose. Any failure on the part of the Organization or its employee, contractor, or agent
to supply within ten (10) business days any reasonably requested information under this
Section shall be considered a material breach of this Section, and the City may immediately
0
terminate this Agreement without prior notice or an opportunity to cure.
10. lutiorishjl�. The Organization shall at all times be an independent
contractor for the performance of the Program rather than an employee of the City, and no
act, action or omission to act by the Organization shall in any way bind or obligate the City.
This Agreement is strictly for the benefit of the parties and not for any third -party or person.
This Agreement was negotiated by the parties at arm's length and each of the parties hereto
has reviewed the Agreement after the opportunity to consult with independent legal
counsel. Neither party shall maintain that the language in the Agreement shall be construed
against any signatory hereto. The City and the Organization hereby renounce the existence
of any form of agency relationship, joint venture or partnership between the Organization
and the City and agree that nothing contained herein or in any document executed in
connection herewith shall be construed as creating any such relationship between the City
and the Organization.
11. Ir°tdetw1i' cation. The Organization hereby agrees to defend, indemnify, and
hold harmless the City, its officials, employees, and agents from any and all claims of any
nature which arise from the performance by the Organization under this Agreement and
from all costs and attorney fees in connection therewith, excepting for claims arising out
of the negligence of the City, its officials, directors, employees, and agents. The
obligations of the Organization under this Section shall survive the termination of this
Agreement.
12. Notices. Any notice required or permitted to be delivered hereunder shall
be deemed to be delivered when deposited in the United States Postal Service, postage
prepaid, registered or certified mail, return receipt requested, addressed to the City or the
Organization, as the case may be, at the address set forth below.
r anization:
Neighborhood Resources
Connection
217 S. Michigan Street
South Bend, IN 46601
Attention: Executive Director
City:
Alkeyna M. Aldridge
Department of Community Investment
City of South Bend, Indiana
227 W. Jefferson Blvd., Suite 1400S
South Bend, IN 46601
13. ES qar l a" ta�nh % The Organization shall comply with federal, state and
local laws in its hiring and employment practices and policies for any activity covered by
this Agreement.
14. Di !r r:Pal ��rc��e. The Organization hereby agrees to make a good
faith effort to provide and maintain a drug -free workplace. The Organization will give
written notice to the City within ten (10) days after receiving actual notice that the
Organization or an employee of the Organization within the State of Indiana has been
convicted of a criminal drug violation occurring in the workplace.
15. -.Vel, . The Organization hereby certifies that it does not and will not
E
knowingly employ or contract with an unauthorized alien, nor retain any employee or
contract with a person that the Organization subsequently learns is an unauthorized alien.
The Organization agrees that he/she/it shall enroll in and verify the work eligibility status
of all of the Organization's newly hired employees through the E-Verify Program as
defined by I.C. Sec. 22-5-1.7-3.
16. Emir• .4 r et)iepit and Amendment. This Agreement sets forth the entire
agreement and understanding between the parties as to the subject matter hereof, and
merges and supersedes all prior discussions, agreements, and understanding of any and
every nature between them. This Agreement may be amended only by separate writing,
approved by both the Organization and the City.
17. Severcdral%J. If any term or provision of this Agreement is held by a court
of competent jurisdiction to be invalid, void, or unenforceable, the remaining terms and
provisions of this Agreement shall continue in full force and effect unless amended or
modified by mutual consent of the Parties.
18. Waiver. Neither the failure nor any delay on the part of a party to exercise
any right, remed
y, power, or privilege under this Agreement shall operate as a waiver
thereof, nor shall nay single or partial exercise of any right, remedy, power, or privilege
preclude any other or further exercise of the same or of any right, remedy, power, or
privilege with respect to any occurrence be construed as a waiver of any such right, remedy,
power, or privilege with respect to any other occurrence. No waiver shall be effective
unless it is in writing and is signed by the party asserted to have granted such waiver.
19. Govern mL,c� Jur is��r,ction „�?rrtlaliyLi e ivilh Laws. This Agreement
shall be construed and interpreted according to the laws of the State of Indiana without
regard to conflicts of laws statutes. Any dispute arising under the terms of this Agreement
shall be filed in any court of competent jurisdiction in St. Joseph County, Indiana. The
Organization agrees to comply with all applicable federal, state and local laws, rules,
regulations and ordinances, and all provisions required thereby are hereby incorporated
herein by reference. The Organization shall comply with federal, state and local law in its
hiring and employment practices and policies for any activity covered by this Agreement.
20. ss,,,�yr„r„ent. The Organization shall not assign or subcontract the whole or
any part of this Agreement or its obligations hereunder without the prior written consent
of the City.
21. (",ou, t crrt.�. This Agreement may be executed in counterparts, all of
which shall be deemed originals.
22. Jeldilional &1y(. ye rl�aliotis. The undersigned persons executing and
delivering this Agreement on behalf of the Organization represent and certify that they are
the duly authorized officers of the Organization and have been fully empowered to execute
and deliver this Agreement and that all necessary corporate action has been taken and done.
R
23. on othi ioll and Prior to the City's execution of this
Agreement, the Organization will execute and file with the City a Contractor's Non -
Collusion And Non -Debarment Affidavit, Certification Regarding Investment With Iran,
Employment Eligibility Verification, Non -Discrimination Commitment And Certification
Of Use Of United States Steel Products Or Foundry Products, the form of which is attached
hereto and incorporated herein as App rfix. 11I.
(remainder of page intentionally left blank)
IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be
executed as of the day and year first above written.
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
Date: February 26, 2019
Gary A. Gilot, President
Therese J. 1 rau, Men ber
u 5-nna 1:�
"r Member
ATTEST:
f Linda M. Martin
NEIGHBORHOOD RESOURCES
CONNECTION
Date: _ ........� ......._.........................................................._.......�m.m.., 2019
Signature
Printed Name and Title
EXHIBIT A
Program Description
The Organization shall actively support neighborhoods by providing the
following programs and services to its residents and neighborhood organizations..
Execute an annual programmatic work plan to develop neighborhood leaders
through education and training; provide evidence of outcomes impacting
neighborhoods based on the resulting work of individuals receiving such
education and training.
2. Collaborate with City of South Bend DCI Business Analyst to construct
outcomes based budget around neighborhood programming
I Resolve structural issues within the Organization's bylaws to support board
development and organizational capacity
4. Create a sustainable mechanism for city -neighborhood communication and
engagement.
Design and implement an active fund development plan that includes a long
term sustainability plan.
Upon the request of the City, participate in miscellaneous City initiated
projects or programs.
Promote activities within South Bend sponsored or encouraged by the City
through NRC's print and electronic mediums.
8. Provide technical assistance to strengthen neighborhood associations; provide
evidence of outcomes for the particular neighborhoods based on such
assistance.
9. Provide networking opportunities for increased information sharing among
neighborhood associations.
10. Work with City Engagement & Empowerment Team to plan and execute
resident -led Empowerment Summit
11. Provide an Annual Report no later than December 15th to the Department of
Community Investment and the Common Council detailing a sustainable fund
development strategy and organizational strategic plan
EXHIBIT B
Program Schedule
The Organization shall provide the Program as described in Exhibit A during the period of
March 1, 2019 — December 31, 2019.
EXHIBIT C
Program Compensation
Total Cost for Programs and Services $100,000.00
$50,000 to be disbursed at time of agreement execution.
$25,000 required to have a 1:1 match, disbursed in minimum increments of $2,000 based
on documentation of match during the term of agreement.
$25,000 required set aside as a strategic reserve for external grant matches or other new
opportunities that may arise.
The City of South Bend CDBG funds will not be eligible as match.
Eligible costs include, but are not limited to: staff, rent, office, insurance, administrative
and program supplies.
�PPu►�`x �'-furfifi�afe Of EX4MU/
APPROVED AND FILED
CONNIE LAWSON
INDIANA SECRETARY OF STATE
06/15/2018 11:15 AM
BUSINESS ID 1993070205
BUSINESS TYPE Domestic Nonprofit Corporation
BUSINESS NAME NEIGHBORHOOD RESOURCES & TECHNICAL SERVICES CORP,
ENTITY CREATION DATE 06/25/1993
JURISDICTION OF FORMATION Indiana
PRINCIPAL OFFICE ADDRESS 115 North William Street, South Bend, IN, 46601, USA
YEARS 2018/2019
EFFECTIVE DATE 06/14/2018
EFFECTIVE TIME 5:09 PM
REGISTERED AGENT TYPE Individual
NAME DIANA HESS
ADDRESS 115 N. William Street, So Bend, IN, 46601, USA
SERVICE OF PROCESS EMAIL nrcneighborsCo)gmaii.com
I acknowledge that the Service of Process email provided above is the email address at which electronic service of process may be accepted and
is publicly viewable,
-Page 1 of 2 -
APPROVED AND FILED
CONNIE LAWSON
MIIAI,iA SECKETA&Y *F STA
06/15/2018 11:15 AM
TITLE
President
NAME
Ronald Silverman
ADDRESS
5652 Yellow Wood Drive, South Bend, IN, 46614 - 5565, USA
TITLE
Treasurer
NAME
Gary Benedix
ADDRESS
1108 High Street, South Bend, IN, 46601, USA
TITLE
Vice President
NAME
Karla Riley
ADDRESS
2530 Summit Ridge Drive, South Bend, IN, 46628, USA
TITLE
Secretary
NAME
Keya Young
ADDRESS
2117 Vassar Avenue, South Bend, IN, 46628, USA
I-FIE-MUNWIDR(S) RE? -RESENTS THA-1 TAE REGISTERED AUENTNAME11, IN r?,'E APPLICATION HAS CONSENTED TO THE
APPOINTMENTOF REGISTERED AGENT.
IN WITNESS WHEREOF, THE UNDERSIGNED HEREBY VERIFIES, SUBJECT TO THE PENALTIES OF PERJURY, THAT THE
STATEMENTS CONTAINED HEREIN ARE TRUE, THIS DAY June 14,2018.
SIGNATURE Diana Lee Hess
TITLE CEO
Business ID : 1993070205
Filing No.: 7938959
M�TI:i►>tiii►L
LAM
INTERNAL REVENUE SERVICE
DISTRICT DIRECTOR
P. O. BOX 2508
CINCINNATI, OH 45201
Date:
JUL
NEIGHBORHOOD RESOURCES & TECHNICAL
SERVICES CORP
1200 COUNTY -CITY BLDG
SOUTH BEND, IN 46601
Dear Applicant:
DEPARTMENT OF THE TREASURY
Employer Identification Number:
35-1897463
DLN:
17053185788018
Contact Person:
D. A. DOWNING
Contact Telephone Number:
(513) 241-5199
Our Letter Dated:
June 1994
Addendum Applies:
No
This modifies our letter of the above date in which we stated that you
would be treated as an organization that is not a private foundation until the
expiration of your advance ruling period.
Your exempt status under section 501(a) of the Internal Revenue Code as an
organization described in section 501(c)(3) is still in effect. Based on the
information you submitted, we have determined that you are not a private
foundation within the meaning of section 509(a) of the Code because you are an
organization of the type described in section 509(a)(1) and 170(b)(1)(A)(vi).
Grantors and contributors may rely on this determination unless the
Internal Revenue Service publishes notice to the contrary. However, if you
lose your section 509(a)(1) status, a grantor or contributor may not rely on
this determination if he or she was in part responsible for, or was aware of,
the act or failure to act, or the substantial or material change on the part of
the organization that resulted in your loss of such status, or if he or she
acquired knowledge that the Internal Revenue Service had given notice that you
would no longer be classified as a section 509(a)(1) organization.
If we have indicated in the heading of this letter that an addendum
applies, the addendum enclosed is an integral part of this letter.
Because this letter could help resolve any questions about your private
foundation status, please keep it in your permanent records.
If you have any questions, please contact the person whose name and
telephone number are shown above.
Sincerely yours,
r �
4
✓�;a�"�N���,�"� �9i wn �AIV�
D�.strI'ct Director
Letter 1050 (DO/CG)
/VPPen�ix to
When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit.
CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT,
CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY
VERIFICATION, NON-DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE
OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS
(Must be completed for all quotes and bids. Please type or print)
STATE OF W W )
SSt
0 A'(:"C1111"1'"y )
The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that:,
1. Contractor has not, nor has any other member, representative, or agent of the firm,
company, corporation or partnership represented by him, entered into any combination, collusion
or agreement with any person relative to the price to be bid by anyone at such letting nor to
prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid
is made without reference to any other bid and without any agreement, understanding or
combination with any other person in reference to such bidding. Contractor further says that no
person or persons, firms, or corporation has, have or will receive directly or indirectly, any
rebate, fee, gift, commission or thing of value on account of such sale; and
2. Contractor certifies by submission of this proposal that neither contractor nor any of its
principals are presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency;
and
3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in
investment activities in Iran.
a. For purposes of this Certification, "Iran" means the government of Iran and any agency or
instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from
time -to -time.
b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is
engaged in investment activities in Iran if either:
i. Contractor, its successor or its affiliate, provides goods or services of twenty million
dollars ($20,000,000) or more in value in the energy sector of Iran; or
ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty
million dollars ($20,000,000) or more in credit to another person for forty-five (45)
days or more, if that person will (i) use the credit to provides goods and services in
Non -Collusion Non-Debarmunt Affidavit Non Iran Form 2016
the energy sector in Iran; and (ii) at the time the financial institution extends credit, is
a person identified on list published by the Indiana Department of Administration.
4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain
any employee or contract with a person that the Contractor subsequently learns is an
unauthorized alien. Contractor agrees that he/she/it shall enroll in and verify the work eligibility
status of all of Contractor's newly hired employees through the E-Verify Program as defined by
I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify
Program is included and attached as part of this bid/quote; and
5. Contractor shall require his/her/its subcontractors performing work under this public
contract to certify that the subcontractors do not knowingly employ or contract with an
unauthorized alien, nor retain any employee or contract with a person that the subcontractor
subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is
participating in the E-Verify Program. The Contractor agrees to maintain this certification
throughout the term of the contract with the City of South Bend, and understands that the City
may terminate the contract for default if the Contractor fails to cure a breach of this provision no
later than thirty (30) days after being notified by the City.
6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by
the City of South Bend through its agencies, boards, or commissions shall not discriminate
against any employee or applicant for employment in the performance of a City contract with
respect to hire, tenure, terms, conditions, or privileges of employment, or any matter directly or
indirectly related to employment because of race, sex, religion, color, national origin, ancestry,
age, gender expression, gender identity, sexual orientation or disability that does not affect that
person's ability to perform the work.
In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials,
or any combination of the foregoing including, but not limited to, public works contracts
awarded under public bidding laws or other contracts in which public bids are not required by
law, the City, its agencies, boards, or commissions may consider the Contractor's good faith
efforts to obtain participation by those Contractors certified by the State of Indiana as a Minority
Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining
the lowest, responsible, responsive bidder.
In no event shall persons or entities seeking the award of a City contract be required to award a
subcontract to an MBE/WBE; however, it may not unlawfully discriminate against said
WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE Utilization Board
shall prohibit that person or entity from being awarded a City contract for a period of one (1)
year from the date of such determination, and such determination may also be grounds for
terminating the contact for which the discriminatory practice or noncompliance pertains.
7. The undersigned contractor agrees that the following nondiscrimination commitment
shall be made a part of any contract which it may henceforth enter into with the City of South
Bend, Indiana or any of its agencies, boards or commissions.
Non -Collusion Nan -Debarment Affidavit Non Iran Form 2016
Contractor agrees not to discriminate against or intimidate any employee or applicant for
employment in the performance of this contract with privileges of employment, or any matter
directly or indirectly related to employment, because of race, religion, color, sex, gender
expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of
this provision may be regarded as material breach of contract.
I, the undersigned bidder or agent as contractor on a public works project, understand my
statutory obligations to the use of steel products or foundry products made in the United States
(I,C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for this project will
use steel products or foundry products on this project if awarded. I understand that violations
hereunder may result in forfeiture of contractual payments.
I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for
public works are true and correct.
Dated this , day of_, 20 / 9
i
t l p 0 ..'e i��oi,"/l
Firm)
Signaturrrrctor/Flidder or Its Agent
Printed Name and Title
Subscribed and sworn to before me this f " day ofj rmm ' LMt,V� , 20,.,_
My Commission Expires Ala/t,�r-Notary Pu4
County of Residence
ARY C. BRAZINSKY
Seal'
Notary Public State of Indiana
St Joseph County
My Commission Expires Dec 12, 2024
Non -Collusion Non -Debarment Anidavit Non Iron Form
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date
Name
February 18, 2019
Department Community
Alke na Aldridge Investment
...._ ..... ....m..�
BPW Date Februa 26 2019 Phone Extension 5896
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Re aired Prior to Submittal to Board
_.
Department
Attorney:
Sandra
Legal ® Kennedy
BPW Attorney:
Clara
McDaniels
Controller review is required for all Contracts $5,000.00 or more
Controller ® and greater than one year in length per the City Purchasing
Policy
Purchasing ❑'
Check the
Z Agreement
El Professional Services
[:] Bid Opening
El Quote Opening
F] Chg Order No.
❑ Ease./Encroach.
Other:
ate Item Tvoe -
L. Contract
❑ Amendment
❑ Bid Award
E] Quote Award
C/O &PCANo
Traffic Control
Required Information
d for All Submissions
Proposal
Req. to Advertise
❑ PCA
❑ Resolution
Claim
Addendum
❑ Title Sheet
Company or Vendor Name
Neighborhood ResourcesC ne
Yes If Ye A Purchasing
Approved y b sing
New Vendor
No
MBE/WBE Contractor
❑ MBE Completed E-Verify Form Attached El Yes
❑ WBE ❑ No
Project Name
Nei hborhood Resources Connection 2019 Program Agreement
Project Number
TBA
Funding Source
_....
Nei hborhood Organization Support
Account No.
m_ .................. --- ..r--- ------
40871001-460.39-30
Amount
Not to exceed $100,0 00
...Marc ......... _� __��_ __
Terms of Contract
..,._. .�. ............... .... ....__-.
h 1 „ 2019-December 31, 2019
Purpose/Description
NeiLkb6rhood Programs &Services
__.._ ...._...... .. or ChgOrders
............
Amount of El Increase $ mm
El Decrease $
Previous Amount $
Current Percent of Change: _
New Amount $
Total Percent of Change: /°
Time Extension:
Dispersal After Approval
Copy Original