HomeMy WebLinkAboutAgreement - DCI - Admin of Supportive Housing Rental Assistance GrantBOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date
Name
'16
Timmer
Department DCI
BPW Date 7/26/16 Phone Extension 5841
I Required Prior to Submittal to Board
Legal ® Attorney Name Michael Schmidt
Controller ❑ Controller review is required for all Contracts $5,000.00 or more and
greater than one year in length per the City Purchasing Policy
Purchasing
Check the Appropriate Item Type — Required for All Submissions
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Agreement
❑ Contract ❑ Proposal ❑ Addendum
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Kequirea mtormation
Company or Vendor Name Department of Community Investment
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MBE/WBE Contractor ❑ MBE ❑ WBE
MBEM/BE Contractor Requested ® No ❑ Yes Name of Company
Project Name Administration of Supportive Housing Rental Assistance Grant
Project Number 16-JS-01
Funding Source Continuum of Care (CoC)
Account No. 212.1001.460.39.30
Amount $ 2,000
Terms of Contract 3/01/16 — 2/28/17
Purpose/Description Fund costs of administering Oaklawn's SHRA grant
® Required Contractor's Certification Form Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.
Required For Change Orders Only
Amount of ❑ Increase $
❑ Decrease $
Previous Amount
Current Percent of Change:
New Amount
Total Percent of Change:
Copy
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Dispersal After Approval
2015 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT
Department of Community Investment - Administration
March 1, 2016 - February 28, 2017
HUD Grant # IN00121-51-1001508
THIS AGREEMENT is entered into this ,p day of -TUIkI , 2016 by and
between the City of South Bend, State of Indiana, by and through its Board'of Public Works (the
"City"), and the Department of Community Investment, (the "Agency") for the 2013 Continuum of Care
Program Grant Administration Project. This award is granted under CFDA 14.267, Continuum of Care
Program, Department of Housing and Urban Development, Office of Community Planning and
Development, Grant Number IN00121.51-1001508.
WHEREAS, the City has received a grant (the "Grant") under Subtitle F of Title IV of the
Stewart B. McKinney Homeless Assistance Act, 42 USC 11301 et seq. (the "Act') and the Continuum
of Care Program regulation (the "Regulation"); and
WHEREAS, the Grant is made in response to an application, prepared and submitted by the
City in October 2013 (the "Application"), and
WHEREAS, pursuant to the Grant, the City is undertaking certain activities supported by the
Grant; and
WHEREAS, the City desires to engage the Agency to give certain assistance in connection
with such undertakings and the Agency desires to perform the activities identified herein.
NOW, THEREFORE, in consideration of the mutual promises and obligations set forth herein,
the City and the Agency do mutually agree as follows:
1.DURATION: This Agreement shall commence on March 1, 2016, and terminate on
February 28, 2017.
2. DEFINITIONS: As used in this Agreement:
a. "Agency' means the entity, whether public or private, which has the responsibility
for administering a project or activity.
b. "HUD" means the U.S. Department of Housing and Urban Development, the
Secretary thereof or a person authorized to act on his/her behalf.
c. "Program" means the Continuum of Care Grant approved by HUD as the same
may be amended from time to time.
3. SCOPE OF SERVICES: The Agency shall perform all services according to the
attached "Scope of Services — Project Description for 2015 Continuum of Care Grant Agreement'.
4. AMENDMENTS: Any revision to this Agreement, including Attachments, shall be made
by written amendment to this Agreement.
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5. COMPLIANCE WITH APPROVED PROGRAM: All activities authorized by this
Agreement shall be performed in accordance with the Act and the Regulation.
6. SUBCONTRACTING: The performance covered by this Agreement shall not be
subcontracted, assigned or delegated without the prior written consent of the City.
7. AWARD: It is expressly understood and agreed that in no event will the City pay the
Agency more than $2,000.00 for full and complete satisfactory performance of this Agreement. The
City shall compensate the Agency for fulfilling this Agreement as provided in accordance with the
terms and conditions contained herein.
8. PROGRAM INCOME: It is anticipated that no income shall ever be directly generated
from this activity, however, if income is received, the Agency must contact the City on how the funds
can be used.
9. FISCAL AND ADMINISTRATIVE RESPONSIBILITIES: The Agency agrees to comply
with the provisions of 24 CFR 340 and its applicable requirements and standards which include but
are not limited to the following:
A. Allowable and Allocable Costs. Costs must be necessary, reasonable and directly
related to the scope of services of this Agreement. In addition, costs must be legal and proper.
The budget included in the attachments shall control amounts of allowable expenditures within
budget categories.
B. Documentation of Costs. All costs shall be supported by properly executed payrolls,
time records, invoices, contracts, or vouchers or other official documentation evidencing in
proper detail the nature and propriety of charges. All checks, payrolls, invoices, contracts,
vouchers, orders, or other accounting documents pertaining in whole or in part to this
Agreement shall be clearly identified and readily accessible.
C. Restriction on Disbursements. No money under this Agreement shall be disbursed
by the Agency to any contractor except pursuant to a written contract which incorporates the
applicable requirements of this Agreement and HUD regulations and unless the contractor is in
compliance with HUD requirements for applicable accounting and fiscal matters.
D. Records and Reports:
1. Establishment and Maintenance of Records. Records shall be maintained in
accordance with requirements prescribed by HUD or the City with respect to all matters
covered by this Agreement. Except as otherwise authorized by HUD, such records shall
be maintained for a period of three (3) years after receipt of final payment under this
Agreement.
2. Reports.
(a) At such times and in such forms as HUD or the City may require,
there shall be furnished to HUD or the City such statements, records, data and
information as HUD or the City may request pertaining to matters covered by
this Agreement.
(b) Additionally, the Agency shall submit an Annual Performance
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Report to the City within forty-five (45) days following the conclusion of the
project for which funds are provided under this Agreement which report
summarizes the successes or failures of the assisted activity. The Agency shall
also provide statistical data with respect to services provided or persons
benefited under this Agreement.
3. Non -Expendable Property.
(a) Inventory. The Agency shall keep inventory records, acceptable to
the City, on all non -expendable property purchased under this Agreement. The
Agency shall submit an inventory record of all items at the end of the program
year and resubmit it each program year with revisions as necessary.
(b) Insurance and Maintenance. For all non -expendable property
purchased under this Agreement, the Agency shall maintain sufficient insurance
to cover the cost of replacement due to loss by fire, theft, or accidental
damage. The Agency shall also be responsible for the replacement and upkeep
of all such property.
4. Cooperation with Agency. The City shall provide all available maps, reports,
and other data requested by the Agency to accomplish the services which are the
subject of this Agreement. The Agency shall pay for all articles so supplied.
E. Audits and Reviews.
1. City and Federal Audits.
(a) The City shall require governmental agency and nonprofit agency
audits consistent with 24 CFR Parts 84 and 85, respectively for those agencies
that have combined receipts of federal financial assistance totaling Five
Hundred Thousand Dollars ($500,000) or more in a fiscal year (applicable to
fiscal years starting on or before December 25, 2014). The City shall require
governmental agency and nonprofit agency audits consistent with 2 CFR Part
200 for those agencies that have combined receipts of federal financial
assistance totaling Seven Hundred Fifty Thousand Dollars ($750,000) or more
in a fiscal year (applicable to fiscal years starting on or after December 26,
2014). However, a# agencies receiving any award amount under this contract
must submit, at a minimum, a fiscal year end financial statement. Audits /
financial statements must be submitted to the City no later than nine (9)
months after the end of the agency's fiscal year.
(b) The City may make an examination of the Agency's fidelity
bonding and fiscal and accounting procedures to determine whether these
procedures meet the requirements of this Agreement.
(c) At any time during normal business hours and as often as the
City, HUD and/or the Comptroller General of the United Stated may deem
necessary, there shall be made available to the City, HUD and/or
representatives of the Comptroller General for examination of all its records with
respect to all matters covered by this Agreement. Further, the Agency shall
permit the City, HUD and/or representatives of the Comptroller General to
audit, examine and make excerpts of transcripts from such records, and to
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make audits of all contracts, invoices, materials, payrolls, records of personnel,
conditions of employment and other data relating to all matters covered by this
Agreement.
2. Periodic Review. At regular intervals during the term of this Agreement
the City may conduct reviews of the content and progress of the Agency services.
If, as a result of such review, it is the opinion of the City that revisions of the
Scope of Services (see paragraphs 2 and 3 above) are necessary or the methods
employed by the Agency are inappropriate, the City may require such revisions by
notifying the Agency in writing. Upon receipt of such notification of revision, the
Agency shall, within ten (10) days, propose the manner in which such revisions
shall be made. The proposed revisions shall be subject to the City's written
approval and amendment to this Agreement.
F. Termination.
1. By giving five (5) working days written notice specifying the effective
date, the City may terminate this Agreement in whole or in part for cause, which
shall include:
(a) failure, for any reason, of the Agency to fulfill in a timely and
proper manner its obligations under this Agreement, including compliance with
the approved program and the conditions of this Agreement, and such statutes,
executive orders, and HUD directives as may become applicable at any time;
(b) submission by the Agency to the City of reports that are incorrect
or incomplete in any material respect:
(c) ineffective or improper use of funds provided under this Agreement;
(d) failure of the Agency to supply the City with monthly reports and
data necessary to the continuing planning process of the City;
(e) suspension or termination by HUD of the Grant to the City under
which this Agreement is made, or the portion of it delegated by this Agreement;
provided, however, that if the Grant is merely reduced and in the absence of
any contrary HUD directive, the Agency may readjust its budget and
recommend amendments to this Agreement to the City
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2. The City may also terminate, assign or transfer this Agreement when
required by HUD direction.
3. The Agency may propose to terminate this Agreement in whole or in
part, for good cause only, by giving at least thirty (30) days written notice
specifically stating the cause for such requested termination. Any such request for
termination shall be subject to the written approval of the City, acted upon by the
City within ten (10) days of receipt of the notice of request to terminate. The
decision of the City shall be final and conclusive, provided that such approval shall
not be unreasonably withheld.
4. This Agreement may also be terminated by either the City or the
Agency in whole or in part, by mutual agreement setting forth the reasons for such
termination, the effective date, and in the case of partial termination, the portion to
be terminated. However, if in the case of a partial termination, the City determines
that the remaining portion of the award will not accomplish the purpose for which
the award was made, the City may terminate the award in its entirety.
G. Project Close -Cut. In the event the Agency does not expend the amount allocated
under this Agreement or the project is canceled, expired, assigned or terminated for any
reason, any funds not claimed by the Agency and approved by the City for allowable costs by
the end of the term or by the date of cancellation, expiration, or termination of this Agreement,
as the case may be, shall no longer be payable to the Agency under this Agreement.
H. Reversion of Assets. It is anticipated there will be no assets at the conclusion,
cancellation, assignment or termination of this Agreement. If there are the Agency shall contact
the city for appropriate disposition under applicable OMB circulars.
10. COPYRIGHTS: If this Agreement results in a book or other copyrightable material, the author
may copyright the work, but the City and HUD reserve royalty free, nonexclusive, and irrevocable licenses to
reproduce, publish, or otherwise use, and to authorize others to use, all copyrighted material and all material
which can be copyrighted.
11. PATENTS: Any discovery or invention arising out of or developed in the course of work aided
by this Agreement shall be promptly and fully reported to HUD for determination by HUD as to whether patent
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protection on such invention or discovery, including rights under any patent issued thereon, shall be disposed
of and administered in order to protect the public interest.
12. EQUAL OPPORTUNITY AND NONDISCRIMINATION: The Agency agrees to comply with
the nondiscrimination and equal opportunity requirements made applicable to Shelter Plus Care Grant
activities by 24 CFR 582.330.
13. OTHER REQUIREMENTS: Notwithstanding the City's responsibilities with respect to the
requirements listed below, the Agency agrees to comply with the following requirements, when applicable:
A. National Program For Minority Business Enterprise. The Agency agrees to comply
with the provisions of Executive Order 11625.
B. Relocation And Acquisition. The Agency agrees to comply with the provisions of the
Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C.
4601), as amended, and the regulations at 24 CFR 582.335, which may be amended from
time to time
C. Environment. The Agency agrees to comply with the Clean Air Act (42 U.S.C.
7401, et seq.), the Federal Water Pollution Control Act (33 U.S.C. 1251, et seq.), the
provisions of the National Environmental Policy Act of 1969 (42 U.S.C. 4321, et seq.) and the
regulations pursuant to these Acts, and the environmental review responsibilities of 24 C.F.R.
582.230, when applicable.
D. Historic Preservation. The Agency agrees to comply with the National Historic
Preservation Act (16 U.S.C. 470 et seq.) and regulations pursuant to it. The Agency agrees to
take into account the effect of the project for which Community Development funding is
provided under this Agreement on any district, site, building, structure, or object listed in or
found by the Secretary of the Interior, to be eligible for inclusion in the National Register of
Historic Places.
E. Architectural Barriers. The Agency agrees to comply with the Architectural Barriers
Act of 1968 (42 U.S.C. 4151) when applicable and with handicapped access requirements of
the State of Indiana and the City of South Bend.
F. Cultural Environment. The Agency agrees to comply with the provisions of
Executive Order 11593.
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G. Flood Disaster. The Agency agrees to comply with the provisions of the Flood
Disaster Act of 1974(42 U.S.C. 4001, et seq.) and regulations pursuant to it.
H. Buildinq Standards. The Agency agrees that any building for which Shelter Plus
Care Grant Funds are used will comply with the provisions of 24 C.F.R. 582.305.
I. Recordkeeping. The Agency Agrees to comply with the recordkeeping and
confidentiality standards detailed in 24 C.F.R. 582.300(d).
J. Use Limitations. The Agency agrees to the limitations on assistance contained in
24 C.F.R. 582.115.
K. Homeless Assistance. The Agency agrees to comply with the provisions in 24
C.F.R. 582.300 concerning assistance and participation of homeless individuals in the program.
L. Displacement. The Agency agrees to minimize displacement of persons and to
provide for relocation assistance for displaced persons as a result of the project as discussed in
24 C.F.R. 582.335.
M. Eligible Activities. The Agency agrees that Shelter Plus Care Grant Funds will be
used only for eligible activities discussed in 24 C.F.R. 582.1.
N. McKinney-Vento Act, The Agency agrees to abide by the requirements of the
McKinney-Vento Homeless Assistance Act, 42 U.S.C. § 11301, et seq., regarding the
implementation of policies to assist in preventing discharge of persons from publicly funded
institutions or systems of care from immediately resulting in homelessness.
O. Information Collecting. The Agency agrees to comply with HUD's standards for the
collection and reporting of information and participation in a local information system.
14. PROHIBITIONS:
A. Prohibition Against Payments of Bonus or Commission. The assistance provided
under this Agreement shall not be used in payment of any bonus or commission to obtain HUD
or City approval of the application for such assistance or for additional assistance, or any other
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approval or concurrence required under this Agreement, Title I of the Housing and Community
Development Act of 1974, as amended, or HUD regulations with respect thereto; provided,
however, that reasonable fees or bona fide technical, consultant, managerial or other such
services, rather than solicitation, are not prohibited if otherwise eligible as program costs.
B. Prohibition Against Kickbacks. The Agency agrees to comply with the Copeland
"Anti -Kickback" Act (18 U.S.C. 874) which prohibits kickbacks from public works employees.
C. Conflict of Interest.
1. No member, officer, or employee of the City, or its designees or
agents, no member of the governing body of the City of South Bend or the
Agency (and no one with whom they have family or business ties) who
exercises any functions or responsibilities with respect to the program during
his or her tenure or for one year thereafter, shall have any personal or financial
benefit, direct or indirect, in any contract or subcontract, or the proceeds
thereof, for work to be performed in connection with the program assisted under
the Agreement.
2. The Agency agrees that it will incorporate into every written
contract the following provision:
"INTEREST OF CONTRACTOR AND EMPLOYEES. The
Contractor covenants that no person who presently exercises any
functions or responsibilities in connection with the Community
Development Program, and no one with whom they have family or
business ties, has any personal Anancial benefit, direct or indirect in this
Contract. "
D. Political Activity Prohibited. None of the funds, materials, property or services provided
directly or indirectly under this Agreement shall be used for any candidate for public office or for
political activities.
E. Prohibition of, and Elimination of, Lead -Based Paint Hazard. Notwithstanding any
other provision, the Agency agrees to comply with the regulations set forth in 24 CFR 576.57
(c) and all applicable rules and orders issued thereunder which prohibit the use of lead -based
paint in residential structures undergoing federally assisted construction or rehabilitation and
require the inspection and abatement of lead -based paint hazards. In addition, appropriate action
must be taken to protect shelter occupants from hazards associated with lead -based paint
abatement procedures. Every contract or subcontract including painting, pursuant to which such
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federally assisted construction or rehabilitation is performed, shall include appropriate provisions
dealing with lead -based paints required under 24 CFR 579.57 (c).
F. Prohibition of Assistance for Religious Activities and/or Organizations. None of the
funds, materials, property or services provided under this Agreement may be used to promote
religious activities or to assist religious organizations in promoting secular activities unless
specifically allowed under 24 CFR 582.115.
G. Lobbying Prohibited. None of the funds provided under this Agreement shall be used
for publicity or propaganda purposes designed to defeat or support legislation pending before
Congress.
15. CERTIFICATION REGARDING LOBBYING: The undersigned representative of the Agency
certifies, to the best of his or her knowledge and belief, that:
A. No federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or any employee of a Member of
Congress in connection with the awarding of any federal contract, the making of any federal loan, the
entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or
modification of any federal contract, grant, loan, or cooperative agreement.
B. If any funds other than federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any agency, a Member
of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection
with this federal contract, Grant, loan, or cooperative agreement, the undersigned representative of the
Agency shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in
accordance with its instructions.
C. The undersigned representative of the Agency shall require that the language of this
certification be included in the award documents for all subawards at all tiers (including subcontracts,
subgrants, agreements) and that all subrecipients shall certify and disclose accordingly.
D. This certification is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a prerequisite for
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making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the
required certification shall be subject to a civil penalty of not less than $10,000 and not more than
$100,000 for each such failure.
16. CERTIFICATION REGARDING DEBARMENT. SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSIONCLOWER TIER COVERED TRANSACTIONS: A person who is
barred or suspended shall be excluded from federal financial and nonfinancial assistance and benefits under
federal programs and activities. The undersigned representative of the Agency certifies, to the best of his or
her knowledge and belief, that:
A. Neither it nor its principals are presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded from participation in this Agreement; and
B. It will include the following clause without modification, in all proposals, agreements,
contracts, proposals, or other lower tier covered transactions:
Certification Regarding Debarment Suspension Ineligibility and Voluntary ExclusioncLower Tier
Covered Transaction: (1) The prospective lower tier participant certifies , by Submission of this
proposal, that neither it nor its principals is presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded from participation in this transaction by
any Federal department or agency. (2) Where the prospective lower tier participant is unable
to certify to any of the statements in this certification, such prospective participant shall attach
an explanation to this proposal.
17. COMPLIANCE WITH FEDERAL RULES AND REGULATIONS: The Agency agrees to abide
by all applicable federal rules and regulations, as amended from time to time, including but not limited to those
federal rules and regulations referred to in this Agreement. Unearned payments under this Agreement may be
suspended or terminated upon refusal to accept any additional conditions that may be imposed by HUD at any
time or if the Grant to the City under the Stewart B. McKinney Homeless Assistance Act Subtitle B of Title IV
(42 USC 11301 (1988)), as amended, is suspended or terminated.
18. CLAIMS AGAINST CITY: The Agency agrees to defend, indemnify and save harmless the
City from any and all claims of any nature whatsoever which may arise from the Agency's performance of this
Agreement; provided, however, that nothing contained in this Agreement shall be construed as rendering the
Agency liable for acts of the City, its officers, agents or employees.
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19. DRUG -FREE WORKPLACE. The Agency hereby covenants and agrees to make a good faith
effort to provide and maintain a drug -free workplace as specified in 24 C.F.R. Part 24. Agency will give
written notice to the City within ten (10) days after receiving actual notice that an employee has been convicted
of a criminal drug violation occurring in Agency=s workplace.
The Agency certifies and agrees that it will provide a drug -free workplace by
A. Publishing and providing to all of its employees a statement notifying their employees
that the unlawful manufacture, distribution, dispensing, possession or use of a controlled
substance is prohibited in the Agency=s workplace and specifying the actions that will be taken
against employees for violations of such prohibition; and
B. Establishing a drug -free awareness program to inform their employees of the (1) the
dangers of drug abuse in the workplace; (2) the Agency=s policy of maintaining a drug -free
workplace; (3) any available drug counseling, rehabilitation, and employee assistance programs;
and (4) the penalties that may be imposed upon an employee for drug abuse violations occurring
in the workplace.
C. Notifying all employees in the statement required by subparagraph (a) above that as
a condition of continued employment the employee will (1) abide by the terms of the statement;
and (2) notify the Agency of any criminal drug statute conviction for a violation occurring in the
workplace no later than five (5) days after such conviction;
D. Notifying in writing the City within ten (10) days after receiving notice from an
employee under subdivision (c)(2) above, or otherwise receiving actual notice of such conviction;
E. Within thirty (30) days after receiving notice under subdivision (c)(2) above of a
conviction, imposing the following sanctions or remedial measures on any employee who is
convicted of drug abuse violations occurring in the workplace: (1) take appropriate personnel
action against the employee, up to and including termination; or (2) require such employee to
satisfactorily participate in a drug abuse assistance or rehabilitation program approved for such
purposes by a Federal, State or local health, law enforcement, or other appropriate agency; and
F. Making a good faith effort to maintain a drug -free workplace through the
implementation of subparagraphs (a) through (e) above.
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20. The Organization hereby represents and certifies that it may enter into this agreement under
Indiana Code § 35-44-1 and, to the extent applicable, has executed and filed 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 Appendix I prior to the City's approval of this Agreement.
(Balance of page intentionally left blank)
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IN WITNESS WHEREOF, the City and the Agency have executed this Agreement as of the date
first above written.
NAME OF AGENCY
Department of Community Investment
B
y
Title Executive Director
OF
Pamela C. Meyer' C/
Director, Neiglfborhood Engagement
CITY OF SOUTH BEND
BO RD OF PUBLIC WORK
Gary A. GiloF President
Therese J. D rau, Member
David P. Relos, Member
Ja s .Mueller Member
Elizabeth A. Maradik, Member
4SATTT
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SCOPE OF SERVICES - PROJECT DESCRIPTION
2015 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT
Department of Community Investment - Administration
March 1, 2016 - February 28, 2017
HUD Grant # IN0012L5H001508
STATEMENT OF PURPOSE AND INTENT:
The primary purpose of the Department of Community Investment grant is to fund the
administration of Continuum of Care Program Grant funds as contracted to agencies that deliver
services to the homeless, in accordance with the requirements in 24 CFR 578, 24 CFR
578.7(a)(8) and 24 CFR 578(a)(9).
PROPOSED GOAL(S):
The targeted goal for the Department of Community Investment is to administer the 2015
Continuum of Care Program Grant.
TIMETABLE:
The activity shall commence as of March 1, 2016 and shall continue to and include February
28, 2017.
COST CATEGORIES:
Costs must be necessary, reasonable and directly related to the grant in accordance with the
Statement of Purpose and Intent. Eligible cost categories are: Administration.
PROGRAM BUDGET:
The total cost of the Department of Community Investment 2015 Continuum of Care Program
Grant Agreement Activity shall not exceed $2,000.00.
PRIOR APPROVAL:
To expend funds for cost categories, types of activities, or locations not listed above will require
prior written approval from the Department of Community Investment. Prior written approval must
be obtained for any reductions, deletions, or additions to the approved line item budget.
NON -EXPENDABLE PROPERTY:
Notwithstanding any provision herein to the contrary, no costs may be incurred for non -expendable
property (equipment, furniture, fixtures, etc.) without obtaining written approval from the Department
of Community Investment.
FINANCIAL AND ADMINISTRATIVE REPORTS:
The Agency shall utilize the Monthly Reimbursement and Program Report (R & P Report) supplied
by the City for submission of claims and activity status reports to the City. The Agency
understands that:
1) Claims for reimbursement of expenses (goldenrod forms) shall be accompanied by an R & P
Report and by proper documentation (check copies, invoices, staff time distributions, etc.) and
2) R&P reports shall be due with each request for reimbursement. The final report is due at the
completion of the activity.
The City reserves the right to refuse any or all claims not properly supported with adequate
and proper documentation of claims and activity progress.
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When the prospective Contractor is unable to certify to any of flee stateneeuts below, it shall atlacle an explanation to this Affidavit.
CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT,
CERTIFICATION REGARDING IlVVESTMENT 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 Inttana_ )
) SS:
Sase COUNTY )
The undersigned Contractor, being duty 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, not 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 -tune.
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 Nan -Debarment Affidavit Non Iran Form
the energy sector in Iran; and (ii) at the time the financialinstitution 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/herlits 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 Nun -Debarment Affidavit Non rmn Fom
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.
1, 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. 1 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_L
pLOR^YLL...,T.I/M��M��EµR�
i 1piMY.•_ JL Joseph Co"
My Commission Expires
lie tember2312017
yan w1OWSlci. zi4- e •D
Printed Name and Title
Subscribed and sworn to before the this AOi day of2014o
My Commission
County of Residence `0 Jd SCjQ�
Non -Collusion Non -Debarment Affidavit Non Lan Form