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HomeMy WebLinkAboutAgreement - DCI - Oaklawn Psychiatric - Supportive Housing Rental AssistanceBOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date Name 7/14/16 Timmer Department DC] BPW Date 7/26/16 Phone Extension 5841 ired Prior to Submittal to 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 — Reqakffor All Submissions ® Agreement ❑ Contract ❑ Proposal ❑ Addendum ❑ Professional Services ❑ Resolution ❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet ❑ Quote Opening ❑ Quote Award ❑ Change Order No. ❑ C/O & PCA No. ❑ PCA ❑ Ease/Encroach. ❑ Traffic Control F Other: Amendment red Information Company or Vendor Name Oaklawn Psychiatric Center, Inc. New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing MBE/1NBE Contractor ❑ MBE ❑ WBE MBEAINBE Contractor Requested ® No ❑ Yes Name of Company Project Name Supportive Housing Rental Assistance Project Number 16-JS-02 Funding Source Account No. Amount Terms of Contract Purpose/Description Amount of Continuum of Care (CoC) 212.1001.460.39.30 100,644 3/01/16 — 2/28/17 Provide rental assistance and supportive services for homeless individuals with severe mental illness ® Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran etc.) Required For Change Orders Only Increase Decrease Previous Amount Current Percent of Change: New Amount Total Percent of Change: Copy Original ® ❑ ❑ ❑ ❑ ❑ Love Dispersal After 2015 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT Oaklawn Psychiatric Center, Inc. — SHRA Oaklawn March 1, 2016 — February 28, 2017 HUD Grant # IN0012LSH001508 THIS AGREEMENT is entered into this LO'day of 2016 by and between the City of South Bend, State of Indiana, by and through is Board of Public Works, for and in behalf of the Department of Community Investment (the "City") and Oaklawn Psychiatric Center, Inc. (the "Subrecipient" or "Agency"). 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 City desires to engage the Subrecipient to give certain assistance in connection with such undertakings and the Subrecipient 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. "Subrecipient" means the entity, whether public or private, which has the responsibility for implementing a project, activity, or service. 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" and the Continuum of Care Interim Rule. Upon publication fore effect of a Final Rule for the Continuum of Care program, the Final Rule will govern this Agreement instead of the Interim Rule. 4. AMENDMENTS: Any revision to this Agreement, including Attachments, shall be made by written amendment to this Agreement. 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. 1 AWARD: It is expressly understood and agreed that in no event will the City pay the Agency more than $100,644 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 on the basis of the fair market value of each Supportive Rental Housing unit occupied, per month. 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 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, 2015). 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, 2015). However, all 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 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 anytime; (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 2. The City may also terminate, assignor transfer this Agreement when required by HUD direction. 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 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 Order11593. 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. Building 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 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 financial 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 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 maybe 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 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 EXCLUSION OF LOWER 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. 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. 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) 10 IN WITNESS WHEREOF, the City and the Agency have executed this Agreement as of the date first above written. OAKLAWN PSYCHIATRIC CENTER, INC. By . Title py`e-cli C& OF COMMUNITY Pamela C. Meyer/ v Director, Neigh rhood Engagement CITY OF SOUTH BEND BOARD OF PUBLIC WORKS Gary A. Gild, President The�Dorl I�— i��c Elizabeth A. Maradik, Member ATTEST: s tt �i z G2�iit �t elk 11 SCOPE OF SERVICES — PROJECT DESCRIPTION 2015 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT Oaklawn Psychiatric Center, Inc. — SHRA Oaklawn March 1, 2016 — February 28, 2017 HUD Grant # IN00121.51-1001508 STATEMENT OF PURPOSE AND INTENT: The primary purpose of the Oaklawn Psychiatric Center, Inc. SHRA Activity grant is to fund tenant -based supportive rental housing assistance for eligible persons in accordance with the requirements in 24 CFR 578.37(a) and 24 CFR 578.51(d). PROPOSED GOAL(S): The targeted goal of Oaklawn Psychiatric Center, Inc. SHRA Activity is to provide eligible Oaklawn clients with tenant -based rental assistance at locations throughout St. Joseph County. 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: Rental Assistance. PROGRAM BUDGET: The total cost of the Oaklawn Psychiatric Center, Inc. 2015 SHRA Program Activity shall not exceed $100,644.00. 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 maybe 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. 12 When the prospective Contractor is unable to certify to any of the statemeztts beloty, 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 ) SS: COUNTY ) The undersigned Contractor, being duly sworn upon his/herfits 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 fiom 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 -Debarment Affidavit Non Iran Form 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-Callusion Non -Debarment AltidavitNon imn Form 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 tinder the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this t q } day of 4114, 20 f Y Subscribed and sworn to before me this day of _ 20 / (o My Commission Expires %'/4 '1 Z Notary Public County of Residence Elkhai- M:'?y CHARLOTTE S. SPRUNGER f+:•,= OkhaACounry My Cwn"on Expires January 16,2022 Non -Collusion Nan-DebamientAfCdavit Non Imn Fomi C ECG