HomeMy WebLinkAboutR-1997-079 1
RESOLUTION NO. 79-97
A RESOLUTION OF THE CITY OF DANIA, FLORIDA APPROVING
AGREEMENT NO. 97-11B-1617-SYETP-18 BETWEEN THE
BROWARD EMPLOYMENT AND TRAINING ADMINISTRATION, A
GOVERNMENTAL CONSORTIUM CREATED TO CONDUCT
MANPOWER TRAINING AND EMPLOYMENT PROGRAMS IN
BROWARD COUNTY, FLORIDA, AND THE CITY OF DANIA; AND
PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, after due consideration, the City of Dania, Florida hereinafter designated as
agent deems it in the public interest to execute a continuing Agreement between the
Broward Employment and Training Administration and the Agent in accordance with the
terms and conditions contained in said Agreement NO. 97-11 B-1617-SYETP-18, a copy of
which is attached hereto and made a part thereof.
BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF DANIA, FLORIDA
Section 1: That that certain Agreement No. 97-11-13-1617-SYETP-18 between the
Broward Employment Training Administration, a Governmental Consortium Created to
Conduct Manpower Training and Employment Programs in Broward County, Florida, and
1 the City of Dania, as agent a copy of which is attached hereto as Exhibit "A", be and the
same is hereby approved, and the City Manager is hereby directed to execute same.
Section 2: That the City Manager is hereby authorized to execute Amendment (s) to
said Agreement, without further authorization, except that the Agent shall have approved
Grant Application Request Funds prior to submission, and such note so the said City
Manager shall undertake pursuant to this Resolution shall become the acts of the Agent.
We understand that this program shall enable the Agent to commence much needed
public services, which under present economic conditions would not be feasible to
undertake, and to provide immediate employment and/or training opportunities for a large
sector of the unemployed labor pool.
Section 3: That the City Manager is hereby authorized to execute Form 100
Amendments to this Agreement, which reflects programmatic changes, (i.e. , : changes in
job slot designations, budget shifts etc.) but which do not alter the amount of a budget
I
I
i
category, without further authorization, and such acts as the said administrative officer shall
undertake pursuant to this Resolution shall become the acts of the Agent.
Section 4: That this resolution shall be in force and take effect immediately upon its
passage and adoption.
Passed and Adopted this 27 day of May 1997.
�AAYOR - COMMISSIONER
ATTEST:
CITY CLERK -AUDITOR
APPROVED AS TO FORM AND CORRECTNESS:
j FRANK C. ADLER, CITY ATTORNEY
I
I
I
RESOLUTION NO. 79-97
i
I
p
i
I '
I
AGREEMENT NO. 97-IIB-1617-SYETP-18
BETWEEN THE BROWARD EMPLOYMENT AND TRAINING ADMINISTRATION.
A GOVERNMENTAL CONSORTIUM CREATED TO CONDUCT MANPOWER
TRAINING AND EMPLOYMENT PROGRAMS IN BROWARD COUNTY, FLORIDA
AND THE
CITY OF DANIA
I
I
I
�I
EXHIBIT "A"
I
AGREEMENT NO. 97-IIB-1617-SYETP-18
THIS AGREEMENT, entered into this day of
19_, by and between the Broward Employment and
Training Administration, a consortium of the Cities of Fort
Lauderdale and Hollywood, and Broward County, existing under and
by virtue of the laws of the State of Florida as a Council of
Governments, having its principal offices at 330 North Andrews
Avenue, Fort Lauderdale, Florida 33301, AND the City of Dania,
existing under and by virtue of the laws of the State of Florida
as a governmental entity having its principal office at 100 West
Dania Beach Boulevard, Dania, Fl to begin June 16th , 1997, and
to be completed by Auoust 22, 1997, unless either party elects
to terminate the Agreement as set forth in Section 205 below.
j WITNESSETH THAT:
WHEREAS, the Broward Employment and Training
Administration and the Broward Workforce Development Board have
entered into an agreement with the Governor of the State of
Florida and the United States Department of Labor for a grant
for the execution and implementation of a job training and
employment program; AND
WHEREAS, the elected officials comprising the Broward
Employment and Training Administration Broward Workforce
Development Board and the officials of the State of Florida and
the United States Department of Labor are desirous of providing
job training which will lead to enhanced self-sufficiency; AND
WHEREAS, the Broward Employment and Training Administration
and the City of Dania desire to provide meaningful employment for
economically disadvantaged youths, ages fourteen (14) through
twenty-one (21).
NOW THEREFORE, in consideration of the premises and the
mutual covenants and obligations herein contained, and subject
to the terms and conditions hereinafter stated, the parties
hereto agree and understand as follows.
I
,..,1 ARTICLE It AGREEMENT PURPOSE AND DEFINITIONS
100. PURPOSE
It is the purpose of this Agreement to state the covenants and
conditions under which BETA and 'the Contractor will implement and
j provide training and employment services, specifically summer work
j experience opportunities to eligible youths as described herein, to
be funded under the guidelines of JTPA, as amended, and under the
contracting powers of BETA.
201. DEFINITIONS
201.1 "BETA" shall mean the Broward Employment and Training
Administration.
101.2 "Collective Bargaining Agents" shall mean a union or
union representatives.
101.3 "Contractor" shall mean the participating governmental
unit or nonprofit agency.
101.4 'IDOL" shall mean the United States Department of Labor.
101.5 I "Economically Disadvantaged" shall mean that income
level as determined by the Governor and/or DOL as being
below the poverty guidelines.
101.6 "Job Order" shall mean the BETA-SYETP JOB ORDER form
(and attachments thereto) used as an application for
requesting work sitee/job slots for SYETP participants
and which is incorporated into and made a part of this
Agreement.
101.7 "Job Site/Worksite" shall mean the physical location
and the department of the participating Contractor to
which the youth has been assigned.
101.8 "JTPA" shall mean the Job Training Partnership Act.
101.9 "Labor Union Concurrence" shall mean a union's consent
to SYETP placements.
101.10 "Participant" shall mean a JTPA eligible youth referred
by the Urban League of Broward County for placement to
Contractor and who is fourteen (14) through twenty-one
(21) years of age.
101.11 "Program" shall mean the activities and services to be
provided by the Contractor under this Agreement.
. 101.12 "SYETP" shall mean Summer Youth Employment and Training
Program.
i
101.13 "Urban League" shall mean the agency selected by the
BETA Council and the BWDB to be responsible for the
development of summer worksites, eligibility
determination of the youths, assignment of the youths
to the workeites, and collection and verification of
participant timesheets and payroll.
101.14 "Worksite Aide" shall mean a youth who is eighteen
(18) through twenty-one (21) years of age and who
serves as an aide to the worksite supervisor or who
performs as an administrative aide as directed by the
SYETP Director.
101.15 "Worksite Supervisor" shall mean Contractor's personnel
designated by Contractor to provide continuous on-site
supervision and direction to SYETP participants at
Contractor's worksite(s) and who will be responsible
for verifying SYETP participants' time sheets.
101.16 "Youth" shall mean a person who
of is fourteen (14)
through twenty-one (21) years
e.
101.17 "Youth Worksite Assistant" shall mean an Urban
League/SYETP staff person who shall serve as
liaison.
END OF ARTICLE I
F
SHAFER/SY:SYSHELL.97
May 7, 1997
�C
S ARTICLE II: PROGRAM OPERATIONS
r
200. PROGRAM
200.1 The program to be provided shall be a work experiences
y the Urban
wherein a youth referred to Contractor
job bfunctione to
r League of Broward County, is g
perform under the guidance and leadership of the
Contractor in accordance with the JTPA regulations.
200.2 The Urban League of Broward County shall be responsible
for participant eligibility certification and
recruitment. The Urban League of Broward County shall
assess each participant to determine their suitability
for Contractor's program.
201. RESPONSIBILITIES OF CONTRACTOR r
201.1 Contractor shall supervise a l participants
arci a conformance thewjob
sites and shall require part pti
the Contractor's Personnel Rulss.
201.2 Contractor shall plan and direct participant work
activities in accordance with the applicable Federal
and State Child Labor Law Acts, rules and regulations,
and other applicable State and local laws.
201.3 � Contractor shall direct participant(s)r work activities
b (
in accordance with their j ) and/or
description(s), which are hereby incorporated by
reference and made a part of this Agreement.
201.4 Contractor shall comply with the Job Training Partner—
ship Act, as amended, and the regulations promulgated
thereunder especially as they relate to the SYSTP.
201.5 Contractor shall ensure that all of Contractor's
` personnel, including any alternate staff, o will beinvolved in supervising the Summer Youth Employment
Training Program participants shall attend the SYETP
Worksite Supervisor's Training Meeting conducted by the
Urban League of Broward County, which will be held
during the months of May and June.
201.6 Contractor shall allow their work site supervisors time
off upon the Urban League of Broward County's written
request so that they may attend the Worksite
Supervisor's orientation Workshops.
i
SHAPER/SY:SYSHELL.97
May 7, 1997
201.7 Contractor shall orient and train their Worksite
the
Supervisory personnel directly ante ns ape for the
supervision of SYETP p P
Contractor's responsibilities and obligations under
? this Agreement by providing each worksite supervisor
with a copy of this Agreement, as well as a copy Of
the Worksite Supervisors Handbook, and assuring the
availability and review of the training handbook and
materials with any assigned alternate supervisors.
201.8 Contractor shall immediately notify the Urban League
of Broward County of any temporary and/or ongoing
changes in the designation of personnel who will be
supervising the youth.
201.9 Contractor shall be accountable Eor maintaining SYETP
participant time sheets by keeping accurate work time
attendance rosters and timesheets, recording time in
segments of fifteen minutes, assuring and supervising
the proper completion of SYETP participant time sheets
consistent with instructions furnished by BETA and/or
the Urban League
of
time ard sheets n y and if all ctheifprior
reigning participant
requirements are met.
201.10 Contractor shall not require participants to work more
than the hours . reflected in the Job Order and
in no
hours per
,event may hours worked exceed thirty (30)
week unless expressly authorized in writing by BETA.
BETA shall be responsible for participant wages only
up to 30 hours a w Participants
paid
not pay for
paid for time actuallyly worked BETA
time not worked, overtime, holidays, vacation, sick,
or other leave or time off from the job. Contractor
shall be responsible for any wages due participants
beyond thirty hours a week, including wages due for
j any over-time worked by participants under
Contractor's supervision, as well as for wages due
and/or paid for holidays, vacation, sick, or other
leave or time off from the job.
201.11 Contractor agrees not to knowingly refer for
eligibility determination any youths who have a wife,
husband, eon, daughter, mother, father, brother,
brother-in-law, sister, sister-in-law, son-in-law,
daughter-in-law, mother-in-law, father-in-law, aunt,
uncle, niece, nephew, stepparent, or stepchild who are
employed in an the nIIrban iveague capacityoranotherrthe
Contractor, BETA,
BETA's contractors.
J
SHAPER/SY:SYSHELL.97
May 7, 1997
1
ti .
201.12 Contractor warrants that no youth will be involved in
a work experience activity that contribv,ss or could
# be expected to contribute to additional sales or income
of thb Contractor or which will r�_:.erwise result in the
subsidization of wage! for the Contractor's
organization. In tns event that the Contractor
unknowingly realizes an income, such income shall be
payable to BETA.
201.13 Contractor assures that all sites where participants
will be assigned have the capability and facilities to
provide services to summer youth in a sanitary and
j safe environment.
201.14 Contractor's worksite shall conform to normal routines
I and functions befitting a reasonable business
establishment, including, but not limited to,
appropriate supervision on the premises at all times,
i developing positive work habits, working conditions,
and attire.
201.15 Contractor shall assure it will have supervisory
personnel who will act as worksite supervisors for
each of the Contractor's worksites so as to provide
for continuous on-site supervision of participants.
202.16 Contractor shall allow BETA or its designated
i. representative or the Urban League of Broward County to
I visit Contractor's training sites for the purpose of
monitoring Contractor's operations to ensure compliance
with this Agreement or any Amendment hereto.
201.17 The Contractor shall allow BETA or its designated
representative or the Urban League of Broward County to
conduct on-site evaluations of participants for the
purpose of monitoring participants' work activities in
accordance with their training plan/job order(s) and/or
job description(s).
201.18 Contractor understands that the program it is operating
is a single site work experience program, which means
that all job sites at which youth are to be located
must be part of the Contractor's organization. Under
no circumstances shall a participant be placed at a
site other than Contractor's designated worksite,
unless prior written permission is granted by the
Urban League of Broward County for outstationing and
in such instances under no circumstances shall the
outstationing site be a private for profit agency.
i
I
SHAFER/SY:SYSHELL.97
May 7, 1997
L
I ,
e
; p
� a
W� 201.19 Contractor shall maintain according to sound management
procedures records, and files, containing, but not
limited to, time sheets, attendance records, supervisor
assignments, and personnel changes, relating to the
Contractor's operation of the SYETP program.
201.20 Contractor shall make original and/or certified copies
of any reports, plans, surveys, information, documents,
maps or other data produced or developed by Contractor
in execution of the project covered by this Agreement,
available to BETA, the Governor of the State of
Florida, the Comptroller General of the United States,
and/or the Department of Labor (DOL) at any time upon
reasonable notice for the purpose of program audit,
examination, excerpts and transcripts, even though the
Contractor may at the time of the request no longer be
operating programs for BETA.
202.21 Contractor shall keep copies of all records pertaining
to the operation of this Agreement and any Amendment
hereto for five (B) years following the expiration of
this Agreement.
201.22 If Contractor, is an agency as defined in Chapter
768.28, Florida Statutes, Contractor agrees to be fully
responsible to the limits set forth in 5.768.28,
Florida Statutes, for acts of negligence of its agents
or employees when acting within the scope of their
employment or agency, and agrees to be liable to the
limits set forth in 5.768.28, Florida Statutes, for
any damages caused by said negligence. Nothing herein
is intended to serve as a waiver of sovereign immunity
by any party to which sovereign immunity may be
applicable. Nothing herein shall be construed as
consent by a state agency or political subdivision of
the State of Florida to be sued by third parties in
any matter arising out of any contract.
contractors who are not state or federal agencies or
unite of general local purpose governments, shall hold
and save BETA, its officers, contractors, and
employees harmless from liability of any nature or
kind, including costs and expenses, for or on account
of any suits or damages of any character whatsoever
resulting from injuries or damages sustained by any
persons or property resulting in whole or in part from
the negligent performance or omission of any employee,
contractor, or representative of the contractor.
SHAPER/SY:SYSHELL.97
May 7, 1997
6
tow _.
201.23 Contractor shall cooperate with SYETP in conducting
SYETP Vocational Skills/Life Skills orientation for
SYETP participants.
I
201.24 Contractor shall inform BETA and Urban League of
Broward County SYETP staff immediately should an
accident or injury occur at the job site, affecting or
involving a participant.
201.25 Contractor shall notify SYETP staff of any problem
concerning participant's performance at a worksits.
201.26 Contractor understands and agrees that no qualified
disabled individual shall on the basis of disability,
be excluded from participation in, be denied the
benefits of, or otherwise be subject to discrimination
under this SYETP program.
201.27 Contractor understands that in accordance with Sections
143(b) (2) and 143(c)(2) of the Job Training Partnership
Act and regulations, Contractor must obtain written
concurrence from the appropriate bargaining agent if a
collective bargaining agreement is in force in
Contractor'B organization covering the occupations in
which the Summer Youth participants are going to be
employed.
I 201.28 Contractor shall provide insurance coverage for
participants under the Contractor's general or public
liability insurance policy, or if the Contractor is
Belf-insured to indemnify BETA against third party
claims involving participants under this Agreement.
202. RESPONSIBILITIES OF BETA AND THE URBAN LEAGUE OF BROWARD COUNTY
202.1 The Urban League of Broward County shall provide "Youth
Workeite Aesistant(s)" and/or "Worksite Aide(s)" who
shall serve as liaisons between the Urban League of
Broward County and Contractor.
202.2 The Urban League of Broward County shall assist the
job site supervisor in resolving any problems
concerning the youths' performance on the job by
responding to the contractor's notice as per Section
201.25 above.
202.3 The Urban League of Broward County shall hear all
grievances concerning program participants' performance
at the job site.
SHAFER/SY:SYSHELL.97
May 7, 1997
7
A
202.4 BETA shall be responsible for participants' wages.
a
202.5 BETA shall provide Workers' Compensation for all
Summer Youth Employment and Training Program (SYETP)
participants.
202.6 The Urban League of Broward County shall provide
counseling and supportive services to SYETP
participants as needed.
I
202.7 The Urban League of Broward County shall be
reaponsible for picking up participant time sheets and
distributing participant paychecks dependent on
Contractor's submission of properly certified time
sheets.
I
202.8 The Urban League of Broward County shall be responsible
for providing Program Orientation and Vocational
Skills/Life Orientation to BEWBYETP participants.
203. MONITORING
i
203.1 Contractor shall allow BETA/the Urban League of Broward
county, the Governor of the State of Florida, or any
of its agents, and the DOL to visit Contractor's
worksites, and monitor, report problems, require
corrective action within specified time periods or
close worksites without prior notice other than a
written notification to be delivered to the Contractor
at the time of the closing of the worksites.
204. NOTICE
204.1 other than as provided herein, notice required to be
given to BETA under this Agreement, shall be
sufficient when hand delivered or mailed to BETA at its
office at 330 North Andrews Avenue, Ft. Lauderdale, FL
333CI.
204.2 All notices required to be given to the Contractor
under this Agreement shall be sufficient when hand
delivered or mailed to Contractor at its office located
at the address identified in paragraph one, page one,
of this Agreement.
SHAFER/SY:SYSHELL.97
May 7, 1997
8
205. TERMINATION
205.1 This Agreement may be terminated as follows:
a. BETA or the contractor may request n termination
for convenience upon fifteen (15) days prior
written notice to the other party.
b. BETA and/or the Urban League of Broward County may
transfer or terminate participants at any time
without written notice to the Contractor whereupon
termination shall become effective immediately.
c. BETA may terminate this Agreement immediately upon
twenty-four (24) hours written notice to the
Contractor in the event that BETA is deobligated
or that the Grant under which this program is ;
l funded is terminated.
d. BETA may terminate this Agreement at any time that
the BETA authorized representative, who shall be
the BETA Executive Director determines that:
1. Contractor has failed to comply with any of the
provisions contained in this Agreement or any
Amendment hereto] or
2. Contractor has failed to perform in whole or in
part under this Agreement or has failed to take
corrective action after receiving oral or within an appropriate
written requests to do so
time period as may be stipulated by BETA and/or
the Urban League of Broward County.
e. This Agreement shall be automatically terminated in
the event that the Urban League of Broward County
is unable to, or does not refer eligible and/or
suitable participants to Contractor's program.
206. INTEGRATION
206.1 The following documents are hereby incorporated into
and made a part of this Agreement:
a. Child Labor Laws (29 USC 203): Employment of
Minors Between Fourteen (14) and Sixteen (16)
Years of Age (Subpart C), occupations Particularly
Hazardous for the Employment of Minors Between
Sixteen (16) and Eighteen (18) Years of Age or
Detrimental to Their Health or Well-being (Subpart
J
SHAFER/SY:SYSHELL.97
May 7, 1997
9
e
A
3
b. Assurances and Certifications. (attached to this
Agreement)
c. JTPA Rules and Regulations governing the operation
of the Summer Youth Employment and Training
Program.
d. Summer Youth Employment and Training Program
Worksite Supervisor's Handbook
f. Completed Job Orders/Training Plane to be
incorporated into this Agreement.
Items a and c are public laws, items d and c are available from BETA.
207. PROHIBITED ACTIVITIES
207.1 All JTPA funded programs and activities come under the
purview of the Federal Hatch Act and JTPA Regulations
which prohibit political activities under any JTPA
program. Participants are prohibited from engaging in
any political activity during hours paid for with JTPA
funds and no participant engaging in any political
activity during off hours may represent himself or
herself as a spokesperson of any JTPA program.
207.2 JTPA funded programs and activities may not be used to
support any religious or anti-religious activity.
JTPA participants may not perform functions which
provide direct religious education services.
i
END OF ARTICLE II
I
I
SHAFER/SY:SYSHELL.97
May 7, 1997
10
IN WITNESS THEREFORE, the parties hereto have made and executed
this document on the respective dates under each signature:
the City of Dania signing by and through its
authorized to execute same by
action on the day of
19_, and the BROWARD EMPLOYMENT AND TRAINING
ADMINISTRATION, signing by and through its Director of
Operations, duly authorized to execute same by Board action.
WITNESSED BY: CONTRACTOR:
City of Dania
100 West Dania Beach Blvd.
Dania, FL 33004
BY:
Signature
Michael W. Smith
ATTEST: Type Name Here
City Clerk-Auditor
Title: City Manager
Date:
1
AS TO BROWARD EMPLOYMENT & THE BROWARD EMPLOYMENT AND
TRAINING ADMINISTRATION, TRAINING ADDMINISTRATION, A
GOVERNMENTAL CONSORTIUM OF THE
WITNESSED BY: CITIES OF FORT LAUDERDALE AND
HOLLYWOOD, AND BROWARD COUNTY,
FLORIDA
BY:
CORINNE S. SLEMENDA
TITLE:
Director of Operations
Approved as to form by
Office of County Attorney DATE:
For Broward County, Florida
JOHN J. COPELAN, JR. , County
Attorney, Governmental Center
Fort Lauderdale, Florida 33301
BY:
Rochelle J. Daniels
Assistant County Attorney
EXECUTION PAGE
3
—�
ARTICLE SII
i 300. CONTRACTOR OBLIGATION TO ADHERE TO PUBLIC ENTITY CRIMES
POLICY
A person or affiliate who has been placed on the
convicted for a public entity crime may not submit a
bid on a contract to provide any goods or services to
a public entity, may not ,submit a bid on a contract
with a public entity for the construction or repair of
a public building or public work, may not submit bids
on leases of real property to a public entity, may not
be awarded or perform work as a contractor, supplies,
subcontractor, or consultant under a contract with any
public entity, and may not transact business with any
public entity, and may not transact business with any
public entity in excess of the threshold amount of
$10,000 as provided in Section 298.017, Florida
Statutes for a period of 36 months from the date of
being placed on the convicted vendor list.
END OF AGREEMENT
}
SHAFER/SY:SYSHELL.97
May 7, 1997
21
F '
t
' 1 CERT' EZ-Q Tnr.i ec.^ .. RE) INQ LOBBYING
RT2FICATION FOR -CONTRACTS GRANTS LOANS
AND COOPFRaTtvc AGR FMFNT�
The undersigned certifies, to the best of his or her knowledge and
belief, that:
( 1 ) 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 an agency, a
Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with the awarding
of any Federal contract, the making of any Federal grant, 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.
(2 ) 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 shall complete and
submit Standard Forrl-LLL , "Disclosure Form to Report Lobbying , " in
accorcance with its instrLctions .
( 3 ) The undersigneo shall reouire that the language of this
certification be included in the award documents for all' subawards
at all tiers ( including subcontracts , subgrants and contracts under
grants , loans , and cooperative agreements ) and that all*
subrecipients shall certify and disclose accordingly.
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 section 1352, title 31 ,
U.S. Code. 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.
CITY OF DANIA TPA _
Grantee/Contractor Organization Program/Title
MICHAEL SMITH, CITY MANAGER
J Name of Certifying Official Ma 27 1997
ture Date
Note: In these instances, "All , in the Final Rule is expected
to be clarified to show that it applies to covered
contract/grant transactions over $100, 000 (per OMB) .
Vibes•
s.
t DISCLOSURE OF LOBBYING ACTIVITIES 4"",dur cue
-Kwnpine d:e form to diaLrae bL'lrying activities punuanl to 71 US.C. 11.2
Kee rev.nt Ikr public burdcn oisc4,3urc.)
1. Type at federal Aclier:• i 9tatul rd ft/eralAatbta 1 Aegwrt Type: e
p ® a. Contgrins
ct
b. grant ❑ a. bid'oNer
Or" /aypiitation A. Eni:ial PGnE
C. cooperative apec rcra b•initial award 0 b. malerisl Lange
d. Ian c posl•a yard For Masstiaf Cawgt Only
e. ban guarantee 'ear Ruiner
/. ban mswance � date of Ifst rrpon +
L Name and Address of Aeperling Easily. L Y Aeperliwg Enlby in fie.44 Euba.arder Ease Alms.
a prime O Subiwidce and Address of ptitme
Tier ifknu%":
i
i
I '
I
Crin rasiun,)DiStriCL if Ltoum: Con tescienal District,drknown:
• [' Ieds.a(Deparlmenf/Agenry:
, T, federal/ropam NameJ1)eKrfplien:
i
. � CIDAwumbrr.ds/J/,hialde: ���
S. federal Action Number,if kno,v,,;
9. Award Amount,dknwtn:
19. a. hame and dddreti of lobbying Enuly b. Individuate Ier(ormin r,l mnrnduali ban name,fell name.AY:; d,Melt u/ram N , f0a7 6S Services bncluda+g atbbess d
o
(/tsf name, font mime. Mth
brow fa•..,u,• JA......tl;;: Awru,p+I '
11. Amount of f aymenl ftl,hkall;Ail IPPi)l 1S. T ed►a -
to trmenllcAeckadthttapply).
S G wlial C planned D A. reranwr
ti form of►ymcnt ICACCii all that a D b. oee•time fee
YFY': 0 C. Cnmmipion
D a. cash O d. contingent fee
u Is. in-kind;spetyly: nature D e. dthwed
Waive O 1. other:tptciif:
ta. odlf Deuryrion of Senitet or Pay IrrlmmedI ur to be performed and Da:e(s)of Service,including efyrcer(IL employee(,),
kle mbe rttl contact[d fur ment ndiNled in Ilem 11:
uu• �fe.v:+.:•,:w iM•�•nl l/IY. .I w.n.u..l
1S. Cnn6nuation Sbeef(,) S =LL•A alraclred: O TeI O No
1a. .w...r..I.,..a M«, ✓..r.w u.ac
�,w,.rU rr/•.,.,,,�4rMy.rb...w...u.+J+►...maw 9igwalYre:etw. .w a;.M or "1 on N... .... rM
..n.,«.nyi..w.,We... r�ra+brr�q..N Hw.w.w raw Mime:
Ir YI C. Int ru...+.ay. wl w .w.N w n. rr.e•...
�•�/wa.a y wwlJw V,hl�....r rwr s••...f,J,w Tide-
a4.Ar o.wa hlr.00 W M..,q u.I P•,er/.. .w.,
....� sweww.r.,..,..trr.or....«u.r•.. TefepAowealo: Oats:
' A.wAr(,.I lr twrJ e.r.wa,wli.w
fW,.r law.lY
]DISCLOSURE OF LOBBYING ACTIVITIES
CONTiNUXYION SHEET
• ►aft of
i
I •
. t
e.L111C OCD[1 1MM1{;II/py1{;MN.11.{; aal.r:al I�lad tep�1.�G,.
C 1 1„11 11fIK1� aS 111M1{,111►11• IIWrt Iw ILIA
t1{:N1M•fel l-01{;1770.114-f 7a1641.r.;Ilq.
eDhil IK;,111'77{;Ia1e 11d:7MI.O
C. K.1118i1{;l7ay l�S N1"I.C•.VISA/.
7111714UM 1•/p.prC 1111K1- 737E
c au.71K Mara{
er
INSTRUCTIONS FOR COMPLETION OF SF•LLrDISCLOS0ftE OF LOBBYING ACTIVITIES
This disclosure farm shah Ile cnmPle:eel by i110''po41ing entity,whether subawardee to prime federal rrripiwn, at its,
Initiation or receipt of a svvered federal action, or a material change to a Previous jding, pursuant to Idle 11 IL1.C.
Section 11SI.The Oiling of a torn is required fa ach Payment or agreement to make payment to any lobbying entity for
influencing or ifeemp6ns to influence an officer or employee of any agency, a haembet of Congress. an officer or
employee of Congress, or an employee of a Member of Congress in eOnnettion wish a covered Federal action. Use the
SF•l lot both boninu initial
Sheet for additions infonnnion it the space on :he form is inadequate. Complete all items that
Apply osh the at iial filing and material change report.[tier to the implementing guidance published by the O19ce of
h(anagement and Budget for additional Inform Won.
1. Identify the I)•pe of covered federal action for which lobbying activity h and'ur hat been secured so influwite the
outcome Alfa covered federal action.
L Identify the status of Ike covered federal action,
3, identify the appropriate a omed.enter
of eNs tepurs. It dws is a fonowvp'court caused by a material change to tilt
infomution previously reposed,enter the Veit and quaver in which the change occurred.Enter the sate of the last
• previously submitted report by this reponing eruity for this covered Federal aedon.
1, Enter the full tarns. address, city, state and tip emde of the ppenin entity. Include Congressional Dislrirt. i/
lwawn.Check the Appropriate
classification of rh.reporting entity that designates if it it, or expects to be,a prime
or subiward recipient.identify the tier of tin suluwudre. e.g. the Gril subawardee of the prime isahe lU lirrt.
Subawsrds Lntlude but are not limited to subumarit.subgranu and contract awards under grants. '
S. If the organitatfon Cling(he repen in item a fll f Ls•11ohawardee',then enter the (tell name,address,city, stab.A+I
sap code of the prime Federal fecfp)ent•Include(.felt Tonal Diur)ct.it own.
,6 Enter the items of the Federal agency making riot Award or loan commitment. Include at least one ogatuati,ul
level below agency name,if known. for example.Department of Transportation,United Stiles Coast Guard.
7. Enter the Federal program name or description lot the covered Federal anion (item 1). If known. enter tilt full
Catalog of Federal Domestic Mtistance (CFDAt number for grants, cooperative agreements, loans-, and Ian commitments.
B. Enter the most apProPrisre Federal identifying number available for the Federal aClfon identified in item 1 (e.g.
Request lot Proposal OFF) number, Invitation (m Uid (IFS) number. grant announcement number the eoniracL
grant, or loan award number: the appl:catioNpropual control number assigned by the Federal agency). Include
prefises, e.g..'RFP•DE•90.001.'
.I 9. For a covered Federal action where there has been an award or Ian commitment by the federal agency,tract the
Federal amount of the awarddoan commitment for the prime entity identified in item 1 Or S.
10. (a)Enter the lull name. addresL city, stare antl rip
identified in ite code of the lobbyists entity misled by the reporting entity
idemm 1 to infl.-emce the covered Federal action. '
(blEnter the full names cif the individuals) pedarming services. and include full address if different from 10 (a),
Enter Last Name, First Name, and Middle Initial(hil),
11. Enter the amount of compensation paid or reasonably eepeeled to be paid by the reporting entity(item a) to the
lobbying entity filtm 1c). Indicate whether the payment his been made (actual)or will be made (planned), Check
all boxes. that apply. If [hit$ a material change report. enter the cumulative amount of payment made. of panned
to be made.
1
11. Check the appropriate boxiest. Check all Botts that apply, If payment is made through an in-Und eontributiun,specify the nature and value of the in-kind pa)nnent. '
0. Check:he appropriate bevies). Check all bowel that apply. If o:har, specify alwe.
11. Provide a specific and detailed description of the senicts that the lobbyist has performed, or will be expected to
Perform.and the date(s)of any services rendered.Include all preparatory and related activity, not just time spent in
actual contact with federal officials. Idenlily the federal alficiala) in
employee(s) contacted or the ofticedt).
IllnP(oyce(s),or Membeds)of Congress that weft C.onaeted.
1S. Chtek'wllalher or not a SF•LLL•A Continuation Sheet(s)it attached.
16. The ctmihing c(li shall sign and date the fomv,prim,his,ker name,tille,and telephone number. '
P
ublic mp•en,ng bwrdrh lot this collection of,nlo,madnn is eumsttJ 10 aveu a 10 min
- clio•s,,rar[hmg eaillina dau towers.gathering and mrin'Jinin 1 ftecitr1r[I pt1 r[spOmr,in[ludiAS time fa rniewtng
nSrnJ cemmmn rtgud:.g the 8mden eu,mare a shy Otherr�upecl to dui cWrcUOn 01lnfarrytioning and ,4uhrdwq suer Lionsp duca•6 ih:l buMtn,10 the Col-te of Msnagrment and Iwh"IfApen.04 Redwetion/rojeea(0)46•0046),w•asMnpon O.C.7050E
I
� '
, ,
� '
I '�
� ,
� `,.
i ,.
,,
I� ,_
f ;'
, ;
� -
i '.
� -„
I
r ,
i
� -
f(
is
I
>; .
�.> %' ':
<`
� i i s
{ 7
k .. . ''�