08-1215_ORANGE, COUNTY OF_Agreementi
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Exhibit B of ASR
2 AGREEMENT TO TRANSFER FUNDS
3 FOR 2008 EMERGENCY MANAGEMENT PERFORMANCE GRANT PROGRAM
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5 THIS AGREEMENT is entered into this day of Der—, 200,3. which date is
6 enumerated for purposes of reference only, by and between the COUNTY OF ORANGE, a political
7d_ ision f the State of California, hereinafter referred to as "COUNTY", and
8 n municipal corporation, hereinafter referred to as
9 "SUBGRANTEE."
10 WHEREAS, COUNTY, acting through its Sheriff -Coroner Department, hereinafter referred to
1 I as SHERIFF, in its capacity as the lead agency for the Operational Area, has applied for, received and
12 accepted the Emergency Management Performance Grant from the Governor's Office of Emergency
13 Services (hereinafter referred to as "the grant").
14 WHEREAS, the purpose of the grant is to support comprehensive emergency management at
15 the state, tribal and local levels and to encourage the improvement of mitigation, preparedness, response
16 and recovery capabilities for all hazards, as set forth in Attachment A hereto (08 EMPG Program
17 Narrative), which is attached hereto and incorporated herein by reference.
18 NOW, THEREFORE, IT IS MUTUALLY AGREED AS FOLLOWS:
19 1. COUNTY shall transfer to SUBGRANTEE grant funds, in arrears, as necessary to
20 reimburse SUBGRANTEE for reasonable and permissible expenditures for the grant purposes. In order
21 to obtain grant funds, SUBGRANTEE shall comply with the instructions and submit to SHERIFF all
22 required information and documentation, as set forth in Attachment B (EMPG City Application) hereto,
23 which is attached hereto and incorporated herein by reference.
24 2. Throughout their useful life, SUBGRANTEE shall use grant property and equipment
25 only for grant purposes in accordance with Attachment A hereto.
26 3. SUBGRANTEE shall exercise due care to preserve and safeguard grant property and
27 equipment from damage or destruction and shall provide regular maintenance and such repairs for grant
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shmilr 2008 Page 1 e174
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Exhibit B of ASR
property and equipment as are necessary, in order to keep said grant property and equipment
I continually in good working order.
S. If grant property or equipment becomes obsolete, SUBGRANTEE shall dispose of it
only in accordance with the instructions of COUNTY or the agency from which COUNTY received the
grant funds.
6. SUBGRANTEE shall submit to the COUNTY grant program reporting documents and
information in accordance with requirements set out in the Attachment C (Emergency Management
Performance Grant Program: Recipient Subgrant Guide for Local Governments Fiscal Year 2008),
which is attached hereto and incorporated herein by reference.
7. By executing this Agreement, SUBGRANTEE agrees to comply with and be fully
bound by this Agreement and all applicable provisions of Attachments A, B, and C hereto.
SUBGRANTEE shall notify COUNTY immediately upon discovery that it has not abided or no longer
will abide by any applicable provision of this Agreement or Attachments A, B, or C hereto.
8. SUBGRANTEE and COUNTY shall be subject to examination and audit by the State
Auditor General with respect to this Agreement for a period of three years after final payment
I hereunder.
9. SUBGRANTEE agrees to indemnify, defend and save harmless COUNTY and the
agency from which COUNTY received grant funds, and their elected and appointed officials, officers,
agents and employees from any and all claims and losses accruing or resulting to any and all contractors,
subcontractors, laborers, and any other person, firm or corporation furnishing or supplying work,
services, materials or supplies in connection with SUBGRANTEE's performance of this Agreement,
including Attachments A, B, and C hereto, and from any and all claims and losses accruing or resulting
to any person, firm, or corporation who may be injured or damaged by SUBGRANTEE in the
performance of this Agreement, including Attachments A, B, and C hereto.
10. No alteration or variation of the terms of this Agreement shall be valid unless made in
writing and signed by duly authorized representatives of the parties hereto, and no oral understanding or
agreement not incorporated herein shall be binding on any of the parties hereto.
Sheriff 2008
Page 2 of 4
Page 2 of 80
Exhibit B of ASR
1 11. SUBGRANTEE may not assign this Agreement in whole or in part without the express
2 written consent of COUNTY.
3 12. For a period of three years after final payment hereunder or until all claims related to
4 this Agreement are finally settled, whichever is later, SUBGRANTEE shall preserve and maintain all
5 documents, papers and records relevant to the work performed or property or equipment acquired in
6 accordance with this Agreement, including Attachments A, B, and C hereto. For the same time period,
7 SUBGRANTEE shall make said documents, papers and records available to COUNTY and the agency
8 from which COUNTY received the grant funds or their duly authorized representative(s), for
9 examination, copying, or mechanical reproduction on or off the premises of SUBGRANTEE, upon
10 request, during usual working hours.
11 13. SUBGRANTEE shall provide to COUNTY all records and information requested by
12 COUNTY for inclusion in quarterly reports and such other reports or records as COUNTY may be
13 required to provide to the agency from which COUNTY received grant funds or other persons or
14 agencies.
15 14. COUNTY may terminate this Agreement and be relieved of the payment of any
16 consideration to SUBGRANTEE if a) SUBGRANTEE fails to perform any of the covenants contained
17 in this Agreement, including the applicable terms of Attachments A, B, and C hereto, at the time and in
18 the manner herein provided, or b) COUNTY loses funding under the grant. In the event of termination,
19 COUNTY may proceed with the work in any manner deemed proper by COUNTY.
20 15. SUBGRANTEE and its agents and employees shall act in an independent capacity in the
21 performance of this Agreement, including Attachments A, B, and C hereto, and shall not be considered
22 officers, agents or employees of COUNTY or SHERIFF or of the agency from which COUNTY
23 received grant funds.
24 //
25 //
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Sheriff 2009 Page 3 of 4
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Exhibit B of ASR
IN WITNESS WHEREOF, the parties have executed this Agreement in the County of Orange,
State of California.
DATED:.2009 COUNTY OF ORANGE, a political
subdivision of the State of California
By
Sheri -Conine
"C '
APPROVED AS TO FORM:
COUNTY COUNSEL
By (—;eZ G�
Nicole A. Sims, Deputy
DATED: 2- 200
DATED: l2 �`� ,200 g SUBGRANTEE: G'�T� oF-r'4rt/Jdg,t/C��sT��b
�o✓E�� Gi�6�11
ATTEST: /
Approved as to form:
Zvwjm &m' n —
Omar Sandoval, City Attorn
swfr2008
Page 4 of4
TED: �a -�S .2006
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174
ATTACHMENT A
Exhibit B of ASR
FY 08 EMPG PROGRAM NARRATIVE
Overview:
The Orange County Operational Area's (OCOA) mission is to promote, facilitate, and support
the County and the Operational Area efforts to prevent, prepare for, respond to, recover from and
mitigate all hazards with the potential to affect the Orange County area. The OCOA works to
promote a progressive inclusive emergency management program. Funds provided under the
EMPG will be used to support activities that contribute to the OCOA's mission.
GOAL/
ACTIVITY
MILESTONES
OBJECTIVE
A2
Communicate and collaborate on local
Participate in monthly Orange County
emergency management, planning, and
Emergency Management Organization
partnerships.
meetings, facilitate quarterly Orange
County Operational Area Executive
Board meetings, and participate in
functional local emergency planning
subcommittee meetings.
A5
Support regional emergency
Build the Orange County WebEOC
management capabilities and
network with local jurisdictions as
infrastructure.
partners to allow access to Cities,
County Agencies, School Districts and
Special Districts; and develop a
Memorandum of Understanding with
the four lead agencies involved with
WebEOC.
Bi
Integrate the National Incident
Produce NIMS compliant plans and
Management System (NIMS), National
procedures and integrate the NRF and
Response Framework (NRF), and the
NPGs into theses plans and procedures.
National Preparedness Goal (NPG)
with emergency lans and procedures.
B3
Support local and regional risk
Coordinate and participate in regional
assessment and hazard mitigation
planning meetings regarding risk
planning.
assessments and hazard mitigation;
initiate the update of existing hazard
mitigation plans.
C2
Ensure compatible emergency
Continue working on a solution for
management communications systems
mass notification for community
with Operational Area (OA) partners.
members and rapid notification systems
for emergency responders, develop
policies and procedures for both mass
notification and responder notifications,
and develop a user manual for WebEOC
for OA partners.
Page 5 of 80
E
ATTACHMENT A
Ci
Exhibit B of ASR
GOAL/
ACTIVITY
MILESTONES
OBJECTIVE
D3
Operational Area training and exercises
Conduct an annual Operational Area
will address critical areas for
Exercise, conduct regular EOC training,
emergency planning and preparedness.
host State offered training, and
administer NIMS training.
D4
Support public education for residents,
Conduct public education presentations
local government leadership, and the
for residents, local government
private sector regarding hazards and
leadership, and the private sector
emergency preparedness.
regarding hazards and emergency
preparedness, represent the emergency
management community at community
events, and work with the media to
produce positive emergency
preparedness coverage.
El
Ensure emergency management
Invite Cities within Orange County to
funding will be effective and equitably
be partners in preparedness by passing
distributed.
through EWG grant funds for those
agencies meeting the grant guidance and
reuirements.
Page 6 of 80
ATTACHMENT B
Exhibit B of ASR
FY08 Emergency Management Performance Grant
City Application Cover Sheet
Applicant (City):
Authorized Agent Information:
Name of Authorized Agent
Mailing Address
City, State, Zip Code
Contact Information:
Name of grant contact person
Contact Email Address
Contact Phone Number
Maximum EMPG Amount Authorized (from Allocation Sheet)
Total Amount Requested from Budget Worksheet
Application Checklist — All items below must be attached to this coversheet
❑ EMPG Application Form
❑ Project Goals & Objectives
❑ Budget Sheet (50150 Match)
❑ City Council Resolution
❑ Grant Assurances
Statement of Certification — City Authorized Agent
By signing below, ! hereby certify that 1 am the duly appointed Authorized Agent and have the
authority to apply for the FY 2008 Homeland Security Grant Program, and the City's
application represents the needs for the Emergency Management Performance Grant.
Signature of Authorized Agent
Title
Printed Name
Date
Page 7 of 80
ATTACHMENT B
Exhibit B of ASR
Emergency Management Performance Grant Application Form
For the Period October 1, 2007 — June 30, 2009
Federal Fiscal Year 2008
It is hereby agreed that the City of
shall meet the following requirements to receive an
Performance Grant for the Federal Fiscal Year 2008:
To receive 100% of your city's allocated funds you must complete all of the Items below.
Completion of Items #1 & #2 entities the city to 50% grant funding, item #3, 25% and
item #4, 25 %.
1. A city representative will attend at least six of the 12 OCEMO meetings per year.
2. The city will activate its EOC this year for an exercise, unless it is activated for an
actual emergency.
3. The city will participate in the Operational Area functional exercise this year by:
❑ Activating their City EOC.
❑ Providing staff to support the OA EOC.
❑ Provide staff to another City's EOC.
J 4. A city representative will participate in one of the OCEMO subcommittees as chair,
l co-chair or active member.
Note: The City will receive a per capita allocation of the total funds available to cities,
dependent upon the number of cities that are participating in the EMPG funding
program. The city will complete the Orange County Operational Area EMPG Activities
Certification Form which must be attested to by the City Manager or designee.
City Manager Signature:
Date:
Page 8 of 80
• ATTACHMENT B •
Exhibit B of ASR
2008 EMPG Project Goals & Objectives
Applicant Name:
Operational Area Goals:
1. Communicate and collaborate on local emergency management, planning, and
partnerships.
2. Support regional emergency management capabilities and infrastructure.
3. Integrate the National Incident Management System (NIMS), National Response
Framework (NRF), and the National Preparedness Goal (NPG) with emergency plans
and procedures.
4. Support local and regional risk assessment and hazard mitigation planning.
5. Ensure compatible emergency management communications systems with Operational
Area (OA) partners.
6. Operational Area training and exercises will address critical areas for emergency
planning and preparedness.
7. Support public education for residents, local government leadership, and the private
sector regarding hazards and emergency preparedness.
8. Ensure emergency management funding will be effective and equitably distributed.
Applicant Goals:
Protect #1
Goal
Objectives
Description:
Performance Measures:
Pro ect #2
Goal
Objectives
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ATTACHMENT B
Description:
Performance Measures:
Pro et #3
Goal
Objectives
Description:
Performance Measures:
Pro ect #4
Goal
Objectives
Description:
Performance Measures:
Proect #5
Goal
Objectives
Description:
Performance Measures:
Exhibit B of ASR
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ATTACHMENT B Exhibit B of ASR
Governing Body Resolution
BE JT RESOLVED BYTHE
(Gowning Body)
OF THE THAT
(Name of Applioad)
OR
(Name orTitle of Audwdwd Agee)
OR
(Name orraic of Audwodwd Agent)
(Name of Title of Audwdmd Agent)
is hereby authorized to execute for and on behalf of the named applicant, a public entity established under
the laws of the State of California, any actions necessary for the purpose of obtaining federal financial
assistance provided by the federal Department of Homeland Security and subgranted through the State of
California.
Passed and approved this day of 20
Certificaden
duly appointed and
of the
(fide) (Gomnins Bwy)
do hereby certify that the above is a true and correct copy of a resolution passed and approved by
the of the on the
(Gomning awy) (Nome of Applicant)
day of 20—.
(oineial position)
(signadne)
Page 11 of 80
ATTACHMENT B
FY08 Emergency Management Performance Grant Exhibit B of ASR
Assurances, Certifications, Terms, and Conditions
ASSURANCES
The applicant hereby assures and certifies compliance with all applicable Federal statutes,
regulations, policies, guidelines, and requirements, including OMB Circulars A-87, A-102, A-
133; Executive Order 12372 (intergovernmental review of federal programs); and 28 C.F.R. pts.
66 (administrative requirements for grants and cooperative agreements). The applicant also
specifically assures and certifies that:
1. It has the legal authority to apply for federal assistance and the institutional, managerial, and
financial capability (including funds sufficient to pay any required non-federal share of project
cost) to ensure proper planning, management, and completion of the project described in this
application.
2. It will establish safeguards to prohibit employees from using their positions for a purpose that
constitutes or presents the appearance of personal or organizational conflict of interest, or
personal gain.
3. It will give the awarding agency, the General Accounting Office, or the State of California,
through any authorized representative, access to and the right to examine all paper or
electronic records related to the financial assistance, and will establish a proper accounting
system in accordance with generally accepted accounting standards or agency directives.
4. It will comply with all lawful requirements imposed by the awarding agency, specifically
including any applicable regulations, such as 28 C.F.R. pts. 18, 22, 23, 30, 35, 38, 42, 61, and
63.
5. It will assist the awarding agency (if necessary) in assuring compliance with section 106 of the
National Historic Preservation Act of 1966 (16 U.S.C. § 470), Executive Order 11593
(identification and protection of historic properties), the Archeological and Historical
Preservation Act of 1974 (16 U.S.C. § 469 a-1 et seq.), and the National Environmental Policy
Act of 1969 (42 U.S.C. § 4321).
6. It will comply (and will require any subgtantees or contractors to comply) with any applicable
statutorily -imposed nondiscrimination requirements, which may include the Omnibus Crime
Control and Safe Streets Act of 1968 (42 U.S.C. § 3789d); the Victims of Crime Act (42
U.S.C. § 10604(e)); The Juvenile Justice and Delinquency Prevention Act of 2002 (42 U.S.C.
§ 5672(b)); the Civil Rights Act of 1964, as amended (42 U.S.C. § 2000d); the Rehabilitation
Act of 1973 (29 U.S.C. § 7 94); the Americans with Disabilities Act of 1990 (42 U.S.C. §
12131-34); the Education Amendments of 1972 (20 U.S.C. §§ 1681, 1683, 1685-86); and the
Age Discrimination Act of 1975 (42 U.S.C. §§ 6101-07); see Ex. Order 13279 (equal
protection of the laws for faith -based and community organizations).
7. It will comply with the requirements of the Uniform Relocation Assistance and Real Property
Acquisitions Act of 1970 (42 U.S.C. § 4601 et seq.), which govern the treatment of persons
displaced as a result of federal and federally -assisted programs;
Page 12 of 80
• •
ATTACHMENT B
8. It will comply with requirements of 5 U.S.C. §§ 1501-08 and §§ 7324-28, whicMigaWR
political activities of State or local government employees whose principal employment is in
connection with an activity financed in whole or in part by federal assistance.
9. It will initiate and complete the work within the approved performance period after receipt of
approval of the State of California.
10. It will comply with Standardized Emergency Management (SEMS) requirements as stated in
the California Emergency Services Act, Government Code, Chapter 7 of Division 1 of Title 2,
Section 8607.1(e) and CCR Title 19, Sections 2445, 2446, 2447, and 2448.
11. It has complied with Homeland Security Presidential Directive #5, dated February 2003 which
directed the establishment of a nationwide incident management system for all hazards, which
is the National Incident Management System, or NIMS, and will continue to comply each
year. Current compliance includes integration of NIMS into training, preparedness, and
emergency plans.
12. It has requested through the State of California, federal financial assistance to be used to
perform eligible work approved in the applicant's application for federal assistance. It will
after the receipt of federal financial assistance, through the State of California, agree to the
following:
a. To return to the State of California such part of the funds so reimbursed pursuant to the
above numbered application, which are excess to the approved actual expenditures.
b. In the event the approved amount of the above numbered project application is reduced, the
reimbursement applicable to the amount of the reduction will be promptly refunded to the
State of California.
13. In general, grantees are not required to comport with the restrictions of the Buy American Act
(41 U.S.C. 10a). However, grants authorized under the Stafford Act, including the EMPG
program, must follow these standards. The Buy American Act requires that all materials
purchased be produced in the United States, unless such materials are not available, or such a
purchase would not be in the public interest.
CERTIFICATIONS
Applicants should refer to the regulations cited below to determine the certification to which they
are required to attest. Applicants should also review the instructions for certification included in
the regulations before completing this form. Signature of this form provides for compliance with
certification requirements under 28 CFR Part 69, "New Restrictions on Lobbying" and 28 CFR
Part 67, "Government -wide Debarment and Suspension (Non -procurement) and Government -
wide Requirements for Drug- Free Workplace (Grants)." The certifications shall be treated as a
material representation of fact upon which reliance will be placed when the State of California
determines to award the covered transaction, grant, or cooperative agreement.
1. LOBBYING: As required by Section 1352, Title 31 of the U.S. Code, and implemented at 28
CFR Part 69, for persons entering into a grant or cooperative agreement over $100,000, as
defined at 28 CFR Part 69, the applicant certifies that:
Page 13 of 80
2.
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ATTACHMENT B
(a) No Federal appropriated funds have been paid or will be paid, by or on behAlM"gof ASR
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
an employee of a Member of Congress in connection with the making of any Federal
grant, the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal grant 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 grant or cooperative agreement, the undersigned
shall complete and submit Standard Form - LLL, "Disclosure of Lobbying Activities," in
accordance with its instructions found at www.whitchouse.gov/ombtgmnts.
(c) The undersigned shall require that the language of this certification be included in the
award documents for all subawards at all tiers (including subgrants, contracts under grants
and cooperative agreements, and subcontracts) and that all sub -recipients shall certify and
disclose accordingly.
As required by Executive Order 12549, Debarment and Suspension, and implemented at 28
CFR Part 67, for prospective participants in primary covered transactions, as defined at 28
CFR Part 67, Section 67.510
A. The applicant certifies that it and its principals:
(1) Are not presently debarred, suspended, proposed for debarment, declared ineligible,
sentenced to a denial of Federal benefits by a State or Federal court, or voluntarily
excluded from covered transactions by any Federal department or agency;
(2) Have not within a three-year period preceding this application been convicted of or had
a civil judgment rendered against them for commission of fraud or a criminal offense
in connection with obtaining, attempting to obtain, or performing a public (Federal,
State, or local) transaction or contract under a public transaction; violation of Federal
or State antitrust statutes or commission of embezzlement, theft, forgery, bribery,
falsification or destruction of records, making false statements, or receiving stolen
property,
(3) Are not presently indicted for or otherwise criminally or civilly charged by a
governmental entity (Federal, State, or local) with commission of any of the offenses
enumerated in paragraph (A)(2) of this certification; and
(4) Have not within a three-year period preceding this application had one or more public
transactions (Federal, State, or local) terminated for cause or default; and
B. Where the applicant is unable to certify to any of the statements in this certification, he or
she shall attach an explanation to this application.
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ATTACHMENT B
3. CERTIFICATIONS REGARDING LOBBYING: DEBARMENT, SUSPENSI6O.' ASR
OTHER RESPONSIBILITY MATTERS: AND DRUG FM WORKPLACE
REOUIREMENT: This certification, which is a required component of the on-line
application, commits the applicant to compliance with the certification requirements under 28
CFR part 67, Government -wide Debarment and Suspension (Non procurement); 28 CFR part
69, New Restrictions on Lobbying; and 28 CFR part 83 Government -wide Requirements for
Drug -Free Workplace (Grants). All of these can be referenced at:
httn:ilwww.access.gpo.govinam/cfr/waisidx 04/28cfv2 04.htm1.
4. SWEATFREE CODE OF CONDUCT:
a. All applicants contracting for the procurement or laundering of apparel, garments or
corresponding accessories, or the procurement of equipment, materials, or supplies, other
than procurement related to a public works contract, declare under penalty of perjury that
no apparel, garments or corresponding accessories, equipment, materials, or supplies
furnished to the state pursuant to the subgrant have been laundered or produced in whole or
in part by sweatshop labor, forced labor, convict labor, indentured labor under penal
sanction, abusive forms of child labor or exploitation of children in sweatshop labor, or
with the benefit of sweatshop labor, forced labor, convict labor, indentured labor under
penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor.
The applicant further declares under penalty of perjury that they adhere to the Sweatfree
Code of Conduct as set forth on the California Department of Industrial Relations website
located at www.dir.ca.gov, and Public Contract Code Section 6108.
b. The applicant agrees to cooperate fully in providing reasonable access to the applicant's
records, documents, agents or employees, or premises if reasonably required by authorized
officials of the contracting agency, the Department of Industrial Relations, or the
Department of Justice to determine the contractor's compliance with the requirements
under paragraph (a).
5. DOMESTIC PARTNERS: For subgrants executed or amended after July 1, 2004, the
applicant may elect to offer domestic partner benefits to the applicant's employees in
accordance with Public Contract Code section 10295.3. However, the applicant cannot
require an employee to cover the costs of providing any benefits which have otherwise been
provided to all employees regardless of marital or domestic partner status.
TERMS AND CONDITIONS
The following laws apply to persons or entities doing business with the State of California.
1. CONFLICT OF INTEREST: Applicant needs to be aware of the following provisions
regarding current or former state employees. If subgrantee has any questions on the status of
any person rendering services or involved with the Agreement, the awarding agency must be
contacted immediately for clarification.
Current State Employees (Public Contract Code §10410):
1) No officer or employee shall engage in any employment, activity or enterprise from which
the officer or employee receives compensation or has a financial interest and which is
sponsored or funded by any state agency, unless the employment, activity or enterprise is
required as a condition of regular state employment. page 16 of 80
ATTACHMENT B
2) No officer or employee shall contract on his or her own behalf as an indeperIMpLAMP&
with any state agency to provide goods or services.
Former State Employees (Public Contract Code §10411):
1) For the two-year period from the date be or she left state employment, no former state
officer or employee may enter into a contract in which he or she engaged in any of the
negotiations, transactions, planning, arrangements or any part of the decision-making
process relevant to the contract while employed in any capacity by any state agency.
2) For the twelve-month period from the date he or she left state employment, no former state
officer or employee may enter into a contract with any state agency if he or she was
employed by that state agency in a policy-making position in the same general subject area
as the proposed contract within the 12 -month period prior to his or her leaving state
service.
If applicant violates any provisions of above paragraphs, such action by applicant shall
render this Agreement void. (Pub. Contract Code § 10420)
Members of boards and commissions are exempt from this section if they do not receive
payment other than payment of each meeting of the board or commission, payment for
preparatory time and payment for per diem. (Pub. Contract Code § 10430 (e))
2. LABOR CODE/WORKERS' COMPENSATION: Applicant needs to be aware of the
provisions which require every employer to be insured against liability for Worker's
Compensation or to undertake self-insurance in accordance with the provisions, and applicant
affirms to comply with such provisions before commencing the perfomtance of the work of
this Agreement. (Labor Code Section 3700)
3. AMERICANS WITH DISABILITIES ACT: Applicant assures the State that it complies with
the Americans with Disabilities Act (ADA) of 1990, which prohibits discrimination on the
basis of disability, as well as all applicable regulations and guidelines issued pursuant to the
ADA. (42 U.S.C. 12101 et seq.)
4. APPLICANT NAME CHANGE: An amendment is required to change the applicant's name
as listed on this Agreement. Upon receipt of legal documentation of the name change the
State will process the amendment. Payment of invoices presented with a new name cannot be
paid prior to approval of said amendment.
5. RESOLUTION: A county, city, district, or other local public body must provide the State
with a copy of a resolution, order, motion, or ordinance of the local governing body which by
law has authority to enter into an agreement, authorizing execution of the agreement.
6. AIR OR WATER POLLUTION VIOLATION: Under the State laws, the applicant shall not
be:
(1) in violation of any order or resolution not subject to review promulgated by the State Air
Resources Board or an air pollution control district;
(2) subject to cease and desist order not subject to review issued pursuant to Section 13301 of
the Water Code for violation of waste discharge requirements or discharge prghi tti9nof ff
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ATTACHMENT B
(3) finally determined to be in violation of provisions of federal law relating to 6yI#,&SR
pollution.
Failure to comply with these requirements may result in suspension of payments under the
Agreement or termination of the Agreement or both and applicant may be ineligible for award of
any future State agreements if the department determines that any of the following has occurred:
the applicant has made false certification, or violated the certification by failing to carry out the
requirements as noted above. (Gov. Code §8350 et seq.)
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly
authorized to legally bind the prospective jurisdiction to the assurances and certifications listed
above.
Jurisdiction (Printed)
By (Authorized Signature)
Printed Name and Title of Person Signing
11 Date Executed
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