Loading...
HomeMy WebLinkAbout2003-231 Contract - DA Boldt ConstructionCITY OF dkSHLAND CITY OF ASHLAND (CITY) 20 East Main Street Ashland, Oregon 97520 Telephone: (541) 488-5350 FAX: (541) 488-5311 CONTRACT FOR WORK LESS THAN $25,000 CONTRACTOR: D.A. Boldt Construction Co Address: PO Box 998, Ashland, OR 97520 Telephone: 482-4865 FAX:482-7190 DATE OF AGREEMENT: 18 Dec 03 BEGINNING DATE FOR WORK: 22 Dec 03 COMPENSATION: $14388.00 COMPLETION DATE: 20 Feb 04 WORK TO BE PROVIDED: Remodel existing two restrooms to create two new ADA compliant restrooms. See detail in proposal. ADDITIONAL TERMS: See attached CDBG Agreement for Public Improvement Projects. Compensation does not include labor and materials for repairs to floor system that may be necessary as a result of water intrusion. CITY AND Contractor AGREE: 1. All Costs by Contractor: Contractor shall, at its own risk and expense, perform the work described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such work. 2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that all personnel assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and workerlike manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also maintain a current City business license. 3. Completion Date: Contractor shall start performing the work under this contract by the date indicated above and complete the work by the completion date indicated above. 4. Compensation: City shall pay Contractor for work performed, including costs and expenses, the sum specified above. Once work commences, invoices shall be prepared and submitted by the tenth of the month for work completed in the prior month. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated payments will be made for work completed and accepted to date of termination. Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00 and City shall not be obligated to pay any sum in excess of $25,000.00 unless a separate written contract is entered into by City. 5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of City. 6. Statutory Requirements: ORS 279.312,279.314,279.316 and 279.320 are made part of this contract. 7. Livin.q Wage Requirements: If the amount of this contract is $15,713 or more, and Contractor is not paying prevailing wage for the work, Contractor must comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor who performs 50% or more of the work under this contract. Contractor must post the attached notice predominantly in areas where it will be seen by all employees. 8. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death,) or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract by Contractor (including but not limited to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this contract.) Contractor shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and approximately caused by the negligence of City. 9. Termination: This contract may be terminated by City by giving ten days written notice to Contractor and may be terminated by Contractor should City fail substantially to perform its obligations through no fault of Contractor. 10. Independent Contractor Status: Contractor is an independent contractor and not an employee of the City. Contractor shall have the complete responsibility for the performance of this contract. Contractor shall provide workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to this contract and prior to commencing any work, Contractor shall provide City with adequate proof of workers' compensation coverage. Contractor is a subject employer that will comply with ORS 656.017. 11. Insurance: Contractor shall, at its own expense, at all times during the term of this agreement, maintain in force a comprehensive general liability policy including coverage for contractual liability for obligations assumed under this Contract, blanket contractual liability, products and completed operations, owner's and contractor's protective insurance and comprehensive automobile liability including owned and non-owned automobiles. The liability under each policy shall be a minimum of $500,000 per occurrence (combined single limit for bodily injury and property damage claims) or $500,000 per occurrence for bodily injury and $100,000 per occurrence for property damage. Liability coverage shall be provided on an "occurrence" not "claims" basis. The City of Ashland, its officers, employees and agents shall be named as additional insureds. Certificates of insurance acceptable to the City shall be filed with City's Risk Manager prior to the commencement of any work by Contractor under this agreement. These certificates shall contain provision that coverages afforded under the policies can not be canceled and restrictive modifications cannot be made until at least 30 days prior written notice has been given to City. 12. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them, and the approval by City of any assignment or subcontract shall not create any contractual relation between the as, si,g,nee or subco.~actor and City. CONTRACTOR ~' OF C/ND. ~~ ' - City Adi'ninistrator TITLE ~r"'~/.~.9 /~/'.z-. ¢,t~ ~ Or BY Finance Director DATE CONTENT REVIEW DATE / J/.T),CE.,¢ ~ PURCHASE ORDER# # ~10.O1~.~. (:X:~. ACCOUNT (for City purposes only) CITY OF ASHLAND WORK CONTRACT<S25,000 (contract for work form 10-02,2. doc.docdoc) NOV 04 2003 IO:O?RH HP LRSERJET 3200 P.O. Box 99&, A.~HLAND. OR£CON 97520, 541/4~2-4,~65 FAX: 54 I}482-7190 · DASOLDT@FIIND.NET November 4, 2003 Dale Peters City of Ashlan~ Project: Pioneer Hall Restroom Remodel Ashland, Oregon Scope of Project: Ranodd e~t~In~ ~ s~l r~roo~ to crmt~ m,w r~troom R~move sinks and toilets of two e~fsting resiroom Modify wall framing per d~wings Modify ptm'abing lines for new restroom fixtures and install fixtures Provide and install door locksets Remove, salvage and reinstall door trim and base Provide and install new lx6 door trim and base molding as nece~ary Install and finish 5/8'* she~ock for drywall with smooth finish Patch drywall where necessary Pa~t walls and ceilings ~ Stain and seal nvw wood work Plumbing fxxUges and faucets Electrical wiring arsd fmtures and installation of such Toilet partitions and installation Restroom door closures and instaIlatJon Floor covering and installation Proposal does not include material or labor for repa~ to the floor system that may be necessary as a result ofvrater intrusion. Total cost: $14,388.00 Includes an allowance of $120.00 for door locksets and hardware Darrell A, Boldt Presidem City of As d per hour effective June 30, 2003 Increases annually every June 30 by the Consumer Price Index) For all hours worked under a service contract between their employer and the City of Ashland if the contract exceeds $15,713 or more. For all hours worked in a month if the employee spends 50% or more of the employee's time in that month working on a project or portion of business of their employer, if the employer has ten or more employees, and has received financial assistance for the project or business from the City of Ashland in excess of $15,713. If their employer is the City of Ashland including the Parks and Recreation Department. In calculating the living wage, employers may add the value of health care, retirement, 401K and IRS eligible cafeteria plans (including childcare) benefits to the amount of wages received by the employee. Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall, 20 East Main Street, Ashland, OR 97520 or visit the city's website at vwvw. ashland.or.us. Notice to Employers: This notice must be posted predominantly in areas where it will be seen by all employees. CiTY OF , SHLAND SUBRECIPIENT AGREEMENT COVER SHEET WRITTEN AGREEMENT FOR PUBLIC IMPROVEMENT PROJECTS FUNDED WITH COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDS Project Title: SUBRECIPIENT Name: SUBREClPIENT Contact: Telephone Number: Address: PIOtlEER HALL RESTROOM IHPROVE,HEIIT City of Ashland Public Works Dept Dale Peters 552-2292 direct 51 Winburn Way Ashland, OR, 97520 Mailing Address: City Hall, Public Works 20 East Main Street Ashland, OR 97520 Agreement Amount: Description: $16,841 To complete the interior accessibility improvements to the Pioneer Hall Restrooms located at 73 Winburn Way. Improvements to include enlarging the restrooms by re- framing the walls, new (wider) doorways, new grab bars, new fixtures, and related plumbing and electrical work. City Contact: Brandon Goldman Telephone Number: 552.2076 CDBG Agreement for Public Improvement Projects Program Year 2003-04 Page 1 TABLE OF CONTENTS SUBRECIPIENT AGREEMENT 1. Parties 2. Term of Agreement 3. Payment Limit 4. Subrecipient's Obligations 5. City's Obligations 6. General and Special Conditions 7. Other Attachments 8. Information and Reports 9. Integration 10. Attomey Fees 11. Severability 12. Notices EXHIBIT A: SCOPE OF SERVICES EXHIBIT A-I: PROGRAM DESCRIPTION EXHIBIT 1. 2. 3. 4. 5. 6. B: EXPENDITURE, PAYMENT AND BUDGE PROVISIONS Program Expenditures Budge Revisions Unexpended Funds Payment Provisions Invoice Documentation Program Income EXHIBIT B-I: LINE ITEM BUDGET EXHIBIT C: SPECIAL CONDITIONS 1. Program Administration 2. Designated Staff 3. Reporting 4. Client Confidentiality 5. Bilingual Assistance EXHIBIT D: 1. 2. 3. 4. 5. 6. 7. GENERAL CONDITIONS Termination for Cause Termination for Convenience Enforcement and Remedies Disputes Agreement Changes Agreement Renewal Further Specifications for Operating Procedures CDBG Agreement for Public Improvement Projects Program Year 2003-04 Page 2 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 32. 33. 34. 35. Non-Discrimination and Affirmative Action Access to Records Maintenance of Records Audit Requirements Monitoring Indemnity and Hold Harmless Insurance Requirements Minimum Scope of Insurance Subcontracting and Assignment Independent Contractor Status Compliance with Laws Conflicts of Interest Agreement Administration Property Management Program Income Expiration/Reversion of Assets Oregon Law and Forum Availability of Funds Minimizing Displacement Program Access by the Disabled Publicity Lobbying Church-State Nonsubstitution for Local Funding Copyrights and Rights in Data Nonparticipation in Political Activities Real Property Acquisition Environmental Review EXHIBIT E: INVOICE FOR SERVICES EXHIBIT F: STATISTICAL REPORT EXHIBIT F-I: CDBG CLIENT/HOUSEHOLD INFORMATION FORM CDBG Agreement for Public Improvement Projects Program Year 2003-04 Page 3 CITY OF ASHLAND COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) SUBRECIPIENT AGREEMENT FOR PUBLIC IMPROVEMENT PROJECTS FUNDED WITH COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDS The parties to this Agreement agree as follows: 1. Parties. The parties to this Agreement are the CITY OF ASHLAND, OREGON (City) and the below-named Subrecipient (Subrecipient): 2. Term of Agreement. The effective date of this Agreement is December 18, 2003 and it terminates December 31, 2004 unless sooner terminated as provided in this agreement. 3. Payment Limit. City's total payments under this Agreement shall not exceed $16,841 4. Subrecipient's Obligations. Subrecipient shall provide those services and carry out that work described in the Scope of Work attached as Exhibits A and A-I. 5. City's Obligations. City shall make to the Subrecipient those payments described in the Payment Provisions and Budget attached as Exhibit B. 6. General Conditions and Special Conditions. This Agreement is subject to the Special Conditions attached as Exhibit C and the General Conditions attached as Exhibit D. 7. Other Attachments. This Agreement includes the Invoice for Services attached as Exhibit E, the Statistical Report attached as Exhibit F, and the CDBG Client/Household Information Form, attached as Exhibit F-1. 8. Information and Reports. The Agreement shall, at such time and in form as the City may require, furnish such periodic reports conceming the status of this Agreement, such statements, certificates, approvals and copies of the proposed and executed plans and claims, and other information relative to this Agreement as may be requested by the City. The Subrecipient shall furnish the City, upon request, with copies of all documents and other materials prepared or developed in relation with or as part of this Agreement. 9. Integration. This Agreement, including the attached exhibits, contains the entire agreement between the parties and supersedes all prior written or oral discussions or agreements. 10. Attorney Fees. In the event a lawsuit of any kind is instituted on behalf of the City to obtain performance of any kind under this Agreement, Subrecipient agrees to pay such additional sums as the court may adjudge for reasonable attorney fees ant to pay all costs and disbursements incurred. 11. Severability. The parities agree that if any term or provision of this Agreement is declared by a court to be illegal or in conflict with any law, the validity of the remaining terms and provisions shall not be affected. 12. Notices. Any notices, bills, invoices, or reports required by this Agreement shall be sent by the parties in the United States mail, postage paid, or personally delivered to the addresses below: CDBG Agreement for Public Improvement Projects Program Year 2003-04 Page 4 City of Ashland Contact Brandon Goldman, Assistant Planner Department of Community Development Planning Division City of Ashland 20 East Main Street Ashland, OR 97520 Subrecipient Contact Dale Peters Department of Public Works Facility Maintenance Division City of Ashland 20 East Main Street Ashland, OR 97520 SUBRECIPIENT: Date: \~ ~-~__~__~ ~)~ OF A ND: By: . Title: City Administrator Da~e: ' ~"/( CDBG Agreement for Public Improvement Projects Program Year 2003-04 Page 5 EXHIBIT A SCOPE OF SERVICES Subrecipient shall provide services described in the Project Description, Exhibit A-1. Project Description, Exhibit A-1 shall include the Subrecipient name, address, telephone number, name of contact, name of signatory officer with title and position, and a statement of work. The statement of work shall include a description of the work to be provided, the purpose and nature of the services to be provided, including where they will be offered, the specific tasks to be performed, the level of service that will be provided (must be quantifiable level of service, e.g., installation of an accessible bathroom within a public facility), and the time schedule for the performance of work with target levels of service indicated at specific points in time. Subrecipient shall ~ubmit reports as required in Special Conditions, Exhibit C and General Conditions, Exhibit D. National Objective The population (clients) benefiting from the CDBG-assisted activities must be comprised of at least 51% or more Iow to moderate-income persons as classified by the U.S. Department of Housing and Urban Development (HUD) in the table below. A Iow- to moderate-income person is defined by the HUD as a member of a family having an income equal to or less than the Iow- to moderate-income limits established by HUD in the table below. If an activity benefits a clientele who are generally presumed to be principally Iow- and moderate-income persons it is considered a presumed benefit activity. Activities that exclusively serve a group of persons in any one or a combination of the following categories may be presumed to benefit persons, 51 percent of whom are Iow and moderate income: abused children, battered spouses, elderly persons, adults meeting the Bureau of the Census' Current Population Reports definition of "severely disabled," homeless persons, illiterate adults, persons living with AIDS, and migrant farm workers. An activity, the benefits of which are available to all the residents in a particular area, where at least 51 percent of the residents are Iow- and moderate-income persons. Such an area need not be coterminous with census tracts or other officially recognized boundaries but must be the entire area served by the activity. An activity that serves an area that is not primarily residential in character shall not qualify under this criterion. An activity that serves to remove material or architectural barriers to the mobility or accessibility of elderly persons or of adults meeting the Bureau of the Census' Current Population Reports definition of "severely disabled" will be presumed to qualify under this criterion if it is restricted, to the extent practicable, to the removal of such barriers by assisting the reconstruction of a public facility or improvement. Public facilities and improvements. Acquisition, construction, reconstruction, rehabilitation or installation of public facilities and improvements, except as provided in 570.207(a), of the Community development Block Grant Entitlement Program Regulations 24 CFR 570, carried out by the recipient or other public or private nonprofit entities. Activities under this paragraph may be directed to the removal of material and architectural barriers that restrict the mobility and accessibility of elderly or severely disabled persons to public facilities and improvements, including those provided for in 570.207(a)(1).) In undertaking such activities, design features and improvements which promote energy efficiency may be included. CDBG Agreement for Public Improvement Projects Program Year 2003-04 Such activities may also include the execution of architectural design features, and similar treatments intended to enhance the aesthetic quality of facilities and improvements receiving CDBG assistance, such as decorative pavements, railings, sculptures, pools of water and fountains, and other works of art. Subrecipient shall collect the family size and income information from every client served by the CDBG funded services described herein using the CDBG Client/Family Information Form, Exhibit F-1 provided for in Condition 3, Exhibit C. A family is defined by HUD as all persons living in the same household who are related by blood, marriage, or adoption. An individual living in a housing unit that contains no other person(s) related to him/her is considered to be a one person family for this purpose. Adult children who continue to live at home with their parent(s) are considered to be part of the family for this purpose and their income must be counted in determining the total family income. A dependent child who is living outside of the home (e.g. students living in a dormitory or other student housing) is considered for these purposes to be part of the family upon which he/she is dependent, even though he/she is living in another housing unit. Subrecipient shall maintain family size and income information on all clients which may be reviewed by the City as provided for in Condition 4, Exhibit C. Statistical Reports, Tables 1 and 3 of Exhibit F, summarizing the family size, income and demographic information shall be submitted to the City no later than 15 days after the end of each claim quarter commencing Jan 1, 2004, and concluding Dec 31, 2004. Current income limits are as follows. Income Limits by Family Size: S/year *For the Medford-Ashland Statistical Area as determined by the Department of Housing and Urban Development FY2003. Income Level Number of Persons in Family Category 1 2 3 4 5 6 7 8+ Extremely Low Income 10,400 11,900 13,350 14,850 16,050 17,250 18,400 19,600 Low Income 17,350 19,800 22,300 24,300 26,750 28,700 30,700 32,650 Moderate Income 27,700 31,700 35,650 39,600 42,750 45,950 49,100 52,250 CDBG Agreement for Public Improvement Projects Program Year 2003-04 EXHIBIT B EXPENDITURE, PAYMENT AND BUDGET PROVISIONS Program Expenditures Subrecipient shall expend up to the Agreement amount in accordance with the Subrecipient Agreement, Item 3 and the Line Item Budget, Exhibit B-I. Budget Revisions Subrecipient has the flexibility to spend 10 percent above or below budgeted line items without a budget adjustment as long as total amount does not exceed the Agreement amount. Once the Line Item Budget, Exhibit B-l, has been approved through the execution of this Agreement, there can be no more than four requests for adjustments to budget line item amounts during the Agreement period, including any final adjustments done at the end of the program year, December 31, 2004. Budget adjustments (i.e., those adjustments which do not alter (1) the basic scope of services or other performance to be provided under this Agreement, or (2) the total amount of money allocated hereunder) may be made upon mutual agreement between the parties and shall only be valid when reduced to writing, and approved and signed by the Subrecipient and the Director of the Department of Community Development. Unexpended Funds Any unexpended or unobligated funds remaining as of December 31,2004 shall be resumed to City unless approval to extend Agreement is authorized by City prior September 1, 2004 in accordance with General Conditions, Exhibit D, Item 5. Payment Provisions Payment will be made by the City up to the amount of the Agreement upon receipt of a properly executed Invoice for Services Provided form, Exhibit E. Invoices and reports shall be signed by Subrecipient's authorized representatives. Invoices will be submitted to the City CDBG Contact, Department of Community Development/Planning Division, City of Ashland, 51 Winburn Way, Ashland, OR 97520. Invoices and reports shall be submitted quarterly, no later than 15 days after the end of each claim quarter commencing January 1, 2004 and concluding in December 31,2004,. Final invoice will be submitted to the City within 30 days of the end of the Agreement, December 31, 2004. Invoice Documentation All invoices shall be supported with signed and dated documentation such as bills, receipts, invoices, payroll records and time sheets. Documentation shall adequately identify the source and application of funds for activities within this Agreement in accordance with the provisions of 24 CFR 85.20, and shall contain information pertaining to grant awards and authorizations, obligations, unobligated balances, assets, liabilities, outlays and income. All documentation shall be maintained in Subrecipient's files for not less than five years. Program Income For CDBG funded projects, the Subrecipient shall comply with provisions of 24 CFR 570.504(c) and 570.500 regarding program income. Program income is defined by HUD as the gross income received by a subrecipient directly generated from the use of CDBG funds. Program income includes, but is not limited to, the following: 1) proceeds from the disposition by sale or long-term lease of real property purchased or improved with CDBG funds; 2) proceeds from the disposition of equipment purchased with CDB funds; CDBG Agreement for Public Improvement Projects Program Year 2003-04 3) gross income from the use or rental of real or personal property acquired by a subrecipient with CDBG funds, less costs incidental to generation of the income; 4) gross income from the use or rental of real property owned by a subrecipient that was constructed or improved with CDBG funds, less costs incidental to generation of income; 5) payments of principal and interest on loans made using CDBG funds; 6) proceeds from the sale of loans made with CDBG funds; 7) proceeds from sale of obligations secured by loans made with CDBG funds; 8) interest earned on program income pending its disposition; and 9) funds collected through special assessment made against properties owned and occupied by households not of Iow and moderate income, where the assessments are used to recover all or part of the CDBG portion of a public improvement. The Subrecipient shall record the receipt and expenditure of program income. The Subrecipient shall submit program income reports with invoices and statistical reports quarterly, no later than 15 days after the end of each claim quarter commencing January 1, 2004 and concluding in December 31, 2004. Program income shall be retained by the Subrecipient provided that it shall be used exclusively for eligible activities as defined in the CDBG Regulations (24 CFR Part 570). CDBG Agreement for Public Improvement Projects Program Year 2003-04 EXHIBIT C SPECIAL CONDITIONS Program Administration The Subrecipient is solely responsible for the conduct of the contracted program. Its employees and agents shall not be deemed employees or agents of the City unless regular employees of the City of Ashland complete the actual work performed. The Subrecipient will perform all necessary and customary functions in the management and supervision of Subrecipient personnel for all work performed under the Agreement. Project activities will be completed in compliance with the terms of this Agreement and the regulations applicable to this program. Specific project activities, which trigger formal procedural regulation, include the following: Subcontracting, Conflict of Interest, Procurement, Nondiscrimination and Public Information. Designated Staff The Subrecipient shall designate an individual responsible for carrying out the contracted program, including coordination with City CDBG Administration Staff. Subrecipient shall further designate one or more individuals authorized to sign payment requests under this Agreement. The names and signatures of these individuals shall be provided to City and maintained in City's program files. City shall designate an individual as City Contact to be responsible for administration of this Agreement. The name of such designated individual shall be provided to the Subrecipient. Reporting Statistical Reports and an Invoice for Services will be submitted to the City no later than 15 days after the end of each claim quarter commencing January 1,2004, and concluding December 31, 2004. The Subrecipient shall collect the family size and income information from every client served by the CDBG funded services described herein using the CDBG Client/Family Information Form, Exhibit F-I. A final report describing program achievements, a comparison to objectives and discussion of problems and solutions, shall be submitted within 30 days of the end of the Agreement, December 31, 2004. Reports shall include statistical reports covering the program period, to date. Client Confidentiality Subject to the requirements of Oregon Public Records Law, ORS 192.410 to 192.505, all client information, including lists of persons receiving services obtained by the Subrecipient in the performance of Agreement, shall be considered confidential and not divulged for any purpose not directly connected with the administration of the Agreement or monitoring and evaluation by City. City shall be allowed to review a sampling of case work history information to determine the adequacy of record keeping and quality of services performed. Nothing, however, prohibits the disclosure of information summaries, statistical, or other forms, which do not identify particular individuals. o Bilingual Assistance Subrecipient will provide bilingual assistance, as needed, to serve its clients. Bilingual assistance will be provided by bilingual staff to the extent possible. Bilingual means capable of using both English and Spanish languages with nearly equal facility. CDBG Agreement for Public Improvement Projects Program Year 2003-04 EXHIBIT D GENERAL CONDITIONS These General Conditions cover the use of Community Development Block Grant (CDBG) funds awarded under this Agreement to the Subrecipient by the City of Ashland. Termination for Cause In accordance with 24 CFR 85.43, if, through any cause, the Subrecipient shall fail to fulfill in a timely and proper manner his/her obligations under this Agreement, or if the Subrecipient shall violate any of the covenants, agreements, or stipulations of this Agreement, the City may avail itself of such remedies as cited in 24 CFR 85.43 including termination of this Agreement, by giving written notice to the Subrecipient of such action and specifying the effective date thereof. In such event, all finished or unfinished documents, data, studies, and reports prepared by the Subrecipient under this Agreement shall, at the option of the City, become the property of the City and the Subrecipient shall be entitled to receive just and equitable compensation for any satisfactory work completed on such documents, not to exceed the Agreement amount. Notwithstanding the above, the Subrecipient shall not be relieved of liability to the City for damages sustained by the City by virtue of any breach of the Agreement by the Subrecipient, and the City may withhold any payments to the Subrecipient for the purpose of set off until such time as the exact amount of damages due the City from the Subrecipient is determined. Termination for Convenience In accordance with 24 CFR 85.44, the City and Subrecipient may terminate this Agreement at any time by mutual written agreement. If the Agreement is terminated by the City as provided herein, the Subrecipient will be paid an amount which bears the same ratio to the total compensation as the services actually performed bear to the total services of the Subrecipient covered by this Agreement less payments of compensation previously made. Enforcement Remedies In the event of termination under Section A hereof by the City due to a breach by the Subrecipient, then the City may complete the work either itself or by agreement with another contractor, or by a combination thereof. In the event the cost of completing the work exceeds the amount actually paid to the Subrecipient hereunder plus the remaining unpaid balance of the compensation provided herein, then the Subrecipient shall pay to the City the amount of excess. Allowable costs shall be determined in accordance with 24 CFR 85.43(c). The remedies provided to the City under Sections 1 and 3 hereof for a breach by the Subrecipient shall not be exclusive. The City also shall be entitled to any other equitable and legal remedies that are available. In the event of breach of this Agreement by the City, then the Subrecipient's remedy shall be limited to termination of the Agreement and receipt of payment as provided in Section 2 hereof. In the event of termination under Section 1, the City shall provide the Subrecipient an opportunity for an administrative appeal. 4. Disputes CDBG Agreement for Public Improvement Projects Program Year 2003-04 Disagreements between the City and Subrecipient concerning the meaning, requirements, or performance of this Agreement shall be subject to final determination in writing by the City Administrator or in accordance with the applicable procedures (if any) required by the State or Federal Government. Agreement Changes The City or Subrecipient may, from time to time, request changes in writing in the scope of services or terms and conditions hereunder. Major changes, including the scope of work, performance measures or any increase or decrease in the amount of the Subrecipient's compensation, shall be incorporated in written amendments to this Agreement, approved by the City Council and signed by the City Administrator on behalf of the City. Minor changes to the scope of work, budget line items, timing, reporting, or performance measures may be approved by the City Administrator on behalf of the City. Agreement Nonrenewal Subrecipient understands and agrees that there is no representation, implication, or understanding that the services provided by Subrecipient under this Agreement will be purchased by the City under a new Agreement following expiration or termination of this Agreement, and waives all rights or claims to notice or heading respecting any failure to continue purchase of all or any such services from Subrecipient. Further Specifications for Operating Procedures Detailed specifications of operating procedures and budgets required by this Agreement, including but not limited to: monitoring, auditing, billing, reporting, or regulatory changes, may be developed and set forth in written Informal Agreements between the City and Subrecipient. Such Informal Agreements shall be designated as such and shall not be amendments to this Agreement except to the extent that they further detail or clarify that which is already required hereunder. Such Informal Agreements may not enlarge in any manner the scope of this Agreement, including any sums of money to be paid the Subrecipient as provided herein. Informal Agreements may be approved and signed by the Director of the Community Development Department on behalf of City. Non-Discrimination During the performance of this Agreement, the Subrecipient shall not discriminate based on race, religion, color, sex, age, national origin, marital status, political affiliation or handicap condition and the Subrecipient shall, to the maximum feasible extent, ensure all interested persons can reasonably obtain information about, and access to, HUD-funded activities. The Subrecipient agrees to comply with the following: The requirements of the Fair Housing Act (42 U.S.C. 3601-20) and implementing regulations at 24 CFR part 100; Executive Order 11063, as amended by Executive Order 12259 (3 CFR, 1958-1963 Comp., p. 652 and 3 CFR, 1980 Comp., p. 307)(Equal Opportunity in Housing) and implementing regulations at 24 CFR part 107; and title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d) (Nondiscrimination in Federally Assisted Programs) and implementing regulations issued at 24 CFR part 1; The prohibitions against discrimination on the basis of age under the Age Discrimination Act of 1975 (42 U.S.C. 6101-07) and implementing regulations at 24 CFR part 146, and the prohibitions against discrimination against handicapped individuals under section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794) and implementing regulations at 24 CFR part 8; Co The requirements of Executive Order 11246 (3 CFR 1964-65, Comp., p. 339)(Equal Employment Opportunity) and the implementing regulations issued at 41 CFR chapter 60; CDBG Agreement for Public Improvement Projects Program Year 2003-04 ~ 10. 11. The requirements of Section 3 of the Housing and Urban Development Act of 1968 (12 U.S.C. 1701) providing: To the greatest extent feasible, opportunities for training and employment be given to Iow- income persons residing within the unit of general local government or the metropolitan area; and (ii) To the greatest extent feasible, contracts for work to be performed in connection with any such project be awarded to business concerns which are located in or owned in substantial part by persons residing in the same metropolitan area as the project; and Eo The requirements of Executive Orders 11625 and 12432 (concerning Minority Business Enterprise), and 12138 (concerning Women's Business Enterprise). Access to Records The City, HUD, the Comptroller General of the United States, or any of their duly authorized representatives, shall have access to any books, general organizational and administrative information, documents, papers, and records of the Subrecipient which are directly pertinent to this Agreement, for the purpose of making audit or monitoring, examination, excerpts, and transcriptions. All required records must be maintained by the Subrecipient for five years after the City makes final payments and all other pending matters are closed. Maintenance of Records The Subrecipient shall maintain fiscal records on a current basis to support its billings to the City. The Subrecipient shall retain fiscal as well as all records relating to program and client eligibility for inspection, audit, and copying for five years from the date of completion or termination of this Agreement. The City or its authorized representative shall have the authority to inspect, audit, and copy on reasonable notice and from time to time any records of the Subrecipient regarding its billings or its work hereunder. Audit Requirements Subrecipient shall arrange for annual, agency-wide audits conducted by an independent certified public accountant and carded out within six months from the end of each Agreement Year. If Subrecipient's fiscal year ends during the term of this Agreement, the audits may cover the Subrecipient's fiscal year provided the audit period includes at least six months of this Agreement period. Said audits shall be performed according to federal and state law and rules, specifically, the audits shall comply with OMB Circular A-133 (nonprofit and institutions of higher education) or A-128 (local governments). A copy of the audit and accompanying management letter shall be submitted annually to the City within two weeks of the date of the audit report. The audit shall include, at a minimum, assurances that: 1 ) financial statements present fairly the financial position of the Subrecipient;, 2) costs charged to City are appropriate; and 3) Subrecipient is complying with conditions of the Agreement. The Subrecipient is responsible for either including subcontractors within its own annual audit or assuring that separate independent audits are conducted and submitted to City for each subcontractor. The City, either directly or through a designated representative, may audit the records of the Subrecipient at any time during the period established by Section 10 above. CDBG Agreement for Public improvement Projects Program Year 2003-04 12. 13. 14. 15. If an audit discloses that payments to the Subrecipient were in excess of the amount to which the Subrecipient was entitled, then the Subrecipient shall repay the amount of the excess to the City. Monitoring The City, through the Department of Community Development, may monitor at least once each year, that portion of the Subrecipient's project funded with CDBG funds. Such monitoring shall ensure that the operation of the project conforms to the provisions of this Agreement. Indemnity and Hold Harmless Subrecipient shall indemnify, defend and hold harmless the City, its officers, officials, boards, commissions, employees, volunteers, and agents from and against all claims, damages, suits, costs, judgments, losses, expenses, and attorney's fees arising directly or indirectly out of the performance of or the failure to perform the work described herein, caused in whole or in part by any negligent act or omission of the Subrecipient, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, regardless of the negligence of the City, except Subrecipient shall not be responsible when such liability arises from the sole negligence or willful misconduct of the City. Subrecipient shall promptly pay city for any costs that City incurs in enforcing this clause. Insurance Requirements For the duration of this Agreement, Subrecipient shall procure and maintain insurance against claims for personal injury, bodily injury or property damage which may arise from or in connection with the work hereunder by the Subrecipient, his agents, representatives and employees. Evidence of insurance acceptable to the City must be provided by the Subrecipient to the City before Subrecipient will be authorized to start work. Minimum Scope of Insurance Ao Workers' Compensation and Employer's Liability insurance as required by state law. Commercial General Liability coverage at least as broad as an ISO form CG0001. Limits no less than $500,000 per occurrence for bodily injury and personal injury. Limits no less than $50,000 for property damage liability. Automobile Liability coverage covering any auto, at least as broad as ISO form CA0001. Limits no less than $500,000 for bodily injury and personal injury. Limits no less than $50,000 for property damage liability. Do Each policy required by this Agreement shall be endorsed to state that coverage shall not be suspended, voided, canceled by either party, reduced in coverage or in limits except after thirty days prior written notice by certified mail, return receipt requested, has been given to the City. The general liability and automobile liability policies are to contain, or be endorsed to contain, the following provisions: The City, its officers, officials, agents, volunteers, and employees are to be covered as insureds for liability arising out of activities performed by or on behalf of the Subrecipient; products and completed operations of the Subrecipient; premises owned, occupied or used by the Subrecipient; and automobiles owned, leased, hired or borrowed by the Subrecipient. The CDBG Agreement for Public improvement Projects Program Year 2003-04 coverage shall contain no special limitations on the scope of protection afforded to the City, its officers, officials, agents, volunteers or employees. For any claims related to this project the Consultant's insurance coverage shall be primary insurance as respects the City, its officers, officials, agents, volunteers and employees. Any insurance or self-insurance maintained by the City, its officers, officials, agents, volunteers, and employees shall be excess of Subrecipient's insurance and shall not contribute with it. Any failure to comply with reporting or other provisions of the Subrecipient's insurance policies including breaches of warranties shall not affect the coverage provided to the City, its officers, officials, agents, volunteers, and employees. The Subrecipient's insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of insurer's liability. Acceptability of Insurers Insurance that is placed with insurers having a current A.M. Best rating of no less than B+:Vll will be considered acceptable without the approval of the City. All other insurers are subject to the approval of the City. Verification of Coverage Subrecipient shall furnish the City with certificates and original endorsements effecting the coverage herein required. Certified copies of policies must be furnished upon the request of the City. Endorsements must be signed by a person authorized by that insurer to bind coverage on its behalf. The form of endorsement is subject to the City's approval. Deductibles and Self-Insured Retentions Any deductibles or self-insured retentions must be declared to the City and are subject to the City's approval. At the option of the City, either the insurer shall reduce or eliminate such deductibles or self-insured retentions with respect to the City; or the Subrecipient may be required by the City to procure a bond guaranteeing payment of losses, claims adjusting expenses, and defense costs below the deductible or self-insured retention. Ho Subcontractors Subrecipient's insurance shall provide coverage for all subcontractors, or Subrecipient shall furnish to the City separate certificates and endorsements showing coverage for each subcontractor. The insurance requirements described herein shall apply to all subcontractors. 16. Subcontracting and Assignment The Subrecipient shall not assign this in whole or in part or any right or obligation hereunder, without prior written approval of the City, which approval shall not unreasonably be withheld. The subcontractor shall be responsible for adhering to all regulations cited within this Agreement. 17. Independent Contractor Status The Subrecipient is engaged as an independent contractor and will be responsible for any federal, state, or local taxes and fees-applicable to payments hereunder. The Subrecipient and its subcontractors and employees are not employees of the City and are not eligible for any benefits through the City, including without limitation, federal CDBG Agreement for Public Improvement Projects Program Year 2003-04 18. 19. 20. 21. 22. social security, health benefits, workers' compensation, unemployment compensation, and retirement benefits. Compliance With Laws In connection with its activities under this Agreement, the Subrecipient shall comply with all applicable federal, state and local laws and regulations. For CDBG-funded projects, the Subrecipient shall carry out its activities in compliance with 24 CFR 570. In particular (but not to the exclusion of other sections) Subrecipient shall comply with applicable uniform administrative requirements, as described in 24 CFR 570.502. Should Federal or State regulations touching upon the subject of this Agreement be adopted or revised during the term hereof, this Agreement may be amended to assure conformance with such Federal or State requirements. Conflicts of Interest No City officer or employee, during his or her tenure or for one year thereafter, shall have any interest, direct or indirect, in this Agreement or the proceeds thereof, as required in 24 CFR 85.36. No board or director member or employee of the Subrecipient, during his or her tenure or for one year thereafter, shall have any interest, direct or indirect, in this Agreement or the proceeds, as required in 24 CFR 85.36. Use of Agreement funds to pay personnel costs itemized in Agreement is exempted from this requirement. For CDBG-funded projects, the Subrecipient shall further comply with the conflict of interest provisions cited in 24 CFR 570.611. Agreement Administration Non-profit contractors shall comply with the applicable provisions of OMB Circular No's. A-122, and A-110 Attachments B, F, H paragraph 2, and O, as described by 24 CFR 92.505. Property Management The Subrecipient agrees that any real property, equipment or supplies purchased wholly or in part with program funds will be managed under the same guidelines applicable to the City in accordance with 24 CFR 570.505 (real property), 24 CFR Part 85.32 (equipment), and 24 CFR Part 85.33 (supplies). Expiration/Reversion of Assets For CDBG-funded projects, the Subrecipient shall comply with the Reversion of Assets provision of 24 CFR 570.503(b)(8). Upon expiration of this agreement, the Subrecipient shall transfer to the recipient any CDBG funds on hand at the time of expiration and any accounts receivable attributable to the use of CDBG funds. The CDBG benefit of acquisition or improvement to real property with CDBG funds will be realized only after ten years of public service to extremely Iow-, Iow- and moderate- income Ashland residents at a level of 51% of all clients served at the property. The Subrecipient shall use real property acquired or improved with CDBG funds to provide eligible CDBG client services to a population of at least 51% or more extremely Iow-, Iow- and moderate-income persons as classified by the U.S. Department of Housing and Urban Development until 10 years after expiration of this agreement. It is the City's intention that the full public benefit of this project inure to the Subrecipient's clients, or in the alternative, that City recover the monetary equivalent of an unrealized public benefit as follows: CDBG Agreement for Public Improvement Projects Program Year 2003-04 If the Subrecipient should sell property acquired or improved with CDBG funds, or for any reason discontinue using the property to provide eligible CDBG client services to a population of at least 51% or more extremely Iow-, Iow- and moderate-income persons as classified by the U.S. Department of Housing and Urban Development, prior to five years from the completion date, the Subrecipient will be obligated to repay CDBG grant funds in the full amount to City. If the Subrecipient should sell property acquired or improved with CDBG funds, or for any reason discontinue using the property to provide eligible CDBG client services to a population of at least 51% or more extremely Iow-, Iow- and moderate-income persons as classified by the U.S. Department of Housing and Urban Development, after five full years of use and prior to ten years from the completion date, the Subrecipient will be obligated to repay CDBG grant funds to City, upon demand, that percentage of the grant equal to the percentage of time then remaining until the expiration of ten years from the completion of the work. (For example, if the Subrecipient discontinues service and the property is sold after six years, the Subrecipient shall repay 40% of the grant funds to City. Payment shall be made by the Subrecipient within 90 days of the date the Subrecipient sells the property or otherwise discontinues its use for the approved, eligible public services. If within the 10 year period, the Subrecipient moves to a new location where it continues to deliver client services similar to those it now provides, City may, at its sole option, find the replacement facility a satisfactory replacement and waive the reimbursement payment required by paragraph 23.A. The Subrecipient may not change the use or planned use of real property acquired or improved with CDBG funds unless the Subrecipient receives approval from the City, and either: The new use of such property qualifies as meeting one of the CDBG national objectives and is an eligible use of CDBG funds or; ii. If the City determines, after consultation with affected citizens, that is necessary or appropriate to change the use of the property to a use which does not qualify under paragraph 23.c.i, it may retain or dispose of the property for such use if City is reimbursed in the amount of the current fair market value of the property less any portion attributable to expenditures of non-grant funds for acquisition of, and improvement to, the property. 23. 24. Oregon Law and Forum This Agreement shall be construed according to the law of the State of Oregon. Any litigation between the City and the Subrecipient arising under this Agreement or out of work performed under this Agreement shall occur, if in the state courts, in the Jackson County court having jurisdiction thereof, and if in the federal courts, in the United States district Court for the State of Oregon. Availability of Funds It is understood by all parties to this Agreement that the funds used to pay for services provided herein are provided to the City through a grant from the U.S. Department of Housing and Urban Development. In the event that funding is reduced, recaptured, or otherwise made unavailable to the City as a result of federal action, the City reserves the right to terminate the Agreement as provided under Section 2 hereof, or change the scope of services as provided under Section 5 hereof. CDBG Agreement for Public Improvement Projects Program Year 2003-04 Should Federal or State regulations touching upon the subject of this Agreement be adopted or revised during the term hereof, this Agreement may be amended to assure conformance with such Federal or State requirements. 25. Minimizing Displacement The Subrecipient assures that it will take all reasonable steps to minimize the displacement of persons as a result of this Agreement, and shall comply with the applicable provisions of 24 CFR 570.606. 26. Program Access by the Disabled The Subrecipient shall, to the maximum feasible extent, ensure interested persons can reasonably obtain information about, and access to, HUD-funded activities. 27. Publicity and Signage Publicity, including signage at any construction/building site, regarding the project shall note participation of the City of Ashland Department of Community Development and the U.S. Department of Housing and Urban Development. All construction projects receiving $50,000 or more in CDBG grant funds shall place a sign on the project site acknowledging the financial assistance from the Department of Housing and Urban Development. The sign shall be installed prior to construction and shall be maintained for the duration of the construction pedod. The sign shall be a minimum of 4 feet by 4 feet. The background of the sign shall consist of three equal horizontal ands: the top red, center white, and the bottom blue. Lettering shall be black. The top section shall contain the name of the project and any other relevant information, e.g., the name of the project sponsor, purpose of the project, etc. The lower section may contain other information as desired, e.g., the name of the local chief executive, other financial contributors, architect, engineer, etc. The center section shall contain the following language, AThis project is funded in whole or in part with funds provided by the U.S. Department of Housing and Urban Development (HUD).@ The words U.S. Department of Housing and Urban Development shall be in 4 inch block letters. Subrecipients may use the design and pattern of previously developed project signs, provided that the sign is amended to acknowledge the contribution by the U.S. Department of Housing and Urban Development, in lettering no smaller than that used to acknowledge other contributors to the project. 28. Lobbying No Federal appropriated funds have been paid or will be paid, by or on behalf of the Subrecipient, 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 awarding of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal Agreement, grant, loan, or cooperative agreement. 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 Agreement, grant, loan, or cooperative agreement, the Subrecipient shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. The Subrecipient shall require 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 agreement) and that all Subcontractors shall certify and disclose accordingly. CDBG Agreement for Public Improvement Projects Program Year 2003-04 29. 30. 31. 32. 33. 34. 35. 36. Church-State The Subrecipient agrees to comply with the applicable provisions of 24 CFR 570.200(j) regarding the use of federal funds by religious organizations. No religious content or materials will be disseminated in any part of the programs or services funded under this Agreement. Nonsubstitution for Local Funding For CDBG-funded projects, the Subrecipient will not utilize grant funds to reduce substantially the amount of local financial support for community development activities below the level of such support prior to the availability of funds under this Agreement. Copyrights and Rights in Data Subrecipient shall not publish or transfer any materials produced or resulting from activities supported by this Agreement without the express written consent of the City Administrator. If any material is subject to copyright, the City reserves the right to copyright such, and the Subrecipient agrees not to copyright such material. If the material is copyrighted, the City reserves a royalty-free, nonexclusive, and irrevocable license to reproduce, publish, and use such materials, in whole or in part, and to authorize others to do so. Nonparticipation in Political Activities The Subrecipient shall comply with the provisions of the Hatch Act (5 USC, Chapter 15). Real Property Acquisition The Subrecipient shall comply with the applicable provisions of 49 CFR 24 regarding the use of federal funds for acquisition of real property, and with the applicable provisions of the Reversion of Assets provision of 24 CFR 570.503(b)(8) as described in D.23 of this agreement. Environmental Review The Subrecipient shall comply with the 24 CRR 92.352, 24 CFR PART 58 and the National Environmental Policy Act of 1969. The Subrecipient shall not enter into a contract for, or otherwise commit CDBG funds for a project prior to the City's completion of an environmental review in accordance with 24 CFR part 50. The Subrecipient shall supply the City with the information necessary for the City to perform any applicable environmental review when requested under CFR 583.225(a). The Subrecipient shall carry out mitigating measures required by the City or ensure that alternate sites are utilized according to 24 CFR 54.22. Debarred, Suspended or Ineligible Contractors, Subrecipient or Officers The Subrecipient agrees to comply with the applicable provisions of 24 CFR 570.609 regarding the Debarred, Suspended or Ineligible Contractors or Subrecipients. The Subrecipient shall not use CDBG funds to directly or indirectly to employ, award contracts to, or other wise engage the services of, of fund any contractor or subrecipient during any period of debarment, suspension, or placement in ineligibility status under the provisions of 24 CFR part 24. The Subrecipient shall not have officers or board members that are debarred, suspended or ineligible to work on projects using federal funds. Labor Standards The Subrecipient agrees to comply with the applicable provisions of the Davis- Bacon Act, the Contract Work Hours and Safety Standards Act (CWHSSA), the Copeland Act and the Fair Labor Standards Act covered under the regulations in 29 CFR Parts 1,3,5,6 and 7. The Subrecipient shall pay all laborers and mechanics employed by contractor or subcontractors on construction work financed in whole CDBG Agreement for Public Improvement Projects Program Year 2003 Page 19 or in part with CDBG funds wage rates not less than those prevailing on similar construction in the locality as determined by the Secretary of Labor in accordance with the Davis-Bacon Act. The Contract Work Hours and Safety Standards also applies. However, these requirements apply to the rehabilitation of residential property only if such property contains not less than 8 units. In addition to the provisions outlined above, the subrecipient also agrees to comply with the City of Ashland Living Wage Ordinance (Chapter 3.12 of the Ashland Municipal Code) which requires that a living wage be paid to employees, employees of contractors to the city, and employees of recipients of city grants. All employers and grant recipients covered under this chapter shall pay employees a "living wage" of wages and benefits equal to or greater than $11.00 per hour (adjusted annually to reflect increases in the Consumer Price Index). Benefits, which can be attributed to a living wage, are limited to health care, retirement, 401k and IRS eligible cafeteria plans including childcare. 37. 38. Lead-Based Paint The Subrecipient shall comply with the applicable provisions of 24 CFR 35, Requirements for Notification, Evaluation and Reduction of Lead-Based Paint Hazards in Federally Owned Residential Property and Housing Receiving Federal Assistance. The purpose of the regulation is to protect young children from lead-based paint hazards in housing that is either receiving assistance from the Federal government or is being sold by the government. Non-Profit Grant Agreements The subrecipient shall comply with all applicable provisions of 24 CFR Part 84, Uniform Administrative requirements for Grants and Agreements with Institutions of Higher Education, Hospitals, and other Non-Profits. Non-profits receiving CDBG funds shall establish written procurement procedures as per the requirements of 24 CFR 84.44. CDBG Agreement for Public Improvement Projects Program Year 2003 Page 20 EXHIBIT E INVOICE FOR SERVICES TO: Brandon Goldman City of Ashland Dept. of Community Development Planning Division 20 E. Main St. Ashland, OR 97520 FROM: Date: Project Title: Pi oneer Ha] ] Invoice No.: Invoice Amount: Purchase Order No. For Month/Qtr. Of: Restroom BUDGET ANNUAL CURRENT EXPENDED UNEXPENDED LINE ITEM BUDGET EXPENDITURES TO DATE BUDGET AMOUNT TOTAL TOTAL REIMBURSEMENT REQUEST: Request is hereby made for reimbursement of current month/quarter expenditures. Reimbursement is requested based on actual expenses incurred in providing services in accordance with the Agreement with the City of Ashland. I certify that this statement of expenditures is made herein to the best of my knowledge. All reported expenditures are supported by documentation, attached and filed in Subrecipient's files and are subject to audit by City of Ashland and the Department t of Housing and Urban Development. SIGNATURE: DATE: TITLE: PHONE: APPROVED FOR PAYMENT: FOR CITY OFFICE USE DATE: CDBG Agreement for Public Improvement Projects Program Year 2003 Pnnm 91 EXHIBIT F STATISTICAL REPORT OF SERVICES PROVIDED Project Title: Month(s) of: Subrecipient Name: TABLE 1 Cumulative for Quarter Month 1 Month 2 Month 3 Number % of Number % of Number % of Number % of Total Total Total Total Extremely Low Low Moderate ///II//// Total of Persons* Served Meeting Program Income Limits ///I////I Total Persons Served * Client data must be collected based on the client's family. A Iow- to moderate-income person is defined by HUD as a member of a family having an income equal to or less than the Iow- to moderate-income limits established by HUD in the table on page 7. A family is defined by HUD as all persons living in the same household who are related by blood, marriage, or adoption. An individual living in a housing unit that contains no other person(s) related to him/her is considered to be a one person family for this purpose. Adult children who continue to live at home with their parent(s) are considered to be part of the family for this purpose and their income must be counted in determining the total family income. A dependent child who is living outside of the home (e.g. students living in a dormitory or other student housing) is considered for these purposes to be part of the family upon which he/she is dependent, even though he/she is living in another housing unit. CDBG Agreement for Public Improvement Projects Program Year 2003 Page 22 TABLE 2 Income Limits by Family Size: S/year *For the Medford-Ashland Statistical Area as determined by the Department of Housing and Urban Development, effective December 10, 2001. Income Level Number of Persons in Family Category 1 2 3 4 5 6 7 8+ Extremely Low Income 8,800 10,050 11,300 12,550 13,600 14,600 15,600 16,600 Low Income 14,650 16,750 18,850 20,950 22,650 24,300 26,000 27,650 Moderate Income 23,450 26,800 30,150 33,500 36,200 38,900 41,550 44,250 TABLE 3 Race American Indian or Alaskan Native Asian or Pacific Islander Black/African American Native Hawaiian/Pacific Islander White American Indian or Alaskan Native and White Asian and White Black or African American and White American Indian or Alaskan Native and Black or African American Other Multi-racial Ethnicity Hispanic or Latino Non-Hispanic or Latino Disabled Households Female Headed Household Numberof Total Persons Served in the Quarter CDBG Agreement for Public Improvement Projects Program Year 2003 Page 23 EXHIBIT F-1 CDBG CLIENT/FAMILY INFORMATION FORM Client's Name: Address: Total Number of Persons In Family (see definitions below): List Names of Family Members Living In Household: Client: ~,dditional Members: Total Monthly Income Sources for All Family Members Living In Household Employment, Gross Income: Other Resources Social Security/SSI: Other Pension: Unemployment Child Support: Public Welfare: Alimony: Veteran's Benefits: Total Monthly Income: Ethnicity and Race Grantees are to ask respondents to identify their clients ethnicity prior to asking them to identify their race. Hispanic will now be considered an ethnicity category rather than a race category. Please check one ethnicity about the client: Hispanic or Latino Not Hispanic or Latino __ Please select one or more of the following as self identified by the client: American Indian/Alaskan Native Asian Black/African American Native Hawaiian/Pacific Islander White Please complete the following about the client. Disabled yes no__ Female Headed Household yes no__ CDBG Agreement for Public Improvement Projects Program Year 2003 Page 24 Low- to Moderate-Income Person - A Iow- to moderate-income person is defined by HUD as a member of a family having an income equal to or less than the Iow- to moderate-income limits established by HUD in the table on page 7. Family - A family is defined by HUD as all persons living in the same household who are related by blood, marriage, or adoption. An individual living in a housing unit that contains no other person(s) related to him/her is considered to be a one person family for this purpose. Adult children who continue to live at home with their parent(s) are considered to be part of the family for this purpose and their income must be counted in determining the total family income. A dependent child who is living outside of the home (e.g. students living in a dormitory or other student housing) is considered for these purposes to be part of the family upon which he/she is dependent, even though he/she is living in another housing unit. Income information provided above subject to verification by local or Federal government. CDBG Agreement for Public Improvement Projects Program Year 2003 Page 25 CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541) 488-5300 CITY RECORDER'S COPY Page 1 / 1 VENDOR: 002799 D A BOLDT CONSTRUCTION PO BOX 998 ASHLAND, OR 97520 SHIP TO: Ashland Public Works (541) 488-5587 27-1/2 N MAIN STREET ASHLAND, OR 97520 FOB Point: Terms: Net Req. Del. Date: Special Inst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown / Dale Peters Confirming? NO ,,Quantity Unit Description Unit Price Ext. Price Remodel existing two restrooms to 14 388.00 create two new ADA compliant restrooms - Pioneer Hall. Includes allowance of $120.00 for door Iocksets and hardware. CSK Date of agreement December 18; 2003 ' : · Beginning date: December 22, 2003 Completion date: February 20, 2004 Insurance required/On file SUBTOTAL 14,388.00 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2028 TOTAL 14,388.00 ASHLAND, OR 97520 E 710.08.24.00.602320 14,388.00 Signature VENDOR COPY