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HomeMy WebLinkAbout2005-148 Agmt - ACLT SUBRECIPIENT AGREEMENT COVER SHEET WRITTEN AGREEMENT FOR PROJECTS FUNDED WITH COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) FUNDS Project Title: Rehabilitate a Duplex at 264 Grant Street SUBRECIPIENT Name: Ashland Community Land Trust SUBRECIPIENT C,ontact: Shelley Austin, ACL T Executive Diredor Telephone Numb4!r: 541-488-7276 Address: Site Addresses of property be Rehabilitated: 264 Grant Street units A and B Ashland Oregon 97520 Mailing Address: Ashland Community Land Trust PO Box 3027 Ashland, OR 97520 Agreement Amount: $14,000 Description: Rehabilitate the 2 rental units existing on the property inc;luding but not limited to a roof replacement. The housing units c:ire to benefit low-income or very-low households for a period of affordability to of not less than 60 years. City Contact: Brandon Goldman Telephone Number: 552.2076 ~{}/39 /3w/d,"'d - //7 L/~ 0/ '0~d CDBq ( !- ~ / ~TVtLC, j//~ cJ1 { gt lit ~ Y~10~ 6'vL /~ uJlk,~ ~ &tGL~ AM-' 4 ~R/l.pO/. ~Io ~~ CDBG Agreement Proglram Year 2004 Page 1 9. Acces:s to Records 10. MaintElnance of Records 11. Audit Requirements 12. Monite.ring 13. Indemnity and Hold Harmless 14. Insurance Requirements 15. Minimum Scope of Insurance 16. Subcontracting and Assignment 17. IndepEmdent Contractor Status 18. Complliance with Laws' 19. Confli(~s of Interest 20. Agreement Administration 21. Property Management 22. Program Income 23. Expiration/Reversion of Assets 24. Oregon Law and Forum 25. Availability of Funds 26. Minimiizlng Displacement 27. Program Access by the Disabled 28. Publicity 29. Lobbying 30. Church-State 31. Nonsubstitution for Local Funding 32. Copyrights and Rights in Data 33. Nonparticipatlon in Political Adivities 34. Real Property Acquisition 35. Environmental Review EXHIBIT E: INVOICE FOR SERVICES EXHIBIT F: STATISTICAL REPORT EXHIBIT F-1: CDSG CLIENT/HOUSEHOLD INFORMATION FORM C[)BG ~reement ProiJram Year 2004 Page 3 City of Ashland Contact Brandon Goldman, Housing Program Specialist Department of Community Development Planning Division City of Ashland 20 East Main street Ashland, OR 97520 Subrecipi~!nt Contact(s) Shelley Austin, ACL T Executive Director Ashland Ct:>mmunity Land Trust PO Box 3027 Ashland, OR 97520 :BRECI~:#t) . ~ Shelley AustIn" ACl T Executive Director Date: ~o5 By: '~/....... I . - CITY OF ASHLAND: BY: Date: ~I /6(~ I, City Administrator ~ COBG Agreement Proi;ram Year 2004 Page 5 works of art. Subreclpient shall collect the family size and income information from eVElry client served by the CDBG funded services described herein using the CDSG ClientlFamily Information Form, Exhibit F-1 provided for in Condition 3, 8thibit C. As the project entails the rehabilitation of property for the provision of afflordable housing the Subreclplent shall provide such Information at each change in tenancy. This requirement Is duplicated In the subreclplent contract exe<<:uted between the City and the Ashland Community Land Trust dated 6-3-2004 in which the City contributed $271,000 toward the acquisition of the property. A family is defined by HUD as all persons living in the same household who arle related by blood, marriage, or adoption. An individual living in a housing unit that contnins no other perso1n(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 IPurposes 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, E><hibit 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 a1!1er the end of ead1 claim quarter commencing July 1, 2004, and conducting June 30, :2005. Current income limits are as follows. Income Umits by Family Size: $/year .For the Medford-Ashland Statistical Area as determined by the Department of Housing and Urban Development 2004. Income Levell Number of Persons in Family Category 1 2 3 4 5 6 7 8+ Extremely Low Income 10950 12500 14050 15650 16900 18150 19400 20650 low Income 50% 18250 20850 23450 26050 28150 30200 32300 34400 Moderate Income 29,200 33350 37500 41700 45000 48350 51700 55000 C[)OO Agreement Proj~ram Year 2004 Page 7 EXHIBIT B EXPENDITURE, PAYMENT AND BUDGET PROVISIONS 1. Program E~xpenditures Subrecipient shall expend up to the Agreement a.mount in accordance with the Subrecipient Agreement, Item 3 and the Line Item Budget, Exhibit B-1. 2. Budget Revisions Subrecipient has the flexibility to spend 10 percent above or below budgeted lilne items without a budget adjustment as long as total amount does not exceed the AgrE!ement amount. Once the Uneltem Budget, Exhibit B-1, has been approved through the execution c>f this Agreement, there can be no more than four requests for adju~rtments to budget line~ item amounts during the Agreement period, including any final adjustments done at thE~ end of the program year, June 30,2005. 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 Subredpient and the Director of the Department of Community DevelopmElnt. 3. Unexpended Funds Any unexpended or unobligated funds remaining as of June 30, 2005 shall be: resumed to City unless approval to extend Agreement is authorized by City prior June, :W, 2005 in accordance with General Conditions, Exhibit 0, Item 7. 4. Payment Provisions Payment will be made by the City up to the amount of the Agreement upon re(~eipt of a properly executed Invoice for Services Provided form, Exhibit E. Invoices and reports shall be si!~ned by Subrecipient's authorized representative(s). Invoices will bE! submitted to the City Contad, Department of Community DevelopmentlPlanning Division, City of Ashland, 5,1 Winburn Way, Ashland, OR 97520. Invoices and reports shall be submitted quarterty t no later than 16 days after tlhe end of each claim quarter commencing July 1, 2004 and concluding June 30, 2005. Final invoice will be submitted to the City within 30 days of the end of the Agreement, June 30, 2005. 5. Invoice Documentation All invoices shall be supported with signed and dated documentation such as bills, receipts, invoices, payroll records including wages paid, 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 CFR85.20, and shall contain information pertaining to grant awards and authorizations, obligations, unobliglated balances, assets, liabilities, outlays and income. All documentation shall be maintained in Subrecipient's files for not less than seven years. 6. Program Ilncome For COSG 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 sub recipient directly generated from 1the use of COBG funds. Program income includes, but is not limited to, the following: 1) proceeds from the disposition by saJe or long-term lease of real property purchased or improved with CDB<3 funds; 2) proceeds from the disposition of equipment purchased v,ith CDSG funds; 3) Uross income from the use or rental of real or personal property acquired by a CI:>BG Agreement Program Year 2004 Page 9 EXHIBIT B-1 Budget The entire grant amount of $14,000 will be used for the rehabilitation of the duph!x at 264 Grant Street. Rehabilitation to include, but not be limited to, the replacement of 'the existing roof. ACL T was also awarded a separate COSG award for $271 ,000 to be applied tCI acquisition of the subject duplex and property. This award is covered under a separate subrecipient agreement as was executed between the City of Ashland and the Ashland Community Land Trust on June 3rd, 2004. c[)ea Agreeme!'rt ProSJram Year 2004 Page 11 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. 1. 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, c)r 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, induding 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 Subreciplent shall not be relieved of liability to jthe 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 Cit), from the Subrecipient is determined. 2. 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 be~irs the same ratio to the total compensation as the services actually performed bear t,o the total services of the Subrecipient covered by this Agreement less payments of compensation previously made. 3. 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 accordc~nce with 24 CFR 8S.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 r1emedy shall be limited to termination of the Agreement and receipt of payment as prctvided in Section 2 hereof. 4. Appeal In the event of termination under Section 1, the City shall provide the SubrecilPient an opportunity for an administrative appeal. CI)OO Agreement Program Year 2004 Page 13 all interested persons can reasonably obtain information about, and access to, HUD-fundE~d activities. The Subrecipient agrees to comply with the following: A. The requirements of the Fair Housing Ad (42 U.S.C. 3601-20) and impllementing 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 V1 of the Civil Rights Act of 1964 (42 U.S.C. :2000d) (Nclndiscrimination in Federally Assisted Programs) and implementing regulations issued at 24 CFR part 1; B. ThE~ prohibitions against discrimination on the basis of age under the A!~e 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; C. Tht~ requirements of Executive Order 11246 (3 CFR 1964-65, Comp., p. 339)(Equal Employment Opportunity) and the implementing regulatiom; issued at 41 CFR chapter 60; D. The requirements of Section 3 of the Housing and Urban Development Act of 1968 (12 U.S.C. 1701) providing: (I) To the greatest extent feasible, opportunities for training and employm4!nt be given to low- 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 oonnedion 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! projed; and - E. The requirements of Executive Orders 11625 and 12432 (concerning Minority Business Enterprise), and 12138 (concerning Women's Business Enterprise). 11. Access to Records The City, IiUD, 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 maint2:tined by the Subrecipient for five years after the City makes final payments and all othE~r pending matters are closed. 12. Maintenance of Records The Subrecipient shall maintain fiscal records on a current basis to support It~, billings to the City. The Subrecipient shall retain fiscal as well as all records relating to program and dient eligibility for inspection, audit, and copying fOf five years from the d~lte of completion or termination. of this Agreement. The City or its authorized repres1entative 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 hereundE~r. 13. Audit Requirements CI)BG Agreement Program Year 2004 Page 15 the City before Subrecipient will be authorized to start work. This provision will relate to any rehabilitation work undertaken on the property. 17. Minimum :Scope of Insurance A. Workers' Compensation and Employer's Uability insurance as required by state law. B. Commercial General Uability coverage at least as broad as an ISO fonn CGOOO1. Umits no less than $500,000 per occurrence for bodily injury and personal injury. Umits no less than $50,000 for property damage liabili1y. C. Aut.omobile Liability coverage covering any auto, at least as broad as ISO fonn CAOOO1. Umits no less than $500,000 for bodily injury and personal injury. Umits no less than $50,000 for property dama9E' liability. D. 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, retum 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: · For any claims related to this projed. the Consultant's insurance coverage shall be primary insurance as respeds the City, its officers, official~>>, 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 Subn~cipient's insurance policies induding 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 daim is made or suit is brought, except with resped to the limits of insurer's liability. E. AC4~ptability of Insurers Insurance that is placed with insurers having a current AM. Best ratin!J of no less than B+:VII will be considered acceptable without the approval of the Gity. All other insurers are subject to the approval of the City. F. Verification of Coverage Subrecipient shall furnish the City with certificates and original endors4~ments effecting the. coverage herein required. Certified copies of policies mwrt 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 fionn of endorsement is subjed. to the City's approval. CI>BG Agreement ~~ram Year 2004 Page 17 Non-profit. C1ontractors shall comply with the applicable provisions of OMS Circular No's. A-122, and A-110 Attachments B, F, H paragraph 2, and 0, as described by 24 CFR 92.505. 23. Property Management The Subrecipient agrees that any real property, equipment or supplies purchas~~d wholly or In part with program funds will be managed under the same guidelines applic:able 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). 24. Explrationl'Reverslon 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 transfE~r to the recipient any CDBG funds on hand at the time of expiration and any accounts re,ceivable attributable to the use of CDSG funds. The CDSG benefit of acquisition or improvement to real property with CDSG funds will be realized only after ten years of public service to extremely low-, low- 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 CDSG funds to provide eligible CDSG client services to a population of at least 51% or more extremely low-, low- and moderate-Income persons as classified by the U.S. Department of Hc)Using and Urban Development until 1 0 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 cUEmts, or in the alternative, that City recover the monetary equivalent of an unrealized public benefit as follows: A. If the Subrecipient should sell property acquired or improved with CDSG funds" or for any reason discontinue using the property to provide eligible CDBG client services to ~ population of at least 51 % or more extremely low-, low- and moderate-income lPersons as classified by the U.S. Department of Housing and Urban Development, priol~ to five years from the completion date, the Subrecipient will be obligated to repay COl3G grant funds in the full amount to City. If the Subrecipient should sell property acquireid or improved with CDBG funds, or for any reason discontinue using the property tC) provide eligible CDBG client services to a population of at least 51 % or more extreme~, low-, low- and moderate-income persons as classified by the U.S. Department of Hctusing and Urban Development, after five full years of use and prior to ten years from the completion date, the Sub recipient will be obligated to repay COBG grant funds to City, upon demand, that percentage of the grant equal to the percentage of time the!n remaining until the expiration of ten years from the completion of the work. (For example. i1~ the Subrecipient discontinues service and the property is sold after six years, the Subrec:ipient 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. B. 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 Ctption, find the replacement facility a satisfactory replacement and waive the reimbursemunt payment required by paragraph 23.A. C. The Subrecipient may not change the use or planned use of real property acquired or improved with CDSG funds unless the Subrecipient receives approval from thl;' City, and either: CI:IOO Agreement Pr~,ram Year 2004 Page 19 provided by the U.S. Department of Housing and Urban Development (HUD)". The words U.S. Department of Housing and Urban Development shalt 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. Departmen1: of Housing and Urban Development, in lettering no smaller than th4:rt used to acknowledge other contributors to the project. 30. Lobbying No Federal appropriated funds have been paid or will be paid, by or on behalf clf the Subreciplent, 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 cooperativEt agreement. If any funds other than Federal.appropriated funds have been paid or will be p21id to any person for influencing or attempting to influence an officer or employee of any ngency, 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 coopen:!ltive agreement11 the Subrecipient shall complete and submit Standard F orm-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 aU subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreement) and that all Subcontractors shall certify and disclose accordingly. 31. Church-State The Subrecipient agrees to comply with the applicable provisions of 24 CFR 5JO.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. 32. Nonsubstitutlon 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 belOYl the level of such support prior to the availability of funds under this Agreement. 33. 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 1the material is copyrighted, the City reserves a royalty-free, nonexclusive, and irre!vocable license to Ireproduce, publish, and use such materials, in whole or in part, and to authorize ()thers to do so. 34. Nonparticlpatlon In Political Activities The Subre!cipient shall comply with the provisions of the Hatch Act (5 USC, Chapter 15). 35. Real Property Acquisition The Subrecipient shall comply with the applicable provisions of 49 CFR 24 re~~arding the use of federal funds for acquisition of real property, and with the applicable pr1ovisions of CDBG Subrecipient Agreement Pro1~m Year 2004 Page 21 Education, l-tospitals, and other Non-Profrts. Non-profits receiving CDBG funds shall establish written procurement procedures as per the requirements of 24 CFR 84.44. CDOO Subrecipient Agreement Pro'gram Year 2004 Page 23 EXHIBIT F STATISTICAL REPORT OF SERVICES PROVIDED (TABLE 1 NOT APPUCABLE TO LAND ACQUISITION - PROCEED TO TABLE 2and 3 and Exhibit F-1) Project Title: Month(s) of: Subrecipient Name~: TABLE 1 Cumulative for Quarter Month 1 Month 2 Month 3 Number % of Number % of Total Total Number % of Total Number %of Total Extremely Low Low Moderate Total of Persons. Served Meeting Program Income LImits Total Persons Served · Client data must be collected based on the client's family. A low- to moderate-income person Is defined by HUD as a member of a family having an Income equal to olr less than the low- to moderate-lncome limits established by HUD In the table on page 7. ,~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 O1ther person(s) related to him/her is considered to be a one person family for this pUlrpose. 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 010 other student housing) is considered for these purposes to 1M! part of the family upon which helshe Is dependent, even though he/she is living in an()lther housing unit. ' CDBG Subrecq)ient Agreement Program Year 2004 Page 25 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: Additional Members: Total Monthly Inc,ome Sources for All Family Members Living In Household Employment, 'Gross Income: Other Resources Social Security/5SI: Other Pension: Unemployment Public Welfare: Child Support: Alimony: Veteran's Benefits: Total Monthly Income: Ethnlcity and Race Grantees are to ask respondents to identify their clients ethnicity prior to askin" them to Identify their race. Hispanic will now be considered an ethnicity category rather than a race category . Please check one ethnlclty about the client: Hispanic or Latino Not Hispanic lor Latino Please select one or more of the following as self identified by the client: American Indian/Alaskan Native Asian Black/African American Native HawaUanlPacific Islander White Please complete the following about the client. Disabled Female Headed Household yes_ no yes_ no CDBG Subrecipiient Agreement Prog'ram Year 2004 Page 27 $ Page 1 /1 r~' CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541) 488-5300 06191 VENDOR: 005068 ASHLAND COMMUNITY LAND TRUST PO BOX 3027 ASHLAND, OR 97'520 SHIP TO: Ashland Planning Department (541 ) 488-5305 51 WINBURN WAY ASHLAND, OR 97520 FOB Point: Terms: Net Req. Del. Date: Speciallnst: Req. No.: Dept.: COMMUNITY DEVELOPMENT Contact: Brandon Goldman Confirming? No BILL TO: Account Payable 20 EAST MAIN ST 541-552-2028 ASHLAND, OR 97520 SUBTOTAL TAX FREIGHT TOTAL 14000.00 0.00 0.00 14,000.00 ~ ~ P7~.r Aut rlzed Signature VENDOR COPY CITY OF A~;HLAND REQUISITION FORM THIS REQUEST IS A: Purchase Order o Change Order( existing PO # ) Date of REK1uest: 8-04-05 Required Date of Delivery/Service: 8-30-05 completion Vendor Name Address City, State, Zip Telephone Number Fax Number Contact Name Ashland Community Land Trust PO Box 3027 Ashland, OR, 97520 488.7276 Shelley Austin, ACL T Executive Director Sole Source Written findings attached Invitation to Bis( (Copies on file) f:1ennediate Procurement (3) Written Quotes (Copies attached) Eroerative Procurement State of ORIWA contract X Other government agency contract CDBG Contract # Reauest for p~~ (Copies on file) SoecIall Exemm Written findings attached Emeraencv Written findings attached X Copy of contract attached Description of SERVICES T'otal Cost x , Per CDSG Subrecipient Contract (attached) for Rehabilitation of the duplex at 264 Grant Street. ACL T is the Subrecipient for the CDBG federal grant. ACL T contracts with contractors to complete the rehabilitation work as eligible and in accordance the CDSG program regulations, Incfuding but not limited to Roof re lacement, bathroom re air, aintin and weatherization. Item # Quantity Unit Description of MATERIALS Unit PrlCl8 Total Cost Project Number _ _ _ _ _ _. _ __ o Per attached QUOTE Account Number 250.09.00.00.609199 * Items and services must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accurate/}'. By signing this requisition form, Ilcsrtify that the iJformation provided above meets the City of Ashland public contracting wW~ docunemaUon can bepro1ffL Employee SlgnatuaM . _ ) Supervlsor/Dept. Head Signature:' tJ . . ~ Upda1ed on: 814/2005 G: Flnance\Procedure\AP\Fonns\8_Requisltbra form revised.doc CITY OF ASHL.AND Today's Date: August 4.2005 Requested Check Issue Date ASAP Please note Vendors an~ paid Net 30 (30days) from today's date if not otherwise specifi~oo. Request(s) must be in A~ccounts Payable Inbox by 5:00pm Friday to be issued the follovring Friday. I Reguest for Check ~ To be used for the following: · Grants and Debt Services (CDBG GRANT) Payee: Ashland Community Land Trust Address: _Po Box 3027 City, State, Zip Ashland.. Oree:on.. 97520 ACLT to pick up the eheck by hand. Please call Shelley Austin (ACLT, Exec. Director) at 488-7276 once available and she will retrieve it directly. Description Partial Payment for rehabilitation work on 264 Grant Street as funded by the Communi1ty Development Block Grant Program. (CDBG Subrecipient contract attached). The total CDBG grant amount is for 14,000, however remainder ($3193.05) will only be distributed after completion of the remaining work. 1'.0. ~ ~<A.~Q11J1tl'tljmb.e.. 250.09.00.00.609199 Amount 10,806.95 .JUnoilnt Requested by: Brandon ~Goldman I Return check to: Send check with I attachment G:\comm-dev\Housing\CDBG\projo::ts by subrecipients\ACL 1\2003-Grant_ duplex\4 _ req for check _REHAB _ 8-03-05.docUpdated on :08/04/05