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HomeMy WebLinkAboutMINUTES - 02271996 - C84 TO BOARD OF SUPERVISORS Contra o FROM: JOAN V. SPARKS, DIRECTOR Costa COMMUNITY SERVICES DEPARTMENT t. County DATE: February 8, 1996 N SUBJECT: APPROVAL OF 1996 STANDARD AGREEMENT#39-800-1 WITH THE STATE DEPARTMENT OF COMMUNITY SERVICES AND DEVELOPMENT FOR LOW INCOME WEATHERIZATION ASSISTANCE PROGRAM SERVICES SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION I. RECOMMENDED ACTION: APPROVE and AUTHORIZE the Community Services Director or her designee to execute and submit to the State, on behalf of the County, the 1996 State Standard Agreement#96C-9003 (County Contract Number 39-800-1) with the State Department of Community Services and Development in the amount of $22,188, for the period from January 1, 1996 through March 31, 1997, for continuation of Low Income Weatherization Assistance Program services. II. FINANCIAL IMPACT: This Contract is Federally funded through the State Department of Community Services and Development. Funding from this agreement for the period from January 1, 1996, through June 30, 1996, is reflected in the Community Services Department's FY 1995-96 budget. Funding for the period from July 1, 1996, through March 31, 1997, will be reflected in the Department's FY 1996- 97 budget. No County funding is required. III. REASONS FOR RECOMMENDATIONS/BACKGROUND: The budget negotiations in Washington, D.C. are still in progress and the State has not yet received a grant award letter from the U.S. Department of Energy regarding its 1996 allocation. When the Department of Energy releases the 1996 award notice to the State, the contract will be amended to include the new allocation. Contract #39-800-1 allows program services to continue for eligible county residents. This contract will be reviewed and approved as to form by County Counsel prior to submission to the State. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOA D COMMITTEE APPROVE OTHER SIGNATURE(S): - ACTION OF BOARD ON February 27, 1996 T -APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS X 1 HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. CONTACT: Joan Sparks, 313-7350 CC: CAO ATTESTEDFebruary27,1996 CSD PHIL BATCHELOR,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR BY , ,DEPUTY M382 (10/88) 61 q y' t INCOMING FUNDS NARRATIVE STATEMENT 1. PROJECT/PROGRAM TITLE. Low Income Weatherization Assistance Program. 2. FUNDING AGENCY. State Department of Community Services and Development. (Department of Economic Opportunity in 1995) 3. SUBMITTAL STATUS. This agreement continues a current program. 4. PROPOSED TERM. January 1, 1996 through March 31, 1997. 5. CURRENT FUNDING. $22,188 of federal funding through the State Department of Community Services and Development. This amount represents a percentage of last year's funding. Budget negotiations in Washington, D.C. are still in progress and the State has not yet received a grant award letter from the U.S. Department of Energy regarding its 1996 allocation. The agreement may be amended to add funds when the Department of Energy releases the 1996 award notice to the State. 6. FUTURE FUNDING. This has been a long-range program for which funding is expected to continue. The amount of future funding is dependent upon Congressional action. 7. BUDGET SUMMARY. A budget is being prepared to cover the amount of funding under this agreement. A revised budget will be prepared when the total amount of 1996 funding is determined. 8. STAFFING REQUIREMENTS. Darnell Turner will be responsible for administration of this project. 9. PROGRAM NEED. The Weatherization Program is needed to provide for energy efficient measures and savings to low-income residents of our County. Contra Costa County participation in this program is part of a national objective established by the federal government to ensure that low-income communities would be able to achieve energy savings on utility bills and gain some knowledge of how to use their utilities more efficiently. All clients served by this program must meet the federal poverty income guidelines as indicated by the program regulations. 10. RELATIONSHIP TO OTHER PROGRAMS. The Weatherization Program in this County interfaces with various County, city, and community-based organizations to prevent the duplication of services and efforts. The Housing/Energy Program Manager has established linkages with various agencies in our County and conducts community needs assessments to maintain a level of contact and resources referrals. 1 r The Community Services Department, Housing and Energy Division currently collaborates with the cities of Concord, Antioch, Richmond and the County's Housing Authority in the sharing of information and referral. 11. PROJECT GOALS. The goal of this program is to provide energy savings measures to low-income communities which result in reduced energy costs under the Low Income Weatherization Program. 12. STATED OBJECTIVES. The objectives of this program are: a. To provide energy savings measures to the low-income communities which result in reduced energy costs. b. To educate low-income residents on how to achieve cost reductions as it relates to energy efficiency in the home. c. Assist clients with utililty bill assistance payments. All clients served by this program must meet the federal poverty income guidelines as indicated by the program regulations. Once the service has been completed, we have meet the objective in addressing the energy deficiencies of the clients energy concerns and awareness. 13. ACTIVITY SUMMARY. This program is operated by the Community Services Department Housing and Energy Division staff and management. The Housing and Energy Division is responsible for the administration of the Weatherization Program and the reporting of all program activities. 14. EVALUATION METHOD(S). Darnell Turner, Program Manager for the Housing and Energy Division will be responsible for Weatherization Program administration. The evaluation tools used in determining our outcomes is measured by the number of homes served and indicated in our work plan as listed in our contract. Once a home has been serviced by our crews, the Assessor is assigned to check for all work performed and completed. All work performed by our staff will be reviewed by the Program Manager for accuracy and compliance. 15. CHANGES COMPARED TO PRIOR YEAR (if any). NONE 16. POTENTIAL CONTROVERSIAL ISSUES. NONE 2 STATE-aF CALIFORNIA T- APPROVED BY THE CONTRACT NUMBER AM.NO. STANDARD AGREEMEN ATTORNEY GENERAL 96C-9003 STU.2(REV.5.91) TAXPAYERS FEDERAL EMPLOYER IDENTIFICATION NUMBER THIS AGREEMENT,made and entered into this 1St day of January 19_26, 94-6000509 in the State of California,by and between State of California,through its duly elected or appointed,qualified and acting TITLE OF OFFICER ACTING FOR STATE AGENCY Duty Director Admin. Dept of Community Services and Development ,hereafter called the Slate,and CONTRACTOR'S NAME Contra Costa County(Community Services Department) x`39-800-1 hereafter called the Contractor. WITNESSETH: That the Contractor for and in consideration of the covenants,conditions,agreements,and stipulations of the State hereinafter expressed, does hereby agree to furnish to the State services and materials as follows: (Set forth service to be rendered by Contractor,amount to be paid Contractor, time for performance or completion,and attach plans and specifications,if any.) WHEREAS, pursuant to 42 United States Code (USC)• 6861 et seq. , as amended, Contractor desires to implement the Department of Energy (DOE) Low-Income Weatherization (WX) Assistance Program to weatherize the dwellings of the eligible low-income population residing within the designated service area as described in Exhibit C. 1 . Consideration A. The total consideration payable by the State. to Contractor for DOE WX assistance under This Agreement shall not exceed $ 22 , 188 . 00 , as set forth in Exhibit F. B. The consideration to be paid Contractor, as provided herein, shall be in compensation for Contractor' s performance installing weatherization measures specified in Section 31 .D of This Agreement . Contractor will also be compensated for all other reasonable expenses incurred in the performance of This Agreement, including travel and per diem. CONTINUED ON SHEETS,EACH BEARING NAME OF CONTRACTOR AND CONTRACT NUMBER. The provisions on the reverse side hereof constitute a part of this agreement. IN WITNESS WHEREOF,this agreement has been executed by the parties hereto,upon the date first above written. STATE OF CALIFORNIA CONTRACTOR AGENCY _ CONTRACTOR(l/other than an individual,state whether a corporation,partnership,etc.) BY(A THORIZED SIGNATURE) BY(AUTHORIZED SIGNATURE) P_ D PRINTED NAME OF PERSON SIGNING PRINTED NAME AND TITLE OF PERSON SIGNING Joan Sparks, Director TITLE ADDRESS AMO T EN MBERED BY THIS PROGRAM/CATEGORY(CODE AND TITLE) FUND TITLE Department of General Services DOCUMENT `r Use Only 20 -50 (OPTIONAL USE) I hereby Certify that all conditions PRIOR AMOU NC PD THIS CONTRACT for exemption have been com- 0 ITEM CHAPTER STATUTE FISCAL YEAR plied with, and this document is TOTAL AMOUNT ENCUMBERED TO - - exempt from the Department of DATE OBJECT OF EXPENDITURE(CODE AND TITLE) $ General Services'approval. I hereby certifj upon my own personal knowledge that budgeted funds T T.B.A.NO. B.R.NO. are available for the period and purpose of the expenditure stated above. SIGNATURE OF ACCOUNTING OFFICER DATE l> 1-1 CONTRACTOR ❑ STATE AGENCY DEPT.OF GEN.SER. CONTROLLER (96C/DOE) C. The total amount budgeted for Administrative Costs shall not exceed the limits described in Section 30.13. Adherence to Section 23.D, regarding equipment purchase or lease, is required and is not altered by the provisions of this Section. Expenditures in excess of the budget total shall not be reimbursed by the State. 2. Term The term of This Agreement shall be from January 1, 1996 through March 31, 1997. 3. Indemnification Contractor agrees to indemnify, defend, and save harmless the State, its officers, agents, and employees from any and all claims and losses accruing or resulting to any and all contractors, subcontractors, materialmen, laborers, and any other person, firm, or corporation furnishing or supplying work, services, materials, or supplies in connection with the performance of This Agreement, and from any and all claims and losses accruing or resulting to.any person, firm, or corporation that may be injured or damaged by Contractor in the performance of This Agreement. 4. Independent Contractor Contractor and its agents and employees, in the performance of This Agreement, shall act in an independent capacity and not as officers, employees, or agents of the State. 5. Suspension and Termination A. Suspension 1. If Contractor or subcontractor has failed to. comply with the performance-based terms of This Agreement, the State may, upon reasonable notice to Contractor or subcontractor, suspend This Agreement in whole or in part. The State may suspend This Agreement, in whole or in part, if Contractor has demonstrated two consecutive contract terms of unexpended funds in an amount of 10% or greater of their contract amount. The 93C DOE contract was designated the base-year or the inception year to calculate the specific time-frame denoting the first in a series of"consecutive" years. Additionally, the State may mandate special contract conditions which may require subcontracting of the DOE weatherization services. In the case of fraud or gross negligence, suspension.without prior notice by the State is permissible. 2 (96C/DOE) �• D� y 2. The notice of suspension shall state the reasons for the suspension, corrective action required of Contractor to comply with the terms of This Agreement, and the effective date of the suspension. 3. A suspension shall remain in effect until Contractor has taken corrective action satisfactory to the State, or has provided evidence satisfactory to the State that such corrective action will be taken. 4. New obligations incurred by Contractor under This Agreement during the suspension period will not be allowed unless expressly authorized by the State in the notice of suspension or in a written authorization document. B. Termination 1. The State may terminate This Agreement and be relieved of the.payment of any consideration to Contractor should Contractor fail to perform the covenants contained herein at the time and in the manner provided herein. In the event of termination, the State may proceed to perform the covenants contained herein in any manner deemed proper by the State. The State retains lien rights on all funds advanced. 2. Either party to This Agreement may terminate it at any time prior to its date of expiration upon thirty (30) calendar days notice to the other party. Such notice shall be delivered to the other party in writing, stating the reason for termination and the effective date thereof. 3. Upon termination of This Agreement, the State, unless expressly granted in writing, shall not pay Contractor for any obligations incurred after the effective date of such termination. 6. Assignment Without the written consent of the State, This Agreement is not assignable by Contractor either in whole or in part. 7. Subcontracts A. Prior to the provision of subcontracted services, Contractor shall provide board resolutions, stating compliance with all the terms and conditions of This Agreement, from all of Contractor's subcontracted nonprofit and local government agencies who shall perform services in the regionalized area described in Exhibit C. 3 (96C/DOE) C'0 B. For all other types of subcontracting, Contractor shall provide to the State within sixty (60) calendar days of execution, the name of the entity, address, telephone number, contact person, contract amount, and program description of each subcontractor to This Agreement. C. Contractor shall assure that subcontractor(s) comply with all terms and conditions of This Agreement. D. Contractor shall immediately notify all of its subcontractor(s) in writing in the event the State suspends or terminates This Agreement. E. Contractor is the responsible party, without recourse to the State, regarding the settlement and satisfaction of all contractual and administrative issues arising out of subcontracts entered into in support of This Agreement, including but not limited to disputes, claims, or other matters of a contractual nature as well as civil liability arising out of negligence or intentional misconduct of subcontractor(s). 8. Time Time is of the essence in the performance of This Agreement. 9. Amendment - Modification A. No alteration or variation of the terms of This Agreement shall be valid unless made in writing in the form of an amendment-modification and signed by the Parties. Exceptions to this requirement are line item changes to the contract budget which do not affect the maximum amount payable under,the contract or the work to be performed, and the exceptions provided for in Section 15, Provisions for Federally- Funded Grants. 1. Request for Amendment/Modification - Energy, CSD 509 (Rev. 1/96) is provided . to submit changes to Exhibit E, Schedule of Energy Program Goals/Expenditures, and Exhibit F, the DOE Weatherization Program Budget. 2. Said requests shall be submitted no later than forty-five (45) calendar days prior to the expiration date of This Agreement. 3. Contractor will advise the State when proposed changes to the contract also affect the Program Budget. B. No oral understanding or agreement not incorporated herein shall be binding on any of the Parties. C. Contractor shall not revise weatherization goals solely for the purpose of meeting the performance-based requirement set forth in Section 29.A 4 (96C/DOE) C' 2,q D. CSD shall not approve a term extension solely for the purpose of meeting weatherization goals. 10. Enforceable Agreement This Agreement shall become a valid, enforceable agreement only after it is signed by authorized agents of the parties. 11. Equitable Treatment Contractor shall assure that owners and renters receive equitable.treatment under this program. 12. Compliance with Rules and Regulations Activities of Contractor with respect to This Agreement.shall be conducted in accordance with pertinent Federal and State rules and regulations, including relevant Office of Management and Budget (OMB) Circulars and amendments thereto. 13. Record-Keeping Resl2onsibilities A. All records maintained by Contractor shall meet the OMB requirements contained in the following circulars: Common Rule, Subpart C, ("Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments") Local Governments or A-110, Subpart C, Nonprofit Organizations, whichever is applicable. B. Contractor shall maintain all records pertaining to This Agreement for a minimum period of three years after submission of the final report. However, Contractor shall maintain all such records until resolution of all audit findings is completed. C. Contractor shall make appropriate books, documents, papers, and records available to the Federal government, the State, or any of their duly-authorized representatives, including representatives of the entity selected by CSD to perform inspections, for examination, copying, or mechanical reproduction, on or off the premises of the appropriate entity upon a reasonable request therefore. D. Contractor shall maintain a separate file for each applicant certified as eligible to receive assistance. Said files shall-include at least the following documentation: 1. Intake and Job Order Sheet, CSD 565 (Rev. 1/96). 2. Copies of source documents supporting eligibility. 5 (96C/DOE) 07 3. Building Check and Job Order Sheet or Contractor's equivalent. E. Contractor shall also maintain an Intake.and Job Order Sheet, CSD 565 (Rev. 1/96) and supporting documents, if any, including any appeal documents, for each applicant who is not certified as being eligible to receive assistance. F. Contractor assures that employee and applicant records shall be maintained in a confidential manner to assure compliance with the Information Practices Act of 1977, as amended, and the Federal Privacy Act of 1974, as amended. 14. Insurance and Fidelity Bond A. General Requirements 1, Third-Party Insurance a. By execution of This Agreement, Contractor agrees that the below required insurance policies and bond shall be in effect at all times during the term of This Agreement. b. Contractor shall provide the State with written notice at least thirty (30) calendar days prior to cancellation or reduction of insurance coverage to an amount less than that required in This Agreement. c. In the event said insurance coverage expires at any time or times during the term of This Agreement, Contractor agrees to provide, at least thirty (30) calendar days prior to said expiration date, a new Certificate of Insurance evidencing insurance coverage as provided for herein for not less than the remainder of the term of This Agreement. d. In the event Contractor fails to keep in effect at all times insurance and bond coverage as herein provided, the State may suspend This Agreement. e. The State shall be named as additional insured on all certificates of insurance, except workers' compensation and fidelity bond, required under This Agreement. 2. Self-Insurance When Contractor is a governmental entity which self-insures, the State, upon satisfactory proof, will waive the appropriate insurance requirements upon written certification. This certification shall be signed by an appropriate county or city risk manager and contain assurance of the adequacy of the governmental entity's ability to cover any potential losses under This Agreement.and shall specify which areas 6 (96C/DOE) Contractor will self-insure. Should Contractor utilize subcontractor(s) to provide services under This Agreement, Contractor shall indemnify and hold the State harmless against any liability incurred by the subcontractor(s). B. Workers' Compensation Insurance 1. Contractor shall have and maintain, for the term of This Agreement, workers' compensation insurance issued by an insurance carrier licensed to underwrite workers' compensation insurance in the State of California. 2. Unless a current copy is on file with CSD, Contractor shall submit either an applicable Certificate of Insurance(ACORD 25) or a Certificate of Consent to Self- Insure issued by the Director of the Department of Industrial Relations to the State as evidence of compliance with the worker's compensation insurance requirement prior to issuance of an initial cash advance. C. Fidelity Bond 1. Contractor shall maintain a fidelity bond in the minimum amount of eight percent (8%) of the total amount of consideration set forth under This Agreement. 2. Contractor shall submit an applicable Certificate of Insurance (ACORD-25) to the State as evidence of compliance with the fidelity bond requirement prior to issuance of an initial cash advance. D. Public Liability Insurance 1. Contractor shall have and maintain for the term of This Agreement general liability and property damage insurance for a combined single limit of not less than $500,000 per occurrence. 2. Unless a current copy is on file with CSD, Contractor shall submit an applicable Certificate of Insurance (ACORD 25), naming CSD as an additional insured, to the State as evidence of compliance with public liability insurance requirements prior to issuance of an initial cash advance. E. Vehicle Insurance 1. Contractor shall have and maintain for the term of This Agreement vehicle insurance in the amount of$500,000 for each.person and each accident for bodily injury and in the amount of$500,000 for each person and each accident for property damage. 7 (96C/DOE) e / 2. When employees use their own vehicles to perform duties within the scope of their employment, Contractor shall have and maintain for the term of This Agreement non-owned and hired-auto liability insurance in the amount of$500,000 for each person and each accident for bodily injury, and $500,000 for each person and each accident for property damage. (Driving to and from work is not in the scope of employment.) 3. Unless a current copy is on file with CSD, Contractor shall submit an applicable Certificate of Insurance (ACORD 25), designating CSD as an additional insured, to the State as evidence of compliance with said vehicle insurance requirements prior to issuance of an initial cash advance. 15. Provisions for Federal]y_Funded Grants A. It is mutually understood between the parties that This Agreement may have been written before ascertaining the availability of congressional appropriation of funds, for the mutual benefit of both Parties, in order to avoid program and fiscal delays which would occur if This Agreement were executed after that determination was made. B. This Agreement is valid and enforceable only if sufficient funds are made available to the State by the United States Government for the purposes of This Program. In addition, This Agreement is subject to any additional restrictions, limitations, or conditions enacted by the Congress or any statute enacted by the Congress which may affect the provisions, terms, or funding of This Agreement in any manner. C. It is mutually agreed that if the Congress does not appropriate sufficient funds for This Program, This Agreement shall be amended to reflect any reduction in funds. D. The State has the option to void This Agreement under the thirty-day (30) cancellation clause, pursuant'to Section S.B.2., or to amend This Agreement to reflect any reduction of funds. 16. Limitation on Use of Funds Contractor shall assure that funds received under This Agreement shall not be used for the purchase or improvement of land, or for the purchase, construction, or permanent improvement of any building or other facility other than low-income weatherization energy-related home repairs. 17. Right to Monitor. Audit, and Investigate A. Any duly-authorized representative of the Federal or State government, which includes but is not limited to the Bureau of State Audits and the entity selected by 8 s (96C/DOE) CSD to perform inspections, shall have the right to monitor and audit Contractor and all subcontractors providing services under This Agreement through on-site inspections, audits, and other applicable means the State determines necessary. 1. Unless Contractor assumes the task of arranging inspection visits with the selected weatherization clients, Contractor shall provide the use of a telephone to the inspector. 2. Contractor is not expected to accompany the inspector on client inspection visits, to provide transportation, or to provide equipment to the inspector unless Contractor desires to do so. The inspector, however, will permit Contractor personnel to participate in client visits. B. Any duly-authorized representative of the Federal or State government shall have the right to undertake investigations in accordance with 42 USC 6861 et seq., as amended. C. All agreements entered into by Contractor with audit firms for purposes of conducting independent audits under This Agreement shall contain a clause permitting the State or a duly-authorized representative of the State or Federal government access to the working papers of said audit firm(s). 18. Contractor's National Labor Relations Board Certification Contractor hereby certifies under penalty of perjury that no more than one final unappealable finding of contempt of court, by a Federal Court, has been issued against Contractor within the immediately preceding two-year period because of Contractor's failure to comply with an order of a Federal Court which orders Contractor to comply with an order of the National Labor Relations Board. 19. Nondiscrimination Compliance A. Contractor hereby certifies compliance with the following: 1. Federal Executive Order 11246, as amended by Executive Order 11375, relating to equal employment opportunity. 2. Title VI and.Title VII of the Civil Rights Act of 1964, as amended. 3. Rehabilitation Act of 1973, as amended. 4. Vietnam Era Veterans Readjustment Assistance Act of 1972, as amended. 5. Title 41, Code of Federal Regulations (CFR), Chapter 60, Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor. 6. Public Law 101.336, Americans with Disabilities Act of 1990. 9 (96C/DOE) • /y B. Contractor agrees to abide with and shall include the nondiscrimination and compliance provisions of the following clause in all subcontracts to perform work under This Agreement: "During the performance of this contract, Contractor and its subcontractors shall not unlawfully discriminate, harass or allow harassment, against any employee or applicant for employment because of sex, race, color, ancestry, religious creed, national origin, physical disability (including HIV and AIDS), mental disability, medical condition (cancer), age (over 40), marital status, and denial of family care leave. Contractors and subcontractors shall insure that the evaluation and treatment of their employees and applicants for employment are free from such discrimination and harassment. Contractor and subcontractors shall comply with the provisions of the Fair Employment and Housing Act (Government Code, Section 12900 et seq.) and the applicable regulations promulgated thereunder (California Code of Regulations, Title 2, Section 7285.0 et seq.). The applicable regulations of the Fair Employment and Housing Commission implementing Government Code, Section 12990 (a-f), set forth in Chapter 5 of Division 4 of Title 2 of the California Code of Regulations are incorporated into this contract by reference and made a part hereof as if set forth in full. Contractor and its subcontractors shall give written notice of their obligations under this clause to labor organizations with which they have a collective bargaining or other agreement." C. Contractor's signature affixed hereon shall constitute a certification under the penalty of perjury under the laws of the State of California that to the best of its knowledge will, unless exempted, comply with the nondiscrimination program requirements set forth in this section. 20. Affirmative Action Compliance A. Each Contractor or Subcontractor that has fifty (50) or more employees and has an agreement of fifty thousand dollars ($50,000) or more shall be required to develop a written Affirmative Action Compliance Program. B. The written program shall follow the guidelines set forth in Title 41, CFR, Section 60-1.40, Sections 60-2.10 through 60-2.32, Sections 60-250.1 through 60-250.33, and Sections 60-741.4 through 60-741.32. C. Each Contractor or subcontractor with less than fifty (50) employees shall comply with Section 202 of Part 11 of Executive Order 11246, as amended by Executive Order 11375. Contractor shall ensure that subcontractors falling within the scope of this provision shall comply in full with the requirements thereof. 10 c �y (96C/DOE) 21. Fair Hearing_Process for Alleged Violation of the Civil Rights Act Against Contractor A. In the event of any violation or alleged violation of Title VI of the Civil Rights Act of 1964, as amended, Contractor has the right to request a fair hearing in response to such violation or alleged violation within thirty (30) calendar days from the date of such action. B. The State shall conduct such fair hearing in accordance with Title 45, Code of Federal Regulations, Section 81.1. 22. Fair Hearing Process for Applicants for Denial of Benefits by Contractor A. Contractor shall inform, at the time of intake, all applicants of their right to appeal all claims for assistance that are denied or are not acted upon with reasonable promptness. 1. Contractor shall conduct a structured, fair, and impartial meeting within five (5) working days of the initial request for appeal and shall make a good faith effort to resolve the applicant's complaint(s) at the local level. Contractor shall make a written finding which sets forth the case of both parties and the decision of Contractor. 2. If the appeal is not resolved to the satisfaction of the applicant at the local level, Contractor shall inform the applicant that an appeal to the State may be requested as part of the Fair Hearing process and shall provide the applicant with an appropriate form. 3. If the applicant decides to appeal to the State, applicant shall submit a written appeal request to be received by the State within ten (10) working days from the date of Contractor's final decision. Upon request from CSD, Contractor shall provide all supportive documentation to be received by the State within five (5) working days. 23. Contractor Assurances and Certification A. Contractor certifies that it possesses legal authority to apply to the State for grants funded under the DOE Weatherization,Assistance Program for Low-Income Persons and assures compliance with the purposes as set forth in 42 USC-6861, et seq., as amended. 11 (96C/DOE) B. Contractor assures that its governing body has adopted and passed a resolution, specific to This Agreement, which shall be forwarded to the State and which includes, at a minimum, the following provisions: 1. Authorization for the submittal to the State of This Agreement, including all exhibits and assurances contained herein; and 2. The name and signature of the chairperson of the board;.the date signed by the chairperson; and, if applicable, the date the resolution was ratified by the board of directors; and 3. Authorization to, and identification of, the person certified as the official representative of the governing board to sign and enter into This Agreement; and 4. Identification of contract number and program; and 5. Authorization to, and identification of, the person certified as the official rep- resentative of the governing board to enter into and accept any subsequent amendments to This Agreement and revisions to exhibits, along with a statement specifying whether the governing board intends to delegate authority for amendments which alter Section 1, Consideration, and/or Section 2, Term of This Agreement; and 6. A statement which stipulates whether the governing board intends to delegate authority for changes to Exhibit D, Assistance Priority and Limits. 7. A statement, if subcontracting DOE Weatherization services with a nonprofit or local government entity, that identifies the name of the subcontracted entity, the type of DOE services to be provided by that entity, and the service area where subcontracted activities shall occur. C. 'Contractor assures that it shall exercise due care in the use, maintenance, protection, and preservation of State-owned property in Contractor's possession or any other property Purchased by Contractor with State funds. Such care shall include, but is not limited to the following: 1. Maintaining insurance coverage against loss or damage to such property. 2. Ensuring that the legal ownership of any motor vehicle or trailer is in the name of the Contractor. 12 (96C/DOE) D. Contractor acknowledges that this is a performance-based contract as cited in Section 29.A. and assures that all supplies, materials, equipment, or services purchased with funds provided by This Agreement shall be used solely for the activities allowed under This Agreement unless a fair market value for such use is charged to the benefiting program and credited to This Agreement. 1. Contractor shall adhere to its established policy and procedures regarding the purchase or lease of equipment having an aggregate cost of five-thousand dollars ($5,000.00) or more. Policy and procedures will be in conformance with OMB requirements.contained in the following Circulars: Common Rule, Subpart C, or A- 110, and approved by the Board of Directors. 2. Include the type and cost of equipment or material to be purchased or leased on the appropriate line item of the budget. If the purchase or lease of equipment is not included in the execution of This Agreement, CSD Form 558, Request for Purchase- Lease Approval must be submitted to CSD for approval. 3. Notwithstanding adherence to.OMB requirements contained in the following Circulars: Common Rule, Subpart C, or A-110, or prior approval from a Board of Directors to procure, prior approval for the purchase or lease of motor vehicles and trailers must be obtained from CSD by submitting CSD Form 558 in each instance. E. Contractor assures that it shall be in compliance with Federal and State Occupational Safety and Health Statutes, the California Safe Drinking Water and Toxic Enforcement Act of 1986, and Workers' Compensation laws. F. Contractor assures that it shall conduct outreach activities designed to assure that eligible households with elderly, disabled, American Indian, migrant or seasonal farm worker individuals, and children age 18 and under are made aware of the assistance available under This Agreement: G. Contractor assures that it shall be in compliance with anti-discrimination provisions of Section 102 of the Immigration Reform and Control Act of 1986, as well as requirements disqualifying certain legalized aliens from receiving benefits under This Agreement for five (5) years from the date they were granted temporary resident status even if they have been provided status according to Section 245A (amnesty or legalization) and 210A (replenishment workers) of the Immigration and Nationality Act, as amended. 13 (96C/DOE) H. Federal Certification Regarding Debarment Suspension. and Related Matters Contractor hereby certifies to the best of its knowledge that it or any of its officers: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; 2. Have not within a three (3) year period preceding This Agreement been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, orperforming a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 3. Are not presently indicted for or otherwise criminally- or civilly-charged by a governmental entity (Federal, State, or local)with commission of any of the offenses enumerated in paragraph 2 of this certification; and 4. Have not within a three (3) year period preceding This Agreement had one or more public (Federal, State, or local) transactions terminated for cause or default. I. Drug-Free Workplace Certification Contractor certifies that a Drug Free Workplace Certification (Std. 21) is on file with CSD. The terms and conditions of Std. 21 shall have the same force, meaning, effect, and enforceability as if a certification were separately, specifically, and individually provided for each.grant between Contractor and CSD. J. Contract Administration Contractors shall administer This Agreement in accordance with OMB requirements contained.in the following Circulars: Common Rule, Subpart C, for public agencies; A- 110 for nonprofit organizations. K. Contractor Licensing Contractors that are nonprofit organizations and are performing weatherization activities under This Agreement certify that they possess an active Class "B", General Building Contractor license, issued by the Contractors' State License Board. 14 C (96C/DOE) 24. Conflict of Interest A. Contractor certifies that its employees and the officers of its governing body shall avoid any actual or potential conflicts of interest, and that no officer or employee who exer- cises any functions or responsibilities in connection with This Agreement shall have any personal financial interest or benefit which either directly or indirectly, arise from This Agreement. B. Contractor shall establish safeguards to prohibit its employees or its officers from using their positions for a purpose which could result in private gain, or which gives the appearance of being motivated for private gain for themselves or others, particularly those with whom they have family, business, or other ties. 25. Political Activities A. Contractor shall refrain from all political activities if such activities involve the use of any funds which are the subject of This Agreement or any other funds, programs, projects, or activities which flow from This Agreement pursuant to 42 USC 9904(e), as amended. B. Contractor is prohibited from any activity which is designed to provide voters or prospective voters with transportation to the polls or to provide similar assistance in' connection with an election if such activities involve the use of any funds which are subject-to This Agreement. 26. Lobbying Activities A.. Contractor shall refrain from all lobbying activities if such activities involve the use of any funds which are the subject of This Agreement or any other funds, programs, projects, or activities which flow from This Agreement. B. If Contractor engages in lobbying activities, Contractor shall complete, sign, and date the Certification Regarding Lobbying/Disclosure of Lobbying Activities (Exhibit G). 27. Severability of Provisions Should a provision of This Agreement be held invalid by a court of competent jurisdiction, the remaining provisions of This Agreement shall continue to be valid and enforceable. 28. Addresses for the State All documents submitted by Contractor to the State pursuant to the terms of This Agreement shall be made by deposit in the U.S. Mail, first class, postage prepaid, or delivered by a commercial carrier bearing a legibly dated receipt, and addressed as follows: 15 (96C/DOE) Department of Community Services and Development ATTENTION: PROGRAMS BRANCH P.O. Box 780 Sacramento, CA 95812-0780 29. Programmatic Provisions A. Performance-Based Requirements Beginning in 1994, CSD established performance-based contracts. Attention to the distribution of carryover funds, or other funds designed to enhance DOE funds, shall consider previous year(s) adequate achievement of fiscal and programmatic performance. Adequate fiscal and programmatic performance will be the achievement of ninety percent (90%) of the stated goals and expenditures as submitted on CSD 564 (Rev. 1/96). Seventy-percent (70%) of the aforementioned 90% achievement shall have occurred prior to February 1, 1997. 1. Advance Payments a. Upon written request by Contractor, the State may issue an advance payment to Contractor in an amount not to exceed twenty-five percent (25%) of the total amount of This Agreement, as set forth in Section I.A. . b. In the event This Agreement is amended to increase the consideration of This Agreement, a subsequent advance payment not to exceed twenty-five percent (25%) of the amount of the increase may be authorized by the State, if Contractor requests such advance payment in writing. The need for such additional advance payment shall be based upon a review of Contractor's cash flow status as recorded on Contractor's current monthly expenditure report. c. Advance payments outstanding ninety (90) days prior to the expiration date of This Agreement will be offset against subsequent payments. 2. Subsequent Payments a. Payments to Contractor are contingent upon receipt by the State of the three-part Monthly Expenditure/Activity/Eamed Measures Report, CSD 571 (Rev. 1/96), as required under Section 29.0 of This Agreement. b. Contractor shall be entitled to obtain a maximum reimbursement of$1,854 per dwelling unit weatherized and for applying the conservation measures and activities described in Section 31.D. In the event the Governor declares a State of Emergency or Local Emergency under Article 13 or 14 of the Emergency Services Act, the maximum reimbursement shall be $2,000 per dwelling unit. 16 C• Sy (96C/DOE) c. In dwelling units in which the heating/cooling unit must be replaced, Contractor may expend no more than $2,750. This limitation includes all weatherization measures installed. d. Contractor may apply no more than 25% of the total program funds expended towards abating health and safety hazards based on heating and cooling services. e. Contractors will be authorized to abate health and safety hazards generated by heating/cooling sources, and to increase air exchange rates which are determined to be less than the minimum level. B. Contractor Activities 1. Coordination - Contractor shall refer potentially eligible applicants to other energy or conservation programs. Contractor shall coordinate its activities with other Federal, State, or local energy conservation programs with the goal of conserving energy, improving thermal efficiency, and defraying energy costs of low-income households. 2. Contractor shall not divide the application of individual weatherization measures between This Program and other weatherization programs unless the maximum CSD rate for a measure has been reached. 3. Client Education Contractor shall provide to all recipients of energy assistance under This Agreement applicable energy conservation information which shall include at least the following: a. A description of the benefits which the client can expect to receive as a result of the weatherization measures installed in the dwelling. b. An explanation of the action of each measure in terms of preventing air infiltration or the escape of heated or cooled air from the dwelling and how to maximize the effect of such measures. c. Written information which describes energy-saving behavioral adjustments which will decrease the energy consumption of the household. d. Resource information and referral, and family and budget counseling in order to assist clients in achieving self-sufficiency. 17 e . gY (96C/DOE) C. Reporting 1. Monthly Reports Contractor shall ensure that the monthly report consisting of the three-part Monthly Expenditure/Activity/Earned Measures Report, CSD 571 (Rev. 1/96) is received by the State on or before the 15th calendar day of each month, regardless of the level of activity or amount of expenditures during the previous month. 2. Close-Out Report Contractor shall submit, on the appropriate CSD forms, a financial and programmatic close-out report and return all unexpended funds to the State within ninety (90) days after expiration of This Agreement. Final reimbursement to Contractor, if owed, shall be contingent upon receipt of this close-out by the State. Subsequent payments for other CSD contracts may also be contingent upon receipt of the close-out of This Agreement. .3. Review a. The State shall review Contractor's monthly program operation reports and evaluate Contractor's demonstrated ability to effectively utilize all funds available under This Agreement. b. As set forth in Section 9, an amendment to the total consideration of This Agreement may occur as a result of the State's review of Contractor's program and fiscal operations. D. Audit Reports 1. Funds provided under This Agreeinent shall be included in an audit conducted in accordance with the provisions of OMB Circular A-133 for nonprofit agencies, or OMB Circular A-128 for public agencies, standards promulgated by the American Institute of Certified Public Accountants (AICPA), and those standards included in "Government Auditing Standards, 1994 Revision". 2. The financial and compliance audit shall contain the following supplementary financial information- a. A combining statement of revenue and expenditures for each contract which presents, by budget line item, revenue and expenditures for the contract or audit period. b. A computation sheet for each contract used to calculate the Contractor's earnings for the contract or audit period, including measurable values, and a 18 C . ?q (96C/DOE) schedule of administrative expenditures. The results of this calculation will be used to determine: (1) The amount due Contractor (2) The amount due CSD, or (3) Whether the Contractor has been paid in full 3. If the Contractor has used the same independent audit firm for more than five (5) consecutive years, the Contractor must submit, to the CSD Audit Services Unit, a written justification for using the same audit firm in excess of five (5) years and request approval from the Audit Services Unit to continue using the same audit firm. 4. Private, nonprofit contractors shall submit to CSD two (2) copies of the required audit report within one hundred eighty (180) calendar days of the end of the Contractor's fiscal year. Upon written request by the Contractor's CPA, which includes an explanation of why the audit cannot be submitted within one hundred eighty (180) calendar days of the end of the Contractor's fiscal year, an extension may be granted by CSD's Audit Services Unit for submittal of the audit report not to exceed thirty (30) calendar days from the original due date. The audit reports are to be submitted to the following address: Department of Community Services and Development Audit Services Unit 700 North 10th Street, Room 258 Sacramento, CA 95814 Attention: Audit Manager 5. Local governmental entities shall submit to CSD two (2) copies of the required audit report within thirty (30) calendar days after the completion of the audit, but no later than one (1) year after the end of the audit period.. The audit reports are to be submitted to the address stated in Section 4 above. a. Local governmental agencies shall submit the required number of copies of the audit report in accordance with the guidelines set by the Division of Audits of the State Controller's Office. Said reports are to be submitted to the following address: State Controller Division of Audits 300 Capitol Mall, Fifth Floor Sacramento, CA 95814 6. Where services or funds under This Agreement are provided to, for, or by a wholly- owned or wholly-controlled subsidiary of Contractor, Contractor hereby provides assurance that an audit shall be performed of this subsidiary organization in 19 (96C/DOE) accordance with this section 29.D. Said required audit report shall be made available to the State upon request. 30. Budget Definitions A. Cost Reporting All costs shall be reported using a "modified accrual" or "accrual" method of accounting. .B. Administrative Costs 1. Administrative Costs shall mean costs for auxiliary functions such as accounting, auditing, monitoring assistance, facilities, utility costs, and like services necessary to sustain the direct effort involved in administering a grant program or an activity providing services to the grant program. 2. Local governments shall use OMB Circular A-87 (Cost Principles for State and Local Governments) as a guide for determining administrative costs. 3. Private, nonprofit corporations shall use OMB Circular A-122 (Cost Principles for Nonprofit.Organizations) as a guide for determining administrative costs. 4. Unless applied for and approved on CSD 574 (Rev. 1/96), payment under this budget line item shall not exceed five percent ( 5 %) of the cumulative allowable program expenditures for weatherization activities performed under This Agreement. C. Program Costs '1. Program Costs are all allowable costs other than Administrative Costs. 2. Program Costs include those costs which are directly attributable to the performance of This Agreement, and which are reasonable and necessary as determined by the State, for the purpose of delivering services. Allowable costs shall be as set forth in Title 10, Code of Federal Regulations, Section 440.18(c). 31. Special Provisions A. Applicant Eligibility 1. Weatherization assistance services shall be available only to the following households: a. Households in which one or more individuals are receiving: 20 C. . 8 y (96C/DOE) 1) Aid to Families with Dependent Children (AFDC); or 2) Supplemental Security Income (SSI)/State Supplementary Program (SSP)payments; or 3) Food Stamps; or 4) Payments under Sections 415, 521, 541, or 542 of Title 38 of the United States Code, or under Section 306 of the Veterans' and Survivors' Pen- sion Improvement Act of 1978. OR b. Households with incomes that do not exceed an amount equal to one hundred fifty percent(150%) of the Federally-established poverty level. If applicable income records for a minimum period of at least sixty (60) days immediately preceding the date of application shall be used in determining eligibility based on income only. C. Appropriate documents shall be maintained in each applicant's file. 2. No household shall be excluded from eligibility for services if the household has an income which is less than one hundred ten percent(110%) of the Federally-. established poverty level. 3. The provision of weatherization services shall begin within one-hundred twenty (120) calendar days of eligibility certification or the household shall be recertified. B. Service Priority 1. Contractor shall give first priority for weatherization services to those households which have the lowest incomes and the highest energy cost in relation to income, taking into account family size. 2. Contractor shall factor into its first priority, eligible households with elderly, handicapped, and children. 3. Additional priorities shall be as set forth in Exhibit D. C. Scope of Services 1. Outreach Contractor may claim reimbursement for outreach as set forth in Section 31.D only once for each unit weatherized whether under This Agreement or a previous CSD agreement. 21 (96C/DOE) a. Unweatherized Dwellings Reimbursement for outreach maybe claimed by Contractor in accordance with Section 3 LD for each eligible unit not previously weatherized. Addi- tionally, Contractor will be allowed to claim reimbursement when a safety check of combustion appliances reveals safety hazards which preclude tightening of the envelope. b. Dwellings Weatherized with Nonfederal Funds Reimbursement for outreach may be claimed.by Contractor only if the previous weatherization was performed by another service provider. C. Dwellings Weatherized with Low-Income Home Energy Assistance Program (LII-1EAP) and DOE Funds Reimbursement for outreach may be claimed by Contractor only once when LII•IEAP and DOE funds are used concurrently in the same unit. 2. Intake a. Unweatherized Dwellings Reimbursement for intake may be claimed by Contractor in accordance with Section 31.D for each eligible household not previously weatherized. Addi- tionally, Contractor will be allowed to claim reimbursement when a safety check of combustion appliances reveals safety hazards which preclude tightening of the envelope. b. Dwellings Weatherized with Nonfederal Funds If the previous weatherization was performed under a nonfederal program, the occupant eligibility must be certified; therefore, Contractor may claim reim- bursement for intake. . C. Dwellings Weatherized with LII-1EAP and DOE Funds Reimbursement for intake may be claimed by Contractor only once when LHMAP and DOE funds are used concurrently in the same unit. 3. Assessment of Dwelling a. Contractor shall inspect the dwelling of each eligible applicant to determine if the unit is structurally sound and not in need of extensive repairs. 22 c, . 8q (96C/DOE) b. If the dwelling unit is not eligible becauseof the need for extensive repair, the unit shall not be serviced and the applicant should be referred to the local Housing and Community Development Department, U.S. Farmers Home Administration Housing Loan Program or other similar organizations or programs. C. Documentation of ineligibility due to the need for extensive repairs sha11 be recorded on the Intake and Job Order Sheet, CSD 565 (Rev. 1/96), and reported to CSD. d. If the applicant can obtain the necessary repairs to make the dwelling unit eligible for weatherization services, weatherization activities may be accomplished following the repair work. e. If an unvented space heater is being utilized, envelope-tightening measures shall not be applied unless venting is installed or the unit is replaced. f. Contractor shall conduct a preliminary combustion appliance safety check on all dwelling units that are not all-electric units, and, where applicable, perform a post-check of said dwelling, using the Combustion Appliance Safety Inspection Form (RHA 1/1/96). g. Reimbursement for assessment may be claimed by Contractor in accordance with Section 3 LD for each eligible household not previously weatherized. Additionally, Contractor will be allowed to claim reimbursement when a safety check of combustion appliances reveals safety hazards which preclude tightening of the envelope. h. Following a determination that no combustion by-product hazards exist, a blower door test may be performed on each dwelling. i. Blower door testing and resulting infiltration repairs, other than Caulking and/or Weatherstripping, may result in attaining the lower limit of cubic feet per minute infiltration, thereby precluding further tightening by Caulking and/or Weatherstripping. j. If the unit otherwise qualified for Weatherization because of the apparent need for Caulking and/or Weatherstripping, it now becomes ineligible. However, Contractor may requalify the unit by substituting Optional Measures (other than Furnace or Air Conditioning Filter Replacement and Water Flow-Restricting Devices), as needed, in place of the now non-feasible Caulking and/or Weatherstripping measures. 23 c .$�I (96C/DOE) 4. Unweatherized Dwellings a. A unit may qualify if a health or safety hazard is found to exist which requires a combustion appliance to be repaired or replaced to correct, the cost of which will preclude the installation of the required number of mandatory measures. If combustion appliances are not present, single family detached and other •single story dwellings which have not been previously weatherized under.a CSD or other program shall not be weatherized unless: o ceiling insulation plus two (2) additional mandatory measures are installed, OR o in the event ceiling insulation is not feasible, at least four mandatory measures are installed, unless the Blower Door test indicates that fewer than four mandatory measures are needed to be installed as noted under Section 31.C.7.a.1. b. Multi-story, multi-unit complexes may qualify with the installation of ceiling insulation and any two (2) other mandatory measures or, in the event ceiling insulation is not feasible, at least three (3) mandatory measures. Installation of ceiling insulation may be counted as a ceiling insulation measure for each unit within that building envelope. The charge shall be prorated among all dwelling units. Insulation of a common water heater shall qualify as a mandatory measure for each unit served by the same water heater. However, reimbursement may be claimed for only one water heater and the equivalent number of standard-sized water heater blankets installed, and the cost shall be prorated among all dwelling units. C. Reimbursement for dwelling assessment may be claimed by Contractor in accordance with Section 31.1) for each eligible unit not previously weatherized. ' 5. Previously-Weatherized Dwellings a. If a dwelling has been previously weatherized under a Federal Program between September 30, 1975, and September 30, 1985, Contractor may provide, within the dollar limits of This Agreement, heretofore unapplied mandatory and optional measures. The dwelling and occupant eligibility must be recertified, therefore, Contractor may claim reimbursement for assessment of the dwelling. 24 (96C/DOE) Additionally, a dwelling unit which has been damaged by a natural disaster such as fire, flood, earthquake, hurricane, etc., or any other act of God, and repair of the damage to weatherization materials is not paid for by insurance, Contractor may have the damages repaired. The occupant must be certified as currently eligible, and a new dwelling assessment must be performed. b. If the previous weatherization was performed under a nonfederal program, the dwelling and occupant eligibility must be recertified; therefore, Contractor may claim reimbursement for assessment of dwelling and intake. 6. Dwellings Weatherized with LH-1EAP and DOE Funds Reimbursement for dwelling assessment may be.claimedby Contractor only once when LII-IEAP and DOE funds are used concurrently in the same.unit. 7. Installation Guidelines a. Mandatory measures are to be installed in priority order, and no measure shall be excluded or skipped unless: (1) a blower door test indicates that installation of the measure is not necessary, or (2) the dwelling already has that measure in place, or (3) the measure cannot be properly installed, or (4) the client refuses installation (client refusal is to be documented and placed in file), or (5) the maximum dollar limit is reached, or (6) the measure is not needed or required. Notations of exception(s) shall be included in the client file. b. If the dollar limit has not been reached in installing feasible mandatory measures, Contractor may install optional measures. C. Measures shall be applied in accordance with the initial dwelling assessment documented on the Building Check and Job Order Sheet or Contractor's equivalent. Installation of those measures contained therein shall be 25 C. 8y (96C/DOE) accomplished in conformance with the CSD Weatherization Installation Standards (WIS) manual and the CSD Weatherization Program Policies and Procedures manual, hereby incorporated by reference. Standards contained in the Uniform Building Code and local city and county codes shall take precedence over the CSD WIS manual if the code requirement:. (1) is not included in the manual or(2) is more stringent. d. Upon the State's request, Contractor shall furnish proof that materials-used ' under this program conform to the requirements of Exhibit A, Materials Standards, the CSD WIS manual and/or State, county, or local regulations and were procured in conformance with OMB requirements contained in the following Circulars: Common Rule, Section 36, or A-110, Attachment O. e. Any weatherization materials purchased with these grant funds and remaining at the expiration of This Agreement shall be credited against Contractor's weatherization materials expenditures under This Agreement and charged to whatever other weatherization program Contractor may have in effect. If Contractor has no other weatherization program in effect, the State shall be contacted for disposition instructions. 8. Quality Assurance a. Contractor, or its designee, shall review all of the dwellings Contractor has weatherized. A statement certifying that all required measures were installed per contract and CSD installation standards shall be noted on the front of the Building Check and Job Order Sheet, or the Contractor's equivalent, and signed and dated by the reviewer. Contractor shall not report a dwelling as weatherized nor request reimbursement prior to this final certification. b. The State, or its designee, may perform an inspection of dwellings weatherized under This Agreement. Contractor agrees to correct any work deficiencies noted by the State or its designee. Contractor agrees to take action and correct such deficiencies within twenty (20) working days of written notification. C. Contractor shall attempt to correct safety hazards resulting from weatherization measure installation within twenty-four (24) hours and shall completely resolve such hazards within five (5) working days of written notification. 26 C.Sy (96C/DOE) 9. Client Education a. Unweatherized Dwellings Client education shall be conducted in accordance with Section 29.13. and reimbursement for such may be claimed in accordance with Section 31.D for the occupants of each eligible unit not previously weatherized. Additionally, Contractor will be allowed to claim reimbursement when a safety check of combustion appliances reveals safety hazards which preclude tightening of the envelope. b. Dwellings Weatherized with Nonfederal Funds Reimbursement for client education shall not be claimed by Contractor unless the dwelling was previously weatherized by non-Federal funds, i.e., regulated or non-regulated utility companies; private sector funds, etc., or by a weatherization service provider not associated with the provisions of This Agreement. If such circumstances exist, client education shall be conducted in accordance with Section 29.1.3. and reimbursement may be claimed in accordance with Section 3 LD for the occupants of each eligible unit previously weatherized. C. Dwellings Weatherized with LH-IF-AP and DOE Funds Reimbursement for client education may be claimed by Contractor only once when LII-1EAP and DOE funds are used concurrently in the same unit. 10. Selection of Units to be Weatherized a. Multiple Unit Dwellings Funds under This Agreement may be used to weatherize an entire building containing multiple dwelling units only if the dwelling units occupied by eligible applicants represent at least sixty-six and two-thirds percent (66- 2/3%) of the total units within the building (as defined in Section 31.A. of This Agreement). In order to weatherize a building which contains two units or four units, at least fifty percent(50%) of the dwelling units must be eligible. Otherwise, only units occupied by eligible households shall be serviced. b. The amount of funds applied to weatherization services in a building shall not exceed the number of eligible dwelling units multiplied by the $1,854 maximum per unit. Example: If a building of ten (10) units has eight (8) units occupied by eligible households and two (2) units occupied by ineligible households, $14,832 is the maximum to be paid. 27 e •g� (96C/DOE) Within the $14,832 ($750 maximum for minor envelope repairs per eligible unit), $6,000 is the maximum amount for the minor envelope repairs which can be reimbursed. C. Contractor shall certify unit eligibility by completing Intake and Job Order Sheet, CSD 565 (Rev. 1/96), for each dwelling unit in each building. Certification of eligibility by the owner/manager of the occupants of the building/complex is not acceptable. d. A CSD Form 75P (Rev. 1/96), Multi-family Dwelling Unit Eligibility Certi- fication form shall be completed for each complex, and a copy shall be maintained in each individual client file. e. Unoccupied Multi-Unit Buildings If an entire building is unoccupied, or it will become eligible within 180 days from assessment, under a Federal, State or local government building improvement program, each dwelling unit within said building may be weatherized providing the owner or owner's agent signs an agreement limiting occupancy to those meeting eligibility guidelines set forth in Section 31.A. of This Agreement for a period of two (2) years from the completion of the weatherization work. f. Group Homes If the building does not qualify as a multi-family structure, income eligibility is based on all occupants as a group, and the building must be weatherized as a single dwelling unit. The maximum which can be paid is $1,854 as specified in Section 29.A.2.b. g. Temporary Shelters/Homeless Individuals Eligibility of the occupants may be assumed if the owner/operator will certify in writing that occupancy is limited to no more than ninety (90) days and that admittance criteria complies with CSD contract eligibility guidelines. Whether or not rent is paid has no effect on eligibility. Maximum reimbursement will be based on the unit otherwise qualifying as a multi- family structure or a group home. h. Contractor shall obtain written permission of the owner of a rental unit, or his/her agent, prior to performing any weatherization services: Such permis- sion shall be recorded on the sample Weatherization Service Agent Agreement - Rental Units form, or Contractor's equivalent. 28 (96C/DOE) i. Weatherization services shall be provided to a dwelling unit on a one-time basis for the same occupant(s), except that Contractor may return to the unit within the same calendar year under which the initial services were provided and apply measures not applied during the initial services within the total remaining expenditure limit. J. Reimbursement for outreach and assessment shall not be claimed nor can the unit be claimed as another completion. Client education may be claimed at the Previously Weatherized rate per Section 31.D. The only exception shall be when the unit is damaged by a natural disaster such as a fire, earthquake, hurricane, etc., and such damage is not covered by insurance. k. Contractor shall not weatherize a dwelling unit which is designated for acquisition or clearance by a Federal, State, or local program within twelve (12) months from the date weatherization of the dwelling unit would be scheduled to be completed. D. Payment Guidelines Reimbursement to Contractor shall be the equivalent of either Contractor's actual expenditures or the value of all energy conservation measures and activities completed and reported, whichever amount is less, provided that Contractor does not request reimbursement or credit for the same activity or measure, except for intake and dwelling assessment, from any other source. Contractor may claim credit only for allowable measures and activities performed under This Agreement In addition to the applicant eligibility criteria set forth in Section 3 LA, each dwelling unit shall be assessed for eligibility. A Building Check and Job Order Sheet, or Contractor's equivalent, and Intake and Job Order Sheet, CSD Form 565 shall be maintained for each dwelling which reimbursement is claimed. 29 e .94 (96C/DOE) REENABURSEMENT GUIDELINES ACTIVITIES PER DWELLING Outreach $25 Intake $25 Non-Blower Door Assessment: Units with attics $50 Units without attics $35 Client Education: Unweatherized $40 Previously Weatherized $25 Reimbursement for any or all of the outreach, intake, assessment, and client education activities shall only be made for dwelling units weatherized under the terms of This Agreement. Initial General Heat Waste and Safely Assessment: Safety Check of Combustion Appliances Pre-Test $45 Post-Test $35 Blower Door Test (Optional) $60 Duct Leakage Tests Pre-Test $35 Post-Test $25 Should the safety check of combustion appliances reveal safety hazards which preclude envelope-tightening measures, and cannot be eliminated, Contractor will be allowed to claim reimbursement for outreach, intake, client education, and safety check and for the installation of mandatory measures identified by Note 5 at the end of this Section. Example: Outreach $ 25 Intake $ 25 Non-blower Door Assessment $ 50 Safety Check of Combustion Appliances 45 Total $145 30 c • $y (96C/DOE) MANDATORY MEASURES (All rates include labor and material costs) Priority I. Combustion Appliance Health or Safety Hazard Repair or Replacement, per dwelling (indicate on the Intake and Job Order Sheet, CSD.Form 565, which Health or Safety conditions are to be addressed) Vented Heating Source Replacement . . . Max. $2,750.00 Heating Source Repair . . . . . . . . . Max. $1,000.00 2. Carbon Monoxide Detector/Alarm . . . . Max. $ 80.00 (Install only if operating carbon monoxide producing appliances. Limit of two detectors per dwelling for a maximum of$160.00 per dwelling. If only one detector is installed, the maximum reimbursement will be $80.00, including labor and materials. Display labor • and material costs on Earned Measures Report, CSD 571). [refer to installation standards forwarded February 7, 1995] 3. Glass Replacement, per dwelling Up to $ 750.00*6 4. Duct and Register Repair/Replace Up to $1,000.00*5,6 5. Minor.Envelope Repairs, per Up to $ 750.00*4,6 dwelling (see Exhibit B) 6. Evaporative Cooler/Air Conditioner Vent Cover $ 55.65^ 7. Attic Venting, per dwelling Up to $ 300.00*" 8. Ceiling Insulation Ceiling' Kneewalls R-11, per square foot_ $.35 $.45 R-19, per square foot .45 .50 R-30, per square foot .50 N/A R-38, per square foot .60 N/A 31 C •8 y (96C/DOE) 9. Water Flow Restrictors: a. Low-Flow Showerhead, each $ 22.005 b. Hot Water Faucet Restrictor, each $ 6.755 10. Door Weatherstrip, per hinged entrance $ 33.60°,6 11. Water Heater Blanket, each $ 28.355 12. Water Heater Pipe Wrap, $ 1.705 per linear foot of pipe 13. Duct Wrap, per linear foot of duct $ 2.255 14. Outlet Switch Gaskets, $ 27.85'6 per dwelling 15. Caulking, per dwelling Up to $ 65.00*4_6 16. Non-door Weatherstrip, $ 1.70, per linear foot (Includes sliding glass doors and open-combustion appliance enclosure doors. Does not include weather- strip applied to attic and crawl-space access hatches, evaporative cooler or air conditioner covers. When insulation is not installed, applies to access hatches and windows.) 32 (96C/DOE) OPTIONAL MEASURES Per Dwelling Evaporative Cooler Repair, per cooler Up to $ 75.00*5 Filter Replacement for Air Conditioning or Furnace Unit: Filters Only $ 16.805 Filters plus Filter Replacement Signal $ 22.005 Floor Foundation Venting (Crawl Space Venting) Up to $ 315.00*:5 Floor Insulation, over 36" clearance, per square foot $ .70**5 Floor Insulation, under 36" clearance, per square foot $ .80**5 Electric Water Heater Timer, each $ 94.505 Setback Thermostat, per dwelling $ 133.355 Shadescreen, per square foot $ 2.805 Shutters, per square foot $ 5.005 Storm Windows, Operable, Vinyl, per square foot $ 5.00, Storm Windows, Operable, Polycarbonate, per square foot $ 5.50, Storm Windows, Operable, Glass, per square foot $ 7.254 Storm Windows, Fixed, per square foot $ 2.504 Tinted Film, per square foot $ 2.805 Wall Insulation, per square foot $ .905 Furnace/Boiler Replacement, Including Vented Space Heaters Up to $ 2,750.00***15 per dwelling Heating Source Repair, per dwelling Up to $ 1,000.00***1,5 Air Conditioning Unit Repair, per dwelling Up to $ 1,000.00***''1,5 33 (96C/DOE) Footnotes: * Materials cost plus $35 per hour per person for labor. ** Crawl space height shall be documented on the Intake and Job Order Sheet, CSD 565 (Rev.. 1/96), (or Contractor's equivalent). *** Must be completed by a licensed contractor. Materials cost plus labor. Furnace/Wood- Fueled Space Heater/Boiler, and vented-space heater installations shall be covered by a building permit. May be classified as mandatory if safety hazard exists. Reimbursement shall be based upon the type of measure repaired or replaced as specified in the rate schedule under Optional Measures. 2 Perform only when installing insulation. ' Do not perform if residence has an operative evaporative cooler. When using a blower door in conjunction with weatherizing a dwelling, these measures are not to be applied if the infiltration rate is less than the Minimum Ventilation Requirement or if the economic stop point for air sealing has been reached. (Refer to the Building Shell/Blower Door Use sections of the CSD Weatherization Installation Standards.) Does not apply to catastrophic leaks that are health and safety hazards (e.g. broken-out window, severely damaged door, etc.) s If a combustion appliance safety hazard is found to exist, Contractor may apply the non-envelope sealing Mandatory and Optional Measures identified by this note. When applying infiltration-reducing measures in conjunction with blower door testing, the crew hours set forth in the charts in Appendix A of the CSD Weatherization Installation Standards (WIS) manual may be increased up to double the applicable amount for no more than the first fifteen (15) units. 34 . e. .gN (96C/DOE) E. Mileage Contractor shall be credited $.53 per mile for one round trip for any one dwelling weatherized. This credit is applicable only to those dwellings located outside a forty (40) mile radius from Contractor's materials storage site, or headquarters if the work is being performed by a subcontractor. If more than one dwelling is weatherized per trip, the mileage credit applies only to the dwelling serviced which is the farthest from Contractor's materials storage site, or headquarters if the work is being performed by a subcontractor. 32. Forms Masters of intake forms and reporting forms shall be provided by-CSD to be duplicated by Contractor for future use. 33. Exhibits The following exhibits are attached to This Agreement and are hereby incorporated-by this reference. A. Materials Standards Which Are Not Included in the CSD Weatherization Installation Standards Manual ' B. Definitions C. Service Area D. Assistance Priority and Limits E. Schedule of Energy Program Goals/Expenditures, CSD 564 (Rev. 1/96) F. DOE Weatherization Program Budget, CSD 570 (Rev. 1/96) G. Certification Regarding Lobbying/Disclosure of Lobbying Activities 35 C. 0 7 (96C/DOE) EXHIBIT A Page 1 of 1 MATERIALS STANDARDS WHICH ARE NOT INCLUDED IN THE CSD WEATHERIZATION INSTALLATION STANDARDS MANUAL REPLACEMENT FURNACES AND BOILERS Chimneys, fireplaces, vents, and NFPA' 211-1988 solid fuel-burning appliances Gas-fired furnaces ANSI2 Z21.47-1987, Z21.47a-1988, Z21.47b-1989, and ANSI2 Z223.1-1988 (NFPAI 54-1988) Oil-fired furnaces UL' 727, August 27, 91991 Revision and NFPA' 31-1987 Liquid petroleum gas storage NFPA' 58-1989 HEATING REPAIRS Replace Combustion Chamber Conformance to NFPA1 31-1987 in Oil-Fired Furnaces or Boilers --------------------------------------------------- National Fire Protection Association 2 American National Standards Institute s Underwriters Laboratory (96C/DOE) Page 1 of 4 E)GnIT B DEFINITIONS GENERAL DEFINITIONS Authorized Agent - The duly-authorized representative of the Board of Directors of Contractor and duly-elected or-appointed, qualified, and acting officer of the State: In the case of Contractor, the State shall be in receipt of a resolution from the Board of Directors affirming an agent's representative capacity to bind Contractor to the terms of This Agreement. Contractor - The entity (partnership, corporation, association, agency, or individual) designated on page 1 of This Agreement. CSD - The Department of Community Services and Development, State of California. Parties - The State of California and the Contractor. Subcontractor - An entity (partnership, corporation, association, agency, or individual) that enters into a Subcontract with Contractor to fulfill the terms of This Agreement. Subcontracts - Contracts entered into by and between Contractor and Subcontractor to carry out the purpose of This Agreement. The State - The State of California, Department of Community Services and Development. This Agreement - The complete contents of this contract entered into by and between the State and Contractor, including all rights, duties, and obligations whether expressed or implied required toward the legal performance of the terms hereof. This Program - Weatherization services provided under 42 USC 6861, et seq.;as amended. (96C/DOE) Page 2 of 4 Exhibit B - Definitions (Continued) APPLICANT DEFINITIONS American Indian - Any individual who is a member or a descendant of a North American tribe, band, or other organized group of native people who are indigenous to the continental United' States or who otherwise have a special relationship with the United States through treaty, agree- ment,.or some other form of recognition, residing within the State. This includes any individual who claims to be an Indian and who is regarded as such by the Indian community of which he or she claims to be a part. This definition also includes Indians of Alaska. Children - Members of a household who have not attained their nineteenth (19) birthday. Dwelling Unit - A house, including a stationary mobile home, an apartment, a group of rooms, or a single room occupied as separate living quarters. Elderly - An individual 60 years of age or older. Family Unit - All persons living together in a dwelling unit. Handicapped Person - Any individual who is: (1) a handicapped individual as defined in Section 7 (6) of the Rehabilitation Act of 1973, (2) under a disability as defined in Section 1614(a)(3)(A) or 223(d)(1) of the Social Security Act or in Section 102(7) of the Developmental Disabilities Services and Facilities Construction Act; or(3) receiving benefits under Chapter 11 or 15 of Title 38 U.S.C. Migrant Farm worker - A seasonal farm worker who performs or has performed farm work during the eligibility determination period (any consecutive 12-month period within the 24-month period preceding application for program benefits and/or services)which requires travel such that the worker is unable to return to his/her domicile (permanent place of residence) within the same day. Seasonal Farm worker- A person who during the eligibility determination period (any 12-month period within the 24-month period preceding application for program benefits and/or services) was employed at least 25 days in farm work or earned at least $400 in farm work; and who has been primarily employed in farm work on a seasonal basis, without a constant, year-round salary. Separate Living Quarters - Living quarters in which the occupants do not live and eat with any other persons in the structure and which have either: (1) direct access from the outside of the building or through a common hall; or(2) complete kitchen facilities for the exclusive use of the occupants. The occupant(s) may be a single family, one person living alone, two or more families living together, or any other group of related or unrelated persons who share living arrangements. c . 7y (96C/DOE) Page 3 of 4 Exhibit B - Definitions (Continued) ENERGY CONSERVATION MEASURE AND ACTIVITY DEFINITIONS Assessment - The process of performing an on-site review of the dwelling unit of an eligible applicant in order to determine the if the dwelling qualifies for weatherization and, if so, to ascertain the labor and materials necessary to weatherize the unit. Energy Conservation Measures - The measures as defined in the CSD Weatherization Installation Standards Manual and the CSD Mobile Home Weatherization Installation Standards listed in Section.31.D. In addition, the following definitions are provided: Evaporative Cooler Repairs - Repair or replacement of filter pads, water pumps, belts, motors, or other components which will promote efficient operation of the unit. Filter Replacement - May be a one- or a two-step measure. The one-step measure is to replace the air conditioning or furnace filter with a washable filter. The two-step measure includes a filter replacement signal in addition to the filter. Heating/Air Conditioning Appliance Repairs - Cleaning of fuel nozzles and jets, replacement of thermocouples, freon, or other component repairs or replacements necessary for safe and efficient operation. Must be accomplished by a person licensed to perform such work. Intake - Includes, but is not limited to, the process of completing an intake form and reviewing applicant documentation in order to verify eligibility. Minor Envelope Repairs _ Those repairs necessary for the effective performance or preservation of weatherization materials or to stop infiltration (general heat waste). Contractor shall maintain labor hours cost, materials cost, and required building permits in client's file. a. Patching holes in the building envelope which are too big to caulk. (Includes replacing attic/crawl space access covers). b. Replacement of entrance doors and attendant hardware (except, no deadbolts) into conditioned areas. (If the original door had a deadbolt, and it can be removed and placed on the new door, then labor costs for this activity can be charged). c. Repair, replacement, or installation of doors and windows, including frames, thresholds, door stops, MINOR roof repairs, and materials such as paint used to protect the materials installed from the weather. C . (96C/DOE) Page 4of4 Exhibit B - Definitions (Continued) . ENERGY CONSERVATION MEASURE AND ACTIVITY DEFINITIONS (continued) d. Modification or repair of entrance doors, including doorshoes, door locksets, heavy-duty strike-plate when standard size will not work (no deadbolts), raindrips, automatic door bottoms, etc. e. Repair of range hood damper and fireplace chimney damper. f. Knob-and-tube wiring Notice of Survey by Electrical Contractor and installation of simple overcurrent protection per the Weatherization Program Policies and Procedures manual. g. Blower door-identified infiltration repairs and final testing. Mobile Home - A manufactured.home that is a permanent, full-time residential dwelling and which is not used for commercial purposes. c .g� (96C/DOE) Page 1 of 1 EXHIBIT C SERVICE AREA Contractor shall provide services to eligible applicants residing within the area(s) described below and/or on the attached pages if zip codes are designated. County(les) of: Contra Costa C (96C/DOE) EXHIBIT D ASSISTANCE PRIORITY AND LIMITS DOE State of California C ?q DEPARTMENT OF COMMUNITY SERVICES AND DEVELOPMENT EXHIBIT E 194 DOE SCHEDULE OF ENERGY PROGRAM GOALS/EXPENDrruREs CSD 564(Rev. 1/96) Contractor Contract Number Service Area 96C- Month Blower Door Total Expenditures Types of Units Owner Rental Other Units Units January Single Family. February ............................ March Multi-Family: April Duplex(ITriplex May Multi Family: June Apartment July Mobile Home August ........ ..... .... .... September ........... ....... .. ...... Temp./Group Shelter ......: w..........: ............. . . ............. ....... .............. .. ............ ........... .... . .......................... October- .... ........ November Unoccupied December TOTAL TOTALS ................. Jan Feb March April May June July Aug Sept Oct Nov Dec Total Children s 18) Elderly Handicapped American Indian MSFW Other TOTAL .... ....... ... .......... ........ ... . ..................... .... ............................................. Jan Feb March April May June JulV Aug Sept Oct Nov Dec Total Number of Persons in Household Children s 18) Elderly Handicapped American Indian MSFW Other Authorized Person's Nametritle(Please print) Telephone Number Authorized Signature Date �• 8`I INSTRUCTIONS — SCHEDULE OF DOE ENERGY PROGRAM GOALS/EXPENDITURES CSD.564 (Rev. 1/96) PROJECTED GOALS/EXPENDITURES Blower Door Units: Where applicable,enter the projected number of units to be weatherized with Blower Door technology. The total number of Blower Door units must comply with Section 31.C.31. Total Units: Where applicable,enter the projected number of units to be weatherized which includes Blower Door and non-Blower Door units. Expenditures: Where applicable,enter the projected amount of expenditures,not to exceed the per dwelling cost as stated in Section 29.A.2.b. PROJECTED UNITS Enter the projected number of units to be weatherized under the applicable Projected Units'columns. The total sum of these columns must match the total under the Projected Goals/Expenditures"Total Units"column HOUSEHOLD CATEGORY Enter the number of households to be assisted monthly under the applicable household category to reflect your Agency's Priority Plan. The monthly Total must match the monthly total indicated under Projected Goals/Expenditures"Total Units"column. EXAMPLE: HOUSEHOLD CATEGORY PROJECTED GOALS/EXPENDITURES Elderly 2 MSFW 4 Total Units(January) 10 Other 4 Total(January) 10 CATEGORY OF PERSONS TO BE ASSISTED NUMBER OF PERSONS IN HOUSEHOLD Enter the total number of persons living in the household. (Unduplicated Count.) CATEGORY CLASSIFICATIONS Enter the total number for the person(s)living in the household under the category that applies. If the person(s)falls into more than one category,enter the person(s)under all of the categories that are applicable.(Duplicate Count.) DO NOT ADD CATEGORY CLASSIFICATIONS TO DETERMINE"NUMBER OF PERSONS IN HOUSEHOLD." (SEE EXAMPLE BELOW.) EXAMPLE: I am projecting to assist five persons(two children and three adults)in one household. One of the children is handicapped,one of the adults is elderly,handicapped and MSFW. The other two adults are MSFW. THE SECTION ON THE FORM"CATEGORY OF PERSONS TO BE ASSISTED"SHOULD BE COMPLETED AS FOLLOWS: :;::::>::::> ;:::>::::>:::>:::::::.:>>::>::;.>;::.:>:r::::>:::;;::::::::::::::.>::::>:::::;......::>::.:>;::::>:<::>:;: TEG(3RY t3FFETTESt N .T'O.EE ASSISTED Jan Feb March Aril Mav June Jul .. Augt Oct Nov Dec Total Number of Persons in Household 5 5 Children s 18 2 2 Elderly 1 1 Handicapped 2 2 American Indian 0 0 MSFW 3 3 Other 0 0 THE NUMBER OF PERSONS IN THE HOUSEHOLD IS 5 NOT 8. State of California . • $ ` DEPARTMENT OF COMMUNTTY SERVICES AND DEVELOPMENT 1996 DOE WEATHERIZATION PROGRAM BUDGET EXHIBIT F CSD 570(Rev. 1/96 Contractor Contract Teem Contract Number 96C- ...........y.........y:: - .: ...}.... Y. ..n v..•.3'J+vv }.{::-.- .._..;..... .... +:' -. ++' ...:'v'1:}:i%i'r'ti?ii'?.S:J{T::v'L:v'i\iiiiii`rii'i::irr}v•••.ti•:y,rY.-ry:}}:}:4:i}n'i}.: :.e. ti'�.. .C,,:• .`4rdS.L.. •Y•. ':!ft` '•iii::::::.:: La Salaries and Wages $ I.b Fringe Benefits Le Facilities Ld Utilities Le Equipment TOTAL i below: 2. :. •c Lf Telephone-Communications Lg Travel 11 Accounting l.i Insurance-Bonding 1.• Office Supplies Lk Miscellaneous TOTAL (specify below: 'p'•:i.g• '4::••:v}YiC::}i:;::�:•ii' TOTAL SECTION A.QA-Lk? (Should not exceed 5%of Section C) ................................................ _. $................................................... Administrative Coats in Excess of 5%Requires CSD Avvroval See CSD Form 574 n..:::Livti^:^:...w•iii:i{_}r:-}riv}}:�:}'r'r}i)}ir}}}}'^ry\Oir....,.} :n.:.. rh..vn.r.nn. .... .- .....n.....:n .4:..k.v:'::•'r.'•.':�:v.. ,...... ..... 2.a Audit Cost $ 2.b Public Liability Insurance 3.a 'Weatherization Materials 40%Minimum of Pro m Costs 'ilii\ir::t'tC:::;i?:: r•:iijL:v;ii....... ...vS.......... 3.b Labor 3.c Outreach 3.d Intake 3.e .Client Education 3.f Equipment TOTAL i below: t. Z. ::fk:<:,?_iij::tiiity�:;:0}.>•:i'Siitj?:Y.:;:ir'f.:ii4'ir :.}:..::•:,yr:-`,i%:i:}'i,'ri�:L�:•:•y::�ti is}i':f?:i::•::�vii�i: 3. 4. <ti 3.R Assessment 3.h Storage 3.i Vehicular Insurance 3.' I Travel-Transportation 3.k Maintenance-Repair 3.1 Miscellaneous TOTAL (specify below: 2. SUBTOTAL PROGRAM SUPPORT AND LABOR 3.b-3.1 $ TOTAL SECTION B 2.a-3.4 (No less than 95%of Section C. % $ rr•r- ......................::...,..:..........................r:::::::::5>v::::n..,.. .1:. ' i•: +'- :v '� '` ': n.�-\>}}}};,i}:SS•}}}}}:•:•::v'}}:•i:::tibi::Y}:.'.•... TOTAL CONTRACT BUDGET ffotal of Sections A&B. $ NOTE: •CSD audit cost and public liability insurance are not to be included in the 40/60 calculation. CYLJ INSTRUCTIONS- DOE PROGRAM BUDGET CSD 570 (Rev. 1/96) SECTION A Enter the total amount of Administrative Costs. Administrative Costs shall not exceed 5% of the total contract budget. Administrative Costs in excess of 5% requires DEO approval. (See DEO form 574.) SECTION B Enter the total amount budgeted for each line item 2.a- 3.1. Weatherization materials costs shall be no less than 40% of the.program budget, not including 2.a and 2.b. Enter program support and labor costs 3.b-3.1. Program support and labor shall not exceed 60% of 3.a- 3.1. Enter the total amount of Program Costs(2.a-3.1). The total shall not be less than 95% of the total contract budget. SECTION C Add the totals of Sections A and B and enter the amount in Section C (Total Contract Budget). Section C should be equal to the total contract budget. Enter the calculated percentages in Sections A and B. e .gq ��AtT H � C�(�p4(�OC�L'Q�[l©a G3L� ' ' o � I�O�C•�C3�7O 1�J� p y� DEPARTMENT OF HEALTH AND HUMAN SERVICES +- x FAMILY SUPPORT ADMINISTRATION Z Ul ca a"' PROGRAM: ___Department of Energy (DOE)__-_--- a�0 • USA • 6�0 1/1/96 - 3/31/97 PERIOD:-------------------------------------- The undersigned certifies, to the best of his br her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an emplovee of a Member of Congress in conriection with the. awarding of any Federal contract, continuation, renewal, amendment, or modification of any Federal . contract, grant, loan, or coc_aerative agreement. (2) if any funds other than Federal .appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in ;onnection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form LLL,- "Disclosure Form to Report Lobbying, " in accordance with its instructions. 3) The undersigned shall require that the language of this certification be included in the award document for subawards at all tiers (including subcontracts; subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.. This certification is -a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352 , Title 31, .U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $101000 and .not more than $100,000 for each such failure. Director, Co=mity Services Dept. Signature Title Contra Costa County Community Services Department Agency / -Organization Date •V4 � t 7 av«—by OWA DISCLOSURE QE 1 OBMNG ACTIVMES 034400" Complete this form reverse for pudisclose b)c burden�iisdosure.)ctiwifies Pursuant to 31 US US2 1. Type of federal Ac'tioK Z Status of Fedent Acfioee 1 Report Tye a. 2pp6Mti0n A. WOW GUN ❑ a. contract ❑ b. material change b. grant b. fislti2f award C. coopesatwe agreement C .award For Material CihanEe Mer d. loan �u -- �' e. loan guarantee date of Last repeat . f. loan irmurance 4. Name and Address of Reporting Entity: s. it Reporting Entity in Na 4 is Subawardee.Enter Name and Address of Prkne: O Prime ❑ Subawardee Ther ,f kno.m: Con sessional District,f known: ConiVessional District if known: C Federal Department/Agenc7: 7. federal Program NaasdDescrsgtion C*D+l Numixr,if aPP6K-J&1e: 3i 'Federal Actium Number.it knowrx !. Aaiasd Arruwfd,if baow+x S Name and Address of Lobbying Entity L tndiriduats pedorming Services t»dudrng address if (it individual,tart Pawn.last carne.LYx differem frown No.1W Bast narme,first name.AN): 11. Amount of Paynnent(check all that apply). 13. Type of ftya ret(check 21f that q)pir. S O acral , C planner! Q :. nttainer O' b. ahe-time fee 12. Form.of Payrw M iaheck at!fret appy: O C. clowwrieswa O a. cash 0 td. com+i wat fee O e.4&erwrd O b. in-kind:spedfr nature O •t. other.specify: value 14. grief Descriooa d smkes Pedarmed or to be Pertonned gad Datefsi el Services fanciiorgrrg aff"icertsl.ewipfvycetsl. or Membeetsl.contacted.for Pannew Indicated it!teas 11: efi Leann:eon EWAMAMMA •1L Continuation Sheet(s)SFdLL.A Madwd: O Yes O No ti infun.rinw OW-0*-00 i4 din.i�w4r b fi► rr t►1C �� sc+.�.1rS2 x41.iubumdirdt - 1 -60*air. s 00W b ow-ow~a WMW Psiat Vitae: wtisirw mx wri w m>w.r Ma,ra:i�iw.i fflopmad Mrd Y . fh U.S.C. %MLL UM+rheum.i N nr..rri n•0,CWW.401M, Tittle: ..wear rd.A M. AAk it WA c.pw§o.Mr rww..Ar 4i M 00 0-+ o.ir+awea«,..M.w raiw7».awa!�^ r 1 w.e ns M T.eiephOne Ka: Date'. ed":Use t?w d 1'"' ttepreb.cn... e. .�y INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYWC ACT( MES This disclosure form shalt be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material lunge to a previous fling, pursuant to title 31 U.S.C- section 1352.The filing of a form ii-required for each payment or agreemenrto make payment to any koAying entity for influencing or attempting to influence an officer or employee of any agency, &'Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Use the SF-LLL-A Continuation Sheet for additional information if the space on the fort is inadequate. Complete all items that apply for both the initial filing and material lunge report.Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify the status of the covered'Federal action. 3. Identify the-appropriate classification of this report. If this is a followup report caused by a material lunge to the information previously reported.enter the year and quarter in which the change occurred.Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city. state and zip code of the reporting entity. Include Congressional District, if known Check the appropriate classification of the reporting entity that designates if it is,or expects to be,a prime or subaward recipient. Identify the tier of the cuhawardee, e.g, the fust subawafdee of the prime is the to tine: Subawards indude but are not limited to subcontracts,subgrants and contract awards under grants. S If the organization filing the report in item 4 ch.v ks'Subawardee',then enter the full name,address,city, stale Jihd zip code of the prime Federal recipient.Include c.othgressionai District.'if known 6..Enter the name of the Federal agency making the ✓ward or loan commitment. lndude at least one organizational Sever below agency name,if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). Af known, enter the fuil Catalog of Fedeiai Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. S. Enter the most appropriate Federal identifying number available for the Federal action Identified in item 1 (e.g„ Request for Proposal (RFP) number, Imitation for Bid (IFS) number, grant announcement number-, the contract. grant. or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes,e.g,'RFP-OE-90.001.' 9. For a covered Federal action where dwe has been an award or loan commitment by the Federal agency. enter the Federal amount of the awani/loan commitment for the prime entity identified in item 4 or S. 10. (&)Enter the full ✓tame, address, city, state and zip code of the lobbying entity engaged by tf�e reporting entity identified In item 4 to influence the coveted Federal action. (b)Enter the full tames of the individuals) performing services. and include full address if different from 10 (a). Enter Lan Name,First Name✓and Middle initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity Ctem 4) to the tobbying'entity Ctem 10). Indicate whether the payment has been made(actual)or will be made(planned). Check all bores that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature acid value of the in-kind payment.. 13. Check the appropriate box(es). Check all boos that apply. If other,specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed,or will be expected to perform.and the date(s)of any services rendered Include all preparatory and related activity,not dust time spent in actual contact with Federal officials. Identify the Federal official(s) or employees) contacted or the officer(s), employe-e(s),or Member(s)of Congress that were contacted 1S. Check whedw or not a5F-M-A Continuation Sheet(s)is attached. 16. The certifying official shall sign and date the forth print his/her name,title,and telephone number. Pubfic reporting burden for this collection of information is estimated to average 30 trimues pw response,indtding tints for reviewing lrtsstucbwu.seMcf-I euisdng dau sauces,gathering and manumning the data needed and compiee l and reriersirtg the codecdon of Wonnaam-Send a m-wrtts regarding the burden estimate or anti odea aspect d"calecWn of information,ktdudirsg suanoom I-redh,cng tM.burde t,to the office of Managemtent and Budget.Paperwork Reduction thof set(03454W).washirgton,D.C.2oso3. d by o"t DISCLOSURE OF LOBBYING ACT VMES 0j44.0044 CONTINUATION SHM el itepecf" A„th.,is�fa tiru�M�+dud"" suadxd Fa -u�a