HomeMy WebLinkAboutCC Resolution 10852 (School-age Resource Program)RESOLUTION NO. 10852
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SAN RAFAEL
AUTHORIZING THE CITY MANAGER TO SIGN A CONTRACT WITH
THE CALIFORNIA DEPARTMENT OF EDUCATION FOR A SCHOOL-
AGE RESOURCE PROGRAM, FOR THE PERIOD MARCH 1, 2001
THROUGH JUNE 309 20029 IN THE AMOUNT OF $59000.00
WHEREAS, the City of San Rafael has been awarded a sixteen month contract with the
California Department of Education School -Age Resource Program in the amount of $5,000;
and
WHEREAS, the City Council approves and authorizes the City Manager to sign
designated contract documents with the Department of Education,
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of San Rafael
enter into a contract in the amount of $5,000 with the California Department of Education a copy
of which is hereby attached and by this reference made a part thereof.
I, JEANNE M. LEONCINI, Clerk of the City of San Rafael, hereby certify that the
foregoing Resolution was duly and regularly introduced and adopted at a regul meeting of the
City Council of said City held on Mondav, the 18th day of June , 2001 by the following vote, to
wit:
AYES: COUNCILMEMBERS: Cohen, Heller, Miller, Phillips & Mayor Boro
NOES: COUNCILMEMBERS: None
ABSENT: COUNCILMEMBERS: None
1�
JE E M. L�CINI.ity Clerk
0I O W k L 16%6'�J
Cl
of
jj `�\ i CALIFORNIA DL 1RTMENT OF EDUCATION
° = - 721 Capitol Mall: P.O. Box 944272
i� Sacramento. CA 94244-2720
LOCAL AGREEMENT FOR CHILD DEVELOPMENT SERVICES
Sixteen (16) Month Contract
CONTRACTOR'S NAME: CITY OF SAN RAFAEL
F. Y. 00-01 thru 01-02
DATE: March 01. 2001
CONTRACT NUMBER: FSCC-0075
PROGRAM TYPE: CCDF SCHOOL AGE
RESOURCE
PROJECT NUMBER: 21-N916-00-0
By signing this contract and returning it to the State, you are agreeing to use the funds identified below for the benefit of Child
Care and Development Programs, serving school-age children ages five to thirteen years in accordance with Attachment A,
GUIDELINES FOR SCHOOL-AGE CHILD CARE RESOURCE PROGRAM, which by this reference are incorporated into this
contract.
These funds shall not be used for any purpose considered nonreimburseable pursuant to the 2000/2001 & 2001/2002
School-age Resource Program Guidelines and Title 5, California Code of Regulations.
This contract is effective from March 1, 2001 through June 30, 2002. The total amount payable pursuant to this agreement
shall not exceed $5,000.00.
Expenditures of these funds shall be reported to the Child Development Fiscal Services Division (CDFS) on Form CDFS-9529
no later than July 20, 2001. For non -local educational agencies, expenditures for the period March 1, 2001 through June 30,
2001 shall be included in their 2000-2001 audit due November 15, 2001 or earlier if specified by the CDE. Expenditures for
the period July 1, 2001 through June 20, 2002 shall be included in the 2001-2002 audit due November 15, 2002 or earlier if
specified by the CDE.
Any provision of this contract found to be in violation of federal or state statute or regulation shall be invalid but such a finding
shall not affect the remaining provisions of this contract.
STATE OF CALIFORNIA
BY (AUTHORIZED SIGNATURE)
PRINTED NAME OF PERSON SIGNING
Donna Sala]
TITLE Manager Contracts Office
AMOUNT ENCUMBERED BY THIS
DOCUMENT
$ 5,000
PRIOR AMOUNT ENCUMBERED FOR
THIS CONTRACT
3 0
PROGRAMICATEGORY (CODE AND TME)
Child Development Programs
(OPTIONAL USE) 0156
13941-N916
CO TRACTOR
WSm.
ATTEST:ANDTE OF PERSDN SIGNING O 111114 t P1. LLU14CIIII
ROD GOULD, City Manaqer City Clerk
ADDRESS 1 00 F 1 ttt . A , , F U. bOX 15 I bbU
San -Ra ael,-CA9881 San Rafael,CA 94915-1560
IFUND TITLE Department of General Services
Federal I use only
FC# 93.575 PC# 000173
REM 30.10.020 CHAPTER
6100-196-0890 1 52
I
STATUTE FISCAL YEAR I
2000 12000-2001
TOTAL AMOUNT ENCUMBERED TO
GATE OBJECT OF EXPENDITURE (CODE AND TITLE)
$ 5,000 702 SACS: Res -6012 Rev -8290
I hereby cerlliy upon my own personal lolo�:Iedge that budgeted funds are avaltable tar the period and T.BA NO. I B.R. NO.
Purpose of the expenditure stated above.
SIGNATURE OF ACCOUNTING OFFICER DATE
1. The contractor agrees to indemnify, defend and save harmless the Sham. Its officers, agents and employees from any and all claims and losses accruing or resuhing to W
and all contractors, subcontractors, malerialmon, laborers and any other person, firm or corporation furnishing or supplying work, services. materials or supplies in connection
wilh the performance of This contact; and from any and d clakns and losses accruing or resulting to any person, firm or corporation who may be Injured or damaged by the
Contractor In the performance of this contact.
2. The Contractor, and the agents and employees of to Contractor, M the performance of this contract, shag act In an independent rapacity and not as officers or employees
or agents of the State of California.
3. The Stale may terminate this contract and be relieved of the payment of any consideration to Contractor should Contractor tag to perform the covenants herein contained at
IN time and in the manner herein provided. In the event of such termination, the Stale may proceed wBh the work in any manner deemed proper by the State. The cost to
the State shag be deducted from any sum due the Contractor under this contract, and the balance, h any shall be paid the Contractor upon demand.
4. Without the written consent of the State, this contract Is not assignable by Contractor either In whole or in part
5. Time Is the essence of this contract
6. No alteration or variation of On terms of this contract shall be valid unless made In writing and signed by the parties hereto, and no oral understanding or agreement not
Incorporated herein. shag be binding on any of the parties hereto.
7. The consideration to be paid Contractor, as provided herein, shag be In compensation for all of Contractor's expenses Incurred M the performance hereof, including travel
and per diem, unless otherwise expressly so provided.
B. Canbacfnrs entemg into a contract funded wholly or in part with funds from the United States Goverment agree to amendments in funding to refect any reduction in funds
tithe Congress does not appropdate sufilclentfunds. In addition, The contract Is subject to any restrictions. limitations or enactments of Congress which affect time provisions,
terms or funding of this contract in any manner. The State shag have the option to terminate the contract without cost to the State In the event the Congress does not
appropriate funds or a United Slates agency withholds or fad to allocate funds.
NONDISCRIMINATION CUUSE IOCP 11 oro. na1REY.31111
1. Dudng the performance of this contrac% contractor and its subcontractors shag not unlawfully discriminate. harass or allow harassment, against any employee or applicant
for employment because of sex, race, color, ancestry, religious creed, national origin, disability (Including HIV and AIDS), medical condition (cancer). age, marital status, and
denial of family and medical care leave and denial of pregnamy disabRty leave. Contractors and subcontractors shag insure that the evaluation and treatment of their employees
and applicants for employment are free from such disabnination and harassment Contractor and subcontractors shag comply with the provisions of the Fair Employment
and Housing Act (Government Code, Section 12900 at seq.) and the applicable regulations promulgated thereunder (California Code of Regulations, Title 2, Section 7285A
et seq.). The applicable regulations of the Fair Employment and Housing Commission implementing Government Code, Section 12990 (a -n, 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 B set forth in fug. Contractor and its subcontractors
shag give written notice of their obligations under this clause to labor organizations with which they have a collective bargaining or other agreement
2. This contractor shag include the nondiscrimination and compliance provisions of this clause In all subcontracts to perform work under the contract
DRUG-FREE WORKPLACE CERTIFICATION
By signing finis conular; the contractor hereby certifies under penalty of perjury under the laws of the Stale of California that the contractor will comply with the requirements
of the Drug -Free Workplace Act of 1990 (Government Code Section 8350 et seq.) and will provide a drug-free workplace by taking the following actions:
A. Publish a statement notifying employees That unlawful manufacture. distribution, dispensation. possession, or use of a controlled substance Is prohibited and
specifying actions to be taken against employees for violations, as required by Goverment Code Section 8355(a).
B. Establish a Drug -Free Awareness Program as required by Government Code Section 8355(b) to Inform employees about all of the following:
1. the dangers of drug abuse in The workplace;
2. the person's or organization's policy of maintaining a drug-free workplace;
3. any available counseling, rehabWtrtlon and employee assistance programs; and
4. penalties that may be Imposed upon employees for drug abuse violations.
C. Provide, as required by Government Code Section 8355(c), That every employee who works on the proposed contract
will receive a copy of the company's drug-free polity statement and
will agree to ablde by the terms of the company's statement as a condition of employment on the contract
Faiure to comply wilh these requirements may result In suspension of payments under the contract or termination of the contract or both and the contractor may be ineligible
for award of any tubae slate contracts it time CDE determines that any of the following has occurred: (1) the contractor has made false certification or (2) the contractor violates
the certification by falling to carry out The requirements as noted above.
ATTACHMENT A
GUIDELINES FOR
SCHOOL-AGE CHILD CARE RESOURCE PROGRAM
March 1, 2001 through June 30, 2002
j ti�{ a � i,
PROGRAM REQUIREMENTS
SCHOOL-AGE CHILD CARE RESOURCE PROGRAM
The intent of this resource contract award is to improve the'quality and availability of
child care and to allow the contractor flexibility in the expenditure of the funds for one-
time only items that primarily benefit the school-age child care services program.
The following program requirements are provided to assist the designated legal entity in
meeting the legislative intent. Each contractor is required, as a condition of its contract
with the California Department of Education (CDE), Child Development Division
(CDD), to adhere to these requirements and Title 5 regulations pertaining to Child
Development Programs, in addition to all other applicable laws and regulations. Any
variance from these requirements, the applicable Title 5 regulations, laws and regulations
could be considered a noncompliance issue and subject the contractor to possible
termination of the contract.
This contract is funded through a grant from the federal Department of Health and
Human Services and subject to Code of Federal Regulations (CFR) 45, Parts 98 and 99,
the Child Care and Development Block Grant Act of 1990, as amended, and Public Law
104-193, the Personal Responsibility and Work Opportunity Reconciliation Act
(PRWORA) of 1996, 42 USC 9858. If the Catalogue of Federal Domestic Assistance
(CFDA) number is 93596 (shown as FC# in the funding block), the fund title is Child
Care Mandatory and Matching Funds of the Child Care and Development Fund. If the
CFDA number is 93575, the fund title is Child Care and Development Block Grant
subject to the Child Care and Development Block Grant Act of 1990, the Omnibus
Budget Reconciliation Act of 1990, Section 5082, Public Law 101-508, as amended,
Section 658J and 658S, and Public Law 102-586.
I. GENERAL PROVISIONS
A. National Labor Relations Board/Federal Court Order
By signing this contract, the contractor swears under penalty of perjury that no more
than one final unappealable finding of contempt of court has been issued by a federal
court against the contractor within the last two (2) years because of failure to comply
with a federal court order for compliance with an order of the National Labor
Relations Board (Public Contract Code Section 10296). This provision does not
apply to public entities.
B. Notification of Address Change
Contractors shall notify the CDD in writing of any change in mailing address for
communication regarding the contract (administrative address) within ten (10)
calendar days of the address change. For non-public agencies, the notification must
be accompanied with (1) board minutes verifying the change in address and (2) a
copy of the notification to the Internal Revenue Service of the address change.
Contractors shall notify the CDD in writing of any proposed change in operating
facility address(es) at least thirty (30) calendar days in advance of the change unless
such change is required by an emergency such as fire, flood or earthquake.
C. Issuance and Use of Checks
Except for external payroll services, private contractors shall not use any pre -signed,
pre -authorized, or pre -stamped checks without the prior written approval of the
CDD.
Private contractors shall require two (2) authorized signatures on all checks unless:
(1) the contractor has a policy approved by its governing board requiring dual
signatures only on checks above a specified dollar amount and (2) the annual audit
verifies that appropriate internal controls are maintained.
D. Prohibition Against Loans and Advances
Contractors shall not loan contract funds to individuals, corporations, organizations,
public agencies or private agencies. Contractors shall not advance unearned salary to
employees. Contractors shall not make advance payments to subcontractors and
shall compensate subcontractors after services are rendered or goods are received.
E. Materials Developed with Contract Funds
If the contractor receives income from materials developed with contract funds, the
use of the income shall be restricted to the child development program. If the
materials were developed in part with contract funds, the income from the sale of the
materials that shall be used in the child development program shall be computed in
direct proportion to the share of contract funds used in development of the materials.
Materials developed with contract funds shall contain an acknowledgement of the
use of State funds in the development of materials and a disclaimer that the contents
do not necessarily reflect the position or policy of the CDE.
F. Contractor's Termination for Convenience
1. General Termination for Convenience
A contractor may terminate the contract for any reason during the contract term.
The contractor shall notify the CDD of its intent to terminate the contract at least
ninety (90) calendar days prior to the date the contractor intends to terminate the
contract.
2
Within fifteen (15) days from the date the contractor notifies the CDD of its intent
to terminate the contract, the contractor shall submit a current inventory of
equipment purchased in whole or in part with contract funds.
Upon receipt of a notice of intent to terminate, the CDD will transfer the program
to another agency as soon as practicable.
The State shall only be obligated to compensate the contractor for net
reimbursable program costs in accordance with this contract through the date of
termination. There shall be no other compensation to the contractor. The State
shall offset any monies the contractor owes the State against any monies the State
owes under this contract.
2. Changes in Laws or Regulations
The CDD shall notify contractors in writing of changes in laws or regulations
prior to the effective date or as soon as possible after enactment. If any laws or
regulations are changed substantially during the contract period, the contractor
shall have the option to discontinue performance and be relieved of all obligations
for further performance.
The contractor has thirty (30) calendar days from receipt of notification of
pending changes to notify the CDD in writing of the contractor's intent to
terminate if the required changes are unacceptable to the contractor. The contract
shall be deemed terminated sixty (60) calendar days after receipt of the
notification of the intent to terminate.
G. Applicability of Corporations Code
Except for partnerships and sole proprietorships, private contractors shall be subject
to all applicable sections of the Corporations Code including standards of conduct
and management of the organization.
H. Conflicts of Interest
For any transaction to which the contractor is a party and the other party is: (a) an
officer or employee of the contractor or of an organization having financial interest
in the contractor; or (b) a partner or controlling stockholder or an organization
having a financial interest in the contractor; or (c) a family member of a person
having a financial interest in the contractor, the transaction(s) shall be fair and
reasonable and conducted at arm's length.
Based on corporate law (Corporations Code sections 310, 5233-5234, 7233 and 9243
as applicable) the general rules that would be followed to ensure that transactions are
conducted "at arm's length" include: (1) prior to consummating the transaction, the
governing body should authorize or approve the transaction in good faith and the
3
board should require the interested party, or parties, to make full disclosure to the
board both in writing and during the board meeting where the transaction is being
discussed and (2) all parties having a financial interest in the transaction should
refrain from voting on the transaction and it should be so noted in the board minutes.
If the transaction involves the renting of property, either land or buildings, owned by
affiliated organizations, officers or other key personnel of the contractor or their
families, the board of directors shall request the interested party to obtain a "fair
market rental estimate" from an independent appraiser. Rental costs for equipment
owned by affiliated organizations, officers or other key personnel of the contractor or
their families are allowable only as use or depreciation allowance.
I. Americans with Disabilities Act
By signing this contract, the contractor assures the CDE that it shall comply with the
Americans with Disabilities Act (ADA) of 1990 (42 U.S.C. 12101 et seq.) as well as
all applicable federal and state laws and regulations, guidelines and interpretations
issued thereto.
J. Air or Water Pollution Violations (Government Code Section 4477)
By signing this agreement, the contractor swears under penalty of perjury that the
contractor is not: (1) in violation of any order or resolution not subject to review
promulgated by the state Air Resources Board or an air pollution control district; (2)
subject to a cease and desist order not subject to review issued pursuant to Section
13301 of the Water Code for violation of waste discharge requirements or discharge
prohibitions; or (3) finally determined to be in violation of provisions of federal law
relating to air or water pollution. This provision does not apply to public agencies.
K. Recycled Paper Certification (Public Contract Code Section 10308.5/10354)
The contractor agrees to certify in writing to the CDE, under penalty of perjury, the
minimum, if not exact, percentage of recycled content, both postconsumer material
and secondary material as defined in Public Contract Code Sections 12161 and
12200, in materials, goods or supplies offered or products used in the performance of
the contract, regardless of whether the product meets the required recycled product
percentage as defined in Sections 12161 and 12200. The contractor may certify that
the product contains zero recycled content Appraisers or the American Institute of
Real Estate Appraisal. If the contractor has no board or is a sole proprietor, the
requirement for a "fair market rental estimate" shall also apply. The contractor has
the burden of supporting the reasonableness of rental costs. If the property is owned
by the contractor, rental costs are not reimbursable and costs may be claimed only as
depreciation or use allowance. Any transaction described in this paragraph shall be
disclosed by the auditor in the notes to the financial statement in the annual audit.
4
L. Child Support Compliance (Public Contract Code Section 7110)
By signing this agreement, the contractor acknowledges that (a) it recognizes the
importance of child and family support obligations and shall fully comply with all
applicable state and federal laws relating to child and family support enforcement
including, but not limited to, disclosure of information and compliance with earnings
assignment orders as provided in Chapter 8 (commencing with Section 5200) of part
5 of Division 9 of the Family Code; and (b) to the best of its knowledge it is fully
complying with the earnings assignment orders of all employees and is providing the
names of all new employees to the New Hire Registry maintained by the California
Employment Development Department.
M. Unlawful Denial of Services (Government Code Section 11135)
No person in the State of California shall, on the basis of ethnic group identification,
religion, age, sex, color, or disability, be unlawfully denied the benefits of, or be
unlawfully subjected to discrimination under, any program or activity that is funded
directly by the state or receives any financial assistance from the state.
With respect to discrimination on the basis of disability, programs and activities
subject to subdivision (a) shall meet the protections and prohibitions contained in
Section 202 of the Americans with Disabilities Act of 1990 (42 U.S.C. Sec. 12132),
and the federal rules and regulations adopted in implementation thereof, except that
if the laws of this state prescribe stronger protections and prohibitions, the programs
and activities subject to subdivision (a) shall be subject to the stronger protections
and prohibitions.
As used in this section, "disability" means any of the following with respect to an
individual: (1) a physical or mental impairment that substantially limits one or more
of the major life activities of the individual, (2) a record of an impairment as
described in paragraph (1), or (3) being regarded as having an impairment as
described in paragraph (1).
N. Computer Software Copyright Compliance
By signing this agreement, the contractor certifies that it has appropriate systems and
controls in place to ensure that state funds will not be used in the performance of this
contract for the acquisition, operation or maintenance of computer software in
violation of copyright laws.
O. Union Organizing and Activities
Contractor by signing this agreement hereby acknowledges the applicability to this
agreement of Government Code Section 16645 through Section 16649.
5
1. Contractor will not assist, promote or deter union organizing by employees
performing work on a state service contract, including a public works contract.
2. No state funds received under this agreement will be used to assist, promote or
deter union organizing.
3. Contractor will not, for any business conducted under this agreement, use any
state property to hold meetings with employees or supervisors if the purpose of
such meetings is to assist, promote or deter union organizing, unless the state
property is equally available to the general public for holding meetings.
4. If the contractor incurs costs or makes expenditures to assist, promote or deter
union organizing, the contractor will maintain records sufficient to show that no
reimbursement from state funds has been sought for these costs. The contractor
shall provide these records to the Attorney General upon request.
Contractor hereby certifies that no request for reimbursement or payment under this
agreement will seek reimbursement for costs incurred to assist, promote or deter
union organizing.
P. Equipment Inventory
Property records must be maintained that include a description of the equipment,
serial number or other identification number, the source of the equipment, the
acquisition date, the cost of the equipment, the location, use and condition of the
equipment and any ultimate disposition date including date of disposal and sale
price if applicable. A physical inventory of equipment must be taken at least every
two years and reconciled with property records. A control system must be
developed to
II. RESOURCE AND REFERRAL AGENCY RESPONSIBILITIES
A. Use of Funds
These school-age resource contract funds must be used for the benefit of school-
age children ages five to thirteen years. Agencies operating or sponsoring
multiple school-age child care service locations must expend the resource contract
funds to provide benefit to all service locations proportionate with the numbers of
subsidized school-age children served at each location.
1. The contract funds may be used to:
a. Purchase equipment and materials for the school-age program.
b. Expand recruitment and outreach efforts to enroll additional school-age
children.
G
c. Train staff to work with school-age children ages five to thirteen years.
d. Make minor renovations and repair to the school-age service area.
2. The contract funds may not be used to pay for:
a. The direct provision of child care services.
b. Construction of a facility to meet basic licensing requirements.
c. Purchase or improvement of land.
d. Lease or rent payments.
e. Salary or benefit expense.
B. Reporting Requirements
The resource grant funds are one-time only funds that must be expended after
March 1, 2001 and prior to June 30, 2002. A report of expenditures is due to
California Department of Education, child Development Fiscal Services, upon full
expenditure of the funds or no later than Julv 20, 2002. The expenditure report
must be made in the format provided for this contract (Form CDFS 9529). Please
complete and submit this form directly to your assigned fiscal analyst at:
California Department of Education
Child Development Fiscal Services
P.O. Box 1317
Sacramento, CA 95812-1317
C. Reimbursement Costs
Reimbursable costs must be incurred during the contract period. Contractors shall
not use current year contract funds to pay prior or future year obligations.
Contracts and subcontracts shall be reimbursed for travel and per diem expenses
at rates not exceeding those amounts paid to the CDE"s represented employees
computed in accordance with State Department of Personnel administration
(DPA) regulation, Title 2 California Code of Regulation, Subchapter 1.
Nonreimbursable costs will be determined in accordance with the 2001-02
Resource and Referral Funding Terms and Conditions, Section V.F.,
"Nonreimbursable Costs."
If there are questions regarding the appropriateness of a proposed expenditure, they may
be to Tom Cole, Consultant, Quality Improvement and Capacity Building Unit, at (916)
323-3034.
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:0.8 (REV. "9)
F&_ )ERAL CERTIFICATION,
'ERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY
4ATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS
1pplicants should refer to the regulations cited below to determine the certification to which they are required to attest. Applicants should also review the
astructions for certification included in the regulations before completing this form. Signature on this form provides for compliance with certification
equirements under 45 CFR Part 93, "New restrictions on Lobbying, " and 45 CFR Part 76, "Government -wide Debarment and Suspension (Non procurement)
nd Government -wide requirements for Drug -Free Workplace (Grants)." The certifications shall be treated as a material representation of fact upon which
eliance will be placed when the Department of Education determines to award the covered transaction, grant, or cooperative agreement.
. LOBBYING
►s required by Section 1352, Title 31 of the U.S. Code, and implemented (c) Are not presently indicted for or otherwise criminally or civilly
t 45 CFR Part 93, for persons entering into a grant or cooperative charged by a governmental entity (federal, state, or local) with commission
greement over $ 100,000 as defined at 45 CFR Part 93, Sections 93.105 of any of the offenses enumerated in paragraph (1) (b) of this certification;
ad 93.110, the applicant certifies that: and
i) No federal appropriated funds have been paid or will be paid, by or on
ehalf of the undersigned, to any person for influencing or attempting to
tfluence an officer or employee of any agency, a member of Congress in
onnection with the making of any federal grant, the entering into of any
ooperative agreement, and the extension, continuation, renewal,
mendment, or modification of any federal grant or cooperative
greement:
)) If any funds other than federal appropriated funds have been or will be
aid to any person for influencing or attempting to influence an employee
f Congress, or any employee of a Member of Congress in connection
rich this Federal grant or cooperative agreement, the undersigned shall
Dmplete and submit Standard Form -LLL, "Disclosure Form to Report
obbying,!' in accordance with this instruction;
:) The undersigned shall require that the language of this certification be
ucluded in the award documents for all subawards at all tiers (including
ibgrants, contracts under grants and cooperative agreements, and
ibcontracts) and that all subrecipients shall certify and disclose
:cordingly.
. DEBARMENT, SUSPENSION, AND OTHER
ESPONSIBILITY MATTERS
s required by executive Order 12549, Debarment and Suspension, and
ther responsibilities implemented at 45 CFR Part 76, for prospective
articipants in primary or a lower tier covered transactions, as defined at
5 CFR Part 76, Sections 76.105 and 76.110.
The applicant certifies that it and its principals:
u) Are not presently debarred, suspended proposed for debarment,
eclared ineligible, or voluntarily excluded from covered transactions by
iy federal department or agency:
r) Have not within a three-year period preceding this application been
mvicted of or had a civil judgment rendered against them for
)mmission of fraud or a criminal offense in connection with obtaining,
tempting to obtain,'or performing a public (federal, state, or local)
ansaction or contract under a public transaction violation of federal or
Late antitrust statutes or commission of embezzlement, theft, forgery,
ibery, falsification or destruction of records, making false statements, or
ceiving stolen property;
(d) Have not within a three-year period proceeding this application had
one or more public transactions (federal, state, or local) terminated for
cause or default; and
B. Where the applicant is unable to certify to any of the statements in this
certification, he or she shall attach an explanation to this application.
3. DRUG-FREE WORKPLACE (GRANTEES OTHER THAN
INDIVIDUALS)
As required by the Drug -Free Workplace Act of 1988, and implemented at
45 CFR Part 76, Subpart F, for grantees, as defined at 45 CFR Part 76,
Sections 76.605 and 76.610-
A. The applicant certifies that it will or will continue to provide a drug-
free workplace by:
(a) Publishing a statement notifying employees that the unlawful
manufacture, distribution, dispensing, possession, or use of a controlled
substance is prohibited in the grantee's workplace and specifying the
actions that will be taken against employees for violation of such
prohibition.
(b) Establishing an on-going drug-free awareness program to inform
employees about -
(1) The danger of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee assistance
programs; and
(4) The penalties that may be imposed upon employees for drug abuse
violations occurring in the workplace;
(c) Making it a requirement that each employeee to be engaged in
performance of the grant be given a copyofthe statement required by
paragraph (a);
(d) Notifying the employee in the statement required by paragraph (a) that,
as a condition of employment under the grant, the employee will -
l) Abide by the terms of the statement; and
(2) Notify the employer in writing of his or her conviction for a violation;
(e) Notifying the agency, in writing, within 10 calendar days after
receiving notice under subparagraph (d) (2) from an employee or
otherwise receiving actual notice of such conviction. Employers of
convicted employees must provide notice, including position title, to.
Director, Grants, and Contracts Service, U.S. Department of Education,
400 Maryland Avenue, S.W. (Room 3124, GSA Regional Office Building
No. 3), Washington, DC 20202-4571. Notice shall include the
identification number(s) of each affected grant;
(f) Taking one of the following actions, within 30 calendar days of
receiving notice under subparagraph (d) (2). with respect to any employee
who is so convicted:
(1) Taking appropriate personnel action against such an employee, up to
and including termination, consistent with the requirements of the
Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a drug abuse
assistance or rehabilitation program approved for such purposes by a
federal, state, or local health, law enforcement, or other appropriate
agency:
(g) Making a good faith effort to continue to maintain a drug-free
workplace through implementation of paragraphs (a), (b). (c), (d), (e), and
(f)•
B. The grantee may insert in the space provided below the site(s) for the
performance of work done in connection with the specific grant:
Place of Performance (Street address, city, county, state, zip code)
PICKLEWEED CNILDRENS CENTER
50 CANAL STREET, SAN RAFAEL, CA 94901
Check [ ) if there are workplaces on file that are not identified hem.
DRUG-FREE WOF —ACE
(GRANTEES WHO ARE INDIVIDUALS)
As required by the Drug -Free Workplace Act of 1988, and implemented at
45 CFR Part 76, Subpart F. for grantees, as defined at 45 CFR Part 76,
Sections 76.605 and 76.610-
a. As a condition of the grant, I certify that I will not engage in the
unlawful manufacture, distribution, dispensing, possession, or use of a
controlled substance in conducting any activity with he grant, and
b. If convicted of a criminal drug offense resulting from a violation
occurring during the conduct of any grant activity, I will report the
conviction, in writing, within 10 calendar days of the conviction, to:
Director, Grants and contracts Service, U.S. department of Education, 400
Maryland Avenue, S.W. (Room 3124, GSA Regional Office Building No.
3) Washington, DC 20202-4571. Notice shall include the identification
numbers(s) of each affected grant.
ENVIRONMENTAL TOBACCO SMOKE ACT
As required by the Pro -Children Act of 1994, (also known as
Environmental Tobacco Smoke), and implemented at Public Law 103-
277, Part C requires that:-
The
hat:
The applicant certifies that smoking is not permitted in any portion of any
indoor facility owned or leased or contracted and used routinely or
regularly for the provision of health care services, day care, and education
to children under the age of 18. Failure to comply with the provisions of
this law may result in the imposition of a civil monetary penalty of up to
$1,000 per day. (The law does not apply to children's services provided
in private residence, facilities funded solely by Medicare or Medicaid
funds, and portions of facilities used for in-patient drug and alcohol
treatment.)
As the duly authorized representative of the applicant, I hereby certify that the applicant wiU comply with the above certifications.
NAME OF APPLICANT CONTRACT #/PROJECT #
CITY OF SAN RAFAEL FSCC-0075 / 21-N916-00-0
PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE
ROD GOULD, CITY MANAGER
SIGNATU DATE