Fillable Incumbent Worker Training Fillable Application Allen 2020 (Allen County Ohio)

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Incumbent Worker Training Fillable Application Allen 2020 (Allen County Ohio)

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Rev. 9/8/16 L. Geary
Rev 8/22/16 M Fields- *All employees must be employed at least 6 months prior to the signing of the agreement.
1
Incumbent Worker Training
Allen County
Program Information, Application/Pre-Award, and Agreement
2020
Rev. 9/8/16 L. Geary
Rev 8/22/16 M Fields- *All employees must be employed at least 6 months prior to the signing of the agreement.
2
IWT Program Information
Purpose
The purpose of the Incumbent Worker Training (IWT) is to support training projects that will benefit local
business and industry by assisting the skill development of existing employees, thereby averting layoff,
increasing employee productivity and growth of the company, as well as assisting in keeping OMJ-Allen
County’s workforce competitive. The training is expected to lead to the creation of new jobs, retention of
jobs, increased wages for better-trained workers, a higher-skilled workforce, and a more profitable business
climate.
Participants
• Trainees need to be employed by the business with which the IWT contract is being written.
• Trainees must meet the Fair Labor Standards Act (FLSA) requirements for an employer-employee
relationship.
• Trainees must have an established employment history with the employer as of the date of the IWT
agreement signing.
• Trainees do not have to meet the eligibility requirements for career and training services for WIOA
Adults or Dislocated Workers.
• Trainees must be reported via the Mini Incumbent Worker registration in OWCMS; however they
are not subject to performance measures.
Applicant Requirements
OMJ-Allen County businesses or non-profit and trade organizations applying for IWT must:
• Address strategy to avoid a layoff or business closure
• Meet any additional policy guidelines OMJ-Allen County sub-grantees may establish
• Be operating in OMJ-Allen County
• Have full-time employees
• Remain current on all state obligations, as verified at:
o Federal Exclusion and Debarment Site: http://www.sam.gov
o Ohio Department of Taxation: http://www.tax.ohio.gov
o Business filing Search: http://sos.state.oh.us
• Employers are required to pay for a share of the total cost of the project, either cash or in-kind:
o At least a 10 percent of the cost, for employers with 50 or fewer employees
o At least 25 percent of the cost, for employers with 51 to 100 employees
o At least 50% of the cost, for employers with more than 100 employees.
• Demonstrate a commitment to retaining operations and employees in OMJ-Allen County, and
• Be willing to participate in a full range of services provided by OMJ-Allen County
Rev. 9/8/16 L. Geary
Rev 8/22/16 M Fields- *All employees must be employed at least 6 months prior to the signing of the agreement.
3
Allowable Costs
Allowable costs may include only costs directly related to training. Allowable costs may include:
• Curriculum development
• Instructor/trainer salaries
• Textbooks, manuals, training software, materials, and non-consumables.
• Wages paid to participants, while in trainings, may be considered as a source of matching funds on
the employer side of training budget.
Unallowable Costs
Unallowable costs include but are not limited to:
• Training tools/equipment (must become real personal property of trainee upon completion of
training)
• Trainee wages (no overtime)
• Foreign travel
• Purchase of capital equipment
• Purchases or lease of capital equipment
• Encouragement of inducement of a business or part of a business to relocate from any location in
the United States
• Use of IWT funds to pay for a worker’s training wages
• Use of IWT funds to train management staff employees in management such as Six Sigma and
LEAN.
Expected Outcomes
As a result of the award of IWT funds, applicants will be expected to demonstrate one or more of the
following outcomes:
• Layoff aversion
• Business growth/expansion
• Increased productivity
• Increased profits, quality, or efficiency
• Increased wages for employees who complete the training
• Increased retention of existing workforce
• Industry-recognized credential for trainees is highly encouraged
Rev. 9/8/16 L. Geary
Rev 8/22/16 M Fields- *All employees must be employed at least 6 months prior to the signing of the agreement.
4
IWT Pre-Award & Application
COMPANY NAME
AUTHORIZED COMPANY REPRESENTATIVE
TITLE
PHONE
EMAIL
FAX
STREET/MAILING ADDRESS
CITY
ZIP
COUNTY
DATE OF INCEPTION OF BUSINESS
YEARS IN BUSINESS AT PRESENT LOCATION
TOTAL NUMBER OF CURRENT FULL-TIME EMPLOYEES (UNDER THE FEIN#)
LEGAL STRUCTURE OF BUSINESS
SOLE PROPRIETORSHIP PARTNERSHIP CORPORATION (DESIGNATION________________________)
FEDERAL ID#
UNEMPLOYMENT COMP ID#
BRIEF COMPANY DESCRIPTION (PLEASE INCLUDE SERVICES AND/OR PRODUCTS)
IS YOUR COMPANY CURRENT ON ALL:
County Tax Obligations: yes no State Tax Obligations: yes no
City or Local Tax Obligations: yes no Federal Tax Obligations: yes no
ESTIMATED TOTAL AMOUNT SPENT ON TRAINING ANNUALLY:
IS YOUR COMPANY RECEIVING / APPLYING FOR ANY OTHER PUBLIC TRAINING FUND (not from DJFS)? yes no
IF YES, EXPLAIN:
HAS YOUR COMPANY HAD AN IWT AGREEMENT IN THE PAST OR WITH A DIFFERENT AGENCY? yes no
IF YES, BREIFLY DESCRIBE OUTCOME/STATUS:
IF YOUR COMPANY IS MINORITY OWNED,.PLEASE CHECK ALL APPLICABLE
Women-owned African-American owned Hispanic/American owned
Asian-American owned Native-American owned Other minority owned: (specify):
DOES YOUR COMPANY USE ONE-STOP SERVICES? yes no
IF YES, CHECK APPLICABLE: list job openings job fairs testing & assessment mass hires other
IF NO, WHY NOT?
IF NO, DO YOU AGREE TO LIST ALL FUTURE OPENINGS WITH THE ONE-STOP? yes no
IF NO, WHY NOT?
Rev. 9/8/16 L. Geary
Rev 8/22/16 M Fields- *All employees must be employed at least 6 months prior to the signing of the agreement.
5
DESCRIBE DESIRED TRAINING
START DATE
END DATE
TOTAL AMOUNT REQUESTED
NUMBER OF TRAINEES
TRAINING PROVIDER INFORMATION
Training organization: public private employee-trainer
Training delivered: on-site training institution remote site If remote site, list location:
NAME OF TRAINING PROVIDER
AUTHORIZED TRAINING PROVIDER REPRESENTATIVE
TITLE
PHONE
EMAIL
FAX
STREET/MAILING ADDRESS
CITY
ZIP
COUNTY
TRAINING PROGRAM FOCUS
layoff aversion upgrade employee skills increase skills/wages portable skills retention
other (specify):
ANTICIPATED OUTCOMES
layoff aversion/save jobs within the company (#_____) enhance viability lower turnover
create new jobs (#_____) increase trainee wage (_____%) training veterans training minorities
training disabled workers training for welfare-to-work prevent relocation increase profitability
BRIEFLY DESCRIBE HOW THE TRAINING WILL ACHIEVE THE ANTICIPATED OUTCOMES AND CONTRIBUTE TO THE PURPOSE OF
INCUMBENT WORKER TRAINING, AS DESCRIBED IN THE INFORMATION SECTION OF THIS PACKET:
HOW DID YOU LEARN ABOUT THE INCUMBENT WORKER TRAINING PROGRAM?
PLEASE ATTACH A DESCRIPTION OF THE TRAINING PROGRAM YOU ARE REQUESTING IWT FUNDS FOR. This could be a course
description from the training provider or any other documentation of what the training will entail.
Rev. 9/8/16 L. Geary
Rev 8/22/16 M Fields- *All employees must be employed at least 6 months prior to the signing of the agreement.
6
IWT Project Budget
Use this template as a guide. You may include other items for consideration as required, such as IWT
Trainee Log. Show all formulas used to calculate totals, as indicated.
Note: Training funds cannot be used to reimburse any training costs occurring before the application is
approved and no partial reimbursements will be made prior to the completion of the total project.
Reimbursement will only occur after the training, once OMJ-Allen County or its sub-grantee receives
verification of training completion, paid invoices, and costs associated with the employer contribution.
Budget Category
IWT Assistance
Employer
Contribution
Total
Instructor Wages
FORMULA:
$
$
$
Tuition (break out costs, including hours)
FORMULA:
$
$
$
Curriculum development
FORMULA:
$
$
$
Materials/supplies/textbooks (itemize)
FORMULA:
$
$
$
Training equipment/tools (itemize)
FORMULA:
*not eligible for reimbursement*
$
*must become property of trainee
$
Trainee wages
FORMULA:
*not eligible for reimbursement*
$
$
Travel (domestic only)
FORMULA:
$
$
Other costs (itemize)
FORMULA:
$
$
$
Other costs (itemize)
FORMULA:
$
$
$
TOTALS*
$
$
$
*Sample formula: 20 trainees x 5 hours x $100/hr = $TUITION
Rev. 9/8/16 L. Geary
Rev 8/22/16 M Fields- *All employees must be employed at least 6 months prior to the signing of the agreement.
7
Assurances and Certifications
SECTION 1: SCOPE OF SERVICES
OMJ-Allen County hereby agrees to engage the CONTRACTOR and the CONTRACTOR shall perform all the necessary services under this
contract.
SECTION 2: TIME OF PERFORMANCE
The length of the contract is dependent upon the complexity of the training to be provided, experience and/or education level of the trainee,
local limitations, and the availability of funds.
SECTION 3: DISBURSEMENT
A. OMJ-Allen County shall reimburse to the CONTRACTOR based upon invoices submitted and receipt of required documentation as
outlined in the contract.
B. Invoices shall be submitted and received at the OMJ-Allen County or sub-grantee office located at _2511 Countryside Dr. Suite D,
Fremont, OH no later than ten (10) working days after the invoice ending date. Non-adherence to this schedule may make this
contract null and void.
C. Amount of reimbursement is solely dependent upon the availability of WIOA funding at time of invoice.
D. Funds may not be redistributed hereunder without approval of the OMJ-Allen County and amendment of the contract.
.
E. Subject to receipt of funds from the State of Ohio, OMJ-Allen County shall make payment under this Contract.
SECTION 4: TERMINATION
A. Contract termination shall be defined as the cancellations of Federal or State assistance, in whole or in part, under a contract at any
time prior to the date of completion.
B. Termination shall be by one of the following methods:
Cause: OMJ-Allen County may terminate any contract in whole, or in part, and any payment pertaining thereto, at any time
before the date of completion whenever it is determined that the CONTRACTOR has failed to comply with the conditions of
this contract. OMJ-Allen County shall promptly notify the CONTRACTOR in writing of the determinations and the reasons
for their termination, together with the effective date.
Convenience: OMJ-Allen County or CONTRACTOR may terminate contracts in whole, or in part, when both parties agree
that the continuation of the contract would not produce beneficial results commensurate with the further expenditure of funds.
The two parties shall agree upon the termination conditions, including the effective date and, in the case of partial terminations,
the portion to be terminated. The CONTRACTOR shall not incur new obligations for the terminated portion after the effective
date, and shall cancel as many outstanding obligations as possible. OMJ-Allen County shall allow full credit to the
CONTRACTOR for the Federal share of the non-cancellable obligations, properly incurred by the CONTRACTOR prior to
termination.
C. In the event of termination of this contract, the CONTRACTOR shall be entitled to compensation for any reimbursed expenses
reasonably and necessarily incurred in satisfactory performances of the contract. Notwithstanding the above, the CONTRACTOR
shall not be relieved of liability to OMJ-Allen County for damages sustained by OMJ-Allen County by virtue of any breach of the
Contract, by the exact amount of damages due OMJ-Allen County from the CONTRACTOR, is determined.
SECTION 5: TERMS AND CONDITIONS
A. In the event of any modification, termination, or other amendment to the Workforce Innovation and Opportunity Act, either by the
act of Congress or administratively by the President of the United States, OMJ-Allen County reserves the right to terminate or
otherwise modify this Contract at its option, notwithstanding any other provision of the Contract.
B. At any time during normal business hours and as often as OMJ-Allen County, the State of Ohio, USDOL and/or Comptroller
General of the United States may deem necessary, there shall be made available to same for examination of all its records with
respect to all matters covered by this Contract and will permit same to audit, examine and make excerpts of invoices, materials,
payrolls, personnel records, conditions of employment and other data relating to all matters covered by this Contract.
C. The CONTRACTOR agrees to hold harmless OMJ-Allen County for ineligible costs and insures that OMJ-Allen County shall be
relieved of liability and damages sustained by ineligible costs as determined by a fiscal audit. Moreover, the CONTRACTOR agrees
to indemnify and hold harmless OMJ-Allen County and insure that OMJ-Allen County shall be relieved of liability and damages
sustained by virtue of any act or failure to act by which the CONTRACTOR shall be responsible.
Rev. 9/8/16 L. Geary
Rev 8/22/16 M Fields- *All employees must be employed at least 6 months prior to the signing of the agreement.
8
D. At the direction of OMJ-Allen County, the CONTRACTOR shall establish such procedures and reporting requirements as are
necessary. The CONTRACTOR shall invoice OMJ-Allen County in accordance with OMJ-Allen County's current invoice
guidelines. It is hereby mutually understood and agreed that the administration and professional implementation of all WIOA
programs is the responsibility of OMJ-Allen County. As such, the implementation personnel of the CONTRACTOR shall perform
the required services of this Contract at the direction and instruction of the USDOL, the State of Ohio, and the WIOA Program
Administrator of OMJ-Allen County.
E. The CONTRACTOR and OMJ-Allen County may, from time to time, require changes to the scope of services to be provided
hereunder that are of substantive nature. Such changes, including any increase or decrease in the amount of the CONTRACTOR's
compensation, which are mutually agreed upon between OMJ-Allen County and the CONTRACTOR, shall be incorporated by
written amendment to this Contract.
F. The CONTRACTOR shall not assign any interests in the Contract without prior mutual agreement between the CONTRACTOR
and OMJ-Allen County and written amendment to this Contract.
G. All trainees are considered employees of the CONTRACTOR as of the date of hire and that they are entitled to all rights and
benefits normally provided to employees of the CONTRACTOR.
H. Appropriate Worker's Compensation shall be provided to all trainees by the CONTRACTOR.
I. The CONTRACTOR shall insure appropriate standards for health and safety in work and training situations.
J. The CONTRACTOR assures that no former employee is on layoff in the same or similar position as the position for which this
contract is being written and approved.
K. No currently employed worker shall be displaced by any trainee. This includes partial displacement such as reduction in the hours of
non-overtime work, wages, or employment benefits.
L. Trainees shall be provided wages, benefits, and working conditions at the same level and to the same extent as other employees
working a similar length of time and doing the same type of work. Compensation must be no less than the highest of Federal or
State minimum wage.
M. No funds may be used to assist in relocating the CONTRACTOR's company or parts thereof from one area to another, especially if
said relocation results in a loss of employment at the original location.
N. The CONTRACTOR assures compliance with all applicable business licensing, taxation, and insurance requirements.
O. The CONTRACTOR assures that trainees are being trained for jobs that are necessary for current and future operation and the
trainees are expected to continue permanent employment upon successful completion of this contract.
P. The CONTRACTOR agrees to adhere to the rules and regulations of the Workforce Innovation and Opportunity Act, as amended.
Q. No trainee hired under this Contract shall be subjected to discrimination because of race, color, religion, sex, national origin, age,
handicap, political affiliation, or solely because they are participating in WIOA under this Contract.
R. The CONTRACTOR will comply with all applicable Federal, State and Local laws, rules, and regulations which deal with or are
related to the employment of persons who perform work or are trained under this Contract.
S. Parties agree to prohibit employees from using their positions for a purpose that is, or gives the appearance of, being motivated by a
desire for private gain for them, particularly those with whom they have family, business, or other ties.
T. The CONTRACTOR shall agree to attempt to resolve disputes arising from this contract through administrative processes and
negotiations in lieu of litigation. The CONTRACTOR ensures performance during disputes.
U. The CONTRACTOR accepts full responsibility for prompt payment of all applicable unemployment compensation contributions or
reimbursements, insurance premiums, workers' compensation premiums, all income tax deductions, social security deductions, and
any and all other employer taxes and payroll deductions required for all employees.
V. Both parties to this Contract ensure that no funds under this Contract shall be used for lobbying activities.
W. The CONTRACTOR certifies that it and its principals are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from covered transactions by any Federal department or agency.
X. Both parties to this Contract ensure that their officers, employees and agents will not solicit or accept gratuities, favors, or anything
of monetary value as a result of this Contract. Neither will any trainee be charged a fee for the referral or placement of said trainee
under this Contract.
Rev. 9/8/16 L. Geary
Rev 8/22/16 M Fields- *All employees must be employed at least 6 months prior to the signing of the agreement.
9
SECTION 6: COLLECTIVE BARGAINING (IF APPLICABLE)
A. The CONTRACTOR shall ensure that no activities, work or training under this Contract are in conflict with the terms and
conditions of an existing collective bargaining agreement or contract for services. The CONTRACTOR further ensures that nothing
under this Contract shall impair any aspect of an existing collective bargaining agreement, except that no program funded by WIOA
which would be inconsistent with the terms of a collective bargaining agreement shall be undertaken without the written
concurrence of the CONTRACTOR and the affected labor organization.
B. No funds received from this Contract shall be used to either promote or oppose unionization.
SECTION 7: WORKFORCE INNOVATION AND OPPORTUNITY ACT OF 2014
Workforce Innovation and Opportunity Act of 2014 (WIOA): Sec. 181 (d) Relocation. (1) Prohibition on use of funds to encourage or induce
relocation. No funds provided under this title shall be used, or proposed for use, to encourage or induce the relocation of a business or part of a
business if such relocation would result in a loss of employment for any employee of such business at the original location and such original
location is within the United States. (2) Prohibition on use of funds for customized or skill training and related activities after relocation. No funds
provided under this title for an employment and training activity shall be used for customized or skill training, on- the-job training, or
company-specific assessments of job applicants or employees, for any business or part of a business that has relocated, until the date that is
120 days after the date on which such business commences operations at the new location, if the relocation of such business or part of a
business results in a loss of employment for any employee of such business at the original location and such original location is within the
United States.
SECTION 8: EEO/AFFIRMATIVE ACTION
As a condition to the award of financial assistance from the Department of Labor under 29CFR37.20 Title I of WIOA, the CONTRACTOR
assures that it will comply fully with the nondiscrimination and equal opportunity provisions of the following:
Section 138 of the Workforce Innovation and Opportunity Act of 2014 (WIOA), which prohibits discrimination against all individuals
in the United States on the basis of race, color, religion, sex, national origin, age, disability, political affiliation or belief, and against
beneficiaries on the basis of either citizenship status as a lawfully admitted immigrant authorized to work in the United States or
participation in any WIOA Title I financially assisted program or activity.
Title VI of the Civil Rights Act of 1964, as amended, which prohibits discrimination on the basis of race, color and national origin:
Section 504 of the Rehabilitation Act of 1973, as amended, which prohibits discrimination against qualified individuals with
disabilities:
The Age Discrimination Act of 1975, as amended, which prohibits discrimination on the basis of age and
Title IX of the Education Amendments of 1972 as amended, which prohibits discrimination on the basis of sex in educational
programs.
The CONTRACTOR also assures that it will comply with 20 CFR part 37 and all other regulations implementing the laws listed above. This
issuance applies to the CONTRACTOR’s operation of the WIOA Title I financially-assisted program or activity, and to all agreements the
CONTRACTOR makes to carry out the WIOA Title I financially assisted program or activity. The CONTRACTOR understands that the
United States has the right to seek judicial enforcement of this assurance.
OMJ-Allen County has the responsibility to implement the Affirmative Action Plan and to be in compliance with requirements of Federal
law.
OMJ-Allen County must receive written notification from sub-contractors (as evidenced by your signature on this Pre-Award Survey that they
are aware of OMJ-Allen County’s Affirmative Action Program and the service goals they are striving to attain in the furtherance of the overall
program.
SECTION 9: RETENTION OF RECORDS
The CONTRACTOR shall retain all records pertaining to this program for a period of six (6) years. These records include, but are not limited
to, financial, statistical, property, and participant records, and supporting documentation. Records for nonexpendable property shall be
retained for whichever period is longer, six (6) or three (3) years after final disposition of the property. The aforementioned records will be
retained beyond the six (6) year period if any litigation is begun and audit has not been completed, or if a claim is instituted involving the
contractual agreement covered by the records. In these instances, the records will be retained until the litigation, audit, or claim has been
resolved. The six (6) year retention period for individual participant records will begin upon the date the participant is terminated from
WIOA.
SECTION 10: CONFIDENTIALITY OF INFORMATION
To the extent feasible and permissible by law, the OMJ-Allen County and its sub-grantee(s) (OMJ-Allen County) will honor an applicant’s
request that confidential information submitted to OMJ-Allen County will remain confidential. OMJ-Allen County will treat the information
as confidential only if: (1) the information is, in fact, protected confidential information such as trade secrets or privileged or confidential
Rev. 9/8/16 L. Geary
Rev 8/22/16 M Fields- *All employees must be employed at least 6 months prior to the signing of the agreement.
10
commercial or financial information not defined as public record, (2) the information is specifically identified as confidential by the applicant,
and (3) no disclosure of the information is required by law or judicial order. If the application is approved, honoring of confidentiality of
identified date shall not limit OMJ-Allen County’s right to disclose the details and results of the project to the public.
Management Certification
I hereby certify I have read the foregoing application and the information contained herein is true and accurate to the best of my
knowledge. Furthermore, our company and/or organization does not have any outstanding liabilities with the State of Ohio,
the county or city where located, or the United States of America, nor are we currently involved in any labor disputes.
I agree that the IWT funding will not supplement or supplant current training efforts and that I have read the OMJ-Allen
County Assurances and Certifications and concur with all sections.
I also agree, for reporting purposes, to provide the following information for each trainee (form attached) and certify that an I-9
is on file for each:
• Name
• Social security number
• Date of birth
• Race/Ethnicity
• Gender * (Males born after January 1, 1960 must be registered for Selective Service.)
• Address
• Phone
• Wages prior to training (Post-training wages must reflect a wage of at least $8.00 for trainees making less than that
prior to training.)
__________________________________________________ ____________________
Signature of company representative, Title Date
__________________________________________________ ____________________
Signature of collective bargaining representative, Title Date
(if applicable)
__________________________________________________ ____________________
Signature of DJFS Rep., Title Date
Rev. 9/8/16 L. Geary
Rev 8/22/16 M Fields- *All employees must be employed at least 6 months prior to the signing of the agreement.
IWT Trainee Log
Company Name: _________________________________________
#
Name*
DOB
SSN
Ethnicity
Gender
Address
City
State
Zip
Phone
Wage prior
to training
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
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Incumbent Worker Training Fillable Application Allen 2020 (Allen County Ohio)

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Completed 18 July 2020

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