LEGAL NOTICE
REQUEST FOR PROPOSALS
Pursuant to the rules and regulations set forth in the Workforce Innovation & Opportunity
Act and pertinent regulations for other sources, the Suffolk County Department of Labor,
Licensing & Consumer Affairs (SCDOLLCA), an equal opportunity employer, on behalf
of the Suffolk County Workforce Development Board (WDB), hereby solicits proposals
from experienced individuals or organizations to coordinate the service delivery of
Workforce Innovation & Opportunity Act (WIOA) One-Stop Core Program services
and Core Partner service providers. Coordination efforts may be conducted within
each One-Stop, within targeted communities and across the One-Stop System. A
detailed description of the services sought is provided in the “Services to be Procured” of
the Request for Proposals (RFP).
A maximum award of $100,000 per year will be made available for each of the four years
covered by this solicitation. This project will begin on or before July 1, 2021.
Any governmental, educational or not-for-profit organization or agency engaged in a
public service, employer with locations in Suffolk County and business associations,
private for profit organizations engaged in providing employment and training and
educational opportunities may apply. Applicants may be single entities or a consortium
of entities; if the consortium of entities includes One-Stop Partners, it must include three
or more One-Stop Partners.
This RFP, and bids submitted by proposers to this request, and any final contracts
negotiated with the successful bidder(s) as a result of this proposal is subject to WIOA
final regulations issued on June 30, 2016 and any subsequent guidance provided by the
United States Department of Labor (USDOL) and New York State Department of Labor
(NYSDOL).
An RFP package may be obtained from the SCDOLLCA website
www.suffolkcountyny.gov/Departments/Labor/RequestForQualifications or by contacting
SCDOLLCA at (631) 853-6582 Monday through Friday between the hours of 8:30 a.m.
and 4:00 p.m.
Completed proposals must be received by February 11, 2021 in order to be considered.
Completed proposals should be mailed to:
Mr. Marc Bossert
Suffolk County Department of Labor, Licensing & Consumer Affairs
P.O. Box 6100
Hauppauge, New York 11788-0099
PLEASE NOTE:
The RFP does not commit the SCDOLLCA or the WDB to award a contract, to pay any
costs incurred in the preparation of a proposal to this request, or to procure or contract
for services or supplies.
The SCDOLLCA and the WDB reserve the right to accept or reject any or all proposals
received as a result of this request, to negotiate with all qualified sources, or to cancel in
part or in its entirety this RFP if it is in the best interest of the County, the funded
program, or the Department to do so or to request further information from any applicant.
Rev. 12/4/20; Law No. 25-LB-004
Issue Date: 12/17/20
RFP for One-Stop Employment Center Operator
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Request for Proposals (RFP)
Suffolk County Suffolk County Department of Labor, Licensing & Consumer Affairs
On behalf of
The Suffolk County Workforce Development Board
Is seeking Proposals for
A Suffolk County One-Stop Employment Center Operator
Timeline
Advertised/Issue Date: December 17, 2020
Technical Questions Due: January 14, 2021
3:30 PM
Must be submitted in writing (fax/email acceptable) to the Marc Bossert (contact information below)
Proposer’s Conference: Not Applicable
(Non-mandatory)
Proposal Due Date: February 11, 2021
3:30 PM
Contact Information:
Name: Marc Bossert
Assistant Administrative Director
Suffolk County Department of Labor, Licensing & Consumer Affairs
725 Veterans Memorial Highway, Hauppauge, NY 11788
Email: marc.bossert@suffolkcountyny.gov
Response Package Requirements
Submissions to be sent to Marc Bossert, Assistant Administrative Director;
Number of Copies - Original plus 4 copies:
o Cost Proposal must be submitted in a separate sealed envelope with the original proposal only;
o The Law Number (upper left corner) must be on all outer mailing envelopes/package;
Original must be labeledORIGINAL”;
Original must contain the actual ink signed and notarized required County forms;
All copies must be complete copies of the Original;
Proposals should be submitted in a tabbed and labeled binder, not permanently bound;
Transmittal letter and all required forms should be placed in First Tab of Binder;
Do NOT return RFP document. This is for you to keep for reference.
Late Proposals Will Be REJECTED
Rev. 12/4/20; Law No. 25-LB-004
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Table of Contents
Section I Administrative Information
1. Purpose of RFP
2. Coordinating Departments
3. Background Information
4. Evaluation Committee and Award of Contract
5. Questions and Comments
6. Proposer’s Conference
7. Due Date for Proposals
8. Number of Copies of Proposal
9. RFP Policies and Procedures
10. RFP Posted on County Website
11. Reservation of Rights
12. Proposal Format
13. Award Criteria
14. Contract Terms and Conditions
15. Use of County Resources to Interfere with Collective Bargaining Activities
Local Law No. 26-2003
16. Non-Responsible Bidder
17. Effective Period of Proposals
18. NYS Freedom of Information Law (FOIL)
Section II Suffolk County Workforce Development Board Background Information
Section III Proposer Profile
1. General Information/Proposer’s History
2. Qualifications and Experience of Personnel
3. Financial Viability
4. Client History
5. References
6. Conflicts of Interest and/or Potential Conflicts of Interest
7. Subcontractors
Section IV Technical Requirements
1. Overview
2. Minimum Requirements for Technical Services Proposals
3. Technical Services Specifications (Detailed Scope of Services)
Section V Cost Proposal/Fee Schedule
1. Separate Envelope
2. Cost Proposal/Fee Schedule is One of Several Evaluation Criteria
3. Additional Information
4. Alternative Proposals
5. Format for Cost Proposal/Fee Schedule
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Section VI Model Contract
Suffolk County Required Compliance Forms in Accordance with County Laws
Note: All required forms may be obtained at https://suffolkcountyny.gov/Departments/Labor
Click on Bids and Proposals and follow the instructions to register and download the documents
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Section I
Administrative Information
1. Purpose of RFP
The Suffolk County Department of Labor, Licensing & Consumer Affairs (“Department or “SCDOLLCA”), on
behalf of the Suffolk County Workforce Development Board (“Board”) set forth on page one, invites proposals
(“Proposal(s)”) from qualified companies (“Proposer) to provide services (“Services”), as described in Section
IV, entitledTechnical Requirements.”
The term Contractor (“Contractor”) or Operator (“Operator”) shall mean the successful Proposer who may be
awarded a contract pursuant to this RFP.
2. Coordinating Departments
a. Prior to Award of Contract
The Department is responsible for coordinating with the Board regarding the issuance of this RFP. Please
submit any questions by mail or email to:
Marc Bossert, Assistant Administrative Director
725 Veterans Memorial Highway
Hauppauge, New York 11980
Email: marc.bossert@suffolkcountyny.gov
All questions and responses will be posted to https://suffolkcountyny.gov/Departments/Labor.
b. After Award of Contract
i. The Department is responsible for coordinating with the Suffolk County Attorney’s Office and
the Contractor regarding the negotiation and execution of the contract.
ii. The Department will execute a contract with the Contractor, based on the Model Contract
included in this RFP. Note that the Model Contract is subject to negotiation and revision, based
on the Department’s needs and the approval of the County Attorney’s Office.
iii. The Proposal submitted by the Proposer in response to this RFP, as may be negotiated by the
Department, will become the basis for the contract.
c. After Execution of Contract
The Department is responsible for administration of the contract.
3. Background Information
a. Suffolk County, with a population of 1.5 million, is Long Island's eastern-most county, and covers an area
of approximately 900 square miles, 20 miles at its widest part and approximately 86 miles in length.
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b. The County of Suffolk is a municipal corporation of the State of New York with an annual operating
budget of approximately $2.6 billion. The County employs approximately 12,000 employees, with main
offices located in Hauppauge, Yaphank, Riverhead, and several smaller locations.
4. Evaluation Committee and Award of Contract
The award of any contract will be made in the best interest of the County, taking into consideration cost as well as
technical or other non-cost factors. The Suffolk County Department of Law acts as counsel to the County
Evaluation Committee, but does not vote in the selection process.
The RFP Evaluation Committee shall include the following:
a. Suffolk County Executive, or his designees;
b. The Department Head, or his or her designee, of the Department requesting the RFP and;
c. Members of the Suffolk County Workforce Development Board.
5. Questions and Comments
a. Administrative Questions
Administrative questions (e.g., procedural questions on how to respond to this RFP) may be submitted by
email or in writing to the Administrative staff member listed on page one of this RFP.
b. Technical Questions
Technical questions (questions which are specific to the service requested in this RFP) must be submitted
in writing by email or writing on or before the date set forth on page one of this RFP to the attention of
the Administrative staff member listed on page one of this RFP. Responses to such technical questions
will be developed by the Department and posted to the Department’s website.
c. No Direct Contact
No questions or comments should be directed to any Department employee or its contractors or any firm
currently in contract with the Department regarding this RFP during the RFP process, except as set forth
in sub-paragraphs 5.a and 5.b above or as may be requested or permitted by the Suffolk County
Purchasing Office and/or the Suffolk County Department of Law. Failure to comply may result in
immediate disqualification.
6. Proposer’s Conference
Not Applicable
7. Due Date for Proposals
Proposals must be submitted to the attention of the administrative staff member listed on page one by 3:30 p.m.
on the date set forth on page one of this RFP.
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In the interest of fairness to all participants, no extensions or exceptions will be permitted, unless issued as an
Addendum to this RFP and applicable to all Proposers.
8. Number of Copies of Proposal
One original, plus such additional numbers of copies as set forth on page one of this RFP of the responses to
Sections III, IV and V, are required to be sent to the Department.
Note: Section V, entitled "Cost Proposal/Fee Schedule," is required to be in a separate, sealed envelope,
properly labeled.
Do not submit Proposals that are permanently bound.
9. RFP Policies and Procedures
a. It is the Departments intent to select the Proposer that provides the best solution for the County’s needs.
In order for the County to conduct a uniform review process of all proposals, proposals must be submitted
in the format set forth below in the paragraph entitled “Proposal Format.” Failure to follow this format
may be cause for rejection of a proposal because adherence to this format is critical for the County’s
evaluation process.
b. The contract will be in the general format set forth in Section VI entitled “Model Contract,” but will be
subject to final contract negotiations.
c. This RFP is not intended, and shall not be construed, to commit the Department to pay any costs incurred
in connection with any proposal or to procure or contract for any services.
d. As a preliminary step, each Proposal will be examined to determine whether it is responsive to the
requirements of this RFP. After such preliminary review, all responsive proposals will be evaluated.
e. The decision to award a contract shall be based on the ability of the Proposer to provide quality and
needed services and products and to comply with all applicable laws, rules, and regulations, including
without limitation the local preference and other Suffolk County local laws referenced in the Section
entitled Suffolk County Required Compliance Forms in Accordance with County Laws.
f. While the Department is under no obligation to contact Proposers for clarifications, it reserves the right to
do so. Depending on the number and quality of the proposals submitted, the County, at the sole discretion
of the RFP Evaluation Committee, may elect to interview all or some of the Proposers during the
selection process and to request presentations.
g. After evaluating proposals, the Department may enter into negotiations with one proposer or multiple
proposers. The primary purpose of negotiations is to maximize the Department’s ability to obtain the best
value based on the mandatory requirements, evaluation criteria, and cost. Multiple rounds of negotiations
may be conducted with one proposer or multiple proposers. Negotiations will be structured by the
Department to safeguard information and ensure that all proposers are treated fairly.
h. The Department may invite one or more proposers to submit a best and final offer (BAFO). Such
invitation will establish the time and place for submission of the BAFO. Any BAFO that is not equal to or
lower in price than the pricing offered in the proposer’s original proposal will be rejected as non-
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responsive and the Department will revert to consideration and evaluation of the proposer’s original
pricing.
i. If required, after review of the BAFO(s), clarification may be sought from the proposer(s). The
Department may conduct more than one round of negotiations and/or BAFO submissions in order to
attain the best value for the County.
j. The Department will not necessarily choose the Proposer(s) with the lowest rates for Services. Based on
the evaluation criteria, a competitive range consisting of those Proposals which are acceptable to the
Department, or which could be made acceptable following written or oral presentations, will be
determined.
k. The award of any contract will be made as judged to be in the best interest of the County.
10. RFP Posted On Department Website
This RFP is available on-line at https://suffolkcountyny.gov/Departments/Labor.
11. Reservation of Rights
The Department expressly reserves the right to:
a. Reject or cancel any or all proposals or any part thereof submitted in response to this RFP;
b. Withdraw the RFP at any time, at the Department’s sole discretion;
c. Disqualify any Proposer whose conduct and/or Proposal fails to conform to the requirements of the RFP;
d. Use Proposal information obtained through site visits, management interviews, and the Department’s
investigation of a Proposer’s qualifications, experience, ability or financial standing, and any material or
information submitted by the Proposer in response to the Department request for clarifying information in
the course of evaluation and/or selection under this RFP;
e. Prior to Bid opening, amend the RFP specifications to correct errors, or oversights, or to supply additional
information as shall become available;
f. Prior to Bid opening, direct Proposers to submit Proposal modifications addressing subsequent RFP
amendments;
g. Change any of the dates concerning the RFP award schedule;
h. Eliminate any mandatory, not-material specification that cannot be complied with by all of the
prospective Proposers;
i. Waive any requirements that are not material;
j. Award negotiated contracts to one or more Proposers;
k. Negotiate with the successful Proposer(s) within the scope of the RFP, in the best interest of the County;
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l. Conduct contract negotiations with the next responsible Proposer should the Department be unsuccessful
in negotiations with the selected Proposer;
m. Require clarification at any time during the procurement process and/or require correction of arithmetic or
other apparent errors for the purpose of assuring a full and complete understanding of a proposal and/or to
determine a Proposer’s compliance with the requirements of the RFP.
12. Proposal Format
The following materials are required to be received by the Department, by the Proposal Due Date set forth on the
first page of this RFP. The topics listed under these general headings are minimum standards and should not be
viewed as limitations to the information provided by the Proposer in response to this RFP.
a. Transmittal Letter (one original plus number of copies listed on page one)
A transmittal letter is a letter on the Proposer’s stationery. A corporate officer or an authorized agent of
the Proposer must sign the transmittal letter. The transmittal letter must state the contact person who will
be responsible for answering all questions of the County Evaluation Committee. Include the telephone
number, fax number, and e-mail address for such contact person.
b. Required Forms
i. Disqualification of Non-responsible Bidders (LL 52-2012 Form) (2 pages)
LL 52-2012 Form is included in the Section entitled Suffolk County Required Compliance Forms
in Accordance with County Laws.”
ii. Suffolk County Form 22 -- Contractor’s/Vendor’s Public Disclosure Statement (2 pages)
SCEX Form 22 is included in the Section entitled Suffolk County Required Compliance Forms in
Accordance with County Laws.”
A corporate officer, or an authorized agent of the Proposer, must sign one (1) original of form and
have it notarized.
Please note that any Proposers who are not-for-profit corporations are not required to complete
this form.
iii. Non-Collusive Offer Certification (FTS Form) (1 page)
FTS Form is included in the Section entitled Suffolk County Required Compliance Forms in
Accordance with County Laws.”
iv. Lawful Hiring Forms (LHE-1 and LHE-2 Forms) (2 pages)
These forms are included in the Section entitled Suffolk County Required Compliance Forms in
Accordance with County Laws.”
The Labor Department’s Lawful Hiring of Employees Unit may be reached at
(631) 853-3808 for specific questions.
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v. Living Wage Forms (LW-1 and LW-38 Forms) (2 pages)
These forms are included in the Section entitled Suffolk County Required Compliance Forms in
Accordance with County Laws.”
If you answer yes to LW-38, then you MUST answer questions 12 and 13 on LW 1 form.
The Labor Departments Living Wage Unit may be reached at (631) 853-3808 for specific questions.
vi. Suffolk County Union Organizing Certification/Declaration (LO1 Form) (2 pages)
LO1 Form is included in the Section entitled Suffolk County Required Compliance Forms in
Accordance with County Laws.”
(Note: this Form will be required only from the Apparent Successful Proposer)
vii. Contractor’s Statement of Applicability of Local Preference Law Section A4-13 of the
Suffolk County Administrative Code (Local Preference Law)
Local Preference Law - Section A4-13 of the Suffolk County Administrative Code establishes a
preference program for Suffolk County consulting contracts. This preference program requires all
contracts for professional consulting services (engineering, architectural, planning, legal, and
accounting, etc.) to be awarded to firms located and doing business within Suffolk or Nassau
County, except where no local consultant has the necessary expertise or credentials to provide the
needed service, or where the local consultant's response to a Request for Proposals (RFP) exceeds
the otherwise lowest response by more than 10%. The local law contains specific definitions and
language relative to application of this law which interested parties should review. The laws of
Suffolk County are available free of charge at http:legis.suffolkcountyny.gov/ under the “Search
the Laws of Suffolk County” tab.
If applicable, include a statement with the Proposal asserting the applicability of the Local
Preference Law. The statement must include the reasons for assertion of the applicability of the
Local Preference Law.
c. Proposer Profile/Response to Questions set forth in the RFP Section entitled Proposer
Profile
Proposers responses will be used in the Department’s evaluation of the Proposers general qualifications.
d. Proposer’s Proposed Technical Services/Response to items set forth in the RFP Section entitled
“Technical Requirements”
This Section will be used in the Department’s evaluation of the Proposer’s proposed technical services.
e. List (if applicable) of Subcontractors
Identify all subcontractors the Contractor plans to use and the function for which such subcontractors will
be responsible. Provide qualifications, including prior relevant experience, for all subcontractors
anticipated to be used (Reference Section III).
Subcontractors must complete all County forms listed above in paragraph 12(b).
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Subcontractors must respond to all questions set forth in the RFP Section entitled Proposer
Profile. This includes financial statements.
Subcontractors must respond to all requirements, to the extent such requirements are applicable to the
services they will be providing, set forth in the RFP Section entitledTechnical Requirements.
Failure to include this information in the Proposal may be grounds for disqualification.
f. Conflict of Interest
Proposers must disclose to the County the existence of any conflicts of interests, whether existing or
potential. If none exist, state so. Proposals shall disclose:
i. Any material financial relationships that the Proposer or any employee of the Proposer has that
may create a conflict of interest in acting as a Contractor for Suffolk County.
ii. Any family relationship that the Proposer or any employee of the Proposer has with any County
employee that may create a conflict of interest or the appearance of a conflict of interest acting as
a Contractor for Suffolk County.
iii. Any other matter that the Proposer believes may create a conflict of interest or the appearance of
a conflict of interest acting as a Contractor for Suffolk County.
g. Proposer’s Cost Proposal/Fee Schedule - Response to items set forth in the RFP Section entitled
“Cost Proposal/Fee Schedule”
This Section will be used in the Department’s evaluation of the Proposer’s proposed Cost Proposal/Fee
Schedule.
h. Proposals shall be prepared avoiding the use of elaborate promotional materials beyond those sufficient to
provide a complete, accurate, and reliable presentation. Each response in a Proposal shall clearly identify
the section and paragraph number from the RFP to which it responds.
13. Award Criteria
a. General Qualifications: 40 points
Proposer’s history, expertise, experience, reliability, financial viability,
and references. See RFP Section III, entitled “Proposer’s Profile”
for specific requirements.
b. Proposed Technical Services/Products: 50 points
Strategies, methodologies, services
offered by Proposer. See RFP Section IV, entitled
“Technical Requirements” for specific requirements.
c. Cost Proposal/Fee Schedule 10 points
Separate sealed envelope.
See Section entitled “Cost Proposal/Fee Schedule Proposal” for specific requirements.
Total 100 points
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14. Contract Terms and Conditions
a. Reference is made to the Model Contract set forth in Section VI entitled “Model Contract.” The Model
Contract is included to illustrate general terms and conditions, including indemnification and insurance,
which will be included in the contract when executed.
b. If the Proposer has a concern or question regarding any of the terms and conditions included in the Model
Contract, the Proposer should note such concerns or questions in the Proposal. The Proposal must identify
any items relating to the Model Contract that the Proposer requests be negotiated.
c. The Model Contract is subject to revision arising out of the terms and conditions imposed by law and/or
deemed appropriate by the County Attorney’s Office.
d. Portions of the Proposal, as may be subsequently modified in negotiations with the County, may be
included as exhibits in any contracts that the County may execute with the Proposer.
e. The Department will execute a contract with principal contractors only. Any arrangements, including fee
arrangements, partnerships, or collaborations between the principal contractor and subcontractors that
provide services as part of the Proposal, must be fully disclosed in the Proposal.
f. The Proposer should not return the Model Contract with the Proposal.
15. Use of County Resources to Interfere with Collective Bargaining Activities
Local Law No. 26-2003
Proposers are advised that the efficient, timely, and nondisruptive provision of goods and services is a paramount
financial interest of the County and, as such, the County requires the potential Contractor to protect the Countys
financial interest by adopting non-confrontational procedures for the orderly resolution of labor disputes,
including but not limited to, neutrality agreements, majority authorization card agreements, binding arbitration
agreements, fair communication agreements, nonintimidation agreements, and reasonable access agreements.
16. Non-Responsible Bidder
It shall be the duty of the Proposer to read, become familiar with, and comply with the requirements of Article II
of Chapter 189 of the Suffolk County Code.
The Proposer certifies that it has complied with the disclosure requirements under section 189-7 of the Suffolk
Code, it is in compliance with all applicable licensing laws, and that it either has not engaged in a prohibited act
covered under section 189-5 of the Suffolk County Code or is otherwise exempt from the provisions of Article II
of Chapter 189 of the Suffolk County Code under section 189-9.
This certification shall be set forth on the LL52-2012 FormDisqualification of Non-Responsible Bidder.”
17. Effective Period of Proposals
All proposals must state the period for which the proposal shall remain in effect (i.e., how much time the County
has to accept or reject the proposal under the terms proposed). Such period shall not be less than 180 days from
the Proposal due date.
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18. NYS Freedom of Information Law (FOIL)
All submissions for the County’s consideration will be held in confidence pending final execution of the
contract(s) unless disclosure is required by law or judicial order. However, fully executed contracts are subject to
the New York State Freedom of Information Law (FOIL), codified at Public Officers Law Article 6. Therefore, if
a Proposer believes that any information in its submission constitutes a trade secret or is otherwise information
which, if disclosed would cause substantial injury to the competitive position of the Proposer’s enterprise, and the
Proposer wishes such information to be withheld if requested pursuant to FOIL, the Proposer shall submit with its
Proposal a separate letter addressed to the primary contact referenced in this RFP, specifically identifying the page
number(s), line(s) or other appropriate designation(s) of the Proposal containing such information, explaining in
detail why such information is a trade secret or is other information which if disclosed would cause substantial
injury to the competitive position of the Proposer’s enterprise, and formally requesting that such information be
kept confidential. Failure by a Proposer to submit such a letter with its submission will constitute a waiver by the
Proposer of any interest in seeking exemption of this information under Article 6 of the Public Officers’ Law
relating to protection of trade secrets. The proprietary nature of the information designated confidential by the
Proposer may be subject to disclosure if it is requested and the County deems it subject to disclosure or if ordered
by a court of competent jurisdiction. A request that an entire Proposal be kept confidential may not be considered
reasonable since a submission cannot reasonably consist of all data exempt from FOIL.
End of Text for Section I
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Section II
Board Background Information
Board and Staff Roles and Responsibilities
The Board is responsible for the workforce development system throughout the County. This system must serve
the needs of employers, job and training seekers, adults, youth, public assistance recipients and ex-offenders
transitioning to employment. The system must provide reliable and valid information to assist customers in
making informed decisions about training and employment; connect customers to other service providers in the
system and the community; help customers access diverse funding sources for training; and provide quality job
matching services for the job seekers and employers.
The Board has the responsibility to oversee and evaluate the County’s One-Stop Employment Center systems and
business services integration throughout the local workforce investment area. As such, the Board is committed to
the highest quality services and achievement of performance standards through outstanding customer satisfaction
and continuous improvement. The Board staff and Department Administration will be available to provide the
successful proposer the technical assistance and capacity building needed to achieve the highest level of
performance combined with outstanding customer satisfaction.
The responsibilities of the Board include:
Federal Connection: Ensure that federal procedures and guidelines are correctly implemented; allocate federal
workforce development funds; provide data and reports as needed to satisfy federal systems and participate in
federal funding opportunities that further the Board’s vision.
State Connection: Ensure that state policies, procedures and guidelines are correctly implemented; allocate state
workforce development funds; provide data and reports as needed to satisfy federal and state systems and
participate in state funding opportunities that further the Board’s vision.
Local Connection: Comply with local government policies (the Board’s fiscal agent) and regulations; serve as
the convener for workforce development in the region and partner with local organizations on community needs.
Technological Connection: Ensure the One-Stop Employment Centers are equipped with current technology to
better serve and assist all customers; manage the local information system for the Workforce Innovation and
Opportunity Act (“WIOA”) programs and activities.
Evaluation and Measurement Metrics: Approve customer satisfaction survey tools throughout the system and
other evaluation tools; measure metrics set for Suffolk County to ensure quality services are being provided and
continuous improvement; designate the successful Operator of the One-Stop Employment Centers; meet with the
One-Stop Operator regularly to listen to suggestions, discuss issues and resolve concerns; and monitor and report
on quality, performance and cost effectiveness, through on-site visits, records review, evaluations, expenditure
review and other methods as needed.
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Performance and Compliance: Provide technical assistance on all policies, procedures and rules that impact the
operation of centers and provide assistance as needed for compliance; develop and provide technical assistance to
build capacity to help operator meet quality and consistency standards as well as to meet or exceed performance
goals within the workforce development system; ensure compliance with all rules, regulations and procedures
issued by all funding sources.
The roles and responsibilities may be refined and changed as the WIOA regulations and procedures are changed
by the United States Department of Labor (“USDOL”); state policy and requirements are created and
implemented throughout the State’s workforce development system and local direction and procedures are
adopted or revised by the Board.
Perform fiscal and programmatic monitoring for compliance in accordance with federal, state and local standards;
track and maintain documentation of each performance measure and approve regional education/training
providers for inclusion on the State Training Provider List.
Fiscal: Ensure that administrative and programmatic cost categories are properly implemented; confirm that
costs are correctly allocated to the associated funding stream; verify that system costs are allocated according to
the Memorandum of Understanding and provide technical assistance to the fiscal staff of the One-Stop Operator.
The Department, as designated by the County Executive and the Board, is the Administrative Entity and Fiscal
Agent for Suffolk County’s WIOA funds.
Required Partners and Programs
Under WIOA Section 121(b) (1), mandated Workforce System Partners include the following:
WIOA Title I programs (Core Program)-
Suffolk County Department of Labor, Licensing & Consumer Affairs
Wagner-Peyser programs (Core Program)
New York State Department of Labor
Adult Education and Literacy programs (Core Program)
New York State Department of Educations -LI Regional Adult Education Network
Rehabilitation Act programs (Core Program)
New York State Department of Education ACCESS VR
Older Americans Act programs
Urban League of Westchester
Perkins post-secondary vocational education
Trade Adjustment Assistance and NAFTA-TAA programs
New York State Department of Labor
Veterans Employment and Training
New York State Department of Labor
Community Service Block Grant (employment and training)
Economic Opportunity Council of Suffolk County
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HUD employment and training activities
Unemployment Compensation programs
New York State Department of Labor
Temporary Assistance for Needy Families (TANF)
Suffolk County Department of Social Services
Note: Core Programs will have to measure effectiveness in serving employers and will report on common
performance indicators which include how many job seekers entered employment, their median wages, whether
they attained credentials and their measurable skill gains.
One-Stop Employment Center Locations:
Suffolk County Department of Labor, Licensing & Consumer Affairs
725 Veteran’s Memorial Highway
Hauppauge, NY 11788
New York State Department of Labor
160 South Ocean Ave
Patchogue, NY 11772
Suffolk County Government Center
300 Center Drive
Riverhead, NY 11901
End of Text for Section II
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Section III
Proposer Profile (40 Points)
1. General Information/Proposer’s History
a. Company name and address.
b. Year company was founded and history.
c. Total number of employees in company, and the number of employees at servicing office(s).
d. Location(s) from which services will be performed (e.g. ability to work on-site and/or remotely to provide
virtual services).
e. Describe the nature of your organization (e.g. business corporation, not-for-profit corporation,
proprietorship, etc.).
f. Contact person and title.
2. Qualifications and Experience of Personnel (40 Points)
a. Provide resumes of the account manager and other key staff who will be assigned to this account.
b. For each professional listed above, describe his/her qualifications and provide information regarding:
i. Education;
ii. Professional licenses and other affiliations (copies of which shall be submitted with Proposals);
iii. Number of years engaged in services relating to the services requested in this RFP (See Statement
of Work);
iv. Other relevant work experience or qualifications;
v. The role each identified person would play.
c. Describe other accounts involving similar services. Describe the role and experience of key personnel
assigned to other similar accounts who will be assigned to this account.
d. Will temporary staff also be involved? If so, include details of their supervision and training.
e. In addition, the Department may make such investigations as it deems necessary to determine the ability
of the Proposer to perform the work. The Proposer shall furnish to the Department, within five (5)
business days of a request, all such information and data for this purpose as may be requested. The
Department reserves the right to reject any Proposal if the information submitted by, or investigation of
such Proposer fails to satisfy the Department that such Proposer is properly qualified to carry out the
obligations of the contract and to complete the work contemplated therein. Conditional Proposals will not
be accepted.
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3. Financial Viability
a. Financial Statements – Mandatory for Nongovernmental Agencies
Requirement specifications:
i. Current financial statement (if current year not available previous calendar year acceptable)
prepared and certified by an Independent Certified Public Accountant (CPA) to include:
o Balance Sheet
o Income Statement
o Statement of Cash Flows
o Opinion Letter
ii. If independently audited financial statement is not available, the most current in-house Company
statement to include
o Balance Sheet
o Income Statement
o Statement of Cash Flows
o Financial Statement to be signed by one of the following attesting to the accuracy of the
statement:
Chief Executive Officer (CEO)/Chief Financial Officer (CFO)/Chief Operating
Officer (COO)
iii. Failure to submit complete, comprehensive documents may result in disqualification for
consideration of an award.
b. Indebtedness to County, Liens, and Litigation
Submit a statement as to indebtedness, if any, to the County; and a listing of all outstanding liens, if any,
against the Proposer. Submit a summary of all litigation, if any, against the Proposer and disposition or
outcome of same.
c. Statement Regarding Bankruptcy
Include a statement disclosing any bankruptcy(ies) filed within the last seven (7) years. The statement
must include the date the bankruptcy was originally filed, the current status, and, if applicable, the date
the bankruptcy was discharged.
4. Client History
Provide a list of all clients for whom you have provided similar services within the last three years. For each
client, provide the following:
a. Client name; and
b. Client address; and
c. Contact name, title, and telephone number; and
d. Description of services provided and time period; and
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e. Results.
5. References
a. From the list provided in response to paragraph 4, entitled Client History, provide three client
references for which you have provided services (current governmental or quasi-governmental agencies
preferred). Provide name of the organization, services, contact name and telephone number.
b. Provide a list of all contracts with the County of Suffolk within the last five (5) years (regardless of type
of service), the time period for those services and your primary County contact.
6. Conflicts of Interest and/or Potential Conflicts of Interest
a. Relationships with Third Parties
Any Proposer to the County of Suffolk is charged with the continuing duty to disclose to the County the
existence of any interests it may have, contractual or otherwise, ongoing or previous, with any companies
or individuals with whom the County of Suffolk does business with respect to the services required by
this RFP. This duty continues for so long as the Proposer is retained on behalf of the County or its
employees.
b. Relationships with County Departments/Agencies/Employees
Any Proposer to the County of Suffolk is charged with the continuing duty to disclose to the County the
existence of any interests it may have, contractual or otherwise, ongoing or previous, with any County
department, agency or employee. This duty continues for so long as the Proposer is retained on behalf of
the County or its employees.
7. Subcontractors
If you intend to use the services of a subcontractor, please provide all of the above information in this Section for
each such subcontractor.
Note that the County must pre-approve the use of any subcontractors.
End of Text for Section III
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Section IV
Technical Requirements (50 Points)
1. Overview
The Suffolk County Executive Steve Bellone and the Board are seeking proposals from experienced individuals
or organizations to coordinate the service delivery of WIOA One-Stop Core Program services and Core Partner
service providers. Coordination efforts may be conducted within each One-Stop, within targeted communities
and across the One-Stop System. A detailed description of the services sought is provided in theServices to be
Procured” section below.
A maximum award of $100,000 per year will be made available for each of the four years covered by this
solicitation. This project will begin on or before July 1, 2021.
Disclaimer
The WIOA, signed into law on July 22, 2014, was implemented on July 1, 2015. This RFP, and bids submitted
by proposers to this request, and any final contracts negotiated with the successful bidder(s) as a result of this
proposal are subject to WIOA final regulations issued on June 30, 2016 and any subsequent guidance provided by
the United States Department of Labor (USDOL) or New York State Department of Labor (NYSDOL).
As the Board continues to develop and refine its One-Stop delivery system, policies and procedures, or regulatory
changes occur from time to time, bidding organizations may be requested to modify program design or the
delivery of services. Should a request for a change in program design or service occur, staff of the Board will
assist bidding organizations or service providers in the redesign to ensure consistency with state and federal
policy.
2. Minimum Requirements for Technical Services Proposals
a. Understanding of the Project
The Proposal must include a statement of work that describes the Proposer’s understanding of the Project.
The Proposer is expected to discuss its understanding of the proposed “Scope of Work.”
i. The complexity, challenges and problems involved in performing the work.
ii. Approach and philosophy for dealing with problems.
iii. Experience dealing with key issues.
iv. Any additional issues or matters relating to theScope of Work” which the Proposer wishes to
address.
b. Key Personnel and Staffing
Key personnel identified in the Proposal will be expected to remain assigned to the project for the term of
the contract. Requests for a change in key personnel assignments during the term of the contract must be
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approved in advance, in writing, by the Department. The Proposal should also include a discussion that
outlines staffing levels/man-hour requirements that should be expected on the Department level to support
the implementation and day-to-day operation of the project. This information will be a recommendation
only for discussion purposes. The Proposer should describe other potential burdens that may be placed on
the Department with respect to the servicing of the account.
c. Subcontractors
Services that are to be subcontracted must be clearly defined in the Proposal. The Contractor retains
responsibility for all acts and omissions of the subcontractor. The Contractor must obtain prior approval
from the Department for all subcontracts.
Subcontractors must respond to all requirements set forth above in this Section, to the extent such
requirements are applicable to the services they will be providing.
The County may require that subcontracted activities be provided under the terms of a three-party
contract between the Contractor, the County and the subcontractor.
3. Technical Services Specifications: (50 Points)
Selected Operators shall focus on building relationships and partnerships in order to create multiple seamless
pathways to employment through enhanced coordination of existing institutions, businesses and funding sources.
Please describe your experience and plan for achieving the stated goals by responding to the questions in the
Statement of Work section below.
Do not exceed 15 pages, using a 12 point font with at least one inch margins. Tables, charts, figures, and
appendixes are included in the page limit. The page limit does not include the other required Parts of the Grant
Application Package. To be eligible to receive an award, a proposal must be completed in full, contain all required
documentation and achieve a minimum score of 70 points. Failure to meet minimum requirements will result in
automatic rejection of the application.
Detailed Scope of Services
In accordance with WIOA Section 678.620, the Board, the County Executive and Suffolk County’s Title I fiscal
agent are seeking proposals from experienced individuals or organizations to coordinate the service delivery of
the four Core One-Stop Partner Programs, their service providers and local business community within Suffolk
County’s One-Stop delivery system. The selected Operator will work closely with the Department’s
Administrative Office to facilitate the coordination and implementation of priorities identified by the Board and
One-Stop Partners (“Partners”). Priorities may include, but are not limited to:
Leverage & Coordinate Partner Services:
Partners within the workforce development system are working with limited resources as well as limited
information about the services being provided by one another. Core Partner Programs have common missions,
shared performance goals and complementary services, yet programs often operate in silos.
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The selected Operator will identify and assess the availability of services provided by each of the Partners, the
process for accessing these services, coordinating the delivery of these services, demonstrate measurable
outcomes and working with our Partners to create strategies that improve the provision of services to our shared
customer and targeted populations (Veterans, Disabled, TANF, Offender). The service strategies should increase
service integration among Partner agencies within the One-Stop delivery system; simplify the process for
customers in order for services to be accessible when, where and how they are needed and ensure the culture of
the One-Stop delivery system promotes knowledge transfer across Partner Programs. This assessment will stress
the importance of creativity and innovation in thinking beyond bricks and mortar locations, while analyzing and
making recommendations regarding the value of co-location with other Core, mandatory or optional Partners.
Performance & Continuous Improvement
The Operator will develop and implement a system to gather, analyze, and report performance related issues of
Core Partner Programs; demonstrate measurable outcomes; coordinate continuous improvement activities with
Core Partners to achieve high level of service quality and to enhance performance against Common Measure
goals; preparing recommendations to ensure compliance with all state and local policies and procedures relative to
One-Stop delivery system and One-Stop Employment Center; prepare and submit monthly and quarterly reports
to the Board staff.
Youth Program Services:
WIOA and the Board seek to increase the variety of services provided to Suffolk County’s disadvantaged and
disenfranchised Youth as well as the number of entities capable of providing the services our customers require.
These services need to be designed and delivered in a manner appropriate for the 16-24 year old population and
provided at a variety of locations throughout Suffolk County.
The selected Operator will identify and assess the availability of youth services provided by the SCDOLLCA,
each of the Partners, the process for accessing these services, coordinating the delivery of these services and
working with our Partners to create strategies that improve the provision of services to our shared youth customer.
The services can be leveraged or if necessary procured via the RFP process utilizing Title I funding.
At minimum, the inventory of services must include:
o Tutoring, study skills training, instruction and evidence-based dropout prevention and recovery strategies
that lead to completion of the requirements for a secondary school diploma;
o Alternative secondary school services or dropout recovery services;
o Paid or unpaid work experiences that have academic and occupational educational component (See
WIOA Section 681.600) including summer employment, pre-apprenticeship programs (See WIOA
Section 681.480), internships and job shadowing and On-theJob Training;
o Occupational skills training that lead to recognized post-secondary credentials (See WIOA Section
681.540);
o Education offered concurrently with and in the same context as workforce preparation activities (See
WIOA Section 681.640);
o Leadership development opportunities, including community service and peer-centered activities
encouraging responsibility and other positive social and civic behaviors (See WIOA Section 681.520);
o Supportive services, including those listed in WIOA Section 681.570;
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o Comprehensive guidance and counseling, which may include drug and alcohol abuse counseling and
referrals to other forms of counseling (See WIOA Section 681.510);
o Financial Literacy education (See WIOA Section 681.500);
o Entrepreneurial skills training (See WIOA Section 681.560)
o Adult mentoring for a duration of at least 12 months, that may occur both during and after program
participation (See WIOA Section 681.490)
o Services that provide labor market information about in demand industry sectors or occupations such as
career awareness, career counseling and career exploration services;
o Activities that help youth prepare for and transition to post-secondary education and training.
Develop and Publicize Labor Market Information:
Labor market information (LMI) includes all quantitative or qualitative data and analysis related to employment
and the workforce. The goal of LMI is to help customers make informed plans, choices, and decisions for a
variety of purposes, including career planning and preparation, education and training offerings, job search
opportunities, hiring, and public or private workforce investments.
The selected operator will work closely with the Department’s Administrative staff to identify and produce LMI
that would be beneficial to Suffolk County’s One-Stop customers, One-Stop staff and Partner agencies. At
minimum LMI provided at the One-Stop should include information on: in-demand industry sectors and
occupations; non-traditional employment; job vacancy listings on Long Island; the job skills necessary to obtain
the vacant job listed; and related occupations in demand and the earnings, skill requirements, and the
opportunities for advancement for these jobs. Other specialized reports may be requested by elected officials, the
Department of Economic Development and educational providers and our Partner agencies.
LMI can be provided through a variety of techniques. Some of these approaches are more traditional and
widespread. Others are more innovative or customized to user needs: Reports; Web sites; Interactive web tools;
Presentations and press releases; Newsletters and email updates; Special data tabulations by request; Special topic
studies and survey results.
Career Pathways oriented workforce development has the goal of increasing individuals’ educational and skills
attainment and improving their employment outcomes while meeting the needs of local employers and growing
sectors and industries. Career pathway programs offer a clear sequence, or pathway, of education coursework
and/or training credentials aligned with employer-validated work readiness standards and competencies.
The Operator, in alignment with the United States Department of Labor’s Career Pathway Tool Kit and Career
Competency Models, will build cross-agency partnerships, establish a shared mission, common goals and define
the roles and responsibilities of each Partner; align these efforts with the Long Island Regional Economic
Development Council’s Workforce, Education and Veterans sub-committee; engage businesses and educational
entities in the development of career ladders and lattices that lead to industry recognized credentials; demonstrate
measurable outcomes; and identify the funds to be contributed by Core Partner Programs. Career pathway
strategies may include:
1. Sector Strategy - education and training programs aligned with the skill needs of industries important
to the Long Island economy and reflect the fact that employers in the targeted industry sectors are
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actively engaged in determining the skill requirements for employment or career progression in high-
demand occupations.
2. Stackable Training Options - include the full range of secondary, adult education, and post-secondary
education options, including registered apprenticeships; they use a non-duplicative progression of
courses clearly articulated from one level of instruction to the next; they provide opportunities to earn
post-secondary credits; and they lead to industry-recognized and/or post-secondary credentials.
3. Contextualized Learning - programs focus on curriculum and instructional strategies that make work
a central context for learning and help students attain work readiness skills.
4. Integrated Education & Training - combine occupational skills training with adult education services,
give credit for prior learning, and adopt other strategies that accelerate the educational and career
advancement of the participant.
5. Industry-recognized Credentials - programs that lead to the attainment of industry-recognized degrees
or credentials that have value in the labor market.
6. Multiple Entry & Exit Points - allow workers of varying skill levels to enter or advance within a
specific sector or occupational field.
In accordance with WIOA, sector strategies and registered apprenticeships are to be given priority with the intent
to improve employment opportunities for workers and to increase their wages once on the job.
Special Populations:
The chosen Operator will further develop partnerships with State entities, including the higher education system
and secondary schools to align activities, training, and resources that demonstrate measurable outcomes for all
parts of the workforce. Priority will be given to individuals with disabilities, veterans, formerly incarcerated
persons, disconnected youth, individuals in economically distressed communities, adults with limited literacy or
English language proficiency who lack a High School Equivalency (HSE), New Americans including immigrants
and refugees, and other special populations.
Staff Training
The USDOL has identified staff capacity-building as part of an organizational strategy to improve overall
productivity, motivate career center staff to deliver high quality services, and create an on-going commitment to
innovation and system improvement. Capacity building, for the employment and training system as a whole,
means the "expansion of the ability of the employment and training system to deliver high quality services to its
customers." The on-going focus of this strategy will be to improve the job skills, knowledge and expertise of the
"front line" workers from each of the Core Partners and Programs which make up our employment and training
system. An emphasis will be placed on staff training regarding the services available to the populations most in
need of our services and the performance outcome to be achieved.
The Operator will identify the technical assistance and training needs of Suffolk County’s employment and
training system. Utilizing a combination of focus groups, surveys, and Partner strategy meetings, the Operator
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will develop, implement and/or improve cross-agency training delivery systems as well as create innovative and
replicable program models and training products that have broad application throughout the system.
Note:
The selected Operator must commit to having a minimum of one full-time (35hrs/wk) staff person or one full-time
equivalent located at the Suffolk County One-Stop Employment Center in Hauppauge.
The selected Operator will remain eligible to provide Youth Program Services, Vocational Training and/or
Career Services such as resume preparation, employability workshops, short term computer training and
financial literacy procured under separate RFP processes.
Eligible Applicants:
Any governmental, educational or not-for-profit organization or agency engaged in a public service, employer
with locations in Suffolk County and business associations, private for profit organizations engaged in providing
employment and training and educational opportunities may apply. Applicants may be single entities or a
consortium of entities; if the consortium of entities includes One-Stop Partners, it must include three or more
One-Stop Partners.
In accordance with Article 5-A of the General Municipal Law and Chapter 1065 of the Suffolk County Code,
preference will be given to organizations located and doing business within Suffolk County or Nassau County.
Entities that are presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily
excluded from participation in this transaction by any federal department or agency are not eligible to respond to
this RFP or to receive a contract.
Outstanding Monitoring, Audit or Legal Concerns Proposers must disclose and rectify any and all outstanding
monitoring and/or audit concerns from any of the Proposer’s other contracts prior to receiving a contract resulting
from this RFP. Additionally, Proposers must disclose any legal judgments, claims, arbitration proceedings,
lawsuits or other legal proceedings pending or outstanding (unresolved) against the organization, its owners,
officers, or principals.
Competency Proposers are expected to have the technical competence, knowledge and expertise in management
and administration, the professional staff, and the administrative and fiscal management systems to accomplish
the scope of work and the goals and objectives stated in this RFP, and must meet high standards of public service
and fiduciary responsibility. Proposers are responsible for being knowledgeable of all laws, regulations, rules, and
policies of the specific funding sources involved and applying them in developing the RFP response. Proposers
are strongly encouraged to follow the United States Department of Labor’s WIOA resource page for WIOA
information and latest updates: www.doleta.gov/wioa.
Workforce development minded organizations with previous experience developing policy, facilitating
relationships and implementing program priorities are encouraged to submit proposals, however, only proposals
from organizations that can thoroughly demonstrate that they have the ability to provide workforce development
services within Suffolk County will be considered. Services offered shall be delivered through the established
and designated One-Stop delivery system made available through the three Suffolk One-Stop Employment
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Centers. For WIOA contracts, efficiency in operation and cost effectiveness is a paramount policy consideration
for the Board.
Prime Contractor Responsibility and Restrictions
No more than one organization will be selected as prime contractor to contractually deliver all activities and
services described above. Each proposer is advised that the SCDOLLCA will hold the prime contractor totally
responsible and accountable for effectively and efficiently managing and delivering the services and activities
described in this RFP. The prime contractor may subcontract with other entities (Partners) with prior approval of
the SCDOLLCA. A formal memorandum documenting the partnership and roles of each Partner must be executed
prior to submitting a proposal under this announcement. A proposal that includes subcontracting all activities and
services in this RFP to other agencies will not be considered responsive.
The Board or Board staff cannot assist proposers with actual preparation of their proposal.
Statement of Work – Qualifications and Experience
One-Stop Partner Engagement (10 Points)
Describe your organizations relationship with each of the “Core” One-Stop Partner agencies and Programs listed
above.
Describe how your relationship with these organizations has allowed or will allow you to convene the Partners to
achieve program goals (as described in theScope of Services” section), including, but not limited to, identifying,
coordinating and leveraging Partner services, conducting an annual assessment of the services provided,
leveraging new funding sources, demonstrating measurable outcomes and preparing and presenting progress
reports and recommendations to the Board staff or applicable Board sub-committee.
Describe your relationship with other Partners and funding sources that will be critical to the targeted strategies.
Other potential Partners may include community based organizations, private institutions of higher education,
adult basic education providers, local economic development agencies and professional/trade associations.
Performance & Continuous Improvement & Staff Training (10 points)
Describe your experience monitoring, analyzing, and identifying program performance related issues,
demonstrating measurable outcomes and facilitating corrective action; coordinating continuous improvement
activities with Core Partners to achieve high level of service quality and to enhance performance against Common
Measure goals and; preparing recommendations to ensure compliance with all state and local policies (i.e. ADA)
relative to One-Stop delivery system and One-Stop Employment Center.
Education Community & Business Engagement (20 Points)
Describe your organizations experience and capacity that will allow you to increase the participation of the
Education and Business communities within the One-Stop Employment Centers:
Describe any experience your organization has had with the business community facilitating the development of
training programs, apprenticeship opportunities and/or sector strategies. Detail how your experience will increase
employer engagement and demonstrate measurable outcomes within the One-Stop delivery system and in
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activities such as On-the-Job Training, Job Fairs, Career Exploration presentations, and/or other workforce
activities. Include the names of the business that participated, the number of people trained and the status of the
training program(s).
Describe your experience collaborating with educational entities to create education and training programs
aligned with the skill needs of local industries and those identified by the Long Island Regional Economic
Development Council. Describe your organizations experience in the development or procurement of secondary,
adult education, and post-secondary education options or implementing contextualized and/or integrated
education and training programs. Please provide examples and the names of the entities involved.
Special Populations (10 Points)
Describe your organizations experience creating or aligning activities, training, and resources that demonstrate
measurable outcomes for individuals with disabilities, veterans, formerly incarcerated persons, disconnected
youth, individuals in economically distressed communities, adults with limited literacy or English language
proficiency who lack a High School Equivalency (HSE), New Americans including immigrants and refugees, and
other special populations.
Describe the strategies utilized for coordinating programs and services for each of the populations mentioned
above. While a description for every target group in not expected for as many of the populations as possible
describe the strategies that went beyond those utilized for the general population.
End of Text for Section IV
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Section V
Cost Proposal/Fee Schedule (10 Points)
1. Separate Envelope
Your Original, plus all of your required extra copies of the Cost Proposal/Fee Schedule, should be submitted in
one (1) sealed envelope and packaged only in yourOriginal” proposals set.
Do not include cost information in the body of your Proposal response.
Do not include Cost Proposal/Fee Schedules in sealed envelopes in any of the extra sets submitted.
Include the name of your company on each page of your Cost Proposal/Fee Schedule.
2. Cost Proposal/Fee Schedule is One of Several Evaluation Criteria
Based on the evaluation criteria set forth in Section I, entitled “Administrative Information,” please note that the
County will not necessarily choose the Proposer with the lowest rates for services.
If the Cost Proposal/Fee Schedule involves revenue in any form to the County, please also note that the County
will not necessarily choose the Proposer with the highest rates for revenue to the County.
3. Additional Information
The Proposer should provide any additional information it deems necessary to explain or clarify its Cost
Proposal/Fee Schedule.
4. Alternative Proposals
The Proposer may submit alternative Technical Proposals and alternative Cost Proposal/Fee Schedules, if there is
more than one viable approach to performing the services.
Proposers must supply Cost Proposal/Fee Schedules in the format set forth below. Cost Proposal/Fee Schedules in
alternative formats will be reviewed and may be accepted. However, all Proposers, at a minimum, must provide a
Cost Proposal/Fee Schedule in the format set forth below. Proposers are requested to submit any additional
information, charts, data and descriptions as the Proposer deems necessary for evaluation.
5. Format for Cost Proposal/Fee Schedule (10 Points)
Proposers shall provide a detailed list for anticipated charges it will impose for items that shall or may apply to
the Services requested under this RFP. Failure to include a charge or schedules of charges may preclude the
Contractor from billing the County for such non-specified items.
All schedules submitted must include the name of the Proposer and must be paginated.
The anticipated term of the Contract is: July 1, 2021 June 30, 2025
Budget Narrative:
Payments to vendor (selected Operator) under contract executed pursuant to this solicitation will be limited to the
salary and fringe benefits of staff services, with the exception of the cost of administrative salaries and fringe
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benefits, which will be approved on a case by case basis, not to exceed five percent (5%) of the total vendor
budget in response to this RFP. (7 Points)
Although matching funds are not required, the budget narrative should include a description of leveraged
resources provided to support staff costs or program activities. (3 Points Max) 0-25% = 0 Points; 25.135% = 1
Points; 35.1-45% = 2 Points; 45.1% and up = 3 Points
Please use the following guidance for preparing the budget narrative:
Personnel List all staff positions by title (both current and proposed). Provide the annual salary of each
position, the percentage of each position’s time devoted to the project, the amount of each position’s salary
funded by the this grant (vs. matching funds), and the total personnel cost for each of the four year periods of
performance (7/1/21 6/30/25) broken out by Program Year. Please identify costs associated with administrative
functions.
Fringe Benefits Provide a breakdown of the amounts and percentages that comprise fringe benefit costs such as
health insurance, FICA, retirement, etc.
Administrative functions include, but are not limited to; grant management, contract development, preparing
invoices, maintaining financial records, fiscal reporting and program reporting to be detailed by the SCDOLLCA
Finance Director. Fiscal oversight will consist of submission of fiscal and budget reports, request for proof of
expenditures, payroll documents and periodic fiscal monitoring by SCDOLLCA Finance staff.
The Department reserves the right to negotiate these payment structures, as may be appropriate, prior to award of
a contract. All payments will be made to the selected Operator. The selected Operator will be responsible for all
providing expenditure documentation before payment is issued.
End of Text for Section V
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Section VI
Model Contract Subject to Negotiation
Consultant/Personal Services Contract
This Contract (“the Contract”) is between the County of Suffolk (“the County”), a municipal
corporation of the State of New York, acting through its duly constituted Department of (Insert Name) (“the
Department”), located at Insert Address; and
Insert Name of Contractor (“the Contractor”), having an address at Insert Address.
The Contractor has been designated to receive funds from the County for Insert Description (“the Services”)
as set forth in Article I, entitled Description of Services.
Term of the Contract:
Total Cost of the Contract: Shall not exceed $x,000.00, as set forth in Article II, attached.
Terms and Conditions: Shall be as set forth in Articles I and II and Exhibits 1 and 2, attached hereto and
made a part hereof.
In Witness Whereof, the parties hereto have executed the Contract as of the latest date written below.
Name of Contractor
By: _______________________________
Name:
Title:
Fed. Tax ID #
Date: ____________________________
Approved as to Form:
Dennis M. Cohen
County Attorney
By: _________________________________
Name: Niranjan Sagapuram
Assistant County Attorney
Date: _____________________________
COUNTY OF SUFFOLK
By: _________________________________
Lisa Black
Chief Deputy County Executive
Date: _____________________________
Approved: Suffolk County Department of
Labor, Licensing and Consumer Affairs
By: __________________________________
Name: Rosalie Drago
Title: Commissioner
Date: ______________________________
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List of Articles & Exhibits
Article I
Description of Services
Article II
Financial Terms and Conditions
1. Conflicting Provisions
2. General Payment Terms
3. Agreement Subject to Appropriation of Funds
4. Accounting Procedures
5. Audit
6. Comptroller’s Rules and Regulations for Consultant’s Agreements
7. Specific Payment Terms and Conditions
Exhibit 1
County Terms and Conditions
1. Elements of Interpretation
2. Meanings of Terms
3. Contractor Responsibilities
4. Qualifications, Licenses, and Professional Standards
5. Notifications
6. Documentation of Professional Standards
7. Credentialing
8. Engineering Certificate
9. Termination
10. Indemnification and Defense
11. Insurance
12. Independent Contractor
13. Severability
14. Merger; No Oral Changes
15. Set-Off Rights
16. Non-Discrimination in Services
17. Nonsectarian Declaration
18. Governing Law
19. No Waiver
20. Conflicts of Interest
21. Cooperation on Claims
22. Confidentiality
23. Assignment and Subcontracting
24. Changes to Contractor
25. No Intended Third Party Beneficiaries
26. Certification as to Relationships
27. Publications
28. Copyrights and Patents
29. Arrears to County
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30. Lawful Hiring of Employees Law in Connection with Contracts for Construction or Future
Construction
31. Record Retention
32. Certification Regarding Lobbying
33. Notice
Exhibit 2
Suffolk County Legislative Requirements
1. Contractor’s/Vendor’s Public Disclosure Statement
2. Living Wage Law
3. Use of County Resources to Interfere with Collective Bargaining Activities
4. Lawful Hiring of Employees Law
5. Gratuities
6. Prohibition Against Contracting with Corporations that Reincorporate Overseas
7. Child Sexual Abuse Reporting Policy
8. Non Responsible Bidder
9. Use of Funds in Prosecution of Civil Actions Prohibited
10. Youth Sports
11. Work Experience Participation
12. Safeguarding Personal Information of Minors
13. Contract Agency Performance Measures and Reporting Requirements
14. Suffolk County Local Laws Website Address
15. Suffolk County Code of Ethics
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Article I
Description of Services
Whereas, the County issued an Request for Proposals (“RFP”) on [DATE]; and
Whereas, the Contractor submitted a proposal in response to such RFP; and
Whereas, the County has selected the Contractor to provide the services as set forth herein;
Now Therefore, in consideration of the mutual provisions and covenants hereafter set forth, the parties hereto
agree as follows:
1. Conflicting Provisions
In the event of any conflict between this Article I and any other provision to this Contract, such other
provision shall prevail unless it is expressly stated that this Article I shall prevail.
2. Services
[DEPARTMENT TO INSERT SPECIFIC DESCRIPTION OF SERVICES]
End of Text for Article I
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Article II
Financial Terms and Conditions
1. Conflicting Provisions
In the event of any conflict between any provision in this Article II and an exhibit to this Contract, the
exhibit shall prevail, unless it is expressly stated in the conflicting provision in this Article II that it shall
prevail over the exhibit.
2. General Payment Terms
a. Presentation of Suffolk County Payment Voucher
In order for payment to be made by the County to the Contractor for the Services, the Contractor
shall prepare and present a Suffolk County Payment Voucher (Voucher), which shall be
documented by sufficient, competent and evidential matter. Each Suffolk County Payment
Voucher submitted for payment is subject to Audit at any time during the Term or any extension
thereof. This provision shall survive expiration or termination of this Contract for a period of not
less than seven (7) years, and access to records shall be as set forth in paragraph 31 of Exhibit 1,
and paragraph 4(b) of Article II.
b. Voucher Documentation
The Suffolk County Payment Voucher shall list all information regarding the Services and other
items for which expenditures have been or will be made in accordance with the Contract. Either
upon execution of the Contract (for the Services already rendered and expenditures already
made), or not more than thirty (30) days after the expenditures were made, and in no event after
the 31
st
day of January following the end of each year of the Contract, the Contractor shall
furnish the County with detailed documentation in support of the payment for the Services or
expenditures under the Contract, e.g., dates of the Service, worksite locations, activities, hours
worked, and pay rates for all Services. The Suffolk County Payment Voucher shall include time
records, certified by the Contractor as true and accurate, of all personnel for whom expenditures
are claimed during the period. All Suffolk County Payment Vouchers must bear a signature as
that term is defined pursuant to New York State General Construction Law §46 by duly
authorized persons. Disbursements made by the Contractor in accordance with the Contract and
submitted for reimbursement must be documented and must comply with accounting procedures
as set forth by the Suffolk County Department of Audit and Control.
c. Payment by County
Payment by the County shall be made within thirty (30) days after approval of the Voucher by
the Comptroller.
d. Final Voucher
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The acceptance by the Contractor of payment of all billings made on an approved voucher shall
operate as and shall be a release of the County from all claims by the Contractor through the date
of the Voucher.
3. Subject to Appropriation of Funds
a. The Contract is subject to the amount of funds appropriated each fiscal year and any subsequent
modifications thereof by the County Legislature and no liability shall be incurred by the County
beyond the amount of funds appropriated each fiscal year by the County Legislature for the
Services.
b. If the County fails to receive Federal or State funds originally intended to pay for the Services, or
to reimburse the County, in whole or in part, for payments made for the Services, the County
shall have the sole and exclusive right to:
i.) determine how to pay for the Services;
ii.) determine future payments to the Contractor; and
iii.) determine what amounts, if any, are reimbursable to the County by the Contractor and the
terms and conditions under which such reimbursement shall be paid.
4. Accounting Procedures
a. The Contractor shall maintain accounts, books, records, documents, other evidence, and
accounting procedures and practices which sufficiently and properly reflect all direct and indirect
costs of any nature expended in the performance of the Contract, in accordance with generally
accepted accounting principles and with rules, regulations and financial directives, as may be
promulgated by the Suffolk County Department of Audit and Control and the Department. The
Contractor shall permit inspection and audit of such accounts, books, records, documents and
other evidence by the Department and the Suffolk County Comptroller, or their representatives,
as often as, in their judgment, such inspection is deemed necessary. Such right of inspection and
audit as set forth in subparagraph (b) below shall exist during the Term and for a period of seven
(7) years after expiration or termination of the Contract.
b. The Contractor shall retain all accounts, books, records, and other documents relevant to the
Contract for seven (7) years after final payment is made by the County. Federal, State, and/or
County auditors and any persons duly authorized by the County shall have full access and the
right to examine any of said materials during said period. Such access is granted notwithstanding
any exemption from disclosure that may be claimed for those records which are subject to
nondisclosure agreements, trade secrets and commercial information or financial information
that is privileged or confidential.
5. Audit
a. All payments made under the Contract are subject to audit by the Comptroller pursuant to Article
V of the Suffolk County Charter. The Contractor further agrees that the Comptroller and the
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Department shall have access to and the right to examine, audit, excerpt, copy or transcribe any
pertinent transactions or other records relating to Services under the Contract. If such an audit
discloses overpayments by the County to the Contractor, within thirty (30) days after the
issuance of an official audit report by the Comptroller or his duly designated representatives, the
Contractor shall repay the amount of such overpayment by check to the order of the Suffolk
County Comptroller or shall submit a proposed plan of repayment to the Comptroller. If there is
no response, or if satisfactory repayments are not made, the County may recoup overpayments
from any amounts due or becoming due to the Contractor from the County under the Contract or
any other Fund Source.
b. The provisions of this paragraph shall survive the expiration or termination of the Contract for a
period of seven (7) years, and access to records shall be as set forth in paragraph 31 of Exhibit 1,
and paragraph 4(b) of Article II.
6. Comptroller’s Rules and Regulations for Consultant’s Agreements
The Contractor shall comply with the Comptroller’s Rules and Regulations for Consultant’s
Agreements” as promulgated by the Department of Audit and Control of Suffolk County and any
amendments thereto during the Term of the Contract. The Comptroller’s Rules and Regulations for
Consultant’s Agreements” may be viewed online at the County’s website, SuffolkCountyny.gov; go to
Government,” then “Comptroller,” then “Consultant’s Agreements.”
7. Specific Payment Terms and Conditions
[DEPARTMENT TO INSERT SPECIFIC TERMS AND CONDITIONS.]
End of Text for Article II
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Suffolk County Required Compliance Forms
In Accordance with County Laws
These mandatory forms are available on Suffolk County Purchasing Website by registering on the website for the RFP.
To register, access the website: www.suffolkcountyny.gov : Select Business tab; click on Bids & Proposals; follow links
to Purchasing site to register and download document. By registering, you will automatically receive all future addenda.
LL52-2012 – Disqualification of Non-responsible Bidders
Suffolk County Form 22 – Contractor’s/Vendor’s Public Disclosure Statement
FTS Form – Non-Collusive Offer Certification
LHE-1 and LHE-2 Forms – Lawful Hiring
LW-1 and LW-38 Forms – Suffolk County Living Wage
DOL-L01- Suffolk County Union Organizing Certification/Declaration
(Note: this Form will be required only from the Apparent Successful Proposer)
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Exhibit 1
Exhibit 1
County Terms and Conditions
1. Elements of Interpretation
As used throughout the Contract:
a. Words of the masculine gender shall mean and
include correlative words of the feminine and neuter
genders and words importing the singular number shall
mean and include the plural number and vice versa. Words
importing persons shall include firms, associations,
partnerships (including limited partnerships), trusts,
corporations and other legal entities, including public
bodies, as well as natural persons, and shall include
successors and assigns.
b. Capitalized terms used, but not otherwise defined
herein, shall have the meanings assigned to them in the
Contract.
2. Meanings of Terms
As used in the Contract:
Comptroller” means the Comptroller of the County of Suffolk.
Contractmeans all terms and conditions herein forming all rights
and obligations of the Contractor and the County.
Contractor means the signatory person, partnership, corporation,
association or other entity, its officers, officials, employees, agents,
servants, sub-contractors, volunteers, and any successor or assign of
any one or more of the foregoing performing the Services.
County means the County of Suffolk, its departments, and
agencies.
County Attorney means the County Attorney of the County of
Suffolk.
Department means the signatory department approving the
Contract.
Engineering Services means the definition of the practice of
engineering and the definition of practice of land surveying, as the
case may be, under Section 7201 and Section 7203 of the State
Education Law, respectively.
Event of Default” means
a. the Contractor’s failure to perform any
duty required of it under paragraphs 4 through 7
of this Exhibit 1 of the Contract; or
b. the Contractor’s failure to maintain the
amount and types of insurance with an authorized
insurer as required by the Contract; or
c. the Contractor’s failure to maintain
insurance required by the Contract with an
insurer that has designated the New York
Superintendent of Insurance as its lawful agent
for service of process; or
d. The Contractor’s failure to comply with
any Federal, State or local law, rule, or
regulation, and County policies or directives; or
e. The Contractor’s bankruptcy or
insolvency; or
f. The Contractor’s failure to cooperate in
an Audit; or
g. The Contractor’s falsification of
records or reports, misuse of funds, or
malfeasance or nonfeasance in financial record
keeping arising out of, or in connection with, any
contract with the County; or
h. The Contractor’s failure to submit, or
failure to timely submit, documentation to obtain
Federal or State funds; or
i. The inability of the County or the
Contractor to obtain Federal or State funds due to
any act or omission of the Contractor; or
j. Any condition the County determines,
in its sole discretion, that is dangerous.
Federalmeans the United States government, its departments and
agencies.
Fund Source means any direct or indirect sum payable to the
Contractor by the County pursuant to any lawful obligation.
Legislature” means the Legislature of the County of Suffolk.
Servicesmeans all that which the Contractor must do, and any part
thereof arising out of, or in connection with, the Contract as
described in Article I “Description of Services.”
Statemeans the State of New York.
Suffolk County Payment Voucher means the document
authorized and required by the Comptroller for release of payment.
Term means the time period set forth on page one of the Contract
and, if exercised by the County, the option period.
3. Contractor Responsibilities
a. It shall be the duty of the Contractor to discharge,
or cause to be discharged, all of its responsibilities, and to
administer funds received in the interest of the County in
accordance with the provisions of the Contract.
b. The Contractor shall promptly take all action as
may be necessary to render the Services.
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Exhibit 1
c. The Contractor shall not take any action that is
inconsistent with the provisions of the Contract.
d. Services provided under this Contract shall be
open to all residents of the County.
4. Qualifications, Licenses, and Professional Standards
a. The Contractor represents and warrants that it
has, and shall continuously possess, during the Term, the
required licensing, education, knowledge, experience, and
character necessary to qualify it to render the Services.
b. The Contractor shall continuously have during
the Term all required authorizations, certificates,
certifications, registrations, licenses, permits, and other
approvals required by Federal, State, County, or local
authorities necessary to qualify it to render the Services.
4. Notifications
a. The Contractor shall immediately notify the
County, in writing, of any disciplinary proceedings,
commenced or pending, with any authority relating to a
license held by any person necessary to qualify him or the
Contractor to perform the Services.
b. In the event that a person is no longer licensed to
perform the Services, the Contractor must immediately
notify the County, but in no event shall such notification be
later than five (5) days after a license holder has lost the
license required to qualify the license holder or the
Contractor to perform the Services.
c. In the event that the Contractor is not able to
perform the Services due to a loss of license, the Contractor
shall not be reimbursed for the Services rendered after the
effective date of termination of such license. Without
limiting the generality of the foregoing, if any part of the
Contract remains to be performed, and the termination of
the license does not affect the Contractor’s ability to render
the Services, every other term and provision of the Contract
shall be valid and enforceable to the fullest extent permitted
by law.
6. Documentation of Professional Standards
The Contractor shall maintain on file, in one location in
Suffolk County, all records that demonstrate that it has
complied with paragraphs 4 and 5 above. The address of
the location of the aforesaid records and documents shall be
provided to the County no later than the date of execution
of the Contract. Such documentation shall be kept,
maintained, and available for inspection by the County
upon twenty-four (24) hours notice.
7. Credentialing
a. In the event that the Department, or any division
thereof, maintains a credentialing process to qualify the
Contractor to render the Services, the Contractor shall
complete the required credentialing process. In the event
that any State credential, registration, certification, or
license, Drug Enforcement Agency registration, or
Medicare or Medicaid certification is restricted, suspended,
or temporarily or permanently revoked, it is the duty of the
Contractor to contact the Department, or division thereof,
as the case may be, in writing, no later than three (3) days
after such restriction, suspension, or revocation.
b. The Contractor shall forward to the Department,
or division thereof, as the case may be, on or before July 1
of each year during the Term, a complete list of the names
and addresses of all persons providing the Services, as well
as their respective areas of certification, credentialing,
registration, and licensing.
8.Engineering Certificate
8. Engineering Certificate
In the event that the Contract requires any Engineering
Services, the Contractor shall submit to the County, no later
than the due date for submission for approval of any
engineering work product, the Certificate of Authorization
(“Certificate”), issued pursuant to § 7210 of the New York
Education Law, of every person performing any
Engineering Services. The failure to file, submit or
maintain the Certificate shall be grounds for rejection of
any engineering work product submitted for approval.
9. Termination
a. Thirty Days Termination
The County shall have the right to terminate the
Contract without cause, for any reason, at any time, upon
such terms and conditions it deems appropriate, provided,
however, that no such termination shall be effective unless
the Contractor is given at least thirty (30) days notice.
b. Event of Default; Termination on Notice
i.) The County may immediately terminate
the Contract, for cause, upon such terms and
conditions it deems appropriate, in the Event of
Default.
ii.) If the Contractor defaults under any
other provision of the Contract, the County may
terminate the Contract, on not less than five (5)
days notice, upon such terms and conditions it
deems appropriate.
c. Termination Notice
Any notice providing for termination shall be
delivered as provided for in paragraph 33 of this
Exhibit 1.
d. Duties upon Termination
i.) The Contractor shall discontinue the
Services as directed in the termination notice.
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Exhibit 1
ii.) Subject to any defenses available to it,
the County shall pay the Contractor for the
Services rendered through the date of
termination.
iii.) The County shall be released from any
and all liability under the Contract, effective as of
the date of the termination notice.
iv.) Upon termination, the Contractor shall
reimburse the County the balance of any funds
advanced to the Contractor by the County no later
than thirty (30) days after termination of the
Contract. The provisions of this subparagraph
shall survive the expiration or termination of the
Contract.
v.) Nothing contained in this paragraph
shall be construed as a limitation on the County’s
rights set forth in paragraphs 5(c) and 15 of this
Exhibit 1.
10. Indemnification and Defense
a. The Contractor shall protect, indemnify, and hold
harmless the County, its agents, servants, officials, and
employees from and against all liabilities, fines, penalties,
actions, damages, claims, demands, judgments, losses, suits
or actions, costs, and expenses caused by the negligence or
any acts or omissions of the Contractor, including
reimbursement of the cost of reasonable attorneys' fees
incurred by the County, its agents, servants, officials, and
employees in any action or proceeding arising out of or in
connection with the Contract.
b. The Contractor hereby represents and warrants
that it will not infringe upon any copyright in performing
the Services. The Contractor agrees that it shall protect,
indemnify, and hold harmless the County, its agents,
servants, officials, and employees from and against all
liabilities, fines, penalties, actions, damages, claims,
demands, judgments, losses, suits or actions, costs, and
expenses arising out of any claim asserted for infringement
of copyright, including reimbursement of the cost of
reasonable attorneys' fees incurred by the County, its
agents, servants, officials, and employees in any action or
proceeding arising out of or in connection with any claim
asserted for infringement of copyright.
c. The Contractor shall defend the County, its
agents, servants, officials, and employees in any proceeding
or action, including appeals, arising out of, or in connection
with, the Contract, and any copyright infringement
proceeding or action. Alternatively, at the Countys option,
the County may defend any such proceeding or action and
require the Contractor to pay reasonable attorneys’ fees or
salary costs of County employees of the Department of
Law for the defense of any such suit.
11. Insurance
a. The Contractor shall continuously maintain,
during the Term of the Contract, insurance in amounts and
types as follows:
i.) Commercial General Liability
insurance, including contractual liability
coverage, in an amount not less than Two Million
Dollars ($2,000,000.00) per occurrence for bodily
injury and Two Million Dollars ($2,000,000.00)
per occurrence for property damage. The County
shall be named an additional insured.
ii.) Automobile Liability insurance (if any
non-owned or owned vehicles are used by the
Contractor in the performance of the Contract) in
an amount not less than Five Hundred Thousand
Dollars ($500,000.00) per person, per accident,
for bodily injury and not less than One Hundred
Thousand Dollars ($100,000.00) for property
damage per occurrence. The County shall be
named an additional insured.
iii.) Workers’ Compensation and
Employer’s Liability insurance, Disability
Benefits insurance, including coverage for Paid
Family Leave Benefits, in compliance with all
applicable New York State laws and regulations,
if required by law. The Contractor shall furnish
to the County, prior to its execution of the
Contract, the documentation required by the State
of New York Workers’ Compensation Board of
coverage or exemption from coverage pursuant to
§§57 and 220 of the Workers’ Compensation
Law. In accordance with General Municipal Law
§108, the Contract shall be void and of no effect
unless the Contractor shall provide and maintain
coverage during the Term for the benefit of such
employees as are required to be covered by the
provisions of the Workers’ Compensation Law.
iv.) Professional Liability insurance in an
amount not less than Two Million Dollars
($2,000,000.00) on either a per-occurrence or
claims-made coverage basis.
b. The County may mandate an increase in the
liability limits set forth in the immediately preceding
paragraphs (11)(a)(i), (ii), and (iv).
c. All policies providing such coverage shall be
issued by insurance companies authorized to do business in
New York with an A.M. Best rating of A- or better.
d. The Contractor shall furnish to the County, prior
to the execution of the Contract, declaration pages for each
policy of insurance and certificates, other than a policy for
commercial general liability insurance, and upon demand, a
true and certified original copy of each such policy
evidencing compliance with the aforesaid insurance
requirements.
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Exhibit 1
e. In the case of commercial general liability
insurance the Contractor shall furnish to the County, prior
to the execution of the Contract, a declaration page or
insuring agreement and endorsement page evidencing the
County’s status as an additional insured on said policy, and
upon demand, a true and certified original copy of such
policy evidencing compliance with the aforesaid insurance
requirements.
f. All evidence of insurance shall provide for the
County to be notified in writing thirty (30) days prior to
any cancellation, nonrenewal, or material change in the
policy to which such evidence relates. It shall be the duty
of the Contractor to notify the County immediately of any
cancellation, nonrenewal, or material change in any
insurance policy.
g. In the event the Contractor shall fail to provide
evidence of insurance, the County may provide the
insurance required in such manner as the County deems
appropriate and deduct the cost thereof from a Fund
Source.
12. Independent Contractor
1.
The Contractor is not, and shall never be, considered an
employee of the County for any purpose. Notwithstanding
anything herein, the Contract shall not be construed as
creating a principal-agent relationship between the County
and the Contractor or the Contractor and the County, as the
case may be.
13. Severability
It is expressly agreed that if any term or provision of the
Contract, or the application thereof to any person or
circumstance, shall be held invalid or unenforceable to any
extent, the remainder of the Contract, or the application of
such term or provision to persons or circumstances other
than those as to which it is held invalid or unenforceable,
shall not be affected thereby, and every other term and
provision of the Contract shall be valid and shall be
enforced to the fullest extent permitted by law.
14. Merger; No Oral Changes
It is expressly agreed that the Contract represents the entire
agreement of the parties and that all previous
understandings are herein merged in the Contract. No
modification of the Contract shall be valid unless in written
form and executed by both parties.
15. Set-Off Rights
The County shall have all of its common law, equitable,
and statutory rights of set-off. These rights shall include,
but not be limited to, the Countys option to withhold from
a Fund Source an amount no greater than any moneys due
and owing to the County for any reason. The County shall
exercise its set-off rights subject to approval by the County
Attorney. In cases of set-off pursuant to a Comptroller’s
audit, the County shall only exercise such right after the
finalization thereof, and only after consultation with the
County Attorney.
16. Non-Discrimination in Services
a. The Contractor shall not, on the grounds of race,
creed, color, national origin, sex, age, disability, sexual
orientation, military status, or marital status:
i.) deny any individual the Services
provided pursuant to the Contract; or
ii.) provide the Services to an individual
that is different, or provided in a different
manner, from those provided to others pursuant
to the Contract; or
iii.) subject an individual to segregation or
separate treatment in any matter related to the
individual’s receipt of the Services provided
pursuant to the Contract; or
iv.) restrict an individual in any way from
any advantage or privilege enjoyed by others
receiving the Services provided pursuant to the
Contract; or
v.) treat an individual differently from
others in determining whether or not the
individual satisfies any eligibility or other
requirements or conditions which individuals
must meet in order to receive the Services
provided pursuant to the Contract.
b. The Contractor shall not utilize criteria or
methods of administration which have the effect of
subjecting individuals to discrimination because of their
race, creed, color, national origin, sex, age, disability,
sexual orientation, military status, or marital status, or have
the effect of substantially impairing the Contract with
respect to individuals of a particular race, creed, color,
national origin, sex, age, disability, sexual orientation,
military status, or marital status, in determining:
i.) the Services to be provided, or
ii.) the class of individuals to whom, or the
situations in which, the Services will be provided;
or
iii.) the class of individuals to be afforded
an opportunity to receive the Services.
17. Nonsectarian Declaration
The Services performed under the Contract are secular in
nature. No funds received pursuant to the Contract shall be
used for sectarian purposes or to further the advancement
of any religion. The Services will be available to all
eligible individuals regardless of religious belief or
affiliation.
18. Governing Law
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Exhibit 1
The Contract shall be governed by and construed in
accordance with the laws of the State of New York, without
regard to conflict of laws. Venue shall be designated in the
Supreme Court, Suffolk County, the United States District
Court for the Eastern District of New York, or, if
appropriate, a court of inferior jurisdiction in Suffolk
County.
19. No Waiver
It shall not be construed that any failure or forbearance of
the County to enforce any provision of the Contract in any
particular instance or instances is a waiver of that
provision. Such provision shall otherwise remain in full
force and effect, notwithstanding any such failure or
forbearance.
20. Conflicts of Interest
The Contractor shall not, during the Term, pursue a course
of conduct which would cause a reasonable person to
believe that he or she is likely to be engaged in acts that
create a substantial conflict between its obligations under
the Contract and its private interests. The Contractor is
charged with the duty to disclose to the County the
existence of any such adverse interests, whether existing or
potential. This duty shall continue as long as the Term.
The determination as to whether or when a conflict may
potentially exist shall ultimately be made by the County
Attorney after full disclosure is obtained.
21. Cooperation on Claims
The Contractor and the County shall render diligently to
each other, without compensation, any and all cooperation
that may be required to defend the other party, its
employees and designated representatives against any
claim, demand or action that may be brought against the
other party, its employees or designated representatives
arising out of, or in connection with, the Contract.
22. Confidentiality
Any document of the County, or any document created by
the Contractor and used in rendering the Services, shall
remain the property of the County and shall be kept
confidential in accordance with applicable laws, rules, and
regulations.
23. Assignment and Subcontracting
a. The Contractor shall not delegate its duties under
the Contract, or assign, transfer, convey, subcontract,
sublet, or otherwise dispose of the Contract, or any of its
right, title or interest therein, or its power to execute the
Contract, or assign all or any portion of the moneys that
may be due or become due hereunder, (collectively referred
to in this paragraph 23 as “Assignment”), to any other
person, entity or thing without the prior written consent of
the County, and any attempt to do any of the foregoing
without such consent shall be void ab initio.
b. Such Assignment shall be subject to all of the
provisions of the Contract and to any other condition the
County requires. No approval of any Assignment shall be
construed as enlarging any obligation of the County under
the terms and provisions of the Contract. No Assignment
of the Contract or assumption by any person of any duty of
the Contractor under the Contract shall provide for, or
otherwise be construed as, releasing the Contractor from
any term or provision of the Contract.
24. Changes to Contractor
a. The Contractor may, from time to time, with the
County’s consent, enter into a Permitted Transfer. For
purposes of the Contract, a Permitted Transfer means:
i.) if the Contractor is a partnership, the
withdrawal or change, voluntary, involuntary or
by operation of law, of the partners, or transfer of
partnership interests (other than the purchase of
partnership interests by existing partners, by the
partnership itself or the immediate family
members by reason of gift, sale or devise), or the
dissolution of the partnership without immediate
reconstitution thereof, and
ii.) if the Contractor is a closely held
corporation (i.e. whose stock is not publicly held and
not traded through an exchange or over the counter),
1. the dissolution, merger,
consolidation or other reorganization of
the Contractor,
2. the sale or other transfer of
twenty percent (20%) or more of the
shares of the Contractor (other than to
existing shareholders, the corporation
itself or the immediate family members
of shareholders by reason of gift, sale
or devise).
b. If the Contractor is a not-for-profit corporation, a
change of twenty percent (20%) or more of its shares or
members shall be deemed a Permitted Transfer.
c. The Contractor shall notify the County in writing,
which notice (the “Transfer Notice”) shall include:
i.) the proposed effective date of the
Permitted Transfer, which shall not be less than
thirty (30) days nor more than one hundred eighty
(180) days after the date of delivery of the
Transfer Notice;
ii.) a summary of the material terms of the
proposed Permitted Transfer,
iii.) the name and address of the proposed
transferee,
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iv.) such information reasonably required
by the County, which will enable the County to
determine the financial responsibility, character,
and reputation of the proposed transferee, nature
of the proposed assignee/transferee’s business
and experience;
v.) all executed forms required pursuant to
Exhibit 2 of the Contract, that are required to be
submitted by the Contractor; and
vi.) such other information as the County
may reasonably require.
d. The County agrees that any request for its
consent to a Permitted Transfer shall be granted provided
that the transfer does not violate any provision of the
Contract, and the transferee has not been convicted of a
criminal offense as described under Article II of Chapter
189 of the Suffolk County Code. The County shall grant or
deny its consent to any request of a Permitted Transfer
within twenty (20) days after delivery to the County of the
Transfer Notice, in accordance with the provisions of
Paragraph 33 of this Exhibit 1 of the Contract. If the
County shall not give written notice to the Contractor
denying its consent to such Permitted Transfer (and setting
forth the basis for such denial in reasonable detail) within
such 20-day period, then the County shall be deemed to
have granted its consent to such Permitted Transfer.
e. Notwithstanding the County’s consent,
i.) the terms and conditions of the
Contract shall in no way be deemed to have been
waived or modified, and
ii.) such consent shall not be deemed
consent to any further transfers.
25. No Intended Third Party Beneficiaries
The Contract is entered into solely for the benefit of the
County and the Contractor. No third party shall be deemed
a beneficiary of the Contract and no third party shall have
the right to make any claim or assert any right under the
Contract.
26. Certification as to Relationships
The Contractor certifies under penalties of perjury that,
other than through the funds provided in the Contract and
other valid agreements with the County, there is no known
spouse, life partner, business, commercial, economic, or
financial relationship with the County or its elected
officials. The Contractor also certifies that there is no
relationship within the third degree of consanguinity,
between the Contractor, any of its partners, members,
directors, or shareholders owning five percent (5%) or
more of the Contractor, and the County. The foregoing
certification shall not apply to a contractor that is a
municipal corporation or a government entity.
27. Publications
Any book, article, report, or other publication related to the Services
provided pursuant to this Contract shall contain the following
statement in clear and legible print:
“This publication is fully or partially funded by the County
of Suffolk.”
28. Copyrights and Patents
a. Copyrights
Any and all materials generated by or on behalf of the
Contractor while performing the Services (including, without
limitation, designs, images, video, reports, analyses, manuals, films,
tests, tutorials, and any other work product of any kind) and all
intellectual property rights relating thereto (“Work Product”) are and
shall be the sole property of the County. The Contractor hereby
assigns to the County its entire right, title and interest, if any, to all
Work Product, and agrees to do all acts and execute all documents,
and to use its best efforts to ensure that its employees, consultants,
subcontractors, vendors and agents do all acts and execute any
documents, necessary to vest ownership in the County of any and all
Work Product. The Contractor may not secure copyright protection.
The County reserves to itself, and the Contractor hereby gives to the
County, and to any other person designated by the County, consent to
produce, reproduce, publish, translate, display or otherwise use the
Work Product. This paragraph shall survive any completion,
expiration or termination of this Contract.
The County shall be deemed to be the author of all the
Work Product. The Contractor acknowledges that all Work Product
shall constitute “work made for hire” under the U.S. copyright laws.
To the extent that any Work Product does not constitute a “work
made for hire,” the Contractor hereby assigns to the County all right,
title and interest, including the right, title and interest to reproduce,
edit, adapt, modify or otherwise use the Work Product, that the
Contractor may have or may hereafter acquire in the Work Product,
including all intellectual property rights therein, in any manner or
medium throughout the world in perpetuity without compensation.
This includes, but is not limited to, the right to reproduce and
distribute the Work Product in electronic or optical media, or in CD-
ROM, on-line or similar format.
b. Patents
If the Contractor develops, invents, designs or creates any
idea, concept, code, processes or other work or materials during the
Term, or as a result of any Services performed under the Contract
(“patent eligible subject matter”), it shall be the sole property of the
County. The Contractor hereby assigns to the County its entire right,
title and interest, if any, to all patent eligible subject matter, and
agrees to do all acts and execute all documents, and to use its best
efforts to ensure that its employees, consultants, subcontractors,
vendors and agents do all acts and execute any documents, necessary
to vest ownership in the County of any and all patent eligible subject
matter. The Contractor may not apply for or secure for itself patent
protection. The County reserves to itself, and the Contractor hereby
gives to the County, and to any other person designated by the
County, consent to produce or otherwise use any item so discovered
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and/or the right to secure a patent for the discovery or invention.
This paragraph shall survive any completion, expiration or
termination of this Contract.
29. Arrears to County
The Contractor warrants that, except as may otherwise be authorized
by agreement, it is not in arrears to the County upon any debt,
contract, or any other lawful obligation, and is not in default to the
County as surety.
30. Lawful Hiring of Employees Law in Connection with
Contracts for Construction or Future Construction
In the event that the Contract is subject to the Lawful Hiring of
Employees Law of the County of Suffolk, Suffolk County Code
Article II of Chapter 353, as more fully set forth in Exhibit 2 entitled
"Suffolk County Legislative Requirements," the Contractor shall
maintain the documentation mandated to be kept by this law on the
construction site at all times. Employee sign-in sheets and
register/log books shall be kept on the construction site at all times
and all covered employees, as defined in the law, shall be required to
sign such sign-in sheets/register/log books to indicate their presence
on the construction site during such working hours.
31. Record Retention
The Contractor shall retain all accounts, books, records, and other
documents relevant to the Contract for seven (7) years after final
payment is made by the County. Federal, State, and/or County
auditors and any persons duly authorized by the County shall have
full access and the right to examine any of said materials during said
period. Such access is granted notwithstanding any exemption from
disclosure that may be claimed for those records which are subject to
nondisclosure agreements, trade secrets and commercial information
or financial information that is privileged or confidential. Without
limiting the generality of the foregoing, records directly related to
contract expenditures shall be kept for a period of ten (10) years
because the statute of limitations for the New York False Claims Act
(New York False Claims Act § 192) is ten (10) years.
32. Certification Regarding Lobbying
Together with this Contract and as a condition precedent to its
execution by the County, the Contractor shall have executed and
delivered to the County the Certification Regarding Lobbying (if
payment under this Contract may exceed $100,000) as required by
Federal regulations, and shall promptly advise the County of any
material change in any of the information reported on such
Certification, and shall otherwise comply with, and shall assist the
County in complying with, said regulations as now in effect or as
amended during the term of this Contract.
33. Notice
Unless otherwise expressly provided herein, all notices shall be in
writing and shall be deemed sufficiently given if sent by regular first
class mail and certified mail, or personally delivered during business
hours as follows: 1.) to the Contractor at the address on page 1 of the
Contract and 2.) to the County at the Department, or as to either of
the foregoing, to such other address as the addressee shall have
indicated by prior written notice to the addressor. All notices
received by the Contractor relating to a legal claim shall be
immediately sent to the Department and also to the County Attorney
at 100 Veterans Memorial Highway, P.O. Box 6100, (Sixth Floor),
Hauppauge, New York, 11788-0099.
End of Text for Exhibit 1
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1 of 3 pages
Exhibit 2
Exhibit 2
Suffolk County Legislative Requirements
NOTE: THE CONTRACTOR’S COMPLETED LEGISLATIVE
REQUIREMENTS FORMS REFERENCED HEREIN ARE
AVAILABLE ON FILE AT THE DEPARTMENT NAMED ON
THE SIGNATURE PAGE OF THIS CONTRACT.
1. Contractor’s/Vendor’s Public Disclosure
Statement
It shall be the duty of the Contractor to read, become
familiar with, and comply with the requirements of section
A5-8 of Article V of the Suffolk County Code.
Unless certified by an officer of the Contractor as being
exempt from the requirements of section A5-8 of Article V
of the Suffolk County Code, the Contractor represents and
warrants that it has filed with the Comptroller the verified
public disclosure statement required by Suffolk County
Administrative Code Article V, Section A5-8 and shall file
an update of such statement with the Comptroller on or
before the 31st day of January in each year of the
Contract’s duration. The Contractor acknowledges that
such filing is a material, contractual and statutory duty and
that the failure to file such statement shall constitute a
material breach of the Contract, for which the County shall
be entitled, upon a determination that such breach has
occurred, to damages, in addition to all other legal
remedies, of fifteen percent (15%) of the amount of the
Contract.
Required Form:
Suffolk County Form SCEX 22; entitled
“Contractor’s/Vendor’s Public Disclosure Statement”
2. Living Wage Law
It shall be the duty of the Contractor to read, become
familiar with, and comply with the requirements of Chapter
575, of the Suffolk County Code.
This Contract is subject to the Living Wage Law of the
County of Suffolk. The law requires that, unless specific
exemptions apply, all employers (as defined) under service
contracts and recipients of County financial assistance, (as
defined) shall provide payment of a minimum wage to
employees as set forth in the Living Wage Law. Such rate
shall be adjusted annually pursuant to the terms of the
Suffolk County Living Wage Law of the County of
Suffolk. Under the provisions of the Living Wage Law, the
County shall have the authority, under appropriate
circumstances, to terminate the Contract and to seek other
remedies as set forth therein, for violations of this Law.
Required Forms:
Suffolk County Living Wage Form DOL-LW-1/38
(Revised 8/2017) entitled “Suffolk County Department of
Labor, LICENSING & CONSUMER AFFAIRS Notice of
Application for County Compensation-LIVING WAGE
CERTIFICATION/DECLARATION-SUBJECT TO
AUDIT.”
3. Use of County Resources to Interfere with
Collective Bargaining Activities
It shall be the duty of the Contractor to read, become
familiar with, and comply with the requirements of Article
I of Chapter 803 of the Suffolk County Code.
County Contractors (as defined by section 803-2) shall
comply with all requirements of Chapter 803 of the Suffolk
County Code, including the following prohibitions:
a. The Contractor shall not use County funds to
assist, promote, or deter union organizing.
b. No County funds shall be used to reimburse the
Contractor for any costs incurred to assist,
promote, or deter union organizing.
c. No employer shall use County property to hold a
meeting with employees or supervisors if the
purpose of such meeting is to assist, promote, or
deter union organizing.
If the Services are performed on County property, the
Contractor must adopt a reasonable access agreement, a
neutrality agreement, fair communication agreement, non-
intimidation agreement, and a majority authorization card
agreement.
If the Services are for the provision of human services and
are not to be performed on County property, the Contractor
must adopt, at the least, a neutrality agreement.
Under the provisions of Chapter 803, the County shall have
the authority, under appropriate circumstances, to terminate
the Contract and to seek other remedies as set forth therein,
for violations of this Law.
Required Form:
Suffolk County Labor Law Form DOL-LO1; entitled
“Suffolk County Department of Labor Labor Mediation
Unit Union Organizing Certification/Declaration - Subject
to Audit.”
4. Lawful Hiring of Employees Law
It shall be the duty of the Contractor to read, become
familiar with, and comply with the requirements of Article
II of Chapter 353 of the Suffolk County Code.
This Contract is subject to the Lawful Hiring of Employees
Law of the County of Suffolk. It provides that all covered
employers, (as defined), and the owners thereof, as the case
may be, that are recipients of compensation from the
County through any grant, loan, subsidy, funding,
appropriation, payment, tax incentive, contract,
subcontract, license agreement, lease or other financial
compensation agreement issued by the County or an
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Exhibit 2
awarding agency, where such compensation is one hundred
percent (100%) funded by the County, shall submit a
completed sworn affidavit (under penalty of perjury), the
form of which is attached, certifying that they have
complied, in good faith, with the requirements of Title 8 of
the United States Code Section 1324a with respect to the
hiring of covered employees (as defined) and with respect
to the alien and nationality status of the owners thereof.
The affidavit shall be executed by an authorized
representative of the covered employer or owner, as the
case may be; shall be part of any executed contract,
subcontract, license agreement, lease or other financial
compensation agreement with the County; and shall be
made available to the public upon request.
All contractors and subcontractors (as defined) of covered
employers, and the owners thereof, as the case may be, that
are assigned to perform work in connection with a County
contract, subcontract, license agreement, lease or other
financial compensation agreement issued by the County or
awarding agency, where such compensation is one hundred
percent (100%) funded by the County, shall submit to the
covered employer a completed sworn affidavit (under
penalty of perjury), the form of which is attached,
certifying that they have complied, in good faith, with the
requirements of Title 8 of the United States Code Section
1324a with respect to the hiring of covered employees and
with respect to the alien and nationality status of the owners
thereof, as the case may be. The affidavit shall be executed
by an authorized representative of the contractor,
subcontractor, or owner, as the case may be; shall be part of
any executed contract, subcontract, license agreement,
lease or other financial compensation agreement between
the covered employer and the County; and shall be made
available to the public upon request.
An updated affidavit shall be submitted by each such
employer, owner, contractor and subcontractor no later than
January 1 of each year for the duration of any contract and
upon the renewal or amendment of the Contract, and
whenever a new contractor or subcontractor is hired under
the terms of the Contract.
The Contractor acknowledges that such filings are a
material, contractual and statutory duty and that the failure
to file any such statement shall constitute a material breach
of the Contract.
Under the provisions of the Lawful Hiring of Employees
Law, the County shall have the authority to terminate the
Contract for violations of this Law and to seek other
remedies available under the law.
The documentation mandated to be kept by this law shall at
all times be kept on site. Employee sign-in sheets and
register/log books shall be kept on site at all times during
working hours and all covered employees, as defined in the
law, shall be required to sign such sign-in
sheets/register/log books to indicate their presence on the
site during such working hours.
Required Forms:
“SUFFOLK COUNTY DEPARTMENT OF LABOR,
LICENSING, & CONSUMER AFFAIRS NOTICE OF
APPLICATION TO CERTIFY COMPLIANCE WITH
FEDERAL LAW (8 U.S.C. SECTION 1324A) WITH
RESPECT TO LAWFUL HIRING OF EMPLOYEES,
Suffolk County Code, Chapter 353 (2006)” DOL-LHE 1 / 2
(REVISED 8/2017).
5. Gratuities
It shall be the duty of the Contractor to read, become
familiar with, and comply with the requirements of Chapter
664 of the Suffolk County Code.
The Contractor represents and warrants that it has not
offered or given any gratuity to any official, employee or
agent of the County or the State or of any political party,
with the purpose or intent of securing an agreement or
securing favorable treatment with respect to the awarding
or amending of an agreement or the making of any
determinations with respect to the performance of an
agreement.
6. Prohibition Against Contracting with
Corporations that Reincorporate Overseas
It shall be the duty of the Contractor to read, become
familiar with, and comply with the requirements of sections
A4-13 and A4-14 of Article IV of the Suffolk County
Code.
The Contractor represents that it is in compliance with
sections A4-13 and A4-14 of Article IV of the Suffolk
County Code. Such law provides that no contract for
consulting services or goods and services shall be awarded
by the County to a business previously incorporated within
the U.S.A. that has reincorporated outside the U.S.A.
7. Child Sexual Abuse Reporting Policy
It shall be the duty of the Contractor to read, become
familiar with, and comply with the requirements of Article
II of Chapter 880 of the Suffolk County Code.
The Contractor shall comply with Article II of Chapter 880,
of the Suffolk County Code, entitled “Child Sexual Abuse
Reporting Policy,” as now in effect or amended hereafter or
of any other Suffolk County Local Law that may become
applicable during the term of the Contract with regard to
child sexual abuse reporting policy.
8. Non Responsible Bidder
It shall be the duty of the Contractor to read, become
familiar with, and comply with the requirements of Article
II of Chapter 189 of the Suffolk County Code.
Upon signing the Contract, the Contractor certifies that it
has not been convicted of a criminal offense within the last
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Exhibit 2
ten (10) years. The term “conviction” shall mean a finding
of guilty after a trial or a plea of guilty to an offense
covered under section 189-5 of the Suffolk County Code
under “Nonresponsible Bidder.”
9. Use of Funds in Prosecution of Civil Actions
Prohibited
It shall be the duty of the Contractor to read, become
familiar with, and comply with the requirements of Article
III of Chapter 893 of the Suffolk County Code.
The Contractor shall not use any of the moneys, in part or
in whole, and either directly or indirectly, received under
the Contract in connection with the prosecution of any civil
action against the County in any jurisdiction or any judicial
or administrative forum.
10. Youth Sports
It shall be the duty of the Contractor to read, become
familiar with, and comply with Article III of Chapter 730
of the Suffolk County Code.
All contract agencies that conduct youth sports programs
are required to develop and maintain a written plan or
policy addressing incidents of possible or actual concussion
or other head injuries among sports program participants.
Such plan or policy must be submitted prior to the award of
a County contract, grant or funding. Receipt of such plan
or policy by the County does not represent approval or
endorsement of any such plan or policy, nor shall the
County be subject to any liability in connection with any
such plan or policy.
11. Work Experience Participation
If the Contractor is a not-for-profit or governmental agency
or institution, each of the Contractor's locations in the
County at which the Services are provided shall be a work
site for public-assistance clients of Suffolk County pursuant
to Chapter 281 of the Suffolk County Code at all times
during the Term of the Contract. If no Memorandum of
Understanding ("MOU") with the Suffolk County
Department of Labor for work experience is in effect at the
beginning of the Term of the Contract, the Contractor, if it
is a not-for-profit or governmental agency or institution,
shall enter into such MOU as soon as possible after the
execution of the Contract and failure to enter into or to
perform in accordance with such MOU shall be deemed to
be a failure to perform in accordance with the Contract, for
which the County may withhold payment, terminate the
Contract or exercise such other remedies as may be
appropriate in the circumstances.
12. Safeguarding Personal Information of Minors
It shall be the duty of the Contractor to read, become
familiar with, and comply with the requirements of Suffolk
County Local Law No. 20-2013, a Local Law to Safeguard
the Personal Information of Minors in Suffolk County.
All contract agencies that provide services to minors are
required to protect the privacy of the minors and are strictly
prohibited from selling or otherwise providing to any third
party, in any manner whatsoever, the personal or
identifying information of any minor participating in their
programs.
13. Contract Agency Performance Measures and Reporting
Requirements
It shall be the duty of the Contractor to read, become
familiar with, and comply with the requirements of Suffolk
County Local Law No. 41-2013, a Charter Law to
Implement Performance Measurement to Increase
Accountability and Enhance Service Delivery by Contract
Agencies (Article VIII of Chapter 189 of the Suffolk
County Code).
All contract agencies having a contract in excess of
$50,000 shall cooperate with the contract’s administering
department to identify the key performance measures
related to the objectives of the service the contract agency
provides and shall develop an annual performance
reporting plan. The contract agency shall cooperate with
the administering department and the County Executive’s
Performance Management Team to establish working
groups to identify appropriate performance indicators for
monthly evaluation of the contract agency’s performance
measures.
14. Suffolk County Local Laws Website Address
Suffolk County Local Laws, Rules and Regulations can be
accessed on the homepage of the Suffolk County
Legislature.
15. Suffolk County Code of Ethics
As required by Suffolk County Standard Operating
Procedure A-06, the following is a link to the Suffolk
County Ethics Booklet, which contains the provisions of
the Suffolk County Code of Ethics:
https://suffolkcountyny.gov/Portals/0/formsdocs/Boardofet
hics/Code%20of%20Ethics%20Booklet%20-
%20New%20Revised%20May%202017.pdf
End of Text for Exhibit 2
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Issue Date:
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4 of 3 pages
Exhibit 2
Suffolk County Required Compliance Forms
In Accordance with County Laws
The following forms will be required from the apparent successful proposer. The apparent successful proposer
will be required to submit original, signed forms:
LL52-2012 Disqualification of Non-responsible Bidders
Suffolk County Form 22 Contractor’s/Vendor’s Public Disclosure Statement
FTS Form Non-Collusive Offer Certification
LHE-1/2 Form Lawful Hiring
LW 1/38 Form Suffolk County Living Wage
DOL-L01- Suffolk County Union Organizing Certification/Declaration
Lobbying Certification Form
Page 1 of 2
DISQUALIFICATION OF NONRESPONSIBLE BIDDERS
PURSUANT TO CHAPTER 189, ARTICLE II OF THE SUFFOLK COUNTY CODE, THE
FOLLOWING IS TO BE COMPLETED BY ALL BIDDERS/CONTRACTORS.
1. The authorized signatory for the entity signing this document acknowledges that s/he has
read and is familiar with the provisions of Chapter 189, Article II of the Suffolk County
Code which applies to the subject contract. For the purposes of this form, the terms
“entity” and “convicted of” shall have the meanings set forth in section 189-4 of Chapter
189.
2. Has the entity, at any time during the ten years preceding the date of submission of the
bid, been convicted of committing or attempting to commit an offense(s) relating to any
of the following: extortion; coercion; bribery; theft; fraud; any violent crime relating to
business, labor or commerce; sabotage, collusive bidding/bid rigging; any environmental
crime including, but not limited to, the illegal use or disposal of toxic/hazardous waste or
chemicals; combination in restraint of trade; conspiracy to commit one of these crimes;
and/or criminal solicitation associated with one of the crimes listed above?
Yes No
3 If the answer to question 2 above is “Yesthe entity shall be determined to be a “non-
responsible bidder” and disqualified from bidding on the County project or contract.
4. List all criminal convictions, dates of conviction, and courts of conviction rendered upon
the entity, whether upon a verdict or plea of guilty or nolo contendere, within the ten
years preceding the date of submission of the bid. Use a separate sheet if more space is
necessary.
5. Is the entity currently in compliance with applicable Suffolk County licensing laws if it
has, or is required to have, a license issued by Suffolk County?
Yes No
6. If the answer to question 5 above is “No” the entity shall be determined to be a “non-
responsible bidder” and disqualified from bidding on the County project or contract until
the entity is in compliance with all applicable County licensing laws.
OFFENSE
DATE OF CONVICTION
COURT
LL52-2012 FORM
Rev. 8/13/14
FORM LL52-2012
Page 2 of 2
Rev. 8/13/14
FORM LL52-2012
7. Has the entity, at any time during the ten years preceding the date of submission of the
bid, been convicted under, or determined by the New York State Department of Labor or
the Suffolk County Department of Labor to be in violation of Chapter 31 of the New
York State Labor Law, Chapter 575 of the Suffolk County Code, or any provision of
State or local law protecting workerssafety?
Yes No
8. If the answer to question 7 above is “Yes” please provide detailed information, on a
separate sheet, regarding the violation(s), history of previous violation(s), and such other
factors which the awarding agency may give due consideration when determining
whether to disqualify the entity as a nonresponsible bidder.
9. In the event the entity claims an exemption from the provisions of Chapter 189, Article II
under section 189-9, provide the relevant written documentation of the request or
command issued by the appropriate official of the United States Government.
10. Any contract entered into in violation of Chapter 189, Article II shall be null and void
and any entity entering into such contract shall not be entitled to any compensation
pursuant to said contract.
11. Any intentional or knowing misrepresentation made pursuant to the requirements of
Chapter 189, Article II shall constitute an unclassified misdemeanor, and the person
making such intentional or knowing misrepresentation shall be subject to punishment of a
fine of $1,000 and/or up to one year of imprisonment and shall be barred from bidding on
future County contracts. Each such violation shall constitute a separate and distinct
offense.
I, __________________________________hereby declare under penalty of perjury under
the Laws of the State of New York that I am authorized to provide this certification and
that the above is true and correct.
________________________________________
Name of Entity
_________________________________________ __________________________
Signature of Authorized Representative Date
________________________________________________
Print Name and Title of Authorized Representative
LL52-2012 Form continued....
Page 1 of 3 Public Disclosure Form
Suffolk County Form 22
Contractor’s/Vendor’s Public Disclosure Statement
Pursuant to Section A5-8 of the Suffolk County Administrative Code, this Public Disclosure Statement
must be completed by all contractors/vendors that have a contract with Suffolk County, with the
exception of hospitals; educational or governmental entities; not-for-profit corporations; and contracts
providing foster care, family day care providers, or child protective services.
1. Contractor’s/Vendor’s Name____________________________________________
Address_______________________________________________________________
City and State________________________________________Zip Code___________
2. Contracting Department’s Name____________________________________________
Address_______________________________________________________________
3. Payee Identification or Social Security No.____________________________________
4. Type of Business__Corporation__Partnership__Sole Proprietorship__Other
5.a Is contractor/vendor entering into or has contractor/vendor entered into a contract with Suffolk
County in excess of $1,000? __Yes__No.
5.b Has contractor/vendor entered into three or more contracts, including the one for which you are
now completing this form, with Suffolk County, any three of which, when combined, exceed
$1,000? __Yes__No.
6. Table of Organization. List names and addresses of all principals; that is, all individuals serving
on the Board of Directors or comparable body, names and addresses of all partners, and names
and addresses of all corporate officers. Conspicuously identify any person in this table of
organization who is also an officer or an employee of Suffolk County. (Attach additional sheet if
necessary.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________
7. List all names and addresses of those individual shareholders holding more than five percent
(5%) interest in the contractor/vendor. Conspicuously identify any shareholder who is also an
officer or an employee of Suffolk County. (Attach additional sheet if necessary).
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Page 2 of 3 Public Disclosure Form
8. Does contractor/vendor derive 50% or more of its total revenues from its contractual or vendor
relationship with Suffolk County? ___Yes___No.
9. If you answered yes to 8 above, you must submit with this disclosure statement, a complete
financial statement listing all assets and liabilities as well as a profit and loss statement. These
statements must be certified by a Certified Public Accountant. (Strike this out if not applicable.)
10. The undersigned shall include this Contractor’s/Vendor’s Public Disclosure Statement with the
contract. (Describe general nature of the contract.)______________________________
______________________________________________________________________
11. Remedies. The failure to file a verified public disclosure statement as required under local law
shall constitute a material breach of contract. Suffolk County may resort, use or employ any
remedies contained in Article II of the Uniform Commercial Code of the State of New York. In
addition to all legal remedies, Suffolk County shall be entitled, upon a determination that a
breach has occurred, to damages equal to fifteen percent (15%) of the amount of the contract.
12. Verification. This section must be signed by an officer or principal of the contractor/vendor
authorized to sign for the company for the purpose of executing contracts. The undersigned
being sworn, affirms under the penalties of perjury, that he/she has read and understood the
foregoing statements and that they are, to his/her own knowledge, true.
Dated: Signed:
Printed Name of Signer:
Title of Signer:
Name of Contractor/Vendor:
Page 3 of 3 Public Disclosure Form
UNIFORM CERTIFICATE OF ACKNOWLEDGMENT
(Within New York State)
STATE OF NEW YORK)
COUNTY OF ) ss.:
On the ____ day of ______________ in the year 20__ before me, the undersigned, personally appeared
____________________ personally known to me or proved to me on the basis of satisfactory evidence
to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to
me that he/she/they executed the same in his/her/their capacity(ies) and that by his/her/their signature(s)
on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed
the instrument.
_______________________________________________
(signature and office of individual taking acknowledgement)
UNIFORM CERTIFICATE OF ACKNOWLEDGEMENT
(Without New York State)
STATE OF )
)ss.:
COUNTY OF )
On the________day of___________________ in the year 20__ before me, the undersigned, personally
appeared_________________________ personally known to me or proved to me on the basis of
satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument
and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies) and that by
his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the
individual(s) acted, executed the instrument, and that such individual(s) made such appearance before
the undersigned in___________________________________________________
_________________________________________________________________________________
(Insert the city or other political subdivision and the state or country or other place the acknowledgement
was taken)
_________________________________________________
(signature and office of individual taking acknowledgement)
Form SCEX-22 Contractor’s/Vendor’s Public Disclosure Statement Form (Rev. 5/15)
Statement of Non-Collusion in Bids or Proposals [General Municipal Law §103-d]
By submission of this bid, each Bidder/Proposer and each person signing on behalf of
any Bidder certifies, and in the case of a joint bid, each party thereto certifies as to its
own organization, under penalty of perjury, that to the best of their knowledge and
belief:
1. The prices in this bid have been arrived at independently without collusion,
consultation, communication, or agreement, for the purpose of restricting
competition, as to any matter relating to such prices with any other
Bidder/Proposer or with any competitor;
2. Unless otherwise required by law, the prices which have been quoted in the bid
have not been knowingly disclosed by the Bidder/Proposer and will not knowingly
be disclosed by the Bidder/Proposer prior to opening directly or indirectly to any
other Bidder/Proposer or to any competitor; and
3. No attempt has been made or will be made by the Bidder/Proposer to induce any
other person, partnership or corporation to submit or not to submit a bid for the
purpose of restricting competition.
No bid/proposal will be considered for award nor shall any award be made where
paragraphs 1, 2, and 3 above have not been complied with; provided however, that if in
any case the bidder/proposer cannot make the foregoing certification, the
bidder/proposer shall so state and shall furnish with the bid/proposal a signed statement
which sets forth in detail the reasons therefor. Where paragraphs 1, 2 and 3 above have
not been complied with, the bid/proposal shall not be considered for award nor shall any
award be made unless the County determines that such disclosure was not made
for the purpose of restricting competition.
The fact that a Bidder/Proposer: a) has published price lists, rates, or tariffs covering
items being procured, b) has informed prospective customers of proposed or pending
publication of new or revised price lists for such items, or c) has sold the same items to
other customers at the same prices being bid/proposed does not constitute, without
more, a disclosure hereunder.
I, __________________________________hereby af firm u nder p enalty of p erjury u nder
the L aws of t he State of N ew York that I am authorized to p rovide t his c ertification and
that the above is true and correct.
________________________________________
Name of Entity
_________________________________________ _____________________
Signature of Authorized Representative Date
FTS Form
Rev. 7/9/13
Steven Bellone Rosalie Drago
Suffolk County Executive Commissioner
SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING, & CONSUMER AFFAIRS
DOL-LHE1/2 (revised 3/20)
NOTICE OF APPLICATION TO CERTIFY COMPLIANCE WITH FEDERAL LAW (8 U.S.C. SECTION 1324A) WITH RESPECT TO
LAWFUL HIRING OF EMPLOYEES, Suffolk County Code, Chapter 353 (2006)
To Be Completed By Applicant/Covered Employer/Owner
EMPLOYER/CORP/BUSINESS/COMPANY NAME: _______________________________________________________________________
ADDRESS: ___________________________________________________________________________________________________________
CONTACT NAME: ___________________________ TELEPHONE #: ___________________ AWARDING AGENCY: _______________
VENDOR, FEDERAL ID OR SOCIAL SECURITY #: _______________________________ CONTRACT ID: ________________________
NOT-FOR-PROFIT: YES_____ NO_____ (Submit Proof of IRS Not-for-Profit Status)
TERM OF CONTRACT OR EXTENSION (PROVIDE DATES): _____________________________
BRIEF DESCRIPTION OF COMPENSATION, PROJECT OR SERVICE: _____________________________________________________
______________________________________________________________________________________________________________________
SUBCONTRACTOR NAME: ____________________________________________________________________________________________
ADDRESS: ___________________________________________________________________________________________________________
VENDOR, FEDERAL ID OR SOCIAL SECURITY #: _______________________________ TELEPHONE #: _______________________
CONTACT NAME: ________________________ DESCRIPTION OF COMPENSATION, PROJECT OR SERVICE: __________________
______________________________________________________________________________________________________________________
EVIDENCE OF COMPLIANCE:
Copies of the following must be maintained by covered employers or the owners thereof for each employee for the time periods set forth in Suffolk County
Code, Section 353-14 (A):
A. United States passport; or
B. Resident alien card or alien registration card; or
C. Birth certificate indicating that person was born in the United States; or
D. (1) A driver’s license, if it contains a photograph of the individual; and
(2) A social security account number card (other than such a card which specifies on its face
that the issuance of the card does not authorize employment in the United States); or
E. Employment authorization documents such as an H-1B visa, H-2B visa, and L-1 visa, or other
work visa as may be authorized by the United States Government at the time the County contract
is awarded for all covered employees.
AFFIDAVIT OF COMPLIANCE WITH THE REQUIREMENTS OF
8 U.S.C. SECTION 1324a WITH RESPECT TO LAWFUL HIRING OF EMPLOYEES
State of New York )
ss:
County of ______________________)
______________________________, being duly sworn, deposes and says:
(Print Name of Deponent)
1. I am owner/authorized representative of ________________________________________________________________.
(Circle one) (Name of Corp., Business, Company)
2. I certify that I have complied, in good faith, with the requirements of Title 8 of the United States Code (U.S.C.) section 1324a (Aliens and
Nationality) with respect to the hiring of covered employees and with respect to the alien and nationality status of the owners thereof, as set
forth in Suffolk County Code Chapter 353 (2006).
______________________________
Sworn to before me this _____ day (Signature of Deponent)
of ________________, 20______
___________________________
(Notary Public)
Steven Bellone Rosalie Drago
Suffolk County Executive
Commissioner
SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING & CONSUMER AFFAIRS
DOL-LW1/38 (Revised 12/20)
NOTICE OF APPLICATION FOR COUNTY COMPENSATION
LIVING WAGE CERTIFICATION/DECLARATION – SUBJECT TO AUDIT
If either of the following definitions of ‘compensation’ (Living Wage Law Chapter 575 2) applies to the contractor’s/recipient’s business or transaction with
Suffolk County, the contractor/recipient must complete Sections 1, 3, 4 below. If the following definitions do not apply, the contractor/recipient must
complete Sections 2, 3 and 4 below. Completed forms must be submitted to the awarding agency.
“Any grant, loan, tax incentive or abatement, bond financing subsidy or other form of compensation of more than $50,000 which is realized by or provided to an
employer of at least ten (10) employees by or through the authority or approval of the County of Suffolk,” or
“Any service contract or subcontract let to a contractor with ten (10) or more employees by the County of Suffolk for the furnishing of services to or for the County of
Suffolk (except contracts where services are incidental to the delivery of products, equipment or commodities) which involve an expenditure equal to or greater than
$10,000. For the purposes of this definition, the amount of expenditure for more than one contract for the same service shall be aggregated. A contract for the
purchase or lease of goods, products, equipment, supplies or other property is not ‘compensation’ for the purposes of this definition.”
Section I
The Living Wage Law applies to this contract. I/we hereby agree to comply with all the provisions of Suffolk County
Local Law No. 12-2001, the Suffolk County Living Wage Law (the Law) and, as such, will provide to all full, part-time or temporary employed persons who
perform work or render services on or for a project, matter, contract or subcontract where this company has received compensation, from the County of
Suffolk as defined in the Law (compensation) a wage rate of no less than $14.00 per hour worked with health benefits, as described in the Law, or otherwise
$14.71 per hour or the rates as may be adjusted annually in accordance with the Law. (Chapter 575-3 B)
I/we further agree that any tenant or leaseholder of this company that employs at least ten (10) persons and occupies property or uses equipment or property that
is improved or developed as a result of compensation or any contractor or subcontractor of this company that employs at least ten (10) persons in producing or
providing goods or services to this company that are used in the project or matter for which this company has received compensation shall comply with all the
provisions of the Law, including those specified above. (Chapter 575-2)
I/we further agree to permit access to work sites and relevant payroll records by authorized County representatives for the purpose of monitoring compliance
with regulations under this Chapter of the Suffolk County Code, investigating employee complaints of noncompliance and evaluating the operation and effects
of this Chapter, including the production for inspection & copying of payroll records for any or all employees for the term of the contract or for five (5) years,
whichever period of compliance is longer. All payroll and benefit records required by the County will be maintained for inspection for a similar period of time.
(Chapter 575-7 D)
The Suffolk County Department of Labor, Licensing & Consumer Affairs shall review the records of any Covered Employer at least once every three years to
verify compliance with the provisions of the Law. (Chapter 575-4 C)
IMPORTANT! IF SECTION I IS CHECKED, APPLICANT MUST PROVIDE THE FOLLOWING INFORMATION:
Projected Wage Levels:
Complete the chart below listing hourly wage rates, number of hours worked per week, compensated days off received yearly and indicate if medical
benefits are received for each employee dedicated to fulfilling the terms of this contract.
Note: Complete the following chart only if the Living Wage Law applies and if Section I above is checked.
Employee Name
and Title
Hourly
Wage
Rate
Works less
than 20 hours
per week
(Yes or No)
Works 20
hours or more
per week
(Yes or No)
Employee
actually
receives health
benefits
(Yes or No)
Full-time employees receive at least 12
compensated days off per year. Part-time
employees receive prorated compensated
time off in increments proportional to full-
time employees (Yes or No)
Section II The Living Wage Law does not apply to this contract for the following reason(s): (Please check all that apply to this contract.)
Employ less than 10 employees Grant, loan, tax incentive or abatement, Amount of Compensation is less than $10,000.
Do not have any employees working in bond subsidy or other form of for the furnishing of services
Suffolk or Nassau Counties compensation is $50,000 or less. Other:
No cost to Suffolk County Pay prevailing wage rates
Section III Contractor Name: ____________________________________________ Federal Employer ID or SSN#: ___________________________
Contractor Address: ______________________________________________________ Amount of Compensation: _________________________________
_______________________________________________________________________ Term of Contract: ________________________________________
Contact Name: __________________________ Contractor Phone # ___________________ Awarding Agency: _______________________________
Contract ID #: ______________________________________ Description of project or service: ____________________________________________
______________________________________________________________________________________________________________________________
Section IV
I declare under penalty of perjury under the Laws of the State of New York that the undersigned is authorized to provide this certification, and that the above is
true and correct.
____________________________________________________________ _________________________
Authorized Signature Date
____________________________________________________________
Print Name and Title of Authorized Representative
Check if
applicable
Check if
applicable
Steven Bellone Rosalie Drago
Suffolk County Executive Commissioner
SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING & CONSUMER AFFAIRS
UNION ORGANIZING CERTIFICATION/DECLARATION SUBJECT TO AUDIT
If the following definition of “County Contractor” (Union Organizing Law Chapter 803) applies to the contractor’s/beneficiary’s
business or transaction with Suffolk County, the contractor/beneficiary must complete Sections I, III, and IV below. If the
following definitions do not apply, the contractor/beneficiary must complete Sections II, III and IV below. Completed forms must
be submitted to the awarding agency.
County Contractor: “Any employer that receives more than $50,000 in County funds for supplying goods or services pursuant to a written
contract with the County of Suffolk or any of its agencies; pursuant to a Suffolk County grant; pursuant to a Suffolk County program;
pursuant to a Suffolk County reimbursement for services provided in any calendar year; or pursuant to a subcontract with any of the above.”
Section I
The Union Organizing Law applies to this contract. I/we hereby agree to comply with all the provisions of Suffolk County
Local Law No. 26-2003, the Suffolk County Union Organizing Law (the law) and, as to the goods and/or services that are
the subject of the contract with the County of Suffolk shall not use County funds to assist, promote, or deter union
organizing (Chapter 803-3), nor seek reimbursement from the County for costs incurred to assist, promote, or deter union
organizing.
I/we further agree to take all action necessary to ensure that County funds are not used to assist, promote, or deter union
organizing.
I/we further agree that I/we will not use County property to hold meetings to assist, promote, or deter union organizing.
I/we further agree that if any expenditures or costs incurred to assist, promote, or deter union organizing are made,
I/we shall maintain records sufficient to show that no County funds were used for those expenditures and, as applicable, that
no reimbursement from County funds has been sought for such costs. I/we agree that such records shall be made available
to the pertinent County agency or authority, the County Comptroller, or the County Department of Law upon request.
I/we further affirm to the following as to the goods and/or services that are the subject of the contract with the County of
Suffolk:
I/we will not express to employees any false or misleading information that is intended to influence the
determination of employee preferences regarding union representation;
I/we will not coerce or intimidate employees, explicitly or implicitly, in selecting or not selecting a bargaining
representative;
I/we will not require an employee, individually or in a group, to attend a meeting or an event that is intended to
influence his or her decision in selecting or not selecting a bargaining representative;
I/we understand my/our obligation to limit disruptions caused by pre-recognition labor disputes through the
adoption of non-confrontational procedures for the resolution of pre-recognition labor disputes with employees
engaged in the production of goods or the rendering of services for the County; and
I/we have or will adopt any or all of the above-referenced procedures, or their functional equivalent, to ensure the
efficient, timely, and quality provision of goods and services to the County. I/we shall include a list of said
procedures in such certification.
Section II
The Union Organizing Law does not apply to this contract for the following reason(s):
______________________________________________________________________________________________________
DOL-L01 rev. 3/20
Check if
Applicable
Check if
Applicable
Section III
Contractor Name: _______________________________________________ Federal Employer ID#: __________________
Contractor Address: ________________________________________________ Amount of Assistance: _________________
________________________________________________ Vendor #: ___________________________
Contractor Phone #: ________________________________________________
Description of project or service: ____________________________________________________________________ ___________
Section IV
In the event any part of the Union Organizing Law, Chapter 803 of the Laws of Suffolk County, is found by a court of competent
jurisdiction to be preempted by federal and/or state law, this certification/declaration shall be void ab initio.
Section V
I declare under penalty of perjury under the Laws of the State of New York that the undersigned is authorized to provide this certification,
and that the above is true and correct.
________________________________________________________ ________________________________________
Authorized Signature Date
________________________________________________________
Print Name and Title of Authorized Representative
DOL-L01 rev. 3/20
GM 50 2-18
CERTIFICATION REGARDING LOBBYING, DEBARMENT, SUSPENSION AND OTHER
RESPONSIBILITY MATTERS AND DRUG-FREE WORKPLACE REQUIREMENTS
Applicant should refer to the regulations cited below to determine the certification included in the regulations
before completing the form. Signature of this form provides for compliance with certification requirements under
34 CFR Part 82, New Restrictions on Lobbying, and 2 CFR Part 180, Government-wide Debarment and
Suspension (Non-Procurement) and representation of fact upon which reliance will be placed when the
Department of Labor determines to award the covered transaction grant, or cooperative agreement.
1. LOBBYING
As required by Section 1352, Title 31 of the U.S. Code and implemented at 34 CFR Part 82 for persons entering into a grant
or cooperative agreement over $100,000, as defined at 34 CFR Part 82, Section 82.105 and 82.110, the applicant certifies
that:
(a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any persons for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or
employee of Congress, or an employee of a Member of Congress in connection with the making of any Federal grant,
the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification
of any Federal grant or cooperative agreement.
(b) If any funds other than federally appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of a member of Congress in connection with the making of any Federal
grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or
modification of any Federal grant or cooperative agreement all certifications pursuant to such payments have been or
will be filed as required under 34 CFR Part 82, Section 82.100 (a-e).
(c) The undersigned shall require that the language of the certifications referenced in 1 (b) be included in the award
documents for all subawards at all tiers (including subgrants, contracts under grants and cooperative agreements and
subcontracts) and that all subrecipients shall certify and disclose accordingly.
2. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS
As required by Executive Order 12549, Debarment and Suspension (1986) and Executive Order 12689, Debarment and
Suspension (1989), implemented at 2 CFR part 180.335, for prospective participants in primary covered transactions, as
defined at 2 CFR part 200 and the Department of Homeland Security’s regulations at 2 CFR Part 3000.
A. The applicant certifies that it and its principals:
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
covered transactions by any Federal department of agency;
(b) Have not within a three-year period preceding this application been convicted of or had a civil judgement rendered
against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or
performing a public (Federal, State or local) transaction or contracts 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;
(c) Are not presently under indictment or otherwise criminally or civilly charged by a Government entity (Federal, State
or local) with commission of any of the offenses enumerated in paragraph A (b) of the certification; and
(d) Have not within a three-year period preceding this application had one or more public transactions (Federal, State and
local) 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 and
explanation to this application.
GM 50 2-18
3. DRUG-FREE WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS)
As required by the Drug-Free Workplace Act of 1988, and implemented at - 2 CFR part 182, Subpart B, for grantees, as
defined at 2 CFR part 182, Sections 182.635 and 182.655.
A. The applicant that it will or will continue to provide a drug-free workplace by:
(a) Publishing a statement notifying employees that the manufacture, distribution, dispensing, possession, or use of a
controlled substance is prohibited in the grantees 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 dangers of drug abuse in the workplace;
2. The grantees policy of maintaining a drug-free workplace;
3. Any available drug counseling, rehabilitation, and employee assistance program; and
4. The penalties that may be imposed upon employee for drug abuse violation occurring in the workplace:
(c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the
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:
1. Abide by the terms of the statement and;
2. Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the
workplace no later than five calendar days after such conviction;
(e) Notifying the agency, in writing within 10 calendar days after having received notice under subparagraph (dx2) from
an employee or otherwise receiving actual police of such conviction. Employers of convicted employees must provide
notice, including position title, to: Director, Grants Management Bureau, State Office Building Campus, Albany, New
York 12240. Notice shall include the identification number(s) of each affected grant.
(f) Taking one of the following action, within 30 calendar days of receiving notice under subparagraph (dx2), 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 purpose 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), (f),
B. The grantee may insert in the space provided below the site(s) for the performance of work done in connection with
this specific grant.
Place of Performance (street, address, city, county, state, zip code).
DRUG-FREE WORKPLACE (GRANTEES WHO ARE INDIVIDUALS)
As required by the Drug-Free Workplace Act of 1988, and implemented at 2 CFR part 182, Subpart C, for grantees, as
defined at 2 CFR part 182, Sections 182.635 and 182.655.
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 the 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 Management
Bureau, State Office Building Campus, Albany, NY 12240. Notice shall include the identification number(s) of each
affected grant.
GM 50 2-18
CERTIFICATION OF COMPLIANCE WITH CLEAN AIR AND WATER POLLUTION CONTROL ACTS
(applicable to grant or subgrant agreements exceeding $150,000)
As required by the Clean Air Act, as amended, 42 USC 7401-1671 et seq., the Federal Water Pollution Control Act, as
amended, 33 USC 1251-1387 et seq., and Executive Order 11738.
In addition to the foregoing requirements, the grantee shall certify, the following:
A. As a condition to the grant, I certify that I will comply with all applicable standards, orders or regulations issued
pursuant to the Clean Air Act (42 U.S.C. 7401-7671q) and the Federal Water Pollution Control Act, as amended, (33
USC 1251-1387).
B. As a condition of the grant, violations will be reported to the Federal awarding agency and the Regional Office of the
Environmental Protection Agency (EPA).
Check if there are workplaces on file that are not identified here.
As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the
above certifications.
Name of Applicant/Grantee/Subgrantee
Printed Name and Title of Authorized Representative
Signature Date