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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 labeled “ORIGINAL”;

 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

Issue Date:

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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

Rev. 12/4/20; Law No. 25-LB-004

Issue Date:

RFP for One-Stop Employment Center Operator

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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

Rev. 12/4/20; Law No. 25-LB-004

Issue Date:

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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, entitled “Technical 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.

Rev. 12/4/20; Law No. 25-LB-004

Issue Date:

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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.

Rev. 12/4/20; Law No. 25-LB-004

Issue Date:

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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 Department’s 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-

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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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;

Rev. 12/4/20; Law No. 25-LB-004

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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.

Rev. 12/4/20; Law No. 25-LB-004

Issue Date:

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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 Department’s 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).

Rev. 12/4/20; Law No. 25-LB-004

Issue Date:

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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 entitled “Technical 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

Rev. 12/4/20; Law No. 25-LB-004

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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 County’s

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 Form “Disqualification 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.

Rev. 12/4/20; Law No. 25-LB-004

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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

Rev. 12/4/20; Law No. 25-LB-004

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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.

Rev. 12/4/20; Law No. 25-LB-004

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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 the “Services 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 the “Scope 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-the–Job 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 the “Scope 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 organization’s 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 organization’s 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 your “Original” 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; 25.1–35% = 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: ______________________________

Rev. 12/4/2020; Law No. 25-LB-004

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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

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

Rev. 12/4/2020; Law No. 25-LB-004

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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

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.

“Contract” means 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.

“Federal” means 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.

“Services” means 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.”

“State” means 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 County’s 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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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

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 County’s 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;

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

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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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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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

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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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 “Yes” the 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 workers’ safety?

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).

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;

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 grantee’s workplace and specifying the actions that will be taken against

employees for violation of such prohibition;

(b) Establishing an on-going drug-free awareness program to inform employees about:

1. The dangers of drug abuse in the workplace;

2. The grantee’s policy of maintaining a drug-free workplace;

3. Any available drug counseling, rehabilitation, and employee assistance program; and

4. The penalties that may be imposed upon employee for drug abuse violation occurring in the workplace:

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

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