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Home My WebLink About55B - RESOLUTION - CATALINA STREET PUMP OWNERS ASSOCIATIONREQUEST FOR COUNCIL ACTION CITY COUNCIL MEETING DATE: DECEMBER 19, 2011 TITLE: RESOLUTION ACCEPTING LETTER OF COMMITMENT FOR THE CATALINA STREET PUMP OWNERS ASSOCIATION CITY MANAGER RECOMMENDED ACTION CLERK OF COUNCIL USE ONLY: APPROVED ? As Recommended ? As Amended ? Ordinance on 1s' Reading ? Ordinance on 2nd Reading ? Implementing Resolution ? Set Public Hearing For_ CONTINUED TO FILE NUMBER Adopt a resolution accepting a letter of commitment for Proposition 84 funding to construct public water system improvements to serve the Catalina Street Pump Owners Association, and authorize Public Works Agency staff to perform actions as required by the State Department of Public Health. DISCUSSION The Catalina Street Pump Owners Association (CSPOA) is a privately owned water system that provides domestic water service to approximately 54 residences in the city. The well serving CSPOA is contaminated with uranium and does not meet Title 22 drinking water standards. The CSPOA cannot afford to purchase a water treatment system; therefore, the State Department of Public Health (DPH) together with CSPOA has requested that water system improvements be constructed and service be provided by the City. A resolution was adopted by the City on July 18, 2011 to accept a Proposition 84 grant to finance construction costs for the public water system improvements (Exhibit 1). On August 16, 2011, the City received a letter of commitment from DPH stating that Proposition 84 funds have been reserved for this project and authorizing the City to begin construction of the water system improvements (Exhibit 2). The project was advertised for bids and a construction contract was awarded by City Council on November 28, 2011. The project is under construction. City staff is proceeding with securing the required funding agreement from DPH. As a condition for final approval of this agreement, the City must adopt a resolution selecting a legally authorized representative to execute the following actions: 1. Sign the funding agreement. 2. Approve claims for reimbursement. 55B-1 Resolution Accepting Letter of Commitment for the Catalina Street Pump Owner's Association December 19, 2011 Page 2 3. Sign the budget and expenditure summary. 4. Sign the final release form. 5. Sign the certification that the project is complete and ready for final inspection. 6. Act as the City's grant administrator. The attached resolution identifies Public Works Agency staff members that are qualified to perform the work in accordance with DPH requirements. ENVIRONMENTAL IMPACT A Notice of Exemption and Categorical Exemption (ER# 2009-190) has been prepared for this project. FISCAL IMPACT There is no fiscal impact associated with this action. Raul Godinez II Executive Director Public Works Agency RG/RB Exhibit: 1. Resolution Exhibit: 2. Letter of Commitment from California Department of Public Health (DPH) 55B-2 Jxs (12/02/11) RESOLUTION NO. 2011- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SANTA ANA TO ACCEPT A LETTER OF COMMITMENT FOR THE CATALINA STREET PUMP OWNERS ASSOCIATION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF SANTA ANA AS FOLLOWS: Section 1. The City Council of the City of Santa Ana finds, determines and declares as follows: A. The Catalina Street Pump Owners Association (CSPOA) is a privately owned water system that provides domestic water service to approximately 54 residences in the City of Santa Ana. B. The well serving CSPOA is contaminated with uranium and does not meet Title 22 drinking water standards. The CSPOA does not have a regular certified operator and cannot afford to purchase a water treatment system. C. The Treasurer for CSPOA, Mr. Jim Stice, has declared his intent to cease operations and direct CSPOA customers to connect to the City's water system. D. The cost to construct the public water system improvements required to serve CSPOA is estimated at approximately $337,516. E. The State of California Department of Public Health (DPH) has filed an application on behalf of CSPOA for a Proposition 84 grant that will cover up to 100% of the construction costs. F. The City has received a Letter of Commitment (LOC) from the DPH promising a grant in the amount of $441,651 to fund costs for this project. Section 2. The Council authorizes the Executive Director of Public Works to be the legally authorized representative for the City of Santa Ana to execute the following actions as required by the LOC: A. Sign the funding agreement; Resolution No. 2011-XXX Exhibit 1 Page 1 of 3 55B-3 Section 3. The Council authorizes the Water Resources Manager to be the legally authorized representative for the City of Santa Ana to execute the following actions as required by the LOC: A. Approve claims for reimbursement; B. Sign the Final Release Form; C. Be the City's Grant Administrator. Section 4. The Council authorizes Cesar Barrera, a registered engineer, to be the legally authorized representative for the City of Santa Ana to execute the following actions as required by the LOC: A. Sign the Budget and Expenditure Summary; B. Review and sign claim forms; C. Sign the certifications that the project is complete and ready for final inspection; and Section 5. Upon completion of the public water system improvements, the City of Santa Ana will make available water service to CSPOA customers, contingent upon each customer applying for water service, with connection fees being fully reimbursable, as specified and required by this Letter of Commitment. Section 6. This Resolution shall take effect immediately upon its adoption by the City Council, and the Clerk of the Council shall attest to and certify the vote adopting this Resolution. ADOPTED this day of 2011. Miguel A. Pulido Mayor Resolution No. 2011-XXX Page 2 of 3 55B-4 Jxs (12/02/11) APPROVED AS TO FORM: Joseph Straka, Interim City Attorney By: Jose Sandoval Chief Assistant City Attorney AYES: Councilmembers NOES: Councilmembers ABSTAIN: Councilmembers NOT PRESENT: Councilmembers CERTIFICATE OF ATTESTATION AND ORIGINALITY I, Maria D. Huizar, Clerk of the Council, do hereby attest to and certify that the attached Resolution No. 2011-XXX to be the original resolution adopted by the City Council of the City of Santa Ana on Date: Clerk of the Council City of Santa Ana Resolution No. 2011-XXX Page 3 of 3 55B-5 55B-6 State of California--Health and Human Services Agency ?..- California Department of Public Health •)CDPH RON CHAPMAN, MD, MPH Director u n Mr. Raul Godinez II, P.E. Executive Director Public Works Agency City of Santa Ana 220 S. Daisy Avenue Santa Ana, CA 92703 Dear Mr. Godinez, W?R EDMUND G. BROWN JR. Govemor RECE NI E-D AUG 2.2 2011 prlnking Water Program Santa Ana District SAFE DRINKING WATER, WATER QUALITY AND SUPPLY, FLOOD CONTROL, RIVER AND COASTAL PROTECTION BOND ACT OF 2006, PUBLIC RESOURCES CODE COMMENCING WITH SECTION 75001 (PROPOSITION 84) FOR THE CITY OF SANTA ANA ON BEHALF OF CATALINA STREET PUMP OWNERS ASSOCIATION, PROJECT NO. P84C-3000662-003C Your application for funding has been reviewed by the California Department of Public Health (State). We have determined that the Catalina Street Pump Owners Association consolidation project, Project No. P84C-3000662-003C, as proposed by the City of. Santa Ana (City) is eligible for a grant funding under Proposition 84, Section 75022. This letter and the attachment hereto serve as your.Letter of Commitment (LOC) stating that, subject to availability of funds, grant funds in the amount of $441,651 have been reserved for this project provided that the terms and conditions as set forth in the attachment to this letter are met. This letter also serves as the State's authorization to the City to begin construction of the project as described in the plans and specifications approved by the CDPH Santa Ana District Office on February 22, 2010, and deemed exempt from California Environmental Quality Act (CEQA) requirements by the City, acting as the CEQA lead agency, on August 1, 2011. This authorization to begin construction is subject to the availability of funds, and the terms and conditions as set forth in the attachment to this letter. In order to maintain this reservation of funds, it is essential that you sign the Attachment at the space provided and return it within 30 calendar days. n Division of Drinking Water and Environmental Management P.Q. Box 997377, MS 7416, 1616 Capitol Avenue, 2"1 Floor, Sacramento, CA 958997377 Exhibit 2 (816) 449-5600 (916) 449-5655 Fax Internet Address: www.cdoh.ca.gov 55B-7 Mr. Raul Godinez II Page 2 of 3 'Au Please mail the signed LOC Attachment to: Lance Reese Proposition 84 Program Division of Drinking Water and Environmental Management California Department of Public Health 1616 Capitol Avenue P.O. Box 997377, MS 7408 Sacramento, CA 95899-7377 We commend the City of Santa Ana for taking steps to enhance the provision and . protection of the drinking water supplied to the residents of the Catalina Street service area. If you have any questions regarding this letter, please contact the Proposition 84 program at (916) 449-5600 or by e-mail at dwpfunds@cdph.ca.gov. Sincerely, dud, c %-kerr, Leah Godsey P.E., Chief Division of Drinking Water and Environmental Management Attachment: Letter of Commitment Enclosures: Funding Agreement Template Sample Resolution STD 204 Payee Data Record CDPH Budget and Expenditure Summary Final Release cc: The Honorable Jose Solorio Member of the Assembly State Capitol, Room 3146 Sacramento, California 95814 The Honorable Lou Correa Member of the Senate State Capitol, Room 5052 Sacramento, Califomia 95814 Jim Stice Board Vice President Catalina Street Pump Owners Association 5520 W. Roosevelt Avenue Santa Ana, CA 92703 55B-8 Mr. Raul Godinez II Page 3 of 3 Oliver Pacifica District Engineer Drinking Water Field Operations Branch California Department of Public Health 605 W. Santa Ana Blvd., Bldg. #28, Room 325 Santa Ana, CA 92701 Ray Burk Project Engineer City of Santa Ana 220 S. Daisy Avenue Santa Ana, CA 92703 55B-9 CITY OF SANTA ANA PROPOSITION 84 SECTION 75022 LETTER OF COMMITMENT ATTACHMENT The California Department of Public Health (State) has determined that the project proposed by the City of Santa Ana (Supplier), Project No. P84C-3000662-003C, is eligible for a grant in the amount of $441,651. The project is for the consolidation project to replace the Catalina Street Pump Owners Association water distribution system, installation of laterals and meters to connect each property to the Supplier, and destruction of Catalina Street Pump Owners Association's only groundwater well (Project). Once the project is completed, the Catalina Street Pump Owners Association (Public Water System No. 3000662) will no longer exist as a public water system. Funding is contingent upon the Supplier's compliance with the following terms and conditions. Compliance shall be determined at the sole discretion of the State or its authorized representative. i. Not later than six (6) months following the date Supplier signs this Letter of Commitment (LOC), unless otherwise specified in this LOC, Supplier shall complete all requirements listed in Section I before a funding agreement will be issued for signature by the Supplier's authorized representative. 1. Supplier shall submit to the State a written resolution, duly adopted by Supplier's governing body, identifying individual(s) with legal authority to: a. sign the funding agreement; b. approve claims for reimbursement; c. sign the Budget and Expenditure Summary; d. sign the Final Release form; and e, sign the certification that the project is complete and ready for final inspection. Person(s) signing the Budget and Expenditure Summary and certification that the project is complete and ready for final inspection must be a registered engineer(s) or person(s) approved by CDPH. 2. Supplier shall submit to the State a written designation of the Supplier's Grant Administrator. Note: You are encouraged to submit a draft of the statements, resolutions, or ordinances to the State for review rior to taking it to your board or governing body for adoption or approval. State will review the draft and recommend to you any-required modifications, thus avoiding unnecessary delays in issuance of your funding agreement. A resolution that does not City of Santa Ana P84C-3000662-003C Page 'i of 5 55B-10 meet program requirements will not be accepted (copy of sample resolution enclosed). 3. If applicable, Supplier shall provide documentation to the State demonstrating that the Supplier has secured the additional funds necessary to assure a fully funded project. II. Prior to final execution of the funding agreement by the State, the following items must be provided: Supplier shall complete and sign the attached Payee Data Record (STD. 204) form. The form shall be submitted to the State with the signed funding agreement. Failure to comply with the State requirements listed in Sections I and 11 may result in the withdrawal of this LOC. If the LOC is withdrawn, your project will be bypassed but will remain on the project priority list. You may submit a new application for future funding only after receiving another letter of invitation from the State. If for any unforeseen reason you are unable to comply with any of.the above requirements, you should contact the State's Santa Ana District Office as soon as possible. III. Before any funds may be disbursed under terms of the funding agreement, the following items must be .provided: 1. Supplier shall submit to the State evidence that a separate checking account or a separate ledger has been established to account for funds received from the State. Please indicate the name and address of the financial institution, exact name of account holder, and the account name and number. If this checking account is not used solely to account for funds received from the State, you must establish a ledger within your accounting system in accordance with generally accepted accounting principles. The ledger must identify the project number and Proposition 84 funding agreement number. You must provide documentation showing that the ledger has been established. (Please note all accounts are subject to audit at any time) 2. Supplier shall submit to the State an initial budget of eligible project costs approved by the State on a Budget and Expenditure Summary form. 3. Prior to disbursement of funds, Supplier shall demonstrate to State that it has obtained applications for water service from not less than 40 of the 54 owners of property served by the Catalina Street Pump Owners Association; applications to be substantially in the form of executed Supplier's "Application for Water Service". City of Santa Ana P84C-3000662-003C Page 2 of 5 55B-11 IV. General Requirements 1. Supplier must use a competitive bid process for the construction of the project. The bid summary must be submitted to the State's Santa Ana District Office for review and approval 2rior to the awarding of the prime construction contract. 2. If any materials submitted to satisfy the conditions of the LOG are deemed inadequate, Supplier must submit additional information as specified, and within the timeframe designated by the State. 3. Supplier must initiate construction of the project within one (1) year of the Date of Execution of the funding agreement. 4. Supplier must complete construction of the project within three (3) years of the Date of Execution of the funding agreement. 5. Supplier may request a one-time increase in funding following the Date of Execution of the funding agreement. The request must be based upon costs received from competitive bids and shall be submitted to the State for review and approval. Approval of the Supplier's request may be granted or denied at the sole discretion of the State and is subject to the availability of funds. 6. All disbursements for construction costs may be subject to a ten percent (10%) retention on each claim until completion of the project as specified in the funding agreement. 7. Supplier may be reimbursed only for such project costs consisting of eligible construction expenses incurred on or after the date of this LOC, and eligible preliminary expenses incurred after November 7, 2006. 8. No funds will be disbursed until the funding agreement has been executed. 9. Supplier shall comply with Public Resources Code Section 75075 regarding Labor Compliance Programs. 10. Supplier acknowledges the importance to public health and safety of assuring that, upon completion of the Project, no person or entity be able to obtain its domestic water supply from the well located on APN 099-211-06 commonly described as 5217 W-Roosevelt Avenue, Santa Ana, CA 92703 (Well) and currently serving the Catalina Street Pump Owners Association service area; and Supplier expressly agrees to destroy or cause to be destroyed the Well not later than 3 years following the Date of Execution of the funding agreement in order for the well destruction costs to be deemed eligible for reimbursement. Supplier shall submit a copy of the Well destruction permit to the State's Santa Ana District Office. City of Santa Ana P84C-3000662-003C Page 3 of 5 55B-12 11. State agrees that the Supplier's usual connection fees associated with providing water to those properties in the Catalina Street Pump Owners Association service area whose owners apply for water service from the Supplier not later than 60 days following the installation of laterals and meters to connect each property to the Supplier shall be deemed eligible for reimbursement. V. Special Conditions to be included in the Funding Agreement 1. The Supplier shall notify the State's Santa Ana District Office when the project construction is 50% complete. Note: Pursuant to Government Code Section 8546.7, the contracting parties shall be subject to the examination and audit of the State or any agent thereof, and the State Auditor. All correspondence with the State, shall be submitted to: California Department of Public Health Division of Drinking Water and Environmental Management Proposition 84 Program P.O. Box 997377, MS 7408 Sacramento, CA 95899-7377 Supplier's signature below indicates Supplier's acceptance of these terms and conditions and Supplier's intention to proceed with the project. It does not constitute any obligation on Supplier's part to enter into the grant funding agreement. Failure to sign and return this LOC within the time period specified will result in the withdrawal of the reservation of funds and the bypass, of this Project. In order to maintain the reservation of funds in the Proposition 84 accountfor this Project, Supplier must sign this LOC at the space provided below and return it within 30 days of receipt to the State. City of Santa Ana P84C-3000662-003C Page 4 of 5 55B-13 The terms and conditions set forth in this Letter of Commitment are acceptable to the Supplier and it is the Supplier's intention to continue with this Project as proposed. City of Santa Ana Signature: Print Name: Title: Address: City of Santa Ana P84C-3000662-003C Page 5 of 5 Date: 55B-14 Proposition 84 Public Agency Grant Funding Agreement No. 84- STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF PUBLIC HEALTH FUNDING AGREEMENT BETWEEN THE STATE OF CALIFORNIA DEPARTMENT OF PUBLIC HEALTH AND* (Entity name) PROJECT NUMBER P84- FOR A CONSTRUCTION GRANT UNDER THE CALIFORNIA PUBLIC RESOURCES CODE, SECTION 75022 OF THE SAFE DRINKING WATER, WATER QUALITY AND SUPPLY, FLOOD CONTROL, RIVER AND COASTAL PROTECTION BOND ACT OF 2066 55B-15 Funding Agreement No. 84 TABLE OF CONTENTS Section 1. Purpose of Funding ............................................................................................... 2. Incorporation of Other Documents .......................................................................... 3. Project Cost ............................................................................................................ 4. Grant Funding ....................................................................................................... 5. Supplier's Cost ......... ........................................................................................... 6. Competitive Bidding ................................................................................................ 7. Requirements for Disbursement ............................................................................. 8. Special Terms and Conditions .............................................................................. 9. Operation and Maintenance of Project ..................................................... ............... 10. Project Officials and Notices ................................................................................... 11. Enforcement ......... ............................................................................................... 12. Miscellaneous Provisions .::.................................................................................... EXHIBIT A STANDARD CONDITIONS Article A- 1. Definitions .............................................. ............................................................... A- 2. Term of Agreement ................................................................................................ A- 3. Basic Conditions Precedent ................................................................................... A- 4. Compliance with Laws, Regulations, and Permit Requirements ............................ A- 5. Project Changes ..................................................................................................... Page 1 2 2 2 2 2 3 3 3 3 5 5 Page 7 7 7 8 8 55B-16 Funding Agreement No. 84 TABLE OF CONTENTS (continued) Article Page A- 6. Disbursements by State .......................................................................................... 8 (a) Claims .............................................................................................................. 8 (b) Disbursement ................................................................................................... 9 (c) Rejection of Claims .......................................................................................... 9 (d) Correction of Claims ........................................................................................ 9 (e) Adjustments to Claims ..................................................................................... 9 (f) Final Claim and Disbursement ......................................................................... 10 (g) Force Account .................................................................................................. 10 A- 7. Withholding of Grant Disbursements by State and Cancellation of Agreement.... ......................................................................................... 10 (a) Conditions for Withholding ............................................................................ 10 (b) Withholding Entire Grant Amount .................................................................... 11 (c) Withholding Balance of Grant Amount ............................................................. 11 A- 8. Timing of Project .................................................................................................... 11 A- 9. Supplier's Contracts ............................................................................................... 11 A-10. Audit and Inspection of Books and Records .......................................................... 12 A-11. Remittance of Funds By Supplier ........................................................................... 12 A-12. Accounting and Deposit of Grant Disbursements ................................................... 12 (a) Separate Accounting of Grant Disbursements ................ ............................ :... 12 (b) Disposition of Funds Disbursed ....................................................................... 13 (c) .interim and Final Audits ................................................................................... 13 A-13. Inspections of Project by State ............................................................................... 13 A-14. Prohibition Against Disposal of Project Without State Permission ......................... 13 A-15. Nondiscrimination Clause ......... .................... .......................................................... 13 A-16. Workers' Compensation Clause ............................................................................. 14 A-17. Successors and Assigns ........................................................................................ 15 A-18. State to be Held Harmless ...................................................................................... 15 A-19. Remedies Not Exclusive ......................................................................................... 15 55B-17 Funding Agreement No. 84 TABLE OF CONTENTS (continued) Article Page A-20. Amendments .......................................................................................................... 15 A-21. Waiver of Rights ..................................................................................................... 15 A-22. Dispute Clause ................. A-23. Performance and Assurances ................................................................................ 16 A-24. Default Provisions ................................................................................................... 16 A-25. Drug-Free Workplace Certification ......................................................................... 17 A-26. Conflict of Interest--Current and Former State Employees .................................... 18 (a) Current State Officers and Employees ............................................................ 18 (b) Former State Officers and Employees ............................................................. 19. A-27. Additional Insured ................................................................................................... 19 A-28. Prohibited Use of State Funds for Software ................................................ ............ 19 A-29 Labor Compliance .................................................................................. 19 EXHIBIT B SPECIAL TERMS AND CONDITIONS Article Paae B- 1 . ............................................................................................................................. 20 ATTACHMENTS 1. Budget and Expenditure Summary (Article A-3(c)) 2. Claim form (Article A-6(a)) 3. Final Release (Article A-6 (f)(4)) 4. Supplier's Certification of Project Completion (Article A-8) 5. Memorandum of Agreement (Article B-1 (1-7)) (Analyst remove if non applicable) 55B-18 Supplier's Name Funding Agreement No. 84 Page 1 of 20 STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF PUBLIC HEALTH FUNDING AGREEMENT BETWEEN STATE OF CALIFORNIA DEPARTMENT OF PUBLIC HEALTH AND (Entity name) PROJECT NUMBER P84- UNDER THE SAFE DRINKING WATER, WATER QUALITY AND SUPPLY, FLOOD CONTROL, RIVER AND COASTAL PROTECTION BOND ACT OF 2006 THIS AGREEMENT, is entered into between the State of California Department of Public Health herein referred to as "State", and (Entity name), a (ownership/business type from Authorization memo), in the County of . State of California, duly organized, existing, and acting pursuant to the laws thereof, herein referred to as "Supplier", which parties do hereby agree as follows: SECTION 1. PURPOSE OF FUNDING This Agreement provides funding in the form of a grant made by State to the Supplier under the provisions of the Safe Drinking Water, Water Quality and Supply, Flood Control, River and Coastal Protection Bond Act of 2006, under Public Resources Code, Section (75022/75025 select one). The purpose of the funding is to assist in financing a project which will enable Supplier to herein referred to as the "Project". Funds may be used only for such eligible project costs as are approved by State. Supplier is solely responsible for the design, construction, operation, and maintenance of the Project; and for all persons or entities engaged in such work, including but not limited to contractors, subcontractors, suppliers, and providers of 55B-19 Supplier's Name Funding Agreement No. 84 Page 2 of 20 services. Review or approval of plans, specifications, bid documents or other construction documents by State is solely for the purpose of proper administration of the funds by State and shall not be deemed to relieve or restrict Supplier's responsibility. SECTION 2. INCORPORATION OF OTHER DOCUMENTS This Agreement incorporates by this reference Exhibit A, "Standard Conditions"; Exhibit B, "Special Terms and Conditions"; Supplier's Application to State for funding; project plans and specifications as submitted to and approved by State; and any attachments to said documents. Supplier accepts and agrees to comply with all terms, provisions, and conditions of this Agreement, including all incorporated documents and exhibits thereto, and to fulfill all assurances, declarations, representations, and statements made by Supplier in its application, documents, amendments, and communications filed in support of its request for funding, including but not limited to any and all plans and specifications submitted to and approved by State. SECTION 3. PROJECT COST Supplier represents that the total cost of the Project is estimated to be $ of which State agrees that $ is the total Eligible Project Costs. SECTION 4. GRANT FUNDING Subject to the availability of funds and in accordance with the terms of this Agreement, State will provide grant funding to Supplier in an amount not to exceed SECTION 5. SUPPLIER'S COST Supplier agrees to fund any project costs which are in excess of the grant funding set forth in Section 4 of this Agreement in order to ensure a fully funded project. Supplier's Cost for this Project is estimated to be-$ , herein referred to as "Supplier's Cost". SECTION 6. COMPETITIVE BIDDING All construction contracts related in any way to the Project shall be let by competitive bid procedures which assure award of such contracts to the lowest responsible bidders. Supplier shall comply with all applicable state, or local ordinances for competitive bidding and all applicable labor laws. 55B-20 Supplier's Name Funding Agreement No. 84 Page 3 of 20 Supplier shall not award a contract until a summary of bids and identification of the lowest responsible bidder are submitted to State. A full explanation must be provided if Supplier is proposing to award a contract to anyone other than the lowest responsible bidder. SECTION 7. REQUIREMENTS FOR DISBURSEMENT Not later than sixty (60) days following Date of Execution of this Agreement, Supplier shall satisfy all conditions precedent to the disbursement of funds under this Agreement, including Basic Conditions Precedent asset forth in Article A-3 of the Standard Conditions. Failure by Supplier to satisfy said conditions and requirements by this date.may, at the option of State, result in cancellation of this Agreement under Article A-7 of the Standard Conditions and/or declaration that Supplier is in default pursuant to Article A-24 of the Standard Conditions. SECTION 8. SPECIAL TERMS AND CONDITIONS Supplier shall satisfy the special terms and conditions set forth in Exhibit B. Failure by Supplier to timely satisfy the special terms and conditions may, at the option of State, result in cancellation of this Agreement under Article A-7 of the Standard Conditions, and/or declaration that Supplier is in default pursuant to Article A-24 of the Standard Conditions. SECTION 9. OPERATION AND MAINTENANCE OF PROJECT Upon project completion, and for a period of years, which is the reasonably expected useful life of the Project, Supplier shall, as further consideration for this funding, commence and continue operation of the Project; cause the Project to be operated in an efficient and economical manner; provide for the making of all repairs, renewals, and replacements necessary for the effective operation of the Project; and cause the Project to be maintained in as good of condition as upon its construction, ordinary and reasonable wear and depreciation excepted. Failure by Supplier to operate and maintain the Project in accordance with this provision may, at the option of State, be considered a material breach of Agreement and may be treated as a default under Article A-24 of the Standard Conditions. - SECTION 10. PROJECT OFFICIALS AND NOTICES State's Grant Administrator shall be the Chief, Drinking Water Infrastructure Financing Section, Division of Drinking Water and Environmental Management, California Department of Public Health. All communications given to State's Grant Administrator shall be deemed given to State. State's Grant Administrator shall be State's representative for administration of this Agreement, and shall have authority to make recommendations and findings with respect to each controversy arising under or in connection with this Agreement. All 55B-21 Supplier's Name Funding Agreement No. 84 Page 4 of 20 such recommendations and findings shall be communicated to the Chief, Division of . Drinking Water and Environmental Management of the California Department of Public Health, and disputes shall be resolved in accordance with Article A-22 of the Standard Conditions. Supplier's Grant Administrator shall be its . Supplier's Grant Administrator shall be Supplier's representative for administration of this Agreement. All communications given to Supplier's Grant Administrator shall be deemed given to Supplier. Either party may change its Grant Administrator upon written notice to the other party. Notices required to be given in writing by Supplier under this Agreement shall be sent to: State of California California Department of Public Health Division of Drinking Water and Environmental Management Attention: Proposition 84 Program 1616 Capitol Avenue, MS 740E Post Office Box 997377 Sacramento, California 96899-7377 Notices required to be given in writing by State under this Agreement shall be sent to: A change of address for delivery of notice may be given by written notice to the other party. All written notices that are required either expressly or by implication to be given by one party to the other under this Agreement shall be signed for State by its Grant Administrator and for Supplier by its Grant Administrator. Except as otherwise expressly required by this Agreement, all such notices shall be deemed to have been given if delivered personally or if enclosed in a properly addressed postage-prepaid envelope and deposited in a United States Post Office for delivery by registered or certified mail. 55B-22 Supplier's Name Funding Agreement No. 84 Page 5 of 20 SECTION 11. ENFORCEMENT Any enforcement action, arising out of or relating to this Agreement, may be brought by State or any agent thereof. SECTION 12. MISCELLANEOUS PROVISIONS ATTORNEY FEES In the event either party commences an.action or proceeding concerning the subject matter of this Agreement, the prevailing party in such action or proceeding shall be entitled to recover reasonable attorney fees incurred therein. SEVERABILITY If any provision of this Agreement is held -invalid or unenforceable by any court of final jurisdiction, it is the intent of the parties that all other provisions of this Agreement be construed to remain fully valid, enforceable, and binding on the parties. GOVERNING LAW This Agreement is governed by and shall be interpreted in accordance with the laws of the State of California. CHILD SUPPORT COMPLIANCE ACT Supplier acknowledges that it is the policy of this state that anyone who enters into a contract with a state agency shall recognize the importance of child and family support obligations and shall fully comply with all applicable state and federal laws relating to child and family support enforcement, including, but not limited to, disclosure of information and compliance with earnings assignment orders, as provided in Chapter 8 (commencing with Section 5200) of Part 5 of Division 9 of the Family Code. Supplier further acknowledges that to the best of its knowledge it is fully complying with the earnings assignment orders of all employees and is providing the names of all new employees to the New Hire Registry maintained by the Employment Development Department. LEGAL CAPACITY Supplier hereby warrants and represents that it is a legal entity in good standing, and that it has the authority to enter into this Agreement. Supplier shall notify State as promptly as feasible of any proposed change in Supplier's ownership, organization, legal form or service area. VENUE The parties agree that venue of any action between the parties arising out of this Agreement, including disputes that may arise following termination of the Agreement, shall be County of Sacramento, State of California. 55B-23 Supplier's Name Funding Agreement No. 84 Page 6 of 24 DATE OF EXECUTION Date of Execution of this Agreement is the date of the latest in time execution by a party hereto. IN WITNESS WHEREOF, the parties hereto have executed this Agreement: Approved as to Legal Form STATE OF CALIFORNIA and Sufficiency: CALIFORNIA DEPARTMENT OF PUBLIC HEALTH By Signature Print Name Title Date SUPPLIER (Entity Name) By Signature Print Name Title Address Date By Signature Print Name Title Date 55B-24 Supplier's Name Funding Agreement No. 84 Page 7 of 20 EXHIBIT A STANDARD CONDITIONS ARTICLE A-1. DEFINITIONS Whenever in this Agreement the following terms are used, their meaning shall be as follows unless the context clearly requires otherwise: Agreement --The Funding Agreement to which this Exhibit A "Standard Conditions" is appended. Days--Calendar days unless otherwise expressly indicated. Month--Calendar month unless otherwise expressly indicated Year--Calendar year unless otherwise expressly indicated. Eligible Project Costs--Those project costs which are eligible for funding under the Act and applicable State law and implementing criteria. Force Account--The use of Supplier's own employees or equipment on the Project. Grant Amount--The total amount disbursed to Supplier under this Agreement. Public Water System or Public Water Supply System--A system for the provision to the public of water for human consumption, as defined in Part 12, Chapter 4 (commencing with Section 116270), of Division 144 of the Health and Safety Code, as it may be amended. ARTICLE A-2. TERM OF AGREEMENT Subject to the provisions of Article A-7, this Agreement shall'become effective on the Date of Execution and shall remain in effect until the Project Completion Date, determined in accordance with the provisions of Article A-8. Such period of time shall be the term of this Agreement. ARTICLE A-3. BASIC CONDITIONS PRECEDENT State shall have no obligation to disburse funds under this Agreement unless and until: (a) Supplier has provided satisfactory documentation of the action taken by its governing body authorizing it to enter into this Agreement, and designating a 7 55B-25 Supplier's Name Funding Agreement No. 84 Page 8 of 20 representative to execute this Agreement and to sign a claim for disbursement of funds. (b) Supplier has provided detailed information concerning the account established for deposit of funds received from State. (c) Supplier has submitted an initial budget approved by State in the form of Attachment 1 to this Agreement. ARTICLE A-4. COMPLIANCE WITH LAWS, REGULATIONS, AND PERMIT REQUIREMENTS Supplier shall at all times comply with, and require its contractors and subcontractors to comply with, all applicable federal and state laws, rules and regulations, permits, and all applicable local ordinances, including, but not limited to, environmental, labor, procurement and safety laws, rules, regulations, permits, and ordinances. ARTICLE A-5. PROJECT CHANGES The Project shall be constructed in accordance with the plans and specifications approved by State on . Supplier shall not make any change in the Project, or issue any change order to a contractor, without receiving prior written approval from State. Supplier may request a one-time increase in the total funding provided in this Agreement. Such request shall be based upon the final accepted construction bids. Such request may be granted or denied at the sole discretion of State. Supplier shall submit to State in writing any proposed changes to the Project budget including but not limited to transferring of funds between line item allotments. Supplier shall obtain written approval of such proposed changes from State before the proposed changes are adopted. Supplier shall not use any funds from any contingency allotment without receiving prior written approval from State. ARTICLE A-6. DISBURSEMENTS BY STATE (a) Claims Supplier shall request disbursement by submitting to State a claim(s) for incurred Eligible Project Costs. A claim for disbursement of funds shall be provided in the form of Attachment 2 to this Agreement and shall not be submitted more than once a month and shall include: 8 55B-26 Supplier's Name Funding Agreement No. 84 . Page 9.of 20 (1) a statement with supporting documentation of Eligible Project Costs that have been incurred during the period identified in the particular claim, including, but not limited to construction, legal, engineering, and -administrative fees associated with the Project; (b) Disbursements Following the review and approval of a claim by State, it will disburse to Supplier an approved amount, subject to any retention requirements specified in Exhibit B, Special Terms and Conditions, and subject to the availability of funds. Any and all funds disbursed to Supplier under this Agreement, and any and all interest earned by Supplier on such funds, shall be used solely to pay Eligible Project Costs. (c) Reiection of Claims A claim may be rejected by State if: (1) it is submitted without signature; (2) it is submitted under signature of a person other than Supplier's duly authorized representative; (3) Supplier fails to timely submit a final claim within the time period specified in Article A-6(f); State will notify Supplier of any claim so rejected, and the reasons therefore. (d) Correction of Claims A claim containing a mathematical error will be corrected by State, after telephone notification to Supplier, and will thereafter be treated as if submitted in the corrected amount. State will confirm correction of the error, to Supplier, in writing. (e) Adjustments to Claims If upon review of a claim State determines that any portion or portions of the costs claimed are ineligible to be funded under the Act, State law, implementing criteria, or the terms of this Agreement, State will notify Supplier, by certified or registered mail, of its determination concerning Supplier's failure to adequately document costs as Eligible Project Costs. Supplier may, within thirty (30) days of the date of receipt of such notice, submit additional documentation or evidence to cure such deficiency(ies). If Supplier does not submit additional information, or if State determines such additional information to be inadequate, State will adjust the pending claim by the amount of the ineligible cost(s). 9 55B-27 Supplier's Name Funding Agreement No. 84 Page 10 of 20 Supplier may submit additional documentation or evidence, and resubmit any such rejected costs on a subsequent claim. (f) Final Claim and Disbursement Not later than six (6) months from the Project Completion Date, as set forth in Article A-8, Supplier shall submit a final claim. With the final claim, Supplier shall provide: (1) A statement of full written disclosure of all sources and amounts of funds contributed to the Project; (2) A certification by Supplier's Grant Administrator that the data disclosed is true and correct; (3) Proof of a Recorded Notice of Completion; (4) A fully executed "Final Release" in the form of Attachment 3 to this Agreement. Should Supplier fail to make the full disclosure and certification required by parts 1 and 2 of this paragraph (f), or should State'become aware through any means that Supplier did not disclose all funding sources for the project, the project may be referred to the California Department of Finance for a full project audit. (g) Force Account Costs of construction or construction related activities performed by Force Account are not eligible for grant funding under the terms of this Agreement. Costs of engineering, legal, and administrative activities performed by Force Account, if determined by State, in its sole discretion, to be Eligible Project Costs, may be eligible for grant funding pursuant to the terms of this Agreement. When Supplier uses the services of its own employees, Supplier shall establish accounts and maintain records which reasonably document all employee hours and costs charged to the Project and the associated tasks performed by each employee. ARTICLE A-7. WITHHOLDING OF GRANT DISBURSEMENTS BY STATE AND CANCELLATION OF AGREEMENT (a) Conditions for Withholding If State determines that the Project is not being carried out substantially in accordance with the provisions of this Agreement or that Supplier has failed in any other respect to comply with the terms and conditions of this Agreement, State may 10 55B-28 Supplier's Name Funding Agreement .No. 84 Page 11 of 20 give written notice of such failure to comply. If Supplier does not cure any such failure to State's satisfaction within thirty (30) calendar days of receipt of such notice, State may withhold from the Supplier all or any portion of the grant funding and take any other action that it deems necessary to protect its interests, including but not limited to declaring Supplier in default as set forth in Article A-24, or canceling this Agreement pursuant to Subpart (b) of this Article A-7. (b) Withholding Entire Grant Amount If State determines to withhold the entire Grant Amount from Supplier pursuant to Subpart (a) of this Article A-7, notice of such a determination shall constitute a notice of cancellation of this Agreement, and this Agreement shall no longer be binding on any party hereto. Said Notice of Cancellation shall be sent to Supplier by certified or registered mail, and shall be effective upon receipt. (c) Withholding Balance of Grant Amount When a portion of the grant amount has been disbursed to Supplier and State determines to withhold funding, State will notify Supplier in writing, via certified or registered mail, that State is withholding the balance of the funding from Supplier, pursuant to Subpart (a) of this Article A-7. In such event, Suppiier will be deemed to be in default and subject to the provisions of Article A-24. ARTICLE A-8.. TIMING OF PROJECT Supplier agrees to proceed expeditiously, and shall meet a Project Completion Date of not later than . Supplier's failure to meet said Project Completion Date may, at the option of State, be considered a material breach of agreement and may be treated as a default under Article A-24. The facility shall not be placed into operation until State has conducted a final inspection and notifies Supplier in writing that the Project is complete. When the Project is complete, Supplier shall certify to State that the Project is complete in accordance with the approved plans and specifications and ready for final inspection by State. The date of such certification by Supplier shall be the Project Completion Date for purposes of this Agreement. ARTICLE A-9. SUPPLIER'S CONTRACTS Supplier shall be solely responsible for resolution of any and all disputes arising out of or related to Supplier's construction and contracts for construction of the Project, including but not limited to bid disputes and payment disputes with Supplier's contractors and subcontractors and shall provide appropriate releases (as set forth in California Civil Code Title 15) as may be requested by State. 11 55B-29' Supplier's Name Funding Agreement No. 84 Page 12 of 20 ARTICLE A-10. AUDIT AND INSPECTION OF BOOKS AND RECORDS (a) Upon execution of this Agreement and until 3 years following final disbursement under this Agreement, pursuant to Government Code Section 8546.7, the parties shall be subject to the examination and audit by State or any agent thereof, and the State Auditor, with respect to all matters connected with the performance of this Agreement, including, but not limited to, the cost of administering this Agreement. If any litigation, claim, negotiation, audit or other action is commenced before the expiration of said three (3) year period, all records must be retained until such action is resolved, or until the end of said three (3) year period whichever shall later occur. All records of Supplier relating in any way to funding received pursuant to this Agreement shall be preserved for this purpose. (b) During regular office hours, each of the parties hereto and their duly authorized representatives shall have the right to inspect and to make copies of any books, records, or reports of either party pertaining to this agreement or matters related hereto. Each of the parties hereto shall maintain and shall make available at all times for such inspection accurate records of all its costs, disbursements, and receipts with respect to its activities under this Agreement. Failure or refusal by Supplier to comply with this provision shall be considered a substantial failure to comply with this Agreement, State may declare Supplier in default as set forth in Article A-24, withhold disbursements to Supplier, or take any other action it deems necessary to protect its interests. The provisions of this Subpart (b) shall be effective until expiration of the time period provided in Subpart (a) of this Article A-10. ARTICLE A-11. REMITTANCE OF FUNDS BY SUPPLIER Within thirty (30) days following the date of final disbursement of funds, Supplier shall remit to State any funds that were disbursed under this Agreement and were not utilized to pay Eligible Project Costs. Such funds will not be included in the Grant Amount. ARTICLE A-12. ACCOUNTING AND DEPOSIT OF GRANT DISBURSEMENTS (a) Separate Accounting of Grant Disbursements Supplier shall account for the funds disbursed pursuant to this Agreement separately from all other Supplier's funds. Supplier shall maintain accounting procedures that are in accordance with Generally Accepted Accounting Principles. Supplier shall keep complete and accurate records of all receipts, disbursements, and interest earned on such funds. Supplier shall require its agents, contractors and subcontractors to maintain books, records, and other documents pertinent to their work in accordance with Generally Accepted Accounting Principles. Such records shall be subject to inspection by State at any and all reasonable times. 12 55B-30 Supplier's Name Funding Agreement No. 84 Page 13 of 20 (b) Disposition of Funds Disbursed In addition to specific requirements set forth in this Agreement, all.funds disbursed pursuant to this Agreement shall be deposited, administered, and accounted for pursuant to all provisions of law applicable to Supplier. (c) Interim and Final Audits In addition to the provisions of Article A-10, at any time following execution of this Agreement and until completion of the Project, or final disbursement whichever shall occur last, State reserves the right to conduct an audit of Supplier's disposition of all funds disbursed under this Agreement. After completion of the Project, State may require Supplier to conduct a final audit, at Supplier's expense, such audit to be conducted by and a report prepared by an independent Certified Public Accountant. Failure or refusal by Supplier to comply with these provisions shall be considered a substantial breach of this Agreement. ARTICLE A-13. INSPECTIONS OF PROJECT BY STATE State shall have the right but not the duty to inspect the work being performed on the Project at any and all reasonable times during the term of this Agreement. This right shall extend to any subcontracts, and Supplier shall include provisions ensuring such access in all its contracts or subcontracts related to the Project. ARTICLE A-14. PROHIBITION AGAINST DISPOSAL OF PROJECT WITHOUT STATE PERMISSION During the term of this Agreement Supplier shall not sell, abandon, lease, transfer, exchange, mortgage, hypothecate, or encumber in any manner whatsoever all or any portion of the Project or any real or other property necessarily connected or used in conjunction with the Project, without prior written consent of State. ARTICLE A-15. NONDISCRIMINATION CLAUSE During the performance of this Agreement, Supplier, its contractors and subcontractors, shall not deny the Agreement's benefits to any person on the basis of religion, color, ethnic group identification, sex, age, physical or mental disability, nor shall they discriminate unlawfully against any employee or applicant for employment because of race, religion, color, national origin, ancestry, physical handicap, mental disability, medical condition, marital status, age, or sex. Supplier, its contractors and subcontractors shall ensure that the evaluation and treatment of employees and applicants for employment are free of such discrimination. Supplier, its contractors and subcontractors shall comply with the provisions of the Fair Employment and Housing Act (Government Code, Section 12500 et seq.), the 13 55B-31 Supplier's Name Funding Agreement No. 84 Page 14 of 20 regulations promulgated thereunder (California Code of Regulations, Title 2, Section 7285.0 et seq.), the provisions of Article 9.5, Chapter 1, Part 1, Division 3, Title 2 of the Government Code (Government Code, Sections 11135-11139.5) and the regulations or standards adopted by the awarding State Agency to implement such article. By signing this Agreement, Supplier assures State that it shall comply with the requirements of the Americans with Disabilities Act (ADA) of 1990, (42 U.S.C. 12101 et seq.), which prohibits discrimination on the basis of disability, as well as all applicable regulations and guidelines issued pursuant to the ADA; the Civil Rights Act-of 1964, as amended, 42 U.S.C. 2000d (1988) et seq.; Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794 (1989); Federal Water Pollution Control Act Amendments of 1972, Pub.L. No. 92-500, 86 Stat 816; and the Age Discrimination Act of 1975, as amended, 42 U.S.C. 6102 (1994); together with all applicable regulations and guidelines adopted to implement same. Said group of laws and requirements are collectively referred to in this Agreement as the "anti-discrimination laws". Supplier agrees to collect and maintain information to show compliance with the "anti-discrimination laws" including a list of discrimination complaints, reports of any compliance reviews conducted by other agencies descriptions of any pending discrimination-based lawsuits and data on the racial, ethnic, national origin, sex and handicap characteristics of the population it serves. Supplier, its contractors and subcontractors shall give written notice of their obligations under this Article to labor organizations with which they have a collective bargaining or other agreement. Supplier's signature on this Agreement shall constitute a certification under penalty of perjury under the laws of the State of California that Supplier has, unless exempted, complied with the nondiscrimination program requirements of Government Code, Section 12990, and Title 2, California Code of Regulations, Section 8103. Supplier shall include the nondiscrimination and compliance provisions of this Article A-15 in all contracts and subcontracts to perform work on the Project. ARTICLE A-16. WORKERS' COMPENSATION CLAUSE Supplier affirms that it is aware of the provisions of Section 3700 of the California Labor Code, which requires every employer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of that code, and Supplier affirms that it will comply with such provisions before commencing performance of work under this Agreement and will make its contractors and subcontractors aware of this provision. 14 55B-32 Supplier's Name Funding Agreement No. 84 Page 15 of 20 ARTICLE.A-17. SUCCESSORS AND ASSIGNS This Agreement and all of its provisions shall inure to the benefit of, apply to, and bind the heirs, successors and assigns of the parties hereto. No assignment or transfer of this Agreement or any part hereof by Supplier shall be valid unless and until it is approved by State and made subject to such reasonable terms and conditions as State may impose. ARTICLE A-18. STATE TO BE HELD HARMLESS Supplier shall indemnify, hold harmless, protect and defend State and its officers, employees, agents and representatives from any loss, suit, action or claim brought for, or on account of any violation of law, ordinance, rule, or regulation, or any injury, damage, or loss, including death, caused by acts or omissions of Supplier, its employees, contractors, or agents; or in any way arising from, or related to the Project. ARTICLE A-19. REMEDIES NOT EXCLUSIVE The use by either party of any remedy specified herein for the enforcement of this Agreement is not exclusive, and shall not deprive the party using such remedy of, or limit the application of, any other remedy provided by law. ARTICLE A-20. AMENDMENTS This Agreement may be amended only by mutual written agreement signed by the parties hereto. Requests by Supplier for amendments must be in writing stating the amendment request and the reason for the request. ARTICLE A-21. WAIVER OF RIGHTS It is the intention of the parties hereto that from time to time either party may waive any of its rights under this Agreement unless contrary to law. Any waiver by either party hereto of rights arising in connection with this Agreement shall not be deemed to be a waiver with respect to any other rights or matters. ARTICLE A-22. DISPUTE CLAUSE Any dispute that Supplier may have regarding the performance of this Agreement including, but not limited to, claims for additional disbursements of funds or extension of time, shall be submitted to State's Grant Administrator identified in Section 10 of this Agreement. State's Grant Administrator may make findings and recommendations and transmit a copy of the claim and any such findings and recommendations to the California Department of Public Health , Chief, Division of Drinking Water and Environmental Management, who shall make a decision on such dispute which decision shall be in writing and transmitted to Supplier by certified or registered mail. Said decision shall be final and conclusive. 15 55B-33 Supplier's Name Funding Agreement No. 84 Page 16 of 20 ARTICLE A-23. PERFORMANCE AND ASSURANCES Supplier agrees to faithfully and expeditiously perform or cause to be performed all Project work as described in the final plans and specifications as submitted to and approved by State, and to apply funds received only to Eligible Project Costs and to operate and maintain the Project in accordance with applicable provisions of the law. ARTICLE A-24. DEFAULT PROVISIONS (a) Supplier will be in default under this Agreement if any of the following occur: (1) Supplier's failure to make any remittances required by this Agreement; (2) Supplier's substantial breach of this Agreement, or any supplement or amendment to it; (3) Supplier's making of any false warranty, representation, or statement with respect to this Agreement or the Project; (4) Dissolution or cessation of operations by Supplier, termination of Supplier's existence, insolvency of Supplier, or filing of a voluntary or involuntary bankruptcy petition by or on behalf of Supplier; and/or (b) When an event of default occurs, State may give Supplier notice of default. Supplier shall have thirty (30) calendar days from the date of such notice to cure the default. If Supplier fails to timely cure the default to the satisfaction of State, then State may do any or all of the following: (1) Declare that any and all amounts disbursed to Supplier under the terms of this Agreement shall be deemed an obligation of Supplier and due and payable to State; (2) Declare Supplier's obligations immediately due and payable, with or without demand or notice to Supplier, which Supplier expressly waives; (3) Terminate any obligation of State to make further disbursements to Supplier under this Agreement; (4) Perform any of Supplier's obligations under this Agreement for Supplier's account; and/or (5) Take any other action it deems necessary to protect its interests. (c) Supplier agrees that any remedy provided in this Agreement is in addition to and not in derogation of any other legal or equitable remedy available to State as a 16 55B-34 Supplier's Name Funding Agreement No. 84 Page 17 of 20 result of a breach of agreement by Supplier, whether such breach occurs before or after completion of the Project. (d) No waiver by State of any breach or default will be a waiver of any other breach or default. ARTICLE A-25. DRUG-FREE WORKPLACE CERTIFICATION By signing this Agreement, Supplier hereby certifies under penalty of perjury under the laws of the State of California that Supplier will comply with the requirements of the Drug-Free Workplace Act of 1990 (Government Code Section 8350 et seq.) and will provide a drug-free workplace by taking the following actions: (a) Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession, or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations. (b) Establish a Drug-Free Awareness program to inform employees about all of the following: (1) The dangers of drug abuse in the workplace; (2) The person's or organization's policy of maintaining a drug-free workplace; (3) Any available counseling, rehabilitation and employee assistance programs; (4) Penalties that may be imposed upon employees for drug abuse violations. (c) Every employee who works on the Project: (1) Shall be issued a copy of Supplier's drug-free policy statement; (2) Shall agree to abide by terms of Supplier's statement as a condition of employment on the Project. This Agreement may be subject to suspension of payments or termination, or both, and Supplier may be subject to debarment if State determines that: (1) Supplier has made a false certification, or (2) Supplier has violated the certification by failing to carry out the requirements of this Article A-25. 17 55B-35 Supplier's (dame Funding Agreement No. 84 Page 18 of 20 ARTICLE A-26. CONFLICT OF INTEREST--CURRENT AND FORMER STATE EMPLOYEES (a) Current State Officers and Employees: (1) Supplier shall not utilize in the performance of this Agreement any state officer or employee in the state civil service or other appointed state official unless the employment, activity, or enterprise is required as a condition of the officer or employee's regular state employment. Employee in the state civil service is defined to be any person legally holding-a permanent or intermittent position in the state civil service. (2) If any state officer or employee is utilized or employed in the performance of this Agreement, Supplier shall first obtain written verification from State that the employment, activity, or enterprise is required as a condition of the officer's, employee's, or official's regular state employment and shall keep said verification on file for three (3) years after the termination of this Agreement. (3) Supplier may not accept occasional work from any currently employed state officer, employee, or official. (4) If Supplier accepts volunteer work from any currently employed state officer, employee, or official, Supplier may not reimburse, or otherwise pay or compensate, such person for expenses incurred, including, without limitation, travel expenses, per diem, or the like, in connection with volunteer work on behalf of Supplier. (5) Supplier shall not employ any state officers, employees, or officials who are on paid or unpaid leave of absence from their regular state employment. (6) Supplier or anyone having a financial interest in the Agreement may not become a state officer, employee, or official during the term of this Agreement. Supplier shall notify each of its employees, and any other person having a financial interest in this Agreement that it is unlawful under the Public Contract Code for such person to become a state officer, employee, or official during the term of this Agreement unless any relationship with the Supplier giving rise to a financial interest, as an employee or otherwise, is first terminated. (7) Occasional or one-time reimbursement of a state employee's travel expenses is not acceptable. (b) Former State Officers and Employees: (1) Supplier shall not utilize in the performance of this Agreement any formerly employed person of any state agency or department that was employed under the state civil service, or otherwise appointed to serve in the State Government, if that person was engaged in any negotiations, transactions, planning, arrangement, or any 18 55B-36 Supplier's Name Funding Agreement No. 84 Page 19 of 20 part of the decision making process relevant to the Agreement while employed in any capacity by any state agency or department. This prohibition shall apply for a two (2) year period beginning on the date the person left state employment. (2) Supplier shall not utilize within twelve (12) months from the date of separation from services, a former employee of the contracting state agency or department if that former employee was employed in a policy making position in the same general subject area as the proposed Agreement within the twelve (12) month period prior to the employee leaving state service. ARTICLE A-27. ADDITIONAL INSURED Supplier agrees that for any policy of general liability insurance concerning the construction of the Project, it will. cause, and will require its contractors and subcontractors to cause, a certificate of insurance to be issued showing State, its officers, agents, employees, and servants as additional insureds; and shall provide State with a copy of all such certificates prior to the commencement of construction of the Project. ARTICLE A-28. PROHIBITED USE OF STATE FUNDS FOR SOFTWARE Supplier certifies that it has appropriate systems and controls in place to ensure that state funds will not be used in the performance of this Agreement for the acquisition, operation or maintenance of computer software in violation of copyright laws. ARTICLE A-29 LABOR COMPLIANCE Supplier shall comply with Public Resources Code section 75075 regarding Labor Compliance Programs. Supplier's failure or refusal to comply with this requirement shall be considered a substantial breach of this Agreement. 19 55B-37 Supplier's Name Funding Agreement No. 84 Page 20 of 20 EXHIBIT B SPECIAL TERMS AND CONDITIONS ARTICLE B-1. (NOTE TO ANALYST: USE CONDITIONS 1-7 OF MOA IF APPLICABLE) 1. Supplier shall notify the California Department of Public Health, District Office when construction is completed. 2. Notwithstanding any other term or condition of this Agreement, Supplier may be reimbursed only for such Eligible Project Costs consisting of eligible construction expenses incurred on or after , the date of Supplier's Letter of Commitment, and eligible preliminary expenses incurred after November 76, 2006. 3. Supplier shall notify the California Department of Public Health, District Office prior to any start up testing of the treatment facilities. 20 55B-38 SAMPLE RESOLUTION - March 2008 RESOLUTION NO. RESOLUTION AUTHORIZING SIGNATURE OF A FUNDING AGREEMENT AND RELATED DOCUMENTS FOR FUNDING UNDER THE SAFE DRINKING WATER, WATER QUALITY AND SUPPLY, FLOOD CONTROL, RIVER AND COASTAL PROTECTION BOND ACT OF 2006 (PROPOSITION 84) WHEREAS, on the application to the State of California for $ ; and WHEREAS, on , the State of California issued a Funding Agreement to committing grant funds under the Proposition 84 Program for (project description number) , subject to terms and conditions; and WHEREAS, on _ project budget totaling $ said (entity name/Board of Directors) adopted a ; and WHEREAS, the remaining $ of project costs are to be funded by, through, or with ; and (for joint funded projects only=may need to use more than one line for this for multiple sources) WHEREAS, prior to the State of California issuing said Funding Agreement, said (entity name/Board of Directors) is required to pass a resolution formally establishing a dedicated source of revenue for operation and maintenance costs associated with this Project, authorizing an officer to execute said Funding Agreement and amendments, designating a person to approve claims for reimbursement, designating a person (registered engineer) to sign the Budget and Expenditure Summary, designating a person (registered engineer) to sign Certification of Project Completion, and designating a person to sign the Final Release form. (NOTE: The italicized portion above is intended for projects that may significantly increase O&M, such as treatment plants.) NOW, THEREFORE, BE IT RESOLVED AND ORDERED, that the (insert title) is hereby authorized to sign The Safe Drinking Water, Water Quality and Supply, Flood Control, River and Coastal Protection Bond Act of 2006 (Proposition 84) Funding Agreement and any amendments thereto, and BE IT FURTHER RESOLVED AND ORDERED, that the (insert title) is hereby authorized to approve claims for reimbursement under the Program (or for the Project); and BE IT FURTHER RESOLVED AND ORDERED, that (insert name), a registered engineer, is hereby authorized to execute the Budget and Expenditure Summary under the Program (or for the Project); and Page 1 of 2 55B-39 made SAMPLE RESOLUTION - March 2008 BE 'IT FURTHER RESOLVED AND ORDERED, that the (insert title) is hereby authorized to sign the Final Release Form under the Program (or for the Project); and BE IT FURTHER RESOLVED AND ORDERED, that (insert name), a registered engineer, is hereby authorized to certify that the project is complete and ready for final inspection; and Passed and adopted by the (entity name/Board of Directory on by the following vote: AYES: Directors NOES: Directors EXCUSED: Directors , President ATTEST: Secretary of the By: Deputy Clerk Page 2 of 2 55B-40 STATE OF CALIFORNIA-DEPARTMENT OF FINANCE PAYEE DATA RECORD (Required when receiving payment from the State of California in lieu of IRS W-9) STD. 204 (Rev. 6-2003) INSTRUCTIONS: Complete all information on this form. Sign, date, and return to the State agency (department/office) address shown at the bottom of this page. Prompt return of this fully completed form will prevent delays when processing payments. Information provided in this form will be used by Stale agencies to prepare Information Returns (1099). See reverse side for more information and Privacy Statement. NOTE: Governmental entities, federal, State, and local (includi school districts), are not required to submit this form. PAYEE'S LEGAL BUSINESS NAME (Type or Print) a SOLE PROPRIETOR - ENTER NAME AS SHOWN ON SSN (Last, First. M. I.) E-MAIL ADDRESS MAILING ADDRESS BUSINESS ADDRESS CITY, STATE, ZIP CODE CITY, STATE, ZIP CODE ENTER FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN): I I I- I I I I I NOTE: D Payment will not Q PARTNERSHIP CORPORATION: be processed PAYEE ? MEDICAL (e.g., dentistry, psychotherapy, chiropractic, eta) without an ENTITY Q ESTATE OR TRUST ? LEGAL (e.g., attorney services) accompanying taxpayer 1. D. TYPE ? EXEMPT (nonprofit) number. ? ALL OTHERS CHECK ONE BOX 0 INDIVIDUAL OR SOLE PROPRIETOR I I_ I ONLY 4 1 ENTER SOCIAL SECURITY NUMBER: 1 1 I t SSN required authority of California Revenue and Tax Code Section 18846 Q Califomia resident - Qualified to do business in California or maintains a permanent place of business in California. Q Califomia nonresident (see reverse side) - Payments to nonresidents for services may be subject to State income tax PAYEE withholding. RESIDENCY ? No services performed in California. STATUS ? Copy of Franchise Tax Board waiver of State withholding attached. I.hereby certify under penalty of perjury that the information provided on this document is true and correct. Should my residency status change, I will promptly notify the State agency below. AUTHORIZED PAYEE REPRESENTATIVE'S NAME (Type or Print) TITLE SIGNATURE DATE TELEPHONE Please return completed form to: Department/Office: Unit/Section: Mailing Address: City/State/Zip: Telephone: (_} Fax: L_) E-mail Address: 55B-41 STATE OF CALIFORNIA-DEPARTMENT OF FINANCE PAYEE DATA RECORD STD. 204 (Rev. 6-2003) IREVERSE) Requirement to Complete Payee Data Record. STD. 204 1 A completed Payee Data Record, STD. 204, is required for payments to all non-governmental entities and will be kept on file at each State agency. Since each State agency with which you do business must have a separate STD. 204 on file, it is possible for a payee to receive this form from various State agencies. Payees who do not wish to complete the STD. 204 may elect to not do business with the State. If the payee does not complete the STD. 204 and the required payee data is not otherwise provided, payment may be reduced for federal backup withholding and nonresident State income tax withholding. Amounts reported on Information Returns (1099) are in accordance with the Internal Revenue Code and the California Revenue and Taxation Code. 2 Enter the payee's legal business name. Sole proprietorships must also include the owner's full name. An individual must list his/her full name. The mailing address should be the address at which the payee chooses to receive correspondence. Do not enter payment address or lock box information here. 3 Check the box that corresponds to the payee business type. Check only one box. Corporations must check the box that identifies the type of corporation. The State of California requires that all parties entering into business transactions that may lead to payment(s) from the State provide their Taxpayer Identification Number (TIN). The TIN is required by the California Revenue and Taxation Code Section 18646 to facilitate tax compliance enforcement activities and the preparation of Form 1099 and other information returns as required by the internal Revenue Code Section 6109(a). The TIN for individuals and sole proprietorships is the Social Security Number (SSN). Only partnerships, estates, trusts, and corporations will enter their Federal Employer Identification Number (FEIN). Are you a California resident or nonresident? 4 A corporation will be defined as a "resident" if it has a permanent place of business in California or is qualified through the Secretary of State to do business in California. A partnership is considered a resident partnership if it has a permanent place of business in California. An estate is a resident if the decedent was a California resident at time of death. A trust is a resident if at least one trustee is a California resident. For individuals and sole proprietors, the term "resident" includes every individual who is in California for other than a temporary or transitory purpose and any individual domiciled in California who is absent for a temporary or transitory purpose. Generally, an individual who comes to California for a purpose that will extend over a long or indefinite period will be considered a resident. However, an individual who comes to perform a particular contract of short duration will be considered a nonresident. Payments to all nonresidents may be subject to withholding. Nonresident payees performing services in California or receiving rent, lease, or royalty payments from property (real or personal) located in California will have 7% of their total payments withheld for State income taxes. However, no withholding is required if total payments to the payee are $1,500 or less for the calendar year. For information on Nonresident Withholding, contact the Franchise Tax Board at the numbers listed below: Withholding Services and Compliance Section: 1-888-7924900 E-mail address: wscs.gen@ftb.ca.gov For hearing impaired with TDD, call: 1-800-822-6268 Website: www.ftb,ca.gov 5 Provide the name, title, signature, and telephone number of the individual completing this form. Provide the date the form was completed. 6 This section must be completed by the State agency requesting the STD. 204. Privacy Statement Section 7(b) of the Privacy Act of 1974 (Public Law 93-579) requires that any federal, State, or local governmental agency, which requests an individual to disclose their social security account number, shall inform that individual whether that disclosure is mandatory or votuntary, by which statutory or other authority such number is solicited, and what uses will be made of it. It is mandatory to furnish the information requested- Federal law requires that payment for which the requested information is not provided is subject to federal backup withholding and State law imposes noncompliance penalties of up to $20,000. You have the right to access records containing your personal information, such as your SSN. To exercise that right, please contact the business services unit or the accounts payable unit of the State agency(ies) with which you transact that business. All questions should be referred to the requesting State agency listed on the bottom front of this form. 55B-42 r C Q? E N v m d J Q W U m D CL LL O z W 2 a W 0 S4 p} 0 a c co 0 0 Q 0 a 0 0 m U 0 ca co 0 v rn co d I.f H z M w z a w 0 D m N D z m LL I .- z W U z J g o a 0 0 0 a 0 0 0 0 0 w 0 w 0 ?a 0 0 o o 0 0 o 0 a a a a? J° a a o 0 . 0 o - a R o c 8 o 0 ) 0 64 tog, 66, 6 ). 65 6 , 6 ? 63 ? 6 to U , E ° z _ a? v E a) °' z o o C r- L z w O 69 `o Q O Ir N N O C! U- 1- k a J U 0 0 a ? ? J F m o z ° z c: Fn U.4 00 E zt; o ? m w L E a z O a U a L O 0 > 9 LL o z a w a. 4 z a w a w r oC N V _ co 0 7 ° h a W 0 Q O E a cn z v 0. W W w w 1 = Q Q a 2 (D c 0 a) I- a IL U) a a -j a -i mo A a w s i - I - I - ? z ? Z O J U z U N N N F- IX - IU -1 O z D U. U. O w O O co w w H 0 L rn a LU ?S 'C 2 d. U 0 a 8 m 0 0 Q 0 c n C h o? ?U S c a EL '6 N a? s(3) om d M V (D 0 5 Q ro c O CL 0 c? rv. s 0 R I o` c d a 2 CL T m a 2 X ao OD Q. 0 lC E E z U) a? v c CL x ui N Ol 3 m 55B-43 Attachment 3 Final Release Definitions: As used in this release "Funding Agreement" refers to that certain State of California Department of Public Health Funding Agreement identified In paragraph 2 below; "final invoice" refers to "final claim" as used in said Funding Agreement and "Supplier" refers to the party identified as "Supplier" in said Funding Agreement. Instructions to Supplier: With your final invoice(s) submit one (1) original and one (1) copy. The original must bear the original signature of a person authorized to bind Supplier. The additional copy may bear photocopied signatures. Submission of Final Invoice Pursuant to Funding Agreement number entered into between the State of California Department of Public Health (CDPH) and the Supplier (identified below), the Supplier does acknowledge that final payment has been requested via invoice number , in the amount of $ and dated Release of all Obligations By signing this form, and upon receipt of the amount specified in the invoice number referenced above, Supplier does hereby release and discharge the State, its officers, agents and employees of and from any and all liabilities, obligations, claims, and demands whatsoever arising from the above referenced Agreement. 4. Repayments Due to Audit Exceptions 1 Record Retention By signing this form, Supplier acknowledges that expenses authorized for reimbursement does not guarantee final allowability of said expenses. Supplier agrees that the amount of any sustained audit exceptions resulting from any subsequent audit made after final payment will be refunded to the State. All expense and accounting records related to the above referenced Agreement must be maintained for audit purposes for no less than three years beyond the date of final payment, unless a longer term is stated in said Funding Agreeement. Other Issues By signing this form, Supplier further agrees, in connection with any claims that are not specifically released as set forth above, that it will comply with all of the provisions contained in the above referenced Funding Agreement, including, but not limited to, those provisions relating to notification to the State and related to resolution of disputes and the defense or prosecution of litigation. ONLY SIGN AND DATE THIS DOCUMENT WHEN ATTACHING TO THE FINAL INVOICE Supplier's Legal Name (as on Agreement) Signature of Supplier Printed Name/Title of Person Signing Date: CDPH Distribution: Accounting (Original) Program(Copy): Division of Drinking Water and Environmental Management 55B-44