02/11/1999 Agreement
COOPERATIVE AGREEMENT
AGREEMENT NO. ~g-4J~9-9-bltJ g
STATE: FLORIDA
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CITY OF KEY WEST
VILLAGE OF ISLAMORADA
MONROE COUNTY COMMISSION
SOUTH FLORIDA RC&D COUNCIL, INC.
NATURAL RESOURCES CONSERVATION SERVICE
EMERGENCY WATERSHED PROTECTION PROGRAM
COOPERATIVE AGREEMENT, IN-KIND CONTRIBUTION AND OPERATION AND
MAThITENANCEAGREEMENT
THIS AGREEMENT, made this Ie TN day of reh. , 1999, by and between the City of
Key West, the Village ofIslamorada and the Monroe County Commission, called the Sponsors; and the
South Florida Resource Conservation & Development Council, Inc., called the Council; and the Natural
Resources Conservation Service, United States Department of Agriculture, called NRCS.
WITNESSETH THAT:
WHEREAS, under the provisions of Section 216 of Public Law 81-516, Emergency Watershed Protection
Program, and Title IV of the Agricultural Credit Act of 1978, Public Law 95-334, NRCS is authorized to
assist the Sponsors in relieving hazards created by natural disaster, Hurricane Georges, that caused a
sudden impairment of watersheds and
WHEREAS, the Sponsors, the Council and NRCS agree to a plan which provides for restoration of certain
works of improvement referenced in Section A and
WHEREAS, NRCS agrees to provide 75% of the cost of the works of improvement and
WHEREAS, the Sponsors agree to provide 25% of the cost of the works of improvement.
NOW THEREFORE, in consideration of the premises and of the several promises to be faithfully
performed by the parties hereto as set forth, the Sponsors and NRCS do hereby agree as follows:
A IT IS AGREED that the following described work is to be performed at an estimated cost of
$4,666,667.
EVENT: Hurricane Georges, September 25, ] 998
LOCATION DESCRIPTION OF WORK EST. COST
City of Key West Removal and disposal of debris in canals and other areas $ 224,100
per approved DSR's.
Village ofIslamorada Removal and disposal of debris in identified canals per $ ] 76,760
aooroved DSR's.
Monroe County Removal and disposal of debris in identified canals and $4,265,807
other areas oer aooroved DSR's.
TOTAL $4,666,667
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COOPERA TIVE AGREEMENT
B. mE SPONSORS WILL:
1. Provide 25 percent of the cost of installing the works of improvement described in Section A. The
division of share between individual Sponsors will be as detailed in Attachment B. These funds
will be placed in an escrow account held by the Council no later than Feb. I, 1999, as described in
Attachment C, to facilitate completion of the works of improvement described in Section A.
2. Accept all financial and other responsibility for excess costs resulting from their failure to obtain
or their delay in obtaining adequate land and water rights, permits, and licenses needed for the
work described in Section A.
3. Provide certification (sign SCS-ADS-78) that real property rights have been obtained for works of
improvement described in Section A supported by an attorney's opinion attached thereto.
Certification shall be provided to NRCS and the Council prior to solicitation for installation of the
works of improvement.
4. Comply with the requirements of the provisions included in Attachment A to this agreement. If
applicable, complete the attached "Clean Air and Water Certification" included in Attachment A.
S. If needed, upon completion of emergency protection measures and the elimination of the threat,
take action to bring the measures up to reasonable standards by other means and/or authority.
Unless the measures are brought up to reasonable standards, the sponsor will not be eligible for
future funding under the Emergency Watershed Protection Program.
6. Upon completion of the work from the Contractor(s) assume responsibility for operation and
maintenance of the works of improvement installed. Operation and maintenance is required as
follows:
(a) For canal debris removal measures (non-structural), the Sponsors will not allow Hurricane
Georges material to be redeposited into improved areas for a period of one year after completion
of installation of the works of improvement.
(b) For measures other than canal debris removal (structural), the Sponsors will work with the
Council to provide a written Operation and Maintenance Agreement and Plan prior to solicitation
for the installation of the works of improvement.
7. Provide copies of site maps to appropriate Federal and State agencies for environmental review.
Sponsor will notify NRCS and the Council of environmental clearance, modification of
construction plans, or any unresolved concerns as well as copies of all permits, licenses, and other
documents required by Federal, State and local statutes and ordinances prior to solicitation for
installation of the works of improvement.
8. Designate an individual to serve as liaison officer between the Sponsors, the Council and NRCS.
A list of his or her duties, responsibilities and authorities shall be furnished in writing to the
Council and NRCS.
9. Hold and save NRCS free from any and all claims or causes of action whatsoever resulting from
the obligations undertaken by the Sponsors under this agreement or resulting from the work
provided for in this agreement.
C. THE COUNCIL WILL:
1. Contract for the works of improvement described in Section A and provide for their completion
within 200 days from the time that this agreement is executed and a notice to proceed is received.
The Council will provide the contract administration and general oversight for the works of
improvement for 6% of the total estimated project cost. The Council will provide NRCS and the
Sponsors a copy of each solicitation (Invitation for Bids, Request for Quotations, etc.), bid
abstract, and awarded contract.
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COOPERATIVE AGREEMENT
2. Hire a qualified engineering firm to complete required survey, design and construction inspection
to perform the needed works of improvement referenced in Section A. The cost for these services
shall not be greater than 19% of the total estimated project cost.
3. Hire qualified contractor(s) to perform the needed works of improvement referenced in Section A.
4. Take reasonable and necessary actions, including legal action, if required, to dispose of any and all
contractual and administrative issues arising out of the contract(s) awarded under this agreement
to include but not be limited to disputes, claims, protests of award, source evaluation, and
litigation that may result from the project, and bringing suit to collect from the contractor any
monies due in connection with the contract. Any monies collected will be distributed to the
parties in the same ratio as contributions are made.
5. Submit billings for reimbursement to NRCS on Form SF-270, Request for Advance or
Reimbursement.
6. Arrange for and conduct final inspection of the works of improvement. A Professional Engineer
registered in the State of Florida furnished by the Council shall certify that the project was
installed in accordance with contractual requirements.
7. Ensure that all contracts for design and construction services will be procured in accordance with
procedures prescribed in the Code of Florida and Federal regulations applicable to the Council,
including the provisions contained in Attachment D to this agreement.
8. Administer their action under this agreement in accordance with 7-CFR 3015, 7-CFR 3016, OMB
Circulars A-I02, A-87, A-128, and other rules referenced in 7-CFR 3015.
9. Comply with the nondiscrimination provisions of the Equal Opportunity Clause and the Notice to
Contracting Local Organizations of the Requirement for Certifications of Nonsegregated Facilities
clause, Form SCS-AS-83, attached hereto.
10. Prepare a design, construction specifications, and drawings in accordance with standard
engineering principles. The construction plans for measures other than canal debris removal and
disposal shall be reviewed and approved by a Professional Engineer registered in the State of
Florida prior to submittal to NRCS.
11. Provide copies of site maps to appropriate Federal and State agencies for environmental review.
Council will notify NRCS of environmental clearance, modification of construction plans, or any
unresolved concerns as well as copies of all permits, licenses, and other documents required by
Federal, State, and local statutes and ordinances prior to solicitation for installation of the works of
improvement.
12. Ensure that any special requirements for compliance with environmental and/or cultural resource
laws are incorporated into the project.
13. Designate an individual to serve as liaison officer between the Council, the Sponsor and NRCS. A
list of his or her duties, responsibilities, and authorities will be furnished in writing to the Sponsors
and NRCS.
14. Hold and save NRCS free from any and all claims or causes of action whatsoever resulting from
the obligations undertaken by the Council under this agreement or resulting from the work
provided for in this agreement.
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COOPERATIVE AGREEMENT
D. NRCS WILL:
1. Provide $3,500,00.00 for constructing the works of improvement.
2. Not be substantially involved with the technical or contractual administration of this agreement,
but will provide advice and counsel as needed.
3. Make payment to the Sponsor covering NRCSs' share of the cost upon receipt and approval of
Form SF-270, Request for Advance or Reimbursement, with supporting documentation.
4. Upon notification of the completion of construction, NRCS shall promptly review the performance
of the Sponsor to determine if it has met the requirements of this agreement and fund expenditures
as agreed.
5. Designate an individual to serve as liaison officer between the NRCS, the Sponsors, and the
Council. The NRCS Assistant STC (programs), or his designee, will serve in this position. The
major duties, responsibilities and authorities of the liaison officer will be to review and approve
specifications and drawings for DSRs that include structural measures, assist in the final
inspection of the contract, certify along with the Councils' Professional Engineer when all work
has been completed according to the specifications and drawings, and review the SF-270 and
supporting documents, approve, sign, and submit the SF-270 and supporting documents to NRCS
for reimbursement to the Council.
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COOPERATIVE AGREEMENT
E. IT IS MUTUALLY AGREED:
I. That the Council will provide contract administration and general oversight services for 6% of the total
estimated project cost. This cost is estimated at $280,000.00.
2. That the Sponsors share of the estimated project costs will be placed in an escrow account held by the
Council no later than Feb. I, 1999, as described in Attachment C. Any management fees associated
with the escrow account will be deducted from interest earnings. Additionally, interest earnings and
excess funds will be reimbursed to Sponsors in proportion to the funds deposited upon project
completion.
3. That the Council will hire a qualified engineering firm to perform needed survey, design and
construction inspection. The cost for these services shall not be greater than 1<J01o of the total estimated
project cost or $886,667.00.
4. That removal of material from canal sites be governed by the following set of priorities:
I. Man made and other organic debris deposited due to Hurricane George
2. Sediment impeding natural flushing action of canal deposited due to Hurricane George
3. Sediment impeding safe navigation deposited due to Hurricane George
Note: Work projected for Islamorada falls into priority 2 & 3 and is dependent on fund availability
after completion of priority I work.
5. That this agreement shall become null and void 90 calendar days after the date NRCS has executed this
agreement if a solicitation for bids has not been publicly advertised or a contract has not been awarded.
6. That this agreement shall be effective on the date appearing in the first paragraph and shall continue in
effect until the purpose of the agreement has been fulfilled.
7. That upon notification from the Sponsor of the completion of construction, NRCS shall promptly
review the performance of the Sponsor to determine if the requirements of this agreement have been
met.
8. That the furnishing of financial and other assistance by NRCS is contingent on the availability of funds
appropriated by Congress from which payment may be made and shall not obligate NRCS upon failure
of the Congress to appropriate funds.
9. NRCS may terminate this agreement in whole or in part when it is determined by NRCS that the
Sponsors or the Council have failed to comply with any of the conditions of this agreement. The
NRCS shall promptly notify the Sponsors and the Council in writing of the determination and reasons
for the termination, together with the effective date. Payments or recoveries made by NRCS under this
termination shall be in accordance with the legal rights and liabilities ofNRCS, the Council and the
Sponsors.
10. This agreement may be temporarily suspended by NRCS if it determines that corrective action by the
Sponsors and/or the Council is needed to meet the provisions of this agreement. Further, NRCS may
suspend this agreement when it is evident that a termination is pending.
II. The program or activities conducted under this agreement will be in compliance with the
nondiscrimination provisions contained in the Titles VI and VII of the Civil Rights Restoration Act of
1987 (Public Law 100-259); and other nondiscrimination statures: namely, Section 504 of the
Rehabilitation Act of 1973, Title IX of the Education Amendments of 1972, and the Age
Discrimination Act of 1975. They will also be in accordance with the regulations of the Secretary of
Agriculture (7 CFR-15, Subparts A & B), which provide that no person in the United States shall on
the grounds of race, color, national origin, age, sex religion, marital status, or handicap be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any
program or activity receiving federal financial assistance from the Department of Agriculture or any
agency thereof
P~OP 'i of"
COOPERATIVE AGREEMENT
F. APPROVED
Title:
By:
Date:
)> Monroe County Commission Date:
Byb~t?~ ~; ~~s action Is authorized at an official meeting
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This action is authorized at an official meeting
of the S rC<c..4- D Co\.>NCi L
on the "2..2- ~ day of :::;:} ~~, rV\.t \
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of Florida.
Title:
~ United States Deoartment of Aericulture
Natural Resources Conservation Service
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ATTACBKENT A - SPBCIAL PROVISIONS
I. DRUG-FREE WORKPLACE CERTIFICATION
II. CERTIFICATION REGARDING LOBBYING
III. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND
OTHER RESPONSIBILITY MATTERS - PRIMARY COVERED
TRANSACTIONS
IV. CLEAN AIR AND WATER CERTIFICATION
V. ASSURANCES AND COMPLIANCE
VI. EXAMINATION OF RECORDS
A'l'TACBHENT A - SPBC1:AL PROV1:S1:0NS
The signatories agree to comply with the following special provisions
which are hereby attached to this agreement.
1:. Drua-Pree WorkDlace
By signing this agreement, the sponsors are providing the
certification set out below. If it is later determined that the
sponsors knowingly rendered a false certification, or otherwise
violated the requirements of the Drug-Free Workplace Act, the Service,
in addition to any other remedies available to the Federal Government,
may take action authorized under the Drug-Fre~ Workplace Act.
controlled substance means a controlled substance in Schedules I
through V of the Controlled Substances Act (21 U.S.C. 812) and as
further defined by regulation (21 CFR 1308.11 through 1308.15);
Conviction means a finding of (inClUding a plea of nolo contendere)
or imposition of sentence, or both, by any judicial body charged with
the responsibility to determine violations of the Federal or state
criminal drug statutes;
criminal drua statute a means a Federal or non-Federal criminal
statute involving the manUfacturing, distribution, dispensing, use, or
possession of any controlled substance;
EmDlovee means _the employee of a grantee directly engaged in the
performance of work under a grant, including: (i) All direct charge
employees; (ii) All indirect charge employees unless their impact or
involvement is insignificant to the performance of the grant; and,
(iii) Temporary personnel and consultants who are directly engaged in
the performance of work under the grant and who are on the grantee's
payroll. This definition-does not include workers not on the payroll
of the grantee (e.g., volunteers, even if used to meet a matching
requirements; consultants or independent contractors not on the
grantees' payroll; or employee of subrecipients or subcontractors in
covered workplaces).
Certification:
A. The sponsors certify that it will or will continue to provide a
drug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful
manufacture, distribution, dispensing, possession, or use of a
controlled substance is prohibited in the grantee's workplace and
specifying the actions that will be taken against employees for
violation of such prohibition;
(b) Establishing an ongoing drug-free awareness program to inform
employees about--
(1) The danger of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee
assistance programs; and
(4) The penalties that may be imposed upon employees for drug
abuse violations occurring in the workplace;
(c) Making it a requirement that each emplqyee to be engaged in the
performance of the grant be given a copy of the statement required by
paragraph (a); .
(d) Notifying the employee in the statement required by paragraph
(a) that, as a condition of employment under the grant, the employee
will--
(1) Abide by the terms of the statement; and
(2) Notifying 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 a conviction;
(e) Notifying the service in writing, within ten calender days
after receiving notice under paragraph (d)(2) from an employee or
otherwise receiving actual notice of such conviction. Employers of
convicted employees must provide notice, including position title, to
every grant officer or other designee on whose grant activity the
convicted employee was working, unless the Federal agency has
designated a central point for the receipt of such notices. Notice
shall include the identification number(s) of each affected grant;
(f) Taking one of the following actions, within 30 calendar days of
receiving notice under paragraph (d)(2), with respect to any employee
who is so convicted--
(1) Taking appropriate personnel action against such an
employee, up to and inclUding termination, consistent with the
requirements of the Rehabilitation Act of 1973, as amended; or
(2) Requiring such employee to participate satisfactorily in a
drug abuse assistance or rehabilitation program approved for such
purposes by a Federal, state or local health, law enforcement, or
other appropriate agency;
(g) Making a good faith effort to continue to maintain a drUg-free
workplace through implementation of paragraphs (a),(b),(c),(d),(e) and
(f) .
(h) Agencies shall keep the original of all disclosure reports in
the official files of the agency.
B. The sponsors may provide a list of the site(s) for the performance
of work done in connection with a specific project or other agreement.
II. certification Reqardinq Lobbvinq (7 CFR 3018) (Applicable if this
agreement exceeds $100,000) - The sponsors certify to the best of
their knowledge and belief, that:
(1) No federal appropriated funds have been paid or will be paid, by
or on behalf of the sponsors, to any person for influencing or
attempting to influence an officer or employee of an agency, Member of
Congress, and officer or employer of Congress, or a Member of Congress
in connection with the awarding of any Federal contract, the making of
any Federal grant, the making of any Federal loan, the entering into
of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal contract, grant,
loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid
or will be paid to any person 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 this Federal contract, grant, loan, or
cooperative agreement, the undersigned shall complete and submit
Standard Form - LLL, "Disclo~ure Form to Report Lobbying," in
accordance with its instructions.
(3) The sponsors shall require that the language of this
certification be included in the award documents for all subawards at
all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) and that all subrecipients
shall certify and disclose accordingly.
This certification is a material representation of ~act.upon which
reliance was placed when this transaction was made or entered into.
Submission of this certification is a prerequisite for making or
entering into this transaction imposed by section 1352, Title 31, U.S.
Code. Any person who fails to file the required certification shall
be subject to a civil penalty of not less than $10,000 and not more
than $100,000 for each such failure.
III. certification Reaardina Debarment. susDension. and Other
ResDonsihilitv Hatters - primary Covered Transactions.
(7 CPR 3017)
(1) The sponsors certify to the best of its knowledge and belief,
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 or agency;
(b) Have not within a three-year period preceding this proposal
been convicted of or had a civil judgment ren4ered 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 contract under a public transaction;
violation of Federal or state antitrust statutes or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of
records, making false statements, or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or
civilly charged by a governmental entity (Federal, state or local)
with commission of any of the offenses enumerated in paragraph (1) (b)
of this certification; and
(d) Have not within a three-year period preceding this
application/proposal has one or more ,public transactions (Federal,
state or local) . terminated for cause or default.
(2) Where the primary sponsor is unable to certify to any of the
statements in this certification, such prospective participant shall
attach an explanation to this agreement.
IV. Clean Air and Water Certification
(Applicable if this agreement exceed $100,000, or a facility to be
used has been the subject of a conviction under the Clean Air Act (42
U.S.C. 1857c-8(C) (1) or the Federal Water Pollution control Act (33
U.S.C. 1319(C) and is listed by EPA, or is not otherwise. exempt.)
The project sponsoring organization(s) signatory to this agreement
certifies as follows:
(a)
Any facility to be utilized
this proposed agreement is
listed on the Environmental
of Violating Facilities.
in the performance of
I is not )(
Protection Agency List
(b)
To promptly notify the state Administrative
Officer prior to the signing of this agreement
by SCS, of the receipt of any communication
from the Director, Office of Federal Activities,
u.s. Environmental Protection Agency, indicating
that any facility which he proposes to use for
the performance of the agreement is under
consideration to be listed on the Environmental
Protection Agency List of Violating Facilities.
To include sUbstantially this certification,
including this subparagraph (c), in every
nonexempt subagreement.
(c)
CLEAN AIR AND WATER CLAUSE
(Applicable only if the agreement exceeds $100,000, or a facility to
be used "has been the subject of a conviction under the Clean Air Act
(42 U.S.C. 1857c-8(c) (1) or the Federal Water Pollution Control Act
(33 U.S.C. (1319{c)) and is listed by EPA or the agreement is not
otherwise exempt.)
A. The project sponsoring organization(s) signatory to this agreement
agrees as follows:
(1) To comply with all the requirements of section 114
of the Clean Air Act as amended (42 U.S.C. 1857,
et seq., as amended by Public Law 91-604) and
section 308 of the Federal Water Pollution Control
Act (33 U.S.C. 1251 et. seq., as amended by Public
Law 92-500), respectively, relating to inspection,
monitoring, entry, reports, and information, as
well as other requirements specified in section 114
and section 308 of the Air Act and the Water Act,"
respectively, and all regulations and guidelines
issued thereunder before the signing of this
agreement by scs.
(2) That no portion of the work required by this
agreement will be performed in a facility listed
on the Environmental Protection Agency List of
Violating Facilities on the date when this
agreement was signed by SCS unless and until
the EPA eliminates the name of such facility
or facilities from such listing.
(3) To use their best efforts to comply with clean
air standards and clean water standards at the
facilities in which the agreement is being
performed.
-----
(4) To insert the substance of the provisions of this
clause in any nonexempt subaqreement, includinq
this subparaqraph A.(4).
B. The terms used in this clause have the followinq meaninqs:
(1) The term "Air Act" means the Clean Air Act, as
amended (42 U.S.C. 1857 et seq., as amended by
Public Law 91-604).
(2) The term "Water Act" means Federal Water Pollution
Control Act, as amended (33 U.S.C. 1251 et seq.,
as amended by Public Law 92-500).
,
(3) The term "clean air standards" means any
enforceable rules, requlations, quidelines,
standards, limitations, orders, controls,
prohibitions, or other requirements which are
contained in, issued under, or otherwise adopted
pursuant to the Air Act or Executive Order 11738,
an applicable implementation plan as described in
section 110(d) of the Clean Air Act (42 U.S.C.
1857c-5(d)), and approved implementation procedure
or plan under section 111(C) or section 111(d),
respectively, of the Air Act (42 U.S.C. 1857c-6(c)
or (d), or an approved implementation procedure
under section 112(d) of the Air Act (42 U.S.C.
1857C-7(d)).
(4) The term "clean water standards" means any
enforceable limitation, control, condition,
prohibition, standards., or 'other requirement
which is promulqated pursuant to the Water Act
or contained in a permit issued to a discharqer
by the Environmental Protection Aqency or by a
state under an approved proqram, as authorized
by section 402 of the Water Act (33 U.S.C. 1342),
or by a local qovernment to ensure compliance with
pertreatment requlations as required by section
307 of the Water Act (3 U.S.C. 1317).
(5) The term "compliance" means compliance with clean
air or water standards. Compliance shall also mean
compliance with the scheduled or plan ordered or
approved by a court of competent jurisdiction, the
Environmental Protection Aqency or any air or water
pollution control issued pursuant thereto.
(6)
The term "facility" means any building, plant,
installation, structure, mine, vessel or other
floating craft, location or site of operations,
owned leased, or supervised by a sponsor, to be
utilized in the performance of an agreement or
subagreement. Where a location or site of
operations contains or includes more than one
building, plant, installation, or structure, the
entire location shall be deemed to be a facility
except where the Director, Office of Federal
Activities, Environmental Protection Agency,
determines that independent facilities are
collocated in one geographical area.
V. Assurances and Comoliance
As a condition of the grant or cooperative agreement, the recipient
assures and certifies that it is in compliance with and will comply in
the course of the agreement with all applicable laws, regulations,
Executive Orders and other generally applicable requirements,
including those set out in 7 CFR 3015, 3016, 3017, 3018 and 3051 which
hereby are incorporated in this agreement by reference, and such other
statutory provisions as are specifically set forth herein.
VI. Examination of Records
Give the Service.or the Comptroller General, through any authorized
representative, access to and the right to examine all records, books,
papers, or documents related to this agreement. Retain all records
related to this agreement for a period of three years after completion
of the terms. of this agreement in accordance with the applicable OMB
Circular.
MONROE CO. EWP COST ESTIMATES & DIVISION OF SHARE
Given that the USDAlNRCS contribution to project is:
$3,500,000 or 75% of total project cost
---
Then it follows that the total project cost is equal to: ---
----------- ._-_._-~- -~--_..,. ~._-
$3.500.000 = $4,666,667
0.75
The local sponsors share of total project cost will be at least 250k.
-- I
Then it follows that the local sponsors share will at least be equal to: i
,
-+------
1$4,666,667 X .25 '= $1,166,667 I --1--------------
c------ ~ I I --~--_._~-
Local share is to be divided between the three local sponsors in proportion to the percentage of -
-------------- ---------m---------------------r 1----------------- -- --,-----
e~lrTl~!ed ....,l:)I".k.~~ed~<:lin_~C!~~j~r~cjl~~~!1~t-----------~---~---- ------ --- i
._._.._--------~ I I · ----- ----
SPONSOR WORK % TOTAL PROJECT COST--+SPONSO'R-sli-ARE---r-
($4,666,667 X WORK %) (Project Cost x .25) 1
1. City of Key West 4.80214 $ 224,100.00 $ 56,025.00
---
2. Village of Islamorada 3.78771 $ 176,760.00 $ 44,190.00
--
I
3. Monroe County $ $ I
91.41015 4,265,807.00 1,066,451.00 1____
---------- -
TOTAL 100.00000 $ 4,666,667.00 $ 1,166,666.00
Note: 1. All sums rounded to nearest dollar.
-_._~
2. The State of Florida Dept. of Community Affairs will provide 12.5% of local sponsor share
I------
under separate agreement with sponsors.
Attachment B
The Sponsors requirement will be deemed satisfied if each Sponsor deposits the following amounts in an
escrow account held by the Council to facilitate the completion of the works of improvement described in
Section A, by February 1, 1999:
. City of Key West $ 28,012.50
. Village ofIslamorada $ 22,095.00
. Monroe County Commission $ 50,000.00
Remaining funds from Monroe County will be transferred to the Councils' escrow account within 30 days
of receipt of invoice for completed work.
Monroe Co. will serve as the principal sponsor in this agreement. As such, monies due from NRCS will be
forwarded to Monroe Co. for work completed in the City of Key West and the Village ofIslamorada.
These funds will then be forwarded to the Council's escrow account to complete payment to contractor(s).
Attachment C
ATTACHMENT D - SPECIAL PROVISIONS
CONSTRUCTION
EQUAL OPPORTUNITY
The Contracting Local Organization agrees to incorporate, or
cause to be incorporated, into any contract for construction
work, or modification thereof, as defined in the rules and
regulations of the Secretary of Labor at 41 CFR, Chapter 60,
which is paid for, in whole or in part, with funds obtained from
the Federal Government or borrowed on the credit of the Federal
Government pursuant to grant, contract, loan, insurance, or
guarantee, or undertaken pursuant to any federal program
involving such grant, contract, loan, insurance, or guarantee,
the following Equal Opportunity (Federally Assisted Construction)
clause:
EQUAL OPPORTUNITY (FEDERALLY ASSISTED CONSTRUCTION)
During the performance of this contract, the Contractor
agrees as follows.:
. 1. The Contractor will not discriminate against any employee
or applicant for employment because of race, color, religion,
sex, or national origin. The Contractor will take affirmative
action to ensure that applicants are employed, and that employees
are treated during employment without regard to their race,
color, religion, sex, or national origin. Such action shall
include, but not be limited to the following: employment,
upgrading, demotion or transfer, recruitment or recruitment
advertising, layoff or termination, rates of payor other forms
of compensation, and selection for training, including
apprenticeship. The Contractor agrees to post in conspicuous
places, available to employees and applicants for employment,
notices to be provided setting forth the provisions of this Equal
Opportunity (Federally Assisted Construction) clause.
2. The Contractor will, in all solicitations or
advertisements for employees placed by or on behalf of the
Contractor, state that all qualified applicants will receive
consideration for employment without regard to race, color,
religion, sex, or national origin.
3. The Contractor will send to each labor union or
representative of workers, with which he has a collective
bargaining agreement or other contract or understanding, a notice
to be provided advising the said labor union or workers'
representative of the Contractor's commitments under this
section, and shall post copies of the notice in conspicuous
places available to employees and applicants for employment.
4. The Contractor will comply with all provisions of
Executive Order No. 11246 of September 24, 1965, and of the
rules, regulations, and relevant orders of the Secretary of
Labor.
5. The Contractor will furnish all information and reports
required by Executive Order No. 11246 of September 24, 1965, and
by the rules, regulations, and orders of the Secretary of Labor,
or pursuant thereto, and will permit access to his books,
records, and accounts by the administering agency and the
Secretary of Labor for purposes of investigation to ascertain
compliance with such rules, regulations, and orders.
6. In the event of the Contractor's noncompliance with the
Equal Opportunity (Federally Assisted Construction) clause of
this contract or with any of the said rules, regulations, or
orders, this contract may be canceled, terminated, or suspended,
in whole or in part, and the Contractor may be declared
ineligible for further Government contracts or federally assisted
construction contracts in accordance with procedures authorized
in Executive Order No. 11246 of September 24, 1965, and such
other sanctions may be imposed and remedies invoked as provided
in Executive Order No. 11246 of September 24, 1965, or by rule,
regulation, or order of the Secretary of Labor, or as provided by
law.
7. The Contractor will include this Equal Opportunity
(Federally Assisted Construction) clause in every subcontract or
purchase order unless exempted by the rules, regulations, or
orders of the Secretary of Labor issued pursuant to section 204
of Executive Order No. 11246 of September 24, 1965, so that such
provisions will be binding upon each subcontractor or vendor.
The Contractor will take such action with respect to any
subcontract or purchase order as the administering agency may
direct as a means of enforcing such provisions, including
sanctions for noncompliance; provided, however, that in the event
a Contractor becomes involved in, or is threatened with,
litigation with a subcontractor or vendor as a result of such
direction by the administering agency, the Contractor may request
the United States to enter into such litigation to protect the
interests of the United States.
The Contracting Local Organization further agrees that it
will be bound by the above Equal Opportunity (Federally Assisted
Construction) clause with respect to its own employment practices
when it participates in federally assisted construction work;
provided, however, that if the Contracting Local Organization so
participating is a State or local government, the above Equal
Opportunity (Federally Assisted Construction) clause is not
applicable to any agency, instrumentality, or subdivision of such
government which does not participate in work on or under the
contract.
The Contracting Local Organization agrees that it will assist
and cooperate actively with the administering agency and the
Secretary of Labor in obtaining the compliance of Contractors and
subcontractors with the Equal Opportunity (Federally Assisted
Construction) clause and the rules, regulations, and relevant
orders of the Secretary of Labor, that it will furnish the
administering agency and the Secretary of Labor such information
as they may require for the supervision of such compliance, and
that it will otherwise assist the administering agency in the
discharge of the agency's primary responsibility for securing
compliance.
The Contracting Local Organization further agrees that it
will refrain from entering into any contract or contract
modification subject to Executive Order No. 11246 of September
24, 1965, with a Contractor debarred from, or who has not
demonstrated eligibility for, Government contracts and Federally
assisted construction contracts pursuant to the Executive Order,
and will carry out such sanctions and penalties for violation of
the Equal Opportunity (Federally Assisted Construction) clause as
may be imposed upon Contractors and subcontractors by the
administering agency or the Secretary of Labor pursuant to Part
II, Subpart D, of the Executive Order. In addition, the
Contracting Local Organization agrees that if it fails or refuses
to comply with these undertakings, the administering agency may
take any or all of the following actions: cancel, terminate, or
suspend, in whole or in part, this grant; refrain from extending
any further assistance to the Contracting Local Organization
under the program with respect to which its failure or refusal
occurred until satisfactory assurance of future compliance has
been received from such Contracting Local Organization; and refer
the case to the Department of Justice for appropriate legal
proceedings.
NOTICE TO CONTRACTING LOCAL ORGANIZATIONS OF REQUIREMENT FOR
CERTIFICATIONS OF NONSEGREGATED FACILITIES
a. A Certification of Nonsegregated Facilities must be
submitted by the Contracting Local Organization prior to any
agreement for Federal financial assistance where the Contracting
Local Organization will itself perform a federally assisted
construction contract exceeding $10,000 which is not exempt from
the provisions of the Equal Opportunity clause.
b. The Contracting Local Organization shall notify prospective
federally assisted construction contractors of the Certification
of Nonsegregated Facilities required, as follows:
NOTICE TO PROSPECTIVE FEDERALLY ASSISTED CONSTRUCTION
CONTRACTORS
a. A Certification of Nonsegregated Facilities must be
submitted prior to the award of a federally assisted construction
contract exceeding $10,000 which is not exempt from the
provisions of the Equal Opportunity clause.
b. Contractors receiving federally assisted construction
contract awards exceeding $10,000 which are not exempt from the
provisions of the Equal Opportunity clause will be required to
provide for the forwarding of the following notice to prospective
subcontractors for supplies and construction contracts where the
subcontracts exceed $10,000 and are not exempt from the
provisions of the Equal Opportunity clause.
NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENT FOR
CERTIFICATIONS OF NONSEGREGATED FACILITIES
a. A Certification of Nonsegregated Facilities must be
submitted prior to the award of a subcontract exceeding $10,000
which is not exempt from the provisions of the Equal Opportunity
clause.
b. Contractors receiving subcontract awards exceeding
$10,000 which are not exempt from the provisions of the Equal
Opportunity clause will be required to provide for the forwarding
of this notice to prospective subcontractors for supplies and
construction contracts where the subcontracts exceed $10,000 and
are not exempt from the provisions of the Equal Opportunity
clause.
NRCS-ADS-818
Rev. 4-70
File Code ADS-14
CERTIFICATION OF NONSEGREGATED FACILITIES
(Applicable to federally assisted construction
contracts and related subcontracts exceeding $10,000 which
are not exempt from the Equal Opportunity clause.)
The federally assisted construction contractor
certifies that he does not maintain or provide for his
employees any segregated facilities at any of his
establishments, and that he does not permit his employees to
perform their services at any location, under his control,
where segregated facilities are maintained. The federally
assisted construction contractor certifies further that he
will not maintain or provide for his employees any
segregated facilities at any of his establishments, and that
he will not permit his employees to perform their services
at any location, under his control, where segregated
facilities are maintained. The federally assisted
construction contractor agrees that a breach of this
certification is a violation of the Equal Opportunity clause
in this contract. As used in this certification, the terms
"segregated facilities" means any waiting rooms, work areas,
restrooms and washrooms, restaurants and other eating areas,
timeclocks, locker rooms and other storage or dressing
areas, parking lots, drinking fountains, recreation or
entertainment areas, transportation, and housing facilities
provided for employees which are segregated by explicit
directive or are in fact segregated on the basis of race,
color, religion, or national origin, because of habit, local
custom, or otherwise. The federally assisted construction
contractor agrees that (except where he has obtained
identical certifications from proposed subcontractors for
specific time periods) he will obtain identical
certifications from proposed subcontractors prior to the
award of subcontracts exceeding $10,000 which ate "not 'exempt
from the provisions of the Equal Opportunity clause, and
that he will retain such certifications in his files.
NOTE: The penalty for making false statements in
offers is prescribed in 18 U.S.C. 1001.
Contractor
Signature
Title
Date
NRCS-ADS-819
Rev. 1-71
NOTICE TO PROSPECTIVE FEDERALLY ASSISTED
CONSTRUCTION CONTRACTORS
(a) A Certification of Nonsegregated Facilities must
be submitted prior to the award of a federally assisted
construction contract exceeding $10,000 which is not exempt
from the provisions of the Equal Opportunity clause.
(b) Conractors receiving federally assisted
construction contract awards exceeding $10,000 whiph are not
exempt from the provisions of the Equal Opportunity clause
will be required to provide for forwarding of the following
notice to prospective subcontractors for supplies and
construction contracts where the subcontracts exceed $10,000
and are not exempt from the provisions of the Equal
Opportunity clause.
NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENT FOR
CERTIFICATION OF NONSEGREGATED FACILITIES
(a) A Certification of Nonsegregated Facilities must
be submitted prior to the award of a subcontract exceeding
$10,000 which is not execmpt from the provisions of the
Equal Opportunity clause.
(b) Contractors receiving subcontract awards exceeding
$10,000 which are not exempt from the provisions of the
Equal Opportunity clause will be required to provide for the
forwarding of this notice to prospective subcontractors for
supplies and construction contracts where the subcontracts
exceed $10,000 and are not exempt form the provisions of the
Equal Opportunity clause.
NOTICE OF REQUIREMENTS FOR AFFIRMATIVE ACTION TO ENSURE EQUAL
EMPLOYMENT OPPORTUNITY (EXECUTIVE ODRER 11246)
1. The Offeror's or Bidder's attention is called to the "Equal
Opportunity Clause" and the "Standard Federal Equal Employment
Specifications" set forth herein.
2. The goals and timetables for minority and female
participation, expressed in percentage terms for the Contractor's
aggregate workforce in each trade on all construction work in the
covered areas, are as follows:
Timetables
Goals for Minority
Participation For
All Trades
Goals for Female
Participation in
All Trades
Indefinite
6.9
These goals are applicable to all the contractor's
construction work (whether or not it is Federal of federally
assisted) performed in the covered area. If the contractor
performs construction work in a geographical area located outside
of the covered area, it shall apply the goals established for
such geographical area where the work is actually performed.
with regard to this second area, the contractor also is subject
to the goals for both its federally involved and non-federally
involved construction.
The Contractor's compliance with the Executive Order and the
regulations in 41 CFR Part 60-4 shall be based on its
implementation of the Equal Opportunity Clause, specific
affirmative action obligations required by the specifications set
forth in 41 CFR 60-4.3 (a), and its efforts to meet the goals.
The hours of minority and female employment and training must be
substantially uniform throughout the length of the contract, and
in each trade, and the contractor shall make a good faith effort
to employ minorities and women evenly on each of its projects.
The transfer of minority or female or trainees from Contractor to
Contractor or from project to project for the sole purpose of
meeting the Contractor's goals shall be a violation of the
contract, the Executive Order and the regulations in 41 CFR Part
60-4. Compliance with the goals will be measured-against the
total work hours performed.
3. The Contractor shall provide written notification to the
Director of the Office of Federal Contract Compliance Programs
within 10 working days of award of any construction subcontract
in excess of $10,000 at any tier for construction work under the
contract resulting from this solicitaiton. The notification
shall list the name, address and telephone number of the
subcontractor; estimated dollar amount of the subcontract;
estimated starting and completion dates of the subcontract; and
geographical area in which the subcontract is to be performed.
4. As used in this Notice, and in the contract resulting from
this solicitation, the "covered area" is:
NRCS-ADS-85
Rev. 2-71
APPLICABILITY OF THE EQUAL OPPORTUNITY CLAUSE
Equal Opportunity (Federally Assisted Construction) is
applicable in any contract which exceeds $10,000 and any
contract for less than $10,000 which is later increased by
modification to more than $10,000.
EQUAL OPPORTUNITY (FEDERALLY ASSISTED CONSTRUCTION)
Duirng the performance of this contract, the Contractor
agrees as follows:
1. The Contractor will not discriminate against any
employee or applicant for employment because of race, color,
religion, sex, or national origin. The Contractor will take
affirmative aciton to ensure that applicants are employed,
and that employees are treated during employment without
regard to their race, color, religion, sex, or national
origin. Such action shall include, but not be limited to
the following: Employment, upgrading, demotion, or
transfer; recruitment or recruitment advertising; layoff or
termination; rate of payor other forms of compensation; and
selection for training, including apprenticeship. The
Contractor agrees to post in conspicuous places, available
to employees and applicants for employment, notices to be
provided setting forth the provisions of this Equal
Opportunity (Federally Assisted Construction) clause.
2. The Contractor will, in all solicitations or
advertisements for employees placed by or on behalf of the
Contractor, state that all qualified applicants will receive
consideration for employment without regard to race, color,
religion, sex, or national origin.
3. The Contractor will send to each labor union or
representative of workers, with which he has a collective
bargaining agreement or other contract or understanding, a
notice to be provided advising the said labor union or
workers' representative of the Contractor's commitments
under this section, and shall post copies of the notice in
conspicuous places available to employees and applicants for
employment.
4. The Contractor will comply with all provisions of
Executive Order No. 11246 of September 24, 1965, and of the
rules, regulations, and relevant orders of the Secretary of
Labor.
5. The Contractor will furnish all information and
reports required by Executive Order No. 11246 of September
24, 1965, and by the rules, regulations, and orders of the
Secretary of Labor, or pursuant thereto, and will permit
access to his books, records, and accounts by the
administering agency and the Secretary of Labor for purposes
of investigation to ascertain compliance with such rules,
regulations, and orders.
6. In the event of the Contractor's noncompliance with
the Equal Opportunity (Federally Assisted Construction)
clause of this contract or with any of the said rules,
regulations, or orders, this contract may be canceled,
terminated, or suspended, in whole or in part, and the
Contractor may be declared ineligible for further Government
contracts or federally assisted construction contracts in
accordance with procedures authorized in Executive Order No
11246 of September 24, 1965, and such other sanctions may be
imposed and remedies invoked as provided in Exeuctive Order
No. 11246 of September 24, 1965, or by rule, regulation, or
order of the Secretary of Labor, or as provided by law.
7. The Contractor will include this Equal Opportunity
(Federally Assisted Construction) clause in every
subcontract or purchase order unless exempted by the rules,
regulations, or orders of the Secretary of Labor issued
pursuant to section 204 Executive Order No. 11246 of
September 24, 1965, so that provisions will be binding upon
each subcontractor or vendor. The Contractor will take such
action with respect to any subcontract or purchase order as
the administering agency may direct as a means of enforcing
such provisions, including sanctions for noncompliance:
Provided, however, that in the event a Contractor becomes
involved in, or is threatened with, litigation with a
subcontractor or vendor as a result of such direction by the
administering agency the Contractor may request the United
States to enter into such litigation to protect the
interests of the United States.
STANDARD FEDERAL EQUAL EMPLOYMENT OPPORTUNITY
CONSTRUCTION CONTRACT SPECIFICATIONS
(EXECUTIVE ORDER 11246)
1. As used in these specifications:
a. "Covered area" means the geographical area described
in the solicitation from which this contract resulted.
b. "Director" means Director, Office of Federal
Contract Compliance Programs, United States Department of
Labor, or any person to whom the Director delegates
authority.
c. "Employer identification number" means the Federal
Social Security number used on the Employer's Quarterly
Federal Tax Return, U. S. Treasury Department Form 941.
d. "Minority" includes:
(i) Black (all persons having or~g~ns in any of the
Black African racial groups not of Hispanic origin);
(ii) Hispanic (all persons of Mexican, Puerto
Rican, Cuban, Central or South American or other Spanish
Culture or origin, regardless of race);
(iii) 'Asian and Pacific Islander (all persons
having origins in any of the original peoples of the Far
East, Southeast Asia, the Indian Subcontinent, or the
Pacific Islands); and
(iv) American Indian or Alaskan native (all persons
having origins in any of the original peoples of North
America and maintaining identifiable tribal affiliations
through membership and participation or community
identification).
2. Whenever the Contractor, or any Subcontractor ,at any
tier, subcontracts a portion of the work involving any
construction trade, it shall physically include in each
subcontract in excess of $10,000, the provisions of these
specifications and the Notice which contains the applicable
goals for minority and female participation and which is set
forth in the solicitations from which the contract resulted.
3. If the Contractor, is participating (pursuant to 41 CFR
60-4.5) in a Hometown Plan approved by the U. S. Department
of Labor in the covered area either individually or through
an association, its affirmative action obligations on all
work in the Plan area (including goals and timetables shall
be in accordance with that Plan for those trades which have
---
unions participating in the Plan. Contractors must be able
to demonstrate their participation in and compliance with
the provisions of any such Hometown Plan. Each Contractor
or Subcontractor participating in an approved Plan is
individually required to comply with its obligations under
the EEO clause, and to make a good faith effort to achieve
each goal under the Plan in each trade in whcih it has
employees. The overall good faith performance by other
Contractors or Subcontractors toward a goal in an approved
Plan does not excuse any covered Contractor's or
Subcontractor's failure to take good faith efforts to
achieve the Plan goals and timetables.
4. The Contractor shall implement the specific affirmative
action standards provided in paragraphs 7a through p of
these specifications. The goals set forth in the
solicitation from which this contract resulted are expressed
as percentages of the total hours of employment and training
of minority and female utilization the Contractor should
reasonably be able to achieve in each construction trade in
which it has employees in the covered area. Covered
construction contractors performing construction work in
geographical areas where they do not have a Federal for
federally assisted construction contract shall apply the
minority and female goals established for the geographical
area where the work is being performed. Goals are published
periodically in the Federal Register in notice form, and
such notices may be obtained from any Office of Federal
Contract Compliance Programs or from Federal procurement
contracting officers. The Contractor is expected to make
substantially uniform progress toward meeting its goals in
each craft during the period specified.
s. Neither the provisions of any collective bargaining
agrement, nor the failure by a union with whom the
Contractor has a collective bargaining agreement, to refer
either minorities or women shall excuse the Contractor's
obligations under these specifications, Executive Order
11246, or the regulations promulgated pursuant thereto.
6. In order for the nonworking training hours o"f'
apprentices and trainees to be counted in meeting the goals,
such apprentices and trainees must be employed by the
contractor during the training period, and the Contractor
must have made a commitment to employ the apprentices and
trainees at the completion of their training, subject to the
availability of employment opportunities. Trainees must be
trained pursuant to training programs approved by the U. S.
Department of Labor.
-2-
7. The Contractor shall take specific affirmative actions
to ensure equal employment opportunity. The evaluation of
the Contractor's compliance with these specifications shall
be based upon its effort to achieve maximum results from its
actions. The Contractor shall document these efforts fully,
and shall implement affirmative action steps at least as
extensive as the following:
a. Ensure and maintain a working environment free of
harassment, intinidation, and coercion at all sites, and in
all facilities at which the Contractor's employees are
assigned to work. The Contractor, where possible, will
assign two or more women to each construction project. The
Contractor shall specifically ensure tha all foremen,
superintendents, and other on-site supervisory personnel are
aware of and carry out the Contractor's obligation to
maintain such a working environment, with specific attention
to minority or female individuals working at such sites or
in such facilities.
b. Establish and maintain a current list of minority
and female recruitment sources, provide written notification
to minority and female recruitment sources and to community
organizations when the Contractor or its unions have
employment opportunities available, and maintain a record of
the organization's responses.
c. Maintain a current file of the names, addresses and
telephone numbers of each minority and female off-the-street
applicant and minority and female referral from a union, a
recruitment source or community organization and of what
aciton was taken with respect to each such individual. If
such individual was sent to the union hiring hall for
referral and was not referred back to the Contractor by the
union or, if referred, not employed by the Contractor, this
shall be documented in the file with the reason therefore,
along with whatever additional actions the Contractor may
have taken.
d. Provide immediate written notification to the
Director when the union or unions with which tha Contr~ctor
has a collective bargaining agreement has not referred to
the Contractor a minority person or woman sent by the
Contractor or when the Contractor has other information that
the union referral process had impeded the Contractor's
efforts to meet its obligations.
e. Develop on-the-job training opportunities and/or
participate in training programs for the area which
expressly include minorities and women, including upgrading
programs and apprenticeship and trainee programs relevant to
the Contractor's employment needs, especially those
-3-
programs funded or approved by the Department of Labor. The
Contractor shall provide notice of these programs to the
sources compiled under 7b above.
f. Disseminate the Contractor's EEO policy by providing
notice of the policy to unions and training programs and
requesting their cooperation in assisting the Contractor in
meeting its EEO obligations; by including it in any policy
manual and collective bargaining agreement; by publicizing
it in 'the company newspaper; annual report, etc.; by
specific review of the policy with all management personnel
and with all minority and female employees at least once a
year; and by posting the company EEO policy on bulletin
boards accessible to all employees at such location where
construction work is performed.
g. Review, at least annually, the company's EEO policy
and affirmative action obligations under these
specifications with all employees having any responsibility
for hiring, assignment, layoff, termination, or other
employment decisions, including specific review of these
items with on-site supervisory personnel such as
Superintendents, General Foremen, etc., prior to the
initiation of construction work at any jobsite. A written
record shall be made and maintained identifying the time and
place of these meetings, persons attending, subject matter
discussed, and disposition of the subject matter.
h. Disseminate the Contractor's EEO policy externally
by including it in any advertizing in the news media,
specifically including minority and female news media, and
providing written notification to and discussing the
Contractor's EEO policy with other Contractors and
Subcontractors with whom the Contractor does or anticipates
doing buisness.
i. Direct its recruitment efforts, both oral and
written, to minority, female and community organizations, to
schools with minority and female students and to minority
and female recruitment and training organizations,serving
the Contractor's recruitment area and employment needs. Not
later than one month prior to the date for the acceptance of
applications for apprenticeship or other training by any
recruitment sources, the Contractor shall send written
notification to organizations such as the above, describing
the openings, screening procedures, and tests to be used in
the selection process.
j. Encourage present minority and female employees to
recruit other minority persons and women and, where
reasonable, provide after school, summer and vacation
employment to minority and female youth both on the site and
in other areas of a Contractor's workforce.
-4-
k. Validate all tests and other selection requirements
where there is an obligation to do so under 41 CFR Part 60-
3.
1. Conduct, at least annually, an inventory and
evaluation at least of all minority and female personnel for
promotional opportunities and encourage these employees to
seek or to prepare for, through appropriate training, etc.,
such opportunities.
m. Ensure that seniority practices, job classification,
work assignments, and other personnel practices, do not have
a discriminatory effect by continually monitoring all
personnel and employment related activities to ensure that
the EEO policy and the Contractor's obligations under these
specifications are being carried out.
n. Ensure that all facilities and company activities
are nonsegregated except that separate or single-user toilet
and necessary changing facilities shall be provided to
assure privacy between the sexes.
o. Document and maintain a record of all solicitations
of offers for subcontracts from minority and female
construction contractors and suppliers, including
circulation of solicitations to minority and female
contractor associations and other business associations.
p. Conduct a review, at least annually, of all
supervisors' adherence to and performance under the
Contractor's EEO policies and affirmative action
obligations.
8. Contractors are encouraged to participate in voluntary
associations which assist in fulfilling one or more of the
affirmative action obligations (7a through p). The efforts
of a contractor association, joint contractor-union,
contractor-community, or other similar group of which the
Contractor is a member and participant, may be asserted as
fulfilling anyone or more of its obligations under 7a
through p of these Specifications provided that -the
Contractor actively participates in the group, makes every
effort to assure that the group has a positive impact on the
employment of minorities and women in the industry, ensures
that the concrete benefits of the program are reflected in
the Contractor's minority and female work force
participation, makes a good faith effort to meet its
individual goals and timetables, and can provide access to
documentation which demonstrates the effectiveness of
actions taken on behalf of the Contractor. The obligation
to comply, however, is the Contractor's and failure of such
a group to fulfill an obligation shall not be a defense for
the Contractor's noncompliance.
-5-
9. A single goal for minorities and a separate single goal
for women have been established. The Contractor, however,
is required to provide equal employment opportunity and to
take affirmative action for all minority groups, both male
and female, and all women, both minority and non-minority.
Consequently, the Contractor may be in violation of the
Executive Order if a particular group is employed in a
substantially disparate manner (for examle, even though the
Contractor has achieved its goal for women generally, the
Contractor may be in violation of the Executive Order if a
specific minority group of women is under-utilized) .
10. The Contractor shall not use the goals and timetables of
affirmative action standards to discriminate against any
person because of race, color, religion, sex or national
origin.
11. The Contractor shall not enter into any Subcontract with
any person or firm debarred from Government contracts
pursuant to Executive Order 11246.
12. The Contractor shall carry out such sanctions and
penalties for violation of these specifications and of the
Equal Opportunity Clause, including suspension, termination,
and cancellation of existing subcontracts as may be imposed
or ordered pursuant to Executive Order 11246, as amended,
and its implementing regulations, by the Office of Federal
Contract Compliance Programs. Any Contractor who fails to
carry out such sanctions and penalties shall be in violation
of these specifications and Executive Order 11246, as
amended.
-6-
SOIL CONSERVATION SERVICE
SUPPLEMENT TO OSHA PAUS 1910 AND 1926
CONSTRUCTION INDUST1Y STANDAllDS AND INTEllP1ETATIONS
The contractor shall co~ly vith OSHA (Occu~ational Safety and Health
~iDistration) Parts 1910 and 1926, Construction Induatry Standards
and Interpretations, and vith .thi. supplement.
lequeau for variances or vaivers froa this supplement are to be made
to the contractins officer in writins supported by evidence that every
reasonable effort has been made to coaply vith the contractual
requirement.. A written request for a waiver or a variance sball
include--
(1) Specific reference to the provision or standard in question.
(2) An explanation a. to why the waiver is considered justified;
and
(3) .The contractor's proposed alternative, including technical
dravings, materials, or equipment specifications needed to
enable the contracting officer to render a decisiou.
No waiver or variance vill be approved if it endangers any person.
The contractor shall not proceed under any requested revision of a
provision until the cou~racting officer ha. given written approval.
The contractor is to hold and save harmless the
free fr01ll any
cla~ or cauaes of action whatsoever resulting from the contractor or
subcontractors proceeding under a vaiver or approved variance.
Copies of OSHA Part 1910 and 1926, Conatruction Industry Standards and
Interpretations, may be obtained from:
Superintendent of Documents
U.S Government Printing Office
Washington, D.C. 20402
SOIL CONS~av ATION SERVICE
SUPPLEMENT TO OSHA PAaTS 1910 AND 1926
CORSTltUCTION INDUSTltY STANDARDS AND INTEIPaE'IATIONS
GElfEltAL CONTRACTOR REQUIltEMENTS
1.1 sAFEtY paOGIAK. Each contractor is to demonstrate that he or
.he ha. facilities for conducting a safety progr.. commensurate with
the work under contract. The contractor is to submit in writing a
propoled c~ehensive safety prograa to the contracting officer for
approval before the atart of con.truction olJerationl. The program is
to lpecifically Itate what proviaion. the contractor propolea to take
for the health and lafety of all employeel. including lubcontractors
and rental equilJlMlnt operatorl. The progr.. Ihall be lite specific
and provide details relevant to the work to be done. the hazards
allociated with the work. ~nd the actions that will be necessary to
minimize the identified hazards.
1.2 PRECONSTltUCTION SAFETY MEETING. Representatives for the
contractor are to meet with the contracting officer (CO) or the CO's
representative before the start of construction to discuss the safety
program and the implementation of all health and safety standards
pertinent to the work under this contract.
1.3 JOINT SAFETY POLICY COKKITT!E. The contractor or designated
onsite represencative is to participate in monthly meetings of a Joint
Safety Policy ~ttee. c~osed of
and contractor supervisory
personnel. At these meetings the contractor1s project manager and the
contracting officer will review the effectiveness of the contractor's
safety effort. re.olve current health and .afety problems. and
coordinate .afety activities for upcoming work.
1.4 SAFETY PEISONNEL. Each contractor is to delignate a
competent supervisory employee satisfactory to the contracting officer
to administer the safety progr...
1.5 SAFETY HEETINGS. A minimum of one "on-the-job" or "toolbox"
safety meeting is to be conducted each week by all fiefd ~uperVisors
or foremen and attended by mechanics and all construction personnel at
the job.ite. the contractor is to .1.0 conduct regularly .cheduled
supervilory safety aeeting. at leaat monthly for all levels of job
supervision.
1.6 SAFETY INSPECTION. The contractor shall perform frequent and
regular safety inspections of the jobsite. materials. aud equipment.
and shall correct deficiencies.
1.7 FIKST AID TBAINING. Every contractor foreman's work crew
mu.t includ. an em~loyee who ha. . current first aid certificate from
the Kine S.fety and He.lth Administration, American Red Cross, or
other st.te-approved org.niz.tion.
1.8 REPOIrS. Each contractor is to maintain an accurate record
of all job-related.deach.. di....... or di..bling 1nJuries. The
records Ih.ll be maintained in'. manner approved by the contracting
officer. A CO~1 of all reports is to be provided to the contracting
officer. All fatal or serious injuries .re to be reported immediately
to the contracting officer, and every assistance is to be given in the
inveltil.tion of the incident, including submission of . co~rehenlive
n.rrative report to the contractinl officer. Other occurrence. with
lerious accident ~otential, such as equi~nt failures, slides, and
cave-ins, must also be re~orted immediately. The contractor is to
assi.t and cooperate fully with the contracting officer in conducting
accident investigations. The contracting officer is to be furnished
all information and data pertinent to investigation of an accident.
rUST AID AND MEDICAL FACILITIES
2.1 FIRST AID KITS. A 16-unit first aid kit approved by the
American Red Crol. is to be provided at accessible, well-identified,
loc.tions at the ratio of at 1ea.t 1 kit for each 25 e~loyees. The
first aid kits are to be moistureproof and dusttilht, and the contents
of the kits are to be replenished a. used or a. they become
ineffective or outdated.
2.2 EMElGEHCY FIIST AID. At 1e.st one employee certified to
admini.ter emergency first aid must be available on each shift and
duly designated by the contractor to c.re for injured em~loyees. The
n.... of the certified em~loyees shall be posted at the joblite.
2.3. COHHUHlCATION AND TIANSPORTATION. Prior to the st.rt of
work, the contractor is to make neces.ary arrangements for prompt and
dapendable communications, transportation, and medical care for
injured em~lo1ees. At lea.t one stretcher and two blankets shall be
readily available for trana~orting injured employeea.-
2~4 FII.S'I' AID AND MEDICAL REPORTS. The contractor is to maintain
a record system for first .id .nd medical treaement on the jobsite.
Such records .re to be readily available to the contracting officer
and are to include--
<a> A daily tre.ement 101 listing chronologically all persons
treated for occup.tional injuries and illnesses;
(b) Cumulative record of injury for each individual:
(c) Moathly statistical records of occu~ational injuries.
cla..ified by type and nature of injury; and
Cd) Required records for worker's co.~ensation.
2.5 SIGNS AND DIIECTIONAL MAlKIHGS. Adequate identification and
directional markers are to be provided to readily denote the location
of all first aid leations.
2.6 EHElGENCY LISTING. A lilting of telephone numbers and
addres.e. of doctor. re.cue squad. ho.pital. police. and fire
de~rtments is to be provided at all first aid locations.
PHYSICAL QUALIFICATION OF EMPLOYEES
3.1 GENERAL REQUIREMENTS. Persons em~loyed throughout the
contract are to be physically qualified to perform their as.igned
duties. Em~loyees mu.e not knowingly be permitted or required to work
while their ability or alertness is impaired by fatigue. illness. or
any other rea.on that may jeopardize themaelves or others.
3.2 HOIST OPERATORS. Operators of cranes. cableways. and other
hoisting equipment .hall be examined annually by a ~bysician and
~rovided with a certification stating that they are ~hy.icallY
qualified to .afely operate hoi.ting equipment. the contractor is to
.ubmit a copy of eacb certification to the contracting officer.
3.3 MOTOR VEHICLE OPERATORS. Ol'erators of motor vehicles engaged
primarily in the trana~ortation of personnel are to be 18 years of age
or older and have a valid .tate operator's ~ermit or license for the
equipment being operated. The o~erators must have ~a..ed a physical
examination adaini.tered by a licen.ed physician within the pa.e year
showing that they. are physically qualified to o~erate vehicles safely.
PDSOlW. PROTECTIVE EQUIPMENT
4.1 HAlDBAT AREAS. The entire jobsite. with the.exce~tion of
office.. shall be con.idered a hardhat area. All perso~s entering the
area are. without exce~tion. required to wear hardbata. 1he
contractor sball ~rovide hardhats for visitors entering hardhat area..
4.1.1 LABELS. Hardhats shall bear a manufacturer's label
indicating design compliance with the appropriate ANSI (American
National Standards Institute) standard.
4.2 POSTING. Signa at leaat 3 by 4 feet worded as follow. with
red letters (minimum 6 inches high) and white background shall be
erected at access points to designated hardhat areas:
CONSTRUCTION AllEA-HAIlDHATS REQUIRED
BSYOND THIS POINT
These signs are to be furnished and installed by the contractor at
entries to shops, construction' yards, and job access points.
MACHINERY AND MECHANIZED EQUIPMENT
5.1 SAFE CONDITION. Before any machinery or mechanized equipment
is initially used on the job, it must be inspected and tested by
qualified personnel and determined to be in .afe operating condition
and appropriate for the intended use. Operators shall inspect their
equipment prior to the beginning of each shift. Any deficiencies or
defects shall be corrected prior to using the equipment. Safety
equipment, such as seatbelts, installed on machinery is to be used by
equipment operators.
5.2 TAGGING AND LOCKING. The controls of power-driven equipment
under repair are to be locked. An effective lockout and cagging
procedure is to be established, prescribing specific responsibilities
and safety procedures to be followed by the person or persons
performing repair work.
5.3 HAUL ROADS FOR EQUIPMENT
5.3.1 ROAD MAINTENANCE. The contractor shall maintain all
roadways, including haul roads and access roads, in a safe condition
so as to eliminate or concrol dust and ice hazards. Wherever dust is
a hazard, adequate dust-laying equipment shall be available at the
job.ite and utilized to control the dust.
5.3.2 SINGLE-LANE HAUL ROADS. Single-lane haul roads with
two-way traffic shall' have adequate turnoutS. Where turnouts are not
practical, a traffic control system shall be provided to prevent
accidents.
5.3.3 TWO-WAY HAUL ROADS. Oll two-way haul roada, arrangementS
an to be .uch that vehicles travel on the right aide vberever
po..ible. Sian' and traffic control device. are to be em~loyed to
indicate clearly any variations from a right-hand traffic pattern.
The road .hall be vide eDough to permit safe ~a.aage of opposing
traffic. couaidering the t~ of hauling equilJ1llent used.
5.3.4 DESIGN AND CONS'II.UCTION OF lWJL ROADS. Haul road design
criteria and drawinga. if requeated by the contracting officer. are to
be lubmitted for ap~roval prior to road conatruction. Suetained
grade. ahall not exceed 11 ~erceut and all curve. shall have
opeD-aight line vith aa great a radiua al practical. All roads shall
be poaced vith curve lips and ......_1111 I~eed liaita that will permit
the equipment to be .sto~~d within one-nalf the minimum sight distance.
5.3.5 OPDA'tORS. Machinery and mechanized equilJ1llent shall be
operated only by authorized qualified perlons.
5.3.6 RIDIBG ON EQUIPMEHt. Riding on equilJ1llenc by uoauthori:ed
personnel i. prohibited. Seating and safety belts Ihall be provided
for the operator aDd all pa..engers.
5.3.7 GETtING ON 08. OFF EQUIPMENT. Getting on or off equipment
while the equipment is in motion is prohibited.
5.3.8 HOUlS OF OP!I.A'IION. Except in emergencies. an equipment
operator shall not operate aDY mobile or hoiating equilJ1llent for more
than 12. hour. vithout an 8-hour re.t interval avay from the job.
5.4 pOWD CRANES AND HOIS'IS (tRUCK CRANES, CRAWLER CRANES, 'IOWER
CIANES, GARTI.Y cBAN!:S. HAltMEKBEAD CRANES, DEIlRICa, CABLEWA YS. AND
HOISTS)
5.4.1 PElJOaHANCE TEST. Before initial oUlite operation, at
l1-.onch interTal.. and after major repairs or modification. paver
cranel. derricka. cablevaya. and hoiata muat latiafactorily complete a
performance teat to demoaatrate the equipment's ability to safely
handle aDd ....uver the rated loada. The teata shall be conducted in
the pre.ence of a revresentative of the contracting 9fficer~ 'Ielt
data Iball be recorded and a cavy furnished the contracting officer.
5.4.2. PEUORMANCE TEST-POWER CUNES (Crawler mounted, truck
IIIOWlted. aad wheel mounted). The performaace telt is to be carried
out with outriggers set aad with a test load weighing 110 percent of
the rated capacity when the boom aagle is from 30. to 60. above the
horizontal. The test is to consist of raising, loweriag aad braking
the load and rotatiag the test load through 360. at the specified boom
anale or radius. Crane. equipped with jibs or boom tip exten.ions are
to be teated uling both the main boom and the jib, with an appropriate
teat load in each caa..
5.4.3 P!IFOBMANCE TEST-DDIlICES. GANnY CRANES, TOWER CRANES.
CABLEWAYS. AND HOISTS, INCLUDING OVERHEAD CRANES. This equipment is
to be performance tested with a test load weighing 110 percent of the
rated load. In te.ting cableway.. the telt load is to be traveled to
the upatream and down.tream limits of travel and thoroughly
performance tested in at lea.t three travel po.itions, including both
limits of travel.
5.4.4 BOOK ANGLE INDICATOR. Power cranes (includes draglines)
with booma capable of moving in the vertical plane shall be provided
with a boom angle indicator in good working order.
5.4.5 CRANE TEST CERTIFICATION. The performance test required by
5.4.2 and 5.4.3 is fulfilled if the contractor provides the
contracting officer a copy of the certificate of ia.pection made
within the pa.t 12 months by a qualified person or by a government or
private ageacy satisfactory to the contracting officer.
5.4.6 POSTING FOR HIGH VOLTAGE LINES. A notice of the lO-foot
(or greater) clearance required by OSHA 1926.550, Subpart N. shall be
po.ted in the operator1s cab of cranes, shovels. boom-type concrete
pump., backhoes, and related equipment.
5.4.7 BOOK STOPS. Cranes or derricks with cable-supported booma.
except dragliaes. shall have a device attached becween the gantry or
the A-frame and ehe boom chords to limit the elevation of the boom.
the device shall coatrol the vertical motions of ehe boom with
increasing resiseance from 83. or less, until compleeely stopping the
boom at aot over 87. above horizontal.
SPECIAL PROVXSIONS
1. Accident Prevention and Safety Measures: The contractor
shall comply with the OSHA Part 1926, Construction Standards
and Interpretations, in effect on the date of issuance of the
invitation for bids, and with the SCS supplement to OSHA PART
1926.
2. Clean Air and Water Clause: (Applicable only if the contract
exceeds $100,000, or the contracting officer has determined
that orders under an indefinite quantity contract in anyone
year will exceed $100,000, or a facility to be used has been
the subject of a conviction under the Clean Air Act (41
U.S.C.1857c-8(c) (1) or the Federal Water Pollution Control
Act (33 U.S.C. 1319(c)) and is listed by the Environmental
Protection Agency (EPA) or the contract is not otherwise
exempt.
A. The contractor agrees as follows:
(1) To comply with all the requirements of Section 114
of the Clean Air Act (42 U.S.C. 1857, et seq, as amended
by Public Law 91-604) an Section 308 of the Federal Water
Pollution Control Act (33 U.S.C. 1251, as amended by
Public Law 92-500), respectively, relating to
inspection, monitoring, entry, reports, and information,
as well as other requirements specified in Section 114
and Section 308 of the Air Act and the Water Act,
respectively, and all regulations and guidelines issued
thereunder before the award of this contract.
(2) That portion of the work required by this contract
will be performed in a facility listed on the
Environmental Protection Agency List of Violating
Facilities on the date when this contract was awarded
unless and until the EPA eliminates the name of such
facility or facilities from such listing.
(3) To use his best efforts to comply with clean air
and clean water standards at the facilities in which
the contract is being performed.
(4) To use the substance of the prov1s1ons of this
clause in any nonexempt subcontract, including this
subparagraph.
B. The terms used in this clause have the following mean-
ings:
(1) The terms "Air Act" means the Clean Air Act (42
U.S.C. 1857 et seq, as amended by Public Law 94-604) .
(2) The term "Water Act" means Federal Water Pollution
control Act (33 U.S.C. 1251 et seq, as amended by
Public Law 92-500) .
(3) The term "clean air standards" means any enforce-
able rules, regulations, guidelines, limitations,
orders, controls, prohibitions, or other requirements
which are contained in, issued under or otherwise adopted
pursuant to the Air Act or Executive Order 11738, an
applicable implementation plan as described in Section
110(d) of the Clean Air Act (42 U.S.C. 1857c-5(d)), an
approved implementation procedure or plan under Section
111(c) or Section 111(d), respectively, of the Air Act,
or an approved implementation procedure under Section
112(d) of the Air Act (42 U.S.C. 1857c-7(d)).
(4) The term "Clean Water Standards" means any
enforceable limitation, control, condition, prohibition,
standard, or othe requirement which is promulgated
pursuant to the Water Act or contained in a permit issued
to a discharger by the EPA or by a state under an
approved program, as authorized by Section 402 of the
Water Act (33 U.S.C. 1342), or by a local government to
ensure compliance with pretreatment regulations as
required by Seciton 307 of the Water Act (33 U.S.C. 1317).
(5) The term "compliance" means compliance with clean
air or water standards. Compliance shall also mean
compliance with a schedule or plan ordered or approved by
a court of competent jurisdiction, the EPA or an air or
water pollution control agency in accordance with the Air
Act or Water Act and regulations issued pursuant thereto.
(6) The term "facility" means any building, plant,
installation, structure, mine, vessell or other floating
craft, location or site of operations, owned, leased or
supervised by a contractor, or subcontractor, to be
utilized in the performance of contract or subcontract.
Where a location or site of operations contains or in-
cludes more than one building, plant, installation or
structure, the entire locaiton shall be deemed to be a
facility~xcept where the Director, Office-of Federal
Activities, Environmental Protection Agency,.determines
that independent facilities are colocated in one
geographical area.
3. Eaual EmDlovment ODcortunitv Recortinq Reauirements: Equal
Employment Opportunity Reporting Requirements for contracts
over $10,000:
(a) Form CC 257 - Monthlv Utilization Recort. All prime
contractors and subcontractors performing work on federally
funded projects are required to complete Form CC 257, listing
their aggregte work force in each trade on all projects, both
federally funded and non-federally funded, in the covered
area. Each prime and subcontractor must also attach a listing
of all projects (both federal and non-federal in the Plan
Area included herein) . The accompanying list must provide
the following information:
1. Name and location of project.
2. OWner project (City, County, Private)
3. Project number, if any.
4. Percent complete.
5. Dollar amount of contract.
6. Estimated date of completion.
Prime contractors are responsible for collecting the Form
CC 257 and the listing of all projects (both federal and non-
federal) in excess of $10,000 from each of his subcontractors
performing work on this project. The prime contractors will
then forward their Form CC 257 and all of their
subcontractor's Forms CC 257 and project list information to:
REGIONAL ADMINISTRATOR FOR OFCCP/ESA-O
U. S. DEPARTMENT OF LABOR
SUITE 7B75, 61 FORSYTH STREET SW
ATLANTA, GA 30303
Failure to submit the Standard Form CC 257 by the fifth day of
each month constitutes noncompliance with Executive Order
11246. Noncompliance is grounds for the issuance of a legal
Show Cause Notice for an informal hearing, authorized by OFCCP
Rules and Regulations 41 CFR Part 60-0.7. Such a hearing
could result in cancellation, termination, or suspension of
the contract..
(b) Reoortinq Subcontractors The prime contractor shall
provide written notification to the Regional Administrator of
the Office of Federal Contract Compliance Programs, within 10
workinq days of award of any consideration work under the
contract resultinq from this solicitation. The notification
shall list the following:
1. Name of contractor
2. Address
3 . Telephone number
4. Employer's identification number
5. Estimated dollar amount of the subcontract
6. Estimated starting and completion dates
7. Geographical area in which the contract is
performed, i.e., city, county, state, etc.
Send information to:
REGIONAL ADMINISTRATOR
OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS - ESA
DEPARTMENT OF LABOR
SUITE 7B75, 61 FORSYTH STREET SW
ATLANTA, GEORGIA 30303
(c) EEO-1 Reoortinq Reauirements
(1) Each construction prime contractor and first
tier subcontractor who has 50 or more employees on
total corporate or company payroll and signs a
direct federal or financially assisted contract or
subcontract amounting to $50,000 or more, shall
file reports on Standard Form 100 (EEO-1 to the
Joint Reporting Committee.
(2) Each contractor or subcontractor required in
paragraph (1) above shall submit an EEO-1 to the
Joint Reporting Committee and shall also file an
EEO-1 to the Office of Federal Contract Compliance
Programs, U. S. Department of Labor, Suite 7B75, 61
Forsyth Street SW, Atlanta, Georgia 30303, WITHIN
30 DAYS after award of such contract or subcontract
as mentioned in paragraph (1) above, UNLESS such
contractor or subcontractor has already submitted
an EEO-1 report to the Joint Reporting Committee
within 12 months preceding the date of award of a
NRCS federal or federally-assisted contract.
(d) Contractors and subcontractors may obtain EEO-1
reporting forms by writing to:
JOINT REPORTING COMMITTEE
2401 E STREET NE
WASHINGTON, DC 20506
USDA NATURAL RESOURCES CONSERVATION SERVICE
EMERGENCY WATERSHED PROTECTION PROGRAM
FINAL/PARTIAL COMPLETION CERTIFICATE
Sponsor:
Agreement No.:
DSR Site(s) :
I hereby certify that I have inspected the repair work for
the site(s) listed above; and that to the best of my
knowledge it is in accordance with the plans and
specifications that have been provided to the Natural
Resources Conservation Service; that the quantities are
correct; and that the work herein has not been reported on
any previous estimate.
Sponsor's Engineer
License No. and Expiration
Date
I certify that the project has been constructed and the
required documentation from the sponsors, including their
engineer's certification, has been submitted to the Natural
Resources Conservation Service.
NRCS Engineer/Liaison Officer
Date
SINGLE SITE EXAMPLE
USDA-NRCS
, Il(C1P'IfNrS ACCDUN' NUMeI..
011 "N~"""
0'" ~ IlOO 'AGl Uf
0348-0004 l I ~
- -.eu
. . ...._..__ I llASlSOFMOUlST
;.".. Of 0 ~ liJ :~. I 0 CAtH
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I'lOUUflO nil 0 I
UlI .... .....nAC. GI ACaIUo1ll
. 'fOlflAl GI'A"' 0.- OMII ,. S. NA1Ut '....N' ..aunT
.00NfIP'tWfG NU..... ASSIGNID ......ICM 1MIMOUIST
IY HOIflAl AGlNCY
68-4lGl-7-23 1
. PERIGO COVEMD II\' THIS nauuT
fllOM___' 10___
REQUEST FOR ADVANCE
OR REIMBURSEMENT
tSH ",stnICtrG". on becal
, '10I1IA4.~ AGINC"t IIHO OIlGAMZA'lON IU"Nt TO
M4ICH THIS "POll' IS SUI..mo
~ 1W\0'It1l IOIN'lfCA'ION
~..
6-1-97
6-30-97
,..M"I~-."--._--"
t MCIPIIN' 0tIGAMlAf1ON
N_
N_ Any Sponsor
VXPOOOOOOOl (if sponsor has VPX)
~~llO Any Street
,.",.".,
......
C",V. S,.,. Anv City, Alabama 32600
.nd ZIP end.. .
cQMPU1'ATION OF AIlIOIIINT ~ J
1"
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PROGRAMs.1=UNCTIONSlACTMTIES to
EXAHP
ONLY
TOTAL
I. Tot.t~
oult..,. to Clate
tM ot "..,
6-30-97 S l33.000.50
s
$
$ 133 000.50
b. le..:Cumutamre
.m income
-0-
-0-
-0-
c. Net .....".,. ...... fLIM . ......,.
/i". 0'
d. Esdm8ted Nt eIIlft out"'" fo' .dv.nce
oen0c2
133 000.50 (Total Pro ect Costs -
Construction in-kind)
e. Tot.t ISum 01 tiltH C .. dl
Non..r ..... ..... elf .mount Oft ..". e
33 250.1:
25%
.lL
Feder.. "'... of .mount on tine .
Co
.. Feder...... now ,",,"," CLift. g
tTfitNn H". ",
99
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n. Fedef8I........... 01..1 Due/l\' ~
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ed by F.... ftlft(Ol'
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1.' montft
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12.
3,d montft
~ ca.........GII fiGR ADVANCH Ot&Y
s
b. leu: Estm'leted .,...nc:e of Fed.,a. usn Oft ".ftCI .1 at beOff..... 01 ~ period
I
1$
c. Amounc teouested ILiM e tnittw Ii,.. b/
AUTHORIZeD FOR lOCAL REPROOUCTION
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~mLTIPLE SITE EXAMPLE
O...~NO
0348-000'
REQUEST FOR ADVANCE
OR REIMBURSEMENT
1
fYflf Of
~&""H'
IltGUlStIO
ISH imttUCffOII. "" O.ctl
: flOlM<<. ~ AOIC\' lIMO QIlCIAMlA'1OH IU"H' '0
..-eM 'MIS llll'01lf IS SUI..mo
'AGl
';f
l 2 e"GI'
I ..........-..- 1 8ASlSO'I'EQutST
o AO\olUG (i] :~. ! 0
II. ...____ CASte
OflNA&.
(i] NImAl I ~ ~
, 'NImAl MYWH' "OUUT
I 1lIUIIII1I lOA '"" ..QUIST
2
I flOlfW. GIlAN' Oft 0fM1I
tOlfllf1'"tfNG ........ ASSIGHlO
IV NOlfW. AGlNCY
USDA. :\RCS
~ 1-.0Yt1l aN'''CA'tON
...........
, IlIONHT'S ACCDUfI' ~
Oil IOIH.....-cI ___"
: .
,''''_ --,
7-1-97
, IlKlPtIH' 0flG01lMlAI'I0H
I
IH_
I
VPX)
N_ Any Sponsor
VPX
,....,
MWStrHf 100 Any Street
{if sponsor has
"....,
~ ."..,
11
cOMPUTATIOIII .,. AMOUNT OIl
I
QiM~
~ZII' c.-:
V fF'ADV~ ImGUUTED
101 t ( I
" c
PROGRAMSlFUNcnONSlACTMTIeS ~ EXAMPLE ONLY TOTAL
DSR 1210-01 DSR 1210-02 DSR 1210-03
I. Tot" ~am ,...--- , S 14 , 400 I $ 120,000
oud-vs 10 date 7-31-97 S 15.600 $150.000
b. L.ss: CutrMa.... m income -0- I -0- -0- -0-
c;,.,. SrI,. Any, City Alabama 32600
.... N Cod. .
oroqq
c. Net ..............,.1LItW . ,.,...
IiM III
15,600
14,400
d. Estlmeted nee UI" out..,.. fo, e~
oenod
-0-
-0-
e. Tar.HSum of NttH c" dl
15.600
14,400
(. NOft~ ......" ImouM Oft tI_ .
3.900
3,600
10 800
g. Fed.,., ltulreof .moum on.ine.
11.700
2 500
I. Fedete...... now ,..,... CUn. 9
"""-1iM It,
9,200
5.800
,. AcIv..... required by
monat. wMft ~-
ed by FedefIIt 9fIItIIO'
~ for use en mati-
inQ p~ .d.
v8nCIS .
I 120,000
I -0-
I 120 000
30.000
I
I "9 -000
I
I
150 000
-0-
1
(25%
37.500 ~n(
( CoO!
st
..24.000
1. month
2nd mam" I
3rd montt'l I
~ C.a.wan~""1'OII ADVANCU OM.Y
12.
S
.. EItimated FedefIIt catI oudavI........ be midi durin9 ....,oct cow"',, IW eM Hwnc8
b. Lea: EstUMted bll.nce of Feder.' usn Oft hlftCll .1 04 ~w....., 01 ..,.,.. period
c. Amount reQUftted (Line. mittu. 1m. 01
AUTHORIZED FOR lOCAL AEPAOOUCTlON
IC:_~ GIft R.-..I
1$
.1'.......... .,. ...... Hit
-..-....... . -----
c., _ A lOJ _ A.IIO
'J
~
, cendv .nee 10 lhe Dele Of my 'rnamld..
.nd be'''' 'fl. O'f' 0" In. r.".,.. ...
camet ,na IfI.. "' aua.ve __ mede 1ft
ICll:OftI8ftCe ..en "'. ,rane con'laa... or
"mer Iq~ '''a "'.. DevmeM . due
Jno fI" nOf 0_ or~ r~
I SGlUIUIlI 011' loUr...- ......- ...... 0f'N:Ill&.
! Si~nature of individual
I f\I'IIfDOII.....O --- .... nna
llWWllIQUUf
M-.nllu
agree nt
~........
....;;;....
who signed
.,u. Ioace lor AqeftCV u..
PutlflC .-ortII" tIufOM tar..... caltnaal1 01 :........ - .. .~.., to .".,...... --....
'......... IndudNII....lor "'.14_ ... ~ I aw........,. eMU eouras..............
mlfftC..,., 1M ... ......... .. ~1M9 ... ._.A__" fM cotloKtlOlt eM lftfonNaaft. Sena
. (;omme!..1 r...... 1M ....... .......... . .., .... __ of ..... ~ ~.. I ~I ~ n of ift_ma-..
Inc:tUd1n9 IU.J 111 .. tor.... 1 ,.. ~ _ ... Offtce .. Man I. .AlI........... PIOeiI-<h.
AecIUCfIOft Pf'lMCItCD.' ..... 'Nwftl.. J I a r. DC ~
PUAU DO MOT ~ ~ ;: :._ ..- TO ,... QRIIC2 OF MAN..... n t
AHa MIOGa'. ..... '" TO". All a . .....4 ~ 8Y n.- UGH' ~ L~ JIll A..JC'1f. l
INSTRUCIIONS
Please tYpe or gtlnr tl9ibly. trems '. 3. S. 9. 10. 11c. 118. 11f. "9. 11i. 12 and 13 are self-exolanarorv; specific
InstructIons tor orner Irems .,. .. foUows:
Item ert"., ".,." Emrv
7 IndlCaf. wMtner reQUftC II DfWIf*I Oft caan Of KCIu.I
........fUf. ""fl. "'" ,...... 'M ,ctv..-. SftaU be
preoaNO on , calflllntl.
. Enfer fM Fedef.. qf.nf nUmG<<. 01 ocn. .4eI~"lCJ numa.
........., &ty 1M HeIer" I0OI...... ...... If .... MV8nCe .
,~ '1 lor more "'an one ,f'8ftt or Of...
'q~. Inaen HI"": IfMft. lIftow .... IIlIr'II" IfftOUftIS.
.In . MtMf... ....... .... eecft ,r.. or ..q........... numo.
anG .n. Fedef.. IN" eM ~ ....... ........ .... 9'''' .
"9f'eement.
6 Enfer 'fll amOlOWl' ~ numoer aueqned bY fN
U.S. 1M....... ........ s.-. or 1M FtCI (iMaCuaon' COCIe"
,~ &ty 'M~"..,.ncv.
ThIS IOKe II ,........ for an KCOUftt n~ or Oftter
'O.....tvlllCJ numoer ",ee ",ey be It . Wd bY ,,,. r____.
8 Enter.... _. aev. anct.,._ for.... ..,It.....~ ana.......
0' "'. oenoa CoveNCl 1ft IfttS NGUaL If me ...... .. 'M ..
..avance Of lor DOl.. an advenC8 anct ~. sna-
In. oenoa Ift'f 1M aavertee .... ~. If "'. ren..... " ..
'"mourMftWftf. snow eM penocI lor wfUCft en. r.-
DufMlMl" II ~
NOC.: The FecMnt 1OOl...... ....- NW 1M ooaon of ..........
'~al' _ co o:NftCIII.. ...... 11 or 12. but ftCM IICMft. ...... '2
snovtd .. uNCI ....... only a '"""'"'"" amount .,.
.nformlC"", .. neeolMG co ...... 1ft 1CIV8nCe .... ouaw
'nformlflOn confllfteCl 1ft Itern 11 can 1M OOfaeneG 1ft a n..-..
ma_ 110m oe"., reoona.
11 Th. IDUf1IOM of I'" ..... COkJ 'loW. C... Ibl. and let. " 10
orCWWlM __ lor ....... co.c ore I l." _ a C)IOfeCIl
na. fMert Ollnneo ana OU'lIIl1oN1 OV oroqrem. luncuon. 01
KUVnY. " 1ddICiOl- cotumM ar. neeoect. 11M .. "....
a"i1lClll_ fonN .. ....... .... indicMe ............. 1ft
,.... IH~ In uQOet' "9nt: IUlI.n... me ~
'Of'" 0' all Dt09fem&. 'uncaona. or laM.... IftOUtd be
IftOWft 1ft I'" ..out- COUnn on me fine D..,..
11. En'... In .'1 0' ....... eh. moncft. an. IftG veer of th.
IftCIIft9 0' ,ne Ir:cllIURCit" penod 10 \lIIftlCft mi8 amount
'oeM.... Enter Dr09f- outlaW fO Oat. lnet of re4uftdL
'-' ,nil ~ 1ft 1M IODI'OOI'" CIMl mo... For
'..... ."... MI Oft . ca'" .,... outlaW ... 1M sum of
acau.e caaft dc.lll ~_ for I0OIII MIl .... U L "'.
,mount of ...... ......... en..-. cne ".. of ln4ind
. COMnOuIIOftI ........ and.... amounc of cuft ad\..~
anct ...~....,....... IL.U."'I II.... .AilUI',..
For r.- OIl IDI .. '011 1ft ~ . _I r If.... .....
.....,..... me sum of"" ecauea _ lIIilllljl_ 4.... 1M
.mount of indiNc:r ~.....lftCUfNd. anct me.... ......,,,
tor Oler.... 1ft me a~ ow.ct &ty ,he ,..:,ojlnc 'or
900dS ancI 0Cfter ~ U lflY'rGClltvecl and for Nt .~
pec'ou"ed OY .moeoo..... _11II1CtI......................
peyees.
11 b Enl.... Ihe cucnuMICIW caaft IftCOftM ,ecetWd fO ..... i'
'....... are ...__ Oft . can 0.... For ~
,.,...,.. Oft 1ft accrued ........,. ...... etfNf' -
~ lftCfIme ""'" co ...... Under ...,.., .....
.... aNy .... __ ....:.,. '1.1 eo ~ ........ .....
_ NQUINClIIO be ..... for 1M INOfKI Of ...... em bY ....
eemw 4M ....... or __ ...eR*1C. .
....: On.v wner. ~~ -__a. lor advence 0"""""". Iftter
.fI. fOfll 41t11nM.... -.nounc of CUft ouctIVI lnlt wMI be
rnede ......... ...... COWNd ...,.... ~
1 J ComGleM eM "*"~ beforw 1U0rntmn9 Iftll ~